湖南省中小学校卫生保健能力现状及改善策略

目的 为分析湖南省中小学校卫生保健能力配置现状,改善中小学卫生保健能力提供依据。 方法 开展学校卫生保健能力建设问卷调查,利用学校卫生工作体系和能力建设调查工作数据采集平台直报数据,对湖南省中小学校卫生保健机构设立以及卫生保健人员配备现状进行分析。 结果 湖南省12 614所中小学校中,3 599所寄宿制学校和1 704所600人以上非寄宿制学校,至少需配备专职校医9 967名,实际仅898名,7 311所不足600人非寄宿制学校,专职保健老师仅197名;调查学校中7.3%设置了卫生室,29.6%设置了保健室;7.5%配备了校医,5.3%配备了专职校医,专职校医配备合格率为1.3%;45.6%配备了保健老师,6.6%配备了专职保健老师;90.0%开展了卫生健康相关课程;5.7%的校医和26.5%的保健老师参加过卫生专业技术培训;设置卫生室或保健室、配备(专职)保健老师、配备(专职)校医、开展卫生健康教育、保健老师或校医参加过学校卫生专业知识培训的学校比例,随学龄阶段的上升、经济水平的提高、学校规模的变大,呈逐渐增加趋势(均P<0.001)。 结论 湖南省中小学校卫生保健机构以及卫生保健人员缺口较大,小于600人的小学卫生保健力量需重视;保健老师和校医学校卫生专业知识培训不足;经济水平仍是影响学校卫生保健机构以及人员配置的关键因素之一。建议通过增加学校卫生工作经费投入,不断完善学校卫生保健机构建立,合理增配学校卫生保健人员,并通过卫生保健人员专业技术培训来提升中小学校卫生保健工作能力。     

上海市中小学校卫生保健机构设置情况和人员能力提升需求

  目的  调查上海市中小学校卫生保健机构设置和卫生保健人员配备情况,了解卫生保健人员自身能力提升的需求,为加强学校卫生保健工作水平提供参考。  方法  采用问卷调查的方法,在2020年4—8月对上海市所有中小学校进行普查。问卷内容涵盖卫生保健机构设置、学校卫生保健人员配备情况和卫生保健人员对自身能力提升的需求。运用χ2检验比较不同学段、不同城郊地区学校在卫生保健室设置和人员配备符合率方面的差异。  结果  2020年上海市中小学校(含分部和分校等)共有1 847所,学校卫生保健机构的配备率达100%。全市仅有51.4%的中小学校按在校学生数不低于600∶1的比例配备了学校卫生保健人员,市区学校的人员配备符合率(59.3%)高于郊区学校(47.3%),差异有统计学意义(χ2=24.27,P < 0.01)。所有学校卫生保健人员都认为目前能接受到的能力提升机会较少,需要卫生机构提供能力提升的指导服务。  结论  上海中小学卫生保健机构配备情况好,但人员空缺较大,且现有人员对自身能力提升的需求非常强烈。     

江苏省东海县中小学校医和保健教师配备情况及其工作现状

目的了解江苏省东海县中小学校医(保健教师)人员配备、专业结构等工作现状并提出相应对策,以促进学校卫生保健工作。方法由经过培训的专业人员进行现场调查,采用自行编制的"学校医务室(保健室)调查表",以查阅相关资料、现场查看、人员访谈相结合的方法进行调查。结果配备专职校医的学校占62.7%,在学校编制的专职校医仅占54.8%,具有执业医师证的校医占40.5%;在校学生数与专职校医比例平均为2 110∶1。专职校医、保健教师40岁以下的占71.1%,大专及以下学历的占93.4%,初级职称及无职称的占88.8%,参加过县级以上卫生知识培训的占86.7%。结论该县校医(保健教师)配备严重不足,学历较低、专业人员较少。可采取由乡镇卫生院托管学校卫生保健工作,对学校实行诊疗、卫生保健、传染病及常见病防治、宣传教育等一体化服务等方法解决目前校医、保健教师缺乏问题。     

深圳市龙华新区民办中小学学校卫生保健人员现况及其需求调查

目的了解深圳市龙华新区民办中小学学校卫生保健人员现状及其需求,为制订学校卫生工作策略和措施提供科学依据。方法采用整群抽样方法,对龙华新区18名民办中小学卫生保健人员采用自制问卷进行面访调查。调查学校和学校卫生保健员的基本情况、学校卫生工作培训的需求和方式,进行描述性分析。结果 11.11%的民办中小学没有设置卫生室,民办中小学的学生人数与学校卫生保健员配比介于967∶1⁴449∶1之间,均大于600∶1。77.78%的学校卫生保健员从事学校卫生工作工龄不超过5年,卫生专业的占27.78%,初级职称的占33.33%,高级职称的占5.56%。结论龙华新区民办中小学的学校卫生保健队伍存在专职卫生技术人员配备比例不达标、人员流动性大、卫生专业技术人员比例低、专业技术职称不高和学校投入不足、卫生室设置不达标等问题,教育和卫生部门要采取针对性措施全面提高学校卫生工作的水平。     

邱隘镇托幼机构保健人员素质调查

目的了解邱隘镇托幼机构保健人员现状和存在问题,进一步提高辖区内托幼机构卫生保健工作质量。方法采取调查问卷形式对保健人员的基本情况进行调查。结果 14家托幼机构保健人员18名,保健人员配备不足,尤其医护专业的保健人员仅11.1%,专业构成不合理,年龄有老化趋势;部分保健人员无法胜任卫生保健工作。结论托幼机构需按园规模,根据在园儿童数配备足够的专职保健人员,保健机构加强对保健人员的业务培训。     

中国托幼机构卫生保健人员现状调查

目的了解中国托幼机构卫生保健人员配备现状及专业技术情况,并分析可能的影响因素,为提高集体儿童保健工作以及政策决策制定提供依据。方法调查数据来自于2013年全国托幼机构卫生保健工作现状调查,采用容量比例概率抽样方法进行分层抽样,共有5 405所托幼机构完成卫生保健人员调查。结果中国托幼机构卫生保健人员的配备率为74.98%,兼职卫生保健人员和专职卫生保健人员配备率分别为44.20%和30.78%;34.11%的卫生保健人员有医学学历,23.35%的卫生保健人员有医师/护士资格,仅15.32%的卫生保健人员有医师/护士执业资格;卫生保健人员配备率和专业技术资格情况在不同地域分布、园所所在地和不同规模间差异有统计学意义。多元logistic回归分析显示,地域划分、园所所在地和园所规模均是影响卫生保健人员配备的因素,东部托幼机构配备卫生保健人员是西部的4倍。结论中国托幼机构卫生保健人员配备较10年前有较大提高,但仍然存在人员配备不足、工作兼职和专业水平不足问题。     

北京市海淀区2003-2009年中小学校卫生保健人员状况

目的 分析2003 -2009年海淀区中小学校卫生保健人员状况,为制定更加科学合理的政策提供依据.方法 采用问卷调查结合访谈的方式,于2009年对海滨区内中小学校的卫生保健人员进行调查,并将结果分别与2003及2008年进行比较.结果 海淀区中小学校卫生保健人员配备状况总体发展良好,小学配备比例明显提高,卫生保健人员年龄结构趋于年轻化,医学专业人员有所增加;但小学卫生保健人员配备率仅为22.2％,中小学校校医及保健教师工作年限5 a以下的占58.0％,且更换频繁;卫生保健人员医学专业结构有待完善.结论 教育行政部门应加强对学校卫生保健队伍的管理,特别是加强小学医务室及专职卫生保健人员配备.     

山西省托幼机构卫生保健人员及保健室配置现状调查

目的了解山西省托幼机构卫生保健人员和保健室设施配置现状,为规范托幼机构卫生保健管理提供可靠依据。方法依据《托儿所幼儿园卫生保健管理办法及工作规范》,对山西全省11个地市196所托幼机构进行现场评估。结果托幼机构卫生保健人员配备率为82. 7%,城市托幼机构保健员配置率远高于乡村。卫生保健人员存在学历低、医学专业化程度低、专职保健医比例不高的问题,公立、城市托幼机构保健人员以专职为主,私立、乡村托幼机构保健人员以兼职为主。保健室的设立率是74. 0%,公立机构保健室设立率、保健室设施得分高于私立机构;城区托幼机构保健室设立率、保健室设施得分高于乡村托幼机构。结论山西省托幼机构卫生保健人员及保健室现状与《托儿所幼儿园卫生保健管理办法》的要求还有一定差距,不同类别托幼机构保健室设立及保健设施得分差异存在显著性,应加强监督管理。     

上海市普陀区2012年学校卫生保健人员配置情况调查

为了解上海市普陀区各类学校中卫生保健教师或卫生室医务人员（以下简称“卫生保健人员”）的实际情况，建设和稳固卫生保健人员队伍，充分发挥其在学校卫生保健工作中的主导作用，积极做好学校的各项卫生工作，并为教育部门更好地使用和管理现有工作人员提供参考意见，我们对本区各类学校2012学年卫生保健人员的配备和基本情况进行了专项调查，现将结果报告如下。     

上海市公立中小学校疾病防控工作现况

【目的】了解上海市中小学校疾病防控工作现况,为进一步制定相关对策提供依据。【方法】采用多阶段随机抽样的方法,在上海市随机抽取3个城区和3个郊区中的36所学校进行问卷调查。【结果】36所学校中,19.4%的学校有卫生室(即持有《医疗机构执业许可证》),学生与卫生保健人员配备比例达到600∶1的学校有17所(占47.2%)。各项疾病防控制度建立的比例均在80.0%以上,市区和郊区学校差异无统计学意义(P0.05)。所有学校均开展了各类健康教育活动,每学年均组织一次学生体检。所有学校厕所均为水冲式厕所,无粪便暴露。5所学校(占13.9%)的垃圾集中存放地距食堂或自备水源的最近距离25 m,市区和郊区学校差异无统计学意义(P0.05)。【结论】上海市中小学疾病防控制度建设及学生健康体检基本符合要求,建议重点关注学校专职卫生技术人员配备不足的问题,加强健康教育工作及学校饮食、饮水的卫生管理。     

Hazing of suburban middle school and high school athletes.

Little is known about the prevalence of hazing behaviors among adolescent athletes. Our survey of 1105 6th-12th grade athletes found that 17.4% had been subjected to practices that qualify as hazing. Many of these teenagers do not comprehend the abusive and potentially dangerous nature of hazing.     

Working to keep school children healthy: the complementary roles of school staff and school nurses

BACKGROUND: Against a background of future uncertainty for school nursing and little previous research, this study aimed to identify and describe the distinctive role of the school nurse in working to keep school children healthy. Particular attention was paid to the 'interface' between nursing and the health-related work of teachers. The research was carried out in four health authority areas in England. METHODS: Seventy-eight semi-structured interviews were carried out with a range of respondents: school nurses, school Heads and teachers, health authority purchasers and NHS Trust managers. Seven focus group discussions were held with parents and eight with young people of secondary school age. RESULTS: Four key elements of the school nurse role were identified: safeguarding the health and welfare of children; health promotion; a pupils' confidante; and family support. In each of these aspects of work, nurses and teachers had shared or complementary roles. An over-arching role for the school nurse as 'health adviser' to pupils, parents and teachers was also identified. Despite these common elements, emphasis in the practice of individual school nurses varied widely. Difficulties for school nurses in developing their role were identified. Parents and young people saw school as an appropriate setting for health-related work. CONCLUSION: The research identified key components of the school nursing role and the complementary roles of nurses and school staff. To optimize school nurses' contribution to child health, a more strategic approach is required, in partnership with education, along with research into the effectiveness of school nursing interventions.     

Parental and school correlates of binge drinking among middle school students

OBJECTIVES: We examined the prevalence and dynamics of binge drinking among middle school students. METHODS: We analyzed data from the National Longitudinal Study of Adolescent Health. The sample was composed of approximately 5300 seventh-and eighth-grade students who were interviewed at 2 points in time. RESULTS: Approximately 8% of seventh graders and 17% of eighth graders reported engaging in binge drinking during the past 12 months. These rates varied as a function of school characteristics. Low scores on the parenting variables-communication quality, use of reasoning, and control and supervision-and binge drinking during middle school also were predictive of binge drinking during high school. CONCLUSIONS: Binge drinking among middle school students is an important phenomenon that for many students forecasts future binge drinking during high school.     

Low accuracy and low consistency of fourth-graders' school breakfast and school lunch recalls

OBJECTIVE: To determine the accuracy and consistency of fourth-graders' school breakfast and school lunch recalls obtained during 24-hour recalls and compared with observed intake. DESIGN: Children were interviewed using a multiple-pass protocol at school the morning after being observed eating school breakfast and school lunch. SUBJECTS: 104 children stratified by ethnicity (African-American, white) and gender were randomly selected and interviewed up to 3 times each with 4 to 14 weeks between each interview. STATISTICAL ANALYSIS: Match, omission, and intrusion rates to determine accuracy of reporting items; arithmetic and/or absolute differences to determine accuracy for reporting amounts; total inaccuracy to determine inaccuracy for reporting items and amounts combined; intraclass correlation coefficients (ICC) to determine consistency. RESULTS: Means were 51% for omission rate, 39% for intrusion rate, and 7.1 servings for total inaccuracy. Total inaccuracy decreased significantly from the first to the third recall (P=0.006). The ICC was 0.29 for total inaccuracy and 0.15 for omission rate. For all meal components except bread/grain and beverage, there were more omissions than intrusions. Mean arithmetic and absolute differences per serving in amount reported for matches were -0.08 and 0.24, respectively. Mean amounts per serving of omissions and intrusions were 0.86 and 0.80, respectively. APPLICATIONS/CONCLUSIONS: The low accuracy and low consistency of children's recalls from this study raise concerns regarding the current uses of dietary recalls obtained from children. To improve the accuracy and consistency of children's dietary recalls, validation studies are needed to determine the best way(s) to interview children.     

Evaluation of Alabama public school wellness policies and state school mandate implementation

BACKGROUND: This study evaluated wellness policies created by Alabama public school districts and progress made in the implementation of Alabama State Department of Education (ALSDE) school food and nutrition mandates. METHODS: Wellness policies from Alabama public school districts were compared to minimum requirements under the Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004. Additionally, data were analyzed from a survey of school district superintendents regarding compliance with ALSDE mandates. Districts were graded based on the percentage of 7 components addressed in wellness policies, and on the percentage of ALSDE mandates implemented. RESULTS: The majority of school districts (71%) were in compliance with all federal wellness policy requirements. An average 6.4 components were addressed, for a mean score of 92%. Mean implementation of ALSDE mandates was 79%; only 7% of districts indicated implementing all of the mandates. No significant differences were found in federal wellness policy or ALSDE mandate compliance scores based on district type, enrollment, percentage of students eligible for free and reduced‐price meals, use of an environmental assessment survey, and use of wellness committee and a nutrition professional during policy development. CONCLUSIONS: The majority of Alabama school districts created school wellness policies with appropriate content. This does not, however, guarantee effective policies. School districts have not done as well implementing ALSDE mandates, demonstrating delay between policy creation and implementation. Future research is needed regarding progress the school districts make in the implementation of school health policy and on factors influencing that progress.     

Bullying among middle school and high school students--Massachusetts, 2009

Multiple studies have documented the association between substance use, poor academic achievement, mental health problems, and bullying. A small but growing body of research suggests that family violence also is associated with bullying. To assess the association between family violence and other risk factors and being involved in or affected by bullying as a bully, victim, or bully-victim (those who reported being both bullies and victims of bullying), the Massachusetts Department of Public Health and CDC analyzed data from the 2009 Massachusetts Youth Health Survey. This report summarizes the results of that analysis, which showed significant differences in risk factors for persons in all three bullying categories, compared with persons who reported being neither bullies nor victims. The adjusted odds ratios (AORs) for middle school students for being physically hurt by a family member were 2.9 for victims, 4.4 for bullies, and 5.0 for bully-victims, and for witnessing violence in the family were 2.6, 2.9, and 3.9, respectively, after adjusting for potential differences by age group, sex, and race/ethnicity. For high school students, the AORs for being physically hurt by a family member were 2.8 for victims, 3.8 for bullies, and 5.4 for bully-victims, and for witnessing violence in the family were 2.3, 2.7, and 6.8, respectively. As schools and health departments continue to address the problem of bullying and its consequences, an understanding of the broad range of associated risk factors is important for creating successful prevention and intervention strategies that include involvement by families.