Health for the school aged: a fledgeling concern

Despite acknowledging India's crucial need for health education for school aged children, government institutions have failed to provide the necessary support. Past experience has shown that while the government has drafted policy statements concerning school health, scant action has followed. What little has been done consists primarily of perfunctory medical check-ups of school children, a service mostly limited to urban centers. Evident from the current status of health education for the school aged, several changes must take place: 1) Government institutions must reach a consensus regarding the content of school health services. Since school health is intended to improve both children's health status and cognitive capability, such a service demands a comprehensive program that includes regular and complete health surveillance. And it also means that the schools themselves must be healthy environments, and that teachers must serve as role models of good health. 2) School health efforts must involve and be supported by the parents and the community. 3) Government policies must take into account children who are not attending school. This means both a long-term policy to solve the problem of drop-outs and a short-term policy of providing non formal education -- including health education -- for these children. 4) Of critical importance, the health and education sectors need to work together; they must have "joint responsibility." 5) A related issue is that both the health and education sectors accord a low priority to the issue of school health -- something that needs to change. 6) Finally, the government must change its generally weak commitment to providing school health services.     

The School Nurse As Health Educator

ABSTRACT: Contrary to common opinion, the number of nurses who provide services in the nation's preschool, elementary, and secondary schools is not declining and currently is about 30,000. These members of school health teams can play a variety of roles that have a positive impact on patterns of health behaviors established during school years. Contributions that school nurses can make to school health instruction could include teaching individual clients, providing classroom instruction, being a member of curriculum planning committees, sharing resources with classroom teachers, and modeling health-promoting behavior. Although all school nurses should assume roles in health education, this article provides a framework to help nurses make decisions about which roles are appropriate in their practice setting, which tasks are within their area of expertise, and how health education fits into expectations of their employers. Specific roles in staff health promotion that use the unique experience, knowledge base, and skills of nurses are suggested, as well as ways that nurses can be advocates for comprehensive school health education. The article also poses four questions to assist nurses in evaluating their situation and their ability to be effective providers and advocates of health education in school.     

Healthy children ready to learn: an essential collaboration between health and education.

The "Healthy Children Ready to Learn" initiative starts with the underlying concept that health is a critical partner to optimum education. All children have a right to be healthy. At a minimum, this right assumes promoting optimum use of available and effective preventive measures, such as ensuring compliance with immunization recommendations; promoting measures to prevent injuries; ensuring opportunities to identify disease and disabilities early; and providing prompt treatment when needed. Families must receive the support and assistance they need to raise healthy and educated children. Activities directed toward National Education Goals and the related National Health Promotion and Disease Prevention Objectives can advance progress toward school readiness, focus attention and available resources on needed programs and services, and thus help the nation in achieving its goal of having all children arriving at school each day healthy, well nourished, and ready to learn. To realize these goals and objectives, the two critical systems of greatest importance to children, those providing health services and education, need to collaborate, not only among themselves, but also with social services. A range of critical health problems will require our attention if the goals are to be met, such as availability of prenatal care, infant mortality, inadequate nutrition during pregnancy or early childhood, or both, disease prevention by immunization, infants who have been exposed to drugs, fetal alcohol syndrome, and the emotional and mental disorders of early childhood, to name a few. At any one time, any family may be in need of appropriate services. To address the health and well-being of their young children, a continuum of appropriate, accessible services must be available in the community. The first steps toward successful achievement of the readiness goal will require the identification of health, education, and social service programs that serve young children and their families, and the creation of a climate that fosters innovative and effective collaboration between programs at the Federal and State levels, especially as it pertains to the community. Policies and programs should be built around the needs of families. In this regard, the critical role that parents play in shaping a healthy environment conducive to school readiness must be recognized as a key element in shaping the strategies that should help in achieving the readiness goal. Similarly important is the need to engage professional organizations and other private sector groups involved with health, education, and other children's issues to work with government and families to achieve the school readiness goal and its related health objectives.     

Sex education from prospective teachers' view poses a dilemma.

A survey was conducted among 102 prospective elementary school teachers enrolled in a required school health education course in a southeastern university in the United States in an effort to determine how these teachers view the need for and their roles in providing human sexuality education. The final sample included 90 females and 6 males. 96.9% of the sample perceived their own knowledge of human sexuality as being adequate or better, but over 1/2 felt that they were not adequately prepared to deal with the subject in the classroom. 70% indicated they would teach sex education only if they were required to do so. These prospective teachers seemed to feel most uncomfortable about the possibility of having to cope with parents who might object to human sexuality education in the schools. They also expressed fear of having to deal with questions their students asked which would be embarrassing. They were equally concerned about not knowing the factual answer to a question a student asked. 50% of the respondents consider the primary purpose of sex education in the schools to be increasing knowledge of the anatomy and physiology of the reproductive system and enabling students to have their questions about sex answered in an objective and factual manner.     

Communicating about pupils in mainstream school with special health needs: the NHS perspective

AIM: To add to previous research carried out with young people, parents and teachers, by investigating health staff's perspectives on the difficulties, and possibilities for, achieving good communication with school staff with regard to children in mainstream school with a chronic illness or physical disability. RESEARCH DESIGN AND METHODS: A qualitative research study was carried out in one NHS Trust. Twenty semi-structured interviews were carried out with a purposive sample of health staff to cover the spectrum of professionals who have responsibility for meeting the needs of children with a chronic illness or physical disability in mainstream schools (paediatricians, school doctors, school nurses, specialist nurses, health visitors, GPs, speech and language therapists, paediatric occupational therapists, paediatric physiotherapists, clinical psychologists and psychiatrists). RESULTS: The extent to which health professionals communicated with school staff, and the way in which they went about it, varied widely. Communication was facilitated by joint meetings, shared documentation, and local policy development. Sources of difficulty in communication between health and education staff were: the parent as a conduit of information; the practical difficulties of arranging meetings; and lack of knowledge about other professionals' roles. The ethos of the school with regard to health matters, and the flow of information within health services, also had an impact on the communication process. Participants' recommendations focused on two key issues: clarification of the roles of health and education staff with regard to this group of pupils; and how information should flow from health to school staff. DISCUSSION: Many of the findings parallel the previous research with teachers, indicating agreement between professionals from different agencies about aspects of the communication process which are problematic and require attention. The findings suggest that improving communication requires both joint work between health and education staff, and improvements to practice within each agency.     

Addressing the service versus education conflicts created by residency training in ambulatory care settings

Much of the tension and conflict that result from the competing demands of work and learning during residency training--the service versus education conflict--can be addressed by mutual adherence to fundamental guidelines of fairness and personal responsibility by residents and their employers, mentors, and teachers. Residents should be recognized by their employers as professionals and by their teachers as colleagues. Because residency is postgraduate professional education for medical school graduates, the content of resident education must be primarily determined by the educational needs of maturing physicians. The greatest value of residents' services for their employing institutions remains in the inpatient setting where they work as inexpensive professional labor, working long and unattractive patient care shifts providing acute care. In the ambulatory setting, they are less efficient, work ordinary hours, and require real-time on-site supervision. Nevertheless, it is clear that the opportunities for medical education are rapidly shifting from the inpatient setting to ambulatory settings--locations in which there is less experience in proven techniques in medical education.     

Roles of Community Organizations in Improving Cancer Prevention Instruction in Schools

Health education can be an important factor in the development of appropriate health behaviors in children. Community agencies that have not traditionally supported school health education can be of significant influence in improving school health education. This study examined the relationships between the involvement of the American Cancer Society (ACS) in schools and the degree of implementation of cancer prevention curricula. School health specialists from 41 metropolitan school districts in Texas were surveyed regarding the coverage of topical areas related to cancer prevention, health instructional patterns in districts, and collaborative efforts with the ACS. Tobacco use was widely covered in all levels of schools (elementary, middle, and high school), as was nutrition. Cancer detection and the concepts of cancer as a disease received most extensive coverage in high schools, and there were no significant grade level differences regarding coverage of the risks of sun exposure. School personnel had little training and felt little district support for school health education. Most respondents felt that teachers saw the ACS primarily as a resource for cancer information and resources than as a collaborative partner in health education efforts. Community organizations can play three roles in supporting school health education. First, the organizations must certainly provide diseasespecific information (in this case, cancer). They must also promote comprehensive school health education in general. Lastly, the study illustrates that community organizations must act as advocates for broader change in schools by supporting the development of organizational capacity within schools and districts to implement quality school health education, enlisting community support for quality school health education, and supporting policy initiatives that strengthen school health education activities.     

论美育在素质教育中的渗透

美育,是通过自然美、社会美、艺术美的丰富内涵来对人进行教育的一项教育活动。学校美育又是实施“大美育”的最佳阵地。它不仅可以培养学生正确、进步、高尚的审美观,更重要的是塑造学生完美的人格,促进学生德智体全面和谐的发展。作为美育课的理论实施者,应自觉地把美渗透在整个素质教育过程中。     

当前中职校学生的思想道德与心理素质教育分析

中职学校不仅要教授学生的专业基本知识,更有责任和义务对学生进行思想道德教育;加强中职校学生的心理健康教育和加强思想道德教育一样已成为刻不容缓的紧迫任务,需要全校上下齐心协力共同关心学生的思想道德和心理问题,因势利导、循循善诱;随着社会经济主体多元化、利益主体多样化的发展,为避免许多纷繁复杂、光怪离奇的不良社会现象对学生的影响,需要社会各方面的大力支持和配合,共同做好思想道德心理素质教育。     

Health education in St. Gall schools: experiences from a 6-year project

In 1982 a general concept for comprehensive health education in schools worked out by an interdisciplinary project team was introduced by the Educational Council. Health education is postulated primarily as an educational principle, but in addition to this general principle 13 distinctive content areas are put forward. In a second phase special project teams for each type of school had to transform the general concept into their own specific needs for the age groups concerned. The most important experiences from this phase can be summarized as follows: Concepts for health education in schools have to be worked out by interdisciplinary teams coordinated by an expert belonging to the educational (not the medical) system. Planning and introduction of health education has to be accompanied by changes in attitudes on all levels; the need for time must therefore not be underestimated. The project team has to discuss its results repeatedly with local educational authorities and teachers in order to ensure practicability and acceptance of its proposals. The cross-curricular nature of health education has to be stressed and to be demonstrated by working out and applying practicable models. Teachers have to be carefully prepared for their task not only by providing them with adequate material but above all by including health education as a priority in the training period as well as in postgraduate courses.     

Diabulimia and the Role of School Health Personnel*

BACKGROUND: Diabulimia, the omission or reduction of insulin use by persons with type 1 diabetes, is a harmful method of weight control. The purpose of this article is to present school health personnel with the information they may need to become more aware of the possibility of diabulimia in their students—especially females—with type 1 diabetes. METHODS: A review of the somewhat limited medical and diabetes-related organizations' literature on diabulimia was conducted to establish the role that school health personnel could play in raising awareness of students with this condition as well as education for diabulimia prevention. RESULTS: Since insulin encourages fat storage, many with type 1 diabetes have discovered the relationship between reducing the amount of insulin they take and corresponding weight loss. Improper regulation of needed insulin treatments poses serious health problems that may require immediate medical attention. CONCLUSION: School personnel, especially those in the Coordinated School Health Program areas of comprehensive school health education, school health services, and guidance and counseling services have key roles to play in the prevention and recognition of diabulimia in students with diabetes.     

Peer Knowledge and Roles in Supporting Access to Care and Treatment

People living with HIV (PLWHIV) have been involved in the continuum of HIV care since the early days of the epidemic providing education and prevention services. There is a growing interest in utilizing HIV positive peers to support access to care and treatment, but little is known about the range of roles these peers perform and what they need to know to do this work. This study of 186 HIV-positive peers currently providing community health services in eight states found that peers perform a wide range of roles, including assistance with care and treatment, emotional support, and service referrals. Over 80% discussed medications with clients. On average, experienced peers provided correct responses to 73% of questions about HIV and AIDS, and 65% of questions about the appropriate role of a peer. Peers living with HIV for more than 5 years, in paid employment with more than a high school education had higher HIV knowledge scores than volunteers. Higher education, length of time living with HIV, age and speaking English as the primary language were associated with higher peer knowledge scores. This study suggests that we cannot assume that peers already working in the field are fully knowledgeable about HIV care and treatment or peer roles. It is important to address gaps in knowledge through continuing education and to create common standards for the training and skills that peers who work in community health settings need to have.     

The contribution of school health education to community health promotion: what can we reasonably expect?

Evaluative studies of outcomes of traditional school health education programs have shown that they are very effective in increasing knowledge, somewhat effective in improving attitudes, and, with few notable exceptions, generally ineffective in changing health practices. This paper discusses the previous reviews of the literature of outcomes of school health education programs, and discusses the constraints inherent in school-based activities; an emphasis on cognitive learning, lecture-oriented teaching methods, inadequate pupil assessment procedures, a captive audience, competing subject areas, competing behavioral influences, behavior change attempts directed at ingrained health habits, inadequate coordination with community resources, and lack of consensus regarding educational goals. The paper then examines several recent successful school health education programs emphasizing non-traditional approaches in self-initiated care, pregnancy prevention, smoking prevention, and nutrition. It is concluded that school-based health education programs have three important roles in community health promotion: 1. the provision of a fundamental understanding of health and disease concepts to large segments of the population; 2. the reinforcement of positive health attitudes; and 3. the alteration of concurrent health behaviors for significant health problems. Although school health education may be helpful in enhancing decision-making and social interaction skills, little empirical evidence exists at this time to support this conclusion.     

Parental schooling & children's health.

Nearly one in every four children in the United States is born to a mother who has not finished high school, and more than one in eight is reared by such a mother during the critical preschool period. Large-scale studies show that the health and welfare of children are linked to the education level of their parents, with parent education often being a stronger predictor of child well-being than family income, single parenthood, or family size. Higher parent education levels make it more likely that children will receive adequate medical care and that their daily environments will be protected and responsive to their needs. Average parent education levels have risen over the last 30 years, but progress has slowed because of high rates of immigration from countries with lower education standards and the tendency of more advantaged women to have children later than less advantaged women. The education system and community organizations must provide young people who are not doing well in school with positive alternatives to low- education, high-risk parenthood. Health care providers should be proactive, teaching parents with few resources how best to promote their children''s growth and development. The changing global economy makes it more important than ever that current and future generations of children are reared by parents who have adequate skills and training to be competent members of society and effective and responsible parents.     

初探在校护生的法律教育

探讨护士在校时的法律教育,通过调查了解发现,她们对法律知识掌握情况却不容乐观,明显不符合当前现实的需要。该文对在校护士生法律教育现有模式进行分析,阐述其不足之处。在此基础上提出了分为三个阶段对护士生进行系统地法律教育,将法律教育贯穿于学习专业知识的整个过程,来促进护士生法律意识、责任意识和安全意识的提高。     

Meeting the Needs of the Teen-age Pregnant Student: An In-school Program That Works

The drop-out rate for pregnant students in the York (Pennsylvania) City School District is dramatically lower than the national average because the district recognized the need for meeting the unique problems of the pregnant student. In York, as in the rest of the nation, teen-age pregnancy was on the increase. Administrators of the district realized that a separately housed alternative education program would be too costly. In January 1979, the authors designed and implemented an in-school program called "Changing Roles." Five years later, that program has become an important factor in keeping the majority of pregnant students in school, at the same time, providing the girls the special information they need. In the 1982-83 school year, only 9.5% of the pregnant students dropped out of York City schools. This rate is far below the national drop-out rate of 80% to 90%.     

学校健康促进教育干预模式的效果观察

目的:进行学校健康促进工作,改变目标学校学生健康行为习惯及知识构成,探讨学校健康教育深化方向并研究卫生部门进行学校健康干预的最佳介入形式。方法:以教学科研课题方式遂进学校健康教育。立项教学科研课题的方式进行健康干预。结果:目标学校学生健康行为习惯养成及知识形成均有所改进,通过健康教育,学生的营养健康知识提高。意外伤害事故发生率下降,对控烟、肥胖、性病、艾滋病等相关知识正确认识率提高,教育前后差异均有统计学意义(P <0 . 0 5～0 .0 1)。青羊区教育系统亦形成较为成熟的健康促进综合教育体系。结论:卫生部门深度介入教育系统,以教学科研课题方式遂进学校健康教育,是深化健康促进工作,加强学校健康教育的良好途径。     

Career Development for Diverse Populations of Handicapped Students

This paper examines some of the issues associated with providing meaningful career education/counseling for handicapped youths. Career awareness begins in elementary school and moves through career exploration at the senior high level to career preparation in high school. Special care must be exercised in advising handicapped individuals who are making decisions regarding college preparatory course work vs. vocational training.