人性化护理管理的探索与体会

随着社会发展及人们生活水平的提高,人们对医疗服务的要求也随之提高。为了适应这种新形势,护理管理人员要不断提高自身素质,坚持运用和发展人性化护理管理,使护士感受到人性化的温暖,为护士营造宽松、和谐的工作氛围,从而充分调动其积极性,促进护理服务质量的提高。     

Kinder und Jugendliche mit Adipositas in Deutschland

Obesity in children and adolescents has become a major public health issue in our country. Until now this issue has not been sufficiently recognized in our health system. Compared to reference values from the 1970s every fifth school child and every third adolescent in Germany is overweight today. Obesity as a disease is found in 4-8% of all school children. The prevalence of obesity in children and adolescents seems to still be increasing steadily in Germany. Overweight children have a high risk to become overweight adults with a high risk for the occurrence of type 2 diabetes, cardiovascular, orthopedic, and other diseases. Due to the steady increase of the prevalence of obesity in children and adolescents and the consequences, it is expected that the German health system and society as a whole will be confronted with considerable costs. The German Ministry for Health and Social Protection as well as the German Ministry for Consumer Protection, Nutrition and Agriculture have established working groups who will propose straightforward activities in the field of prevention and treatment. Hopefully these working groups will have enough political and financial support that they will be able to establish activities which are effective in counteracting this important health problem.     

Work ethics and general work attitudes in adolescents are related to quality of life,sense of coherence and subjective health – a Swedish questionnaire study

Background  

Working life is an important arena in most people's lives, and the working line concept is important for the development of welfare in a society. For young people, the period before permanent establishment in working life has become longer during the last two decades. Knowledge about attitudes towards work can help us to understand young people's transition to the labour market. Adolescents are the future workforce, so it seems especially important to notice their attitudes towards work, including attitudes towards the welfare system. The aim of this study was to describe and analyse upper secondary school students' work attitudes, and to explore factors related to these attitudes.     

Identity Crisis in School Psychology

The problem of identity crisis in school psychology has been with us for many years. It has been suggested in these pages that the problem does not constitute a weakness within the profession but rather promotes a healthy interchange in ideas. Instead of seeking to provide a narrow definition of the school psychologist's identity, it seems to be wiser to recognize the roles of school psychologists to be as broad as the needs of children in the schools. There will continue to be debate about school psychologists' identity and about what they can do or ought to do in the schools. Those whom school psychologists serve will be the ultimate beneficiaries of this vibrant and constructive debate within the profession.     

Perception and practice of child labour among parents of school‐aged children in Ibadan,southwest Nigeria

Background The problem of child labour has lingered on in many countries because of the complex combination of social, cultural and economic factors involved. Parents play a critical role in child labour as it provides much needed extra income for the family. This study was carried out among parents of school‐aged children in an urban, low‐income community to determine the factors associated with child labour and attitudes to child labour in the community. Methods A cross‐sectional study was carried out in an urban community in Ibadan, southwest Nigeria. Questionnaires were administered to parents of school‐aged children. Results A total of 473 parents were interviewed. They were aged between 23 and 56 years, mean 37.9 years. Thirty‐nine per cent of parents indicated that they thought their school‐aged children should work. More women than men, those from polygamous homes and those with lower educational status held this view. Reasons given for wanting their children to work were to supplement family income, 45%, to gain experience, 35% and to help in family business, 10%. In all, 236 (50%) respondents reported that their school‐aged children were working. Parental factors associated with practice of child labour were polygamous marriage, low educational status, unskilled or partly skilled occupation and large family size. Seventeen per cent of parents with working children were not satisfied with their children's work conditions and complained of low earnings, long working hours, work on school days and unsafe work environment. Measures suggested to control child labour include addressing the issue of household poverty, public enlightenment about the ills of child labour and free education up to junior secondary level. Enforcement of child labour laws was the least mentioned. Conclusion We conclude that control of child labour should be a multifaceted approach involving poverty alleviation, family planning to reduce family size and free, compulsory education up to junior secondary level. Public enlightenment especially for mothers will be of additional benefit.     

School climate for the internally displaced children (IDPs) in Manila,Philippines

ABSTRACT

The article aims to examine the spheres which help create positive school climate suitable for the integration of internally displaced children (IDPs). The paper looks at how the experience of IDP children affects their overall school life as perceived by their own teachers. Data from this study were taken from nine (9) elementary school teachers who participated in the focus group discussion (FGD). The participants, all from a particular school in Manila, handled the IDP students as they continued their studies after displacement. Results suggest that the spheres of safety, supportive and inclusive environment have created a positive school climate for the IDP students. The paper argues that school integration of IDP children requires the positive fulfillment of these spheres. Feeling secured, being surrounded with supportive social network, and learning in inclusive environment are all non-negotiable features of a school climate that facilitates successful school integration. Results of this study provide insights as to what components have to be improved and focused on by host schools when receiving IDP school children.     

Health promotion and health for all

The recognition that health is intimately related to economic status, education, physical living conditions, culture, history, issues of gender and human rights, the level of peace and safety, and the life people live, is not entirely new. The health sector has been making its way towards this position for a very long time. The literature describes recognition of the connection between living conditions and health status from the early 19th century. To ensure that people live in societies that create health, there is a need to first recognize the following: that there are multiple and diverse forces within society which create or undermine health; and that most of the factors which are essential for a healthy community reside outside the formal health sector. Action to create healthy societies with healthy people then must tap multiple power sources and involve broad collaboration and alliances. The health promotion strategies of the Caribbean Health Promotion Charter and the Ottawa Charter are outlined. Some of these strategies include the establishment of public policies on health, creation of supportive environments, empowerment of communities through community action, promotion of personal health skills, reorientation of health services, and the need to create alliances. The health promotion is an approach, which respects people's rights to healthy living and is based on the recognition that health is the result of an interconnection between all aspects of life. The strategy can best be achieved through full participation of the various sectors, interest groups and communities in a society.     

SCHIP Directors' Perception of Schools Assisting Students in Obtaining Public Health Insurance

Background:  Health insurance coverage increases access to health care. There has been an erosion of employer-based health insurance and a concomitant rise in children covered by public health insurance programs, yet more than 8 million children are still without health insurance coverage.
Methods:  This study was a national survey to assess the perceptions of State Child Health Insurance Program (SCHIP) directors (N = 51) regarding schools assisting students in obtaining public health insurance. This study examined the perceived benefits of and barriers to working with school systems and the perceived benefits to schools in assisting students to enroll in SCHIPs and what SCHIP activities were actually being conducted with school systems.
Results:  The majority (78%) of SCHIPs had been working with school systems for more than a year. Perceived benefits of working with schools were greater access to SCHIP-eligible children (75%), assistance with meeting mandates to cover all SCHIP-eligible children (65%), and greater ability of state agencies to identify SCHIP-eligible children (58%). A majority of the directors did not identify any of the potential barrier items. The directors cited the following benefits to schools in helping enroll students in public health insurance programs: reduces the number of students with untreated health problems (80%), reduces student absenteeism rates (68%), improves student attention and concentration during school (58%), and reduces the number of students being held back in school because of health problems (53%).
Discussion:  The perceived benefits derived from schools assisting in enrolling eligible students into SCHIPs are congruent with the mission of schools. Schools need to become proactive in helping to establish a healthy student body, which is more likely to be an academically successful body.     

The SOS Children's Villages: Behaviour of Children reared in a Permanent Foster Care

The present study has investigated the behavioural development of 157 children aged 7‐15 reared in a long term placement. They had been in a SOS children's village for 4 and a half years. All school results and questionnaires from teachers scale were collected. Family backgrounds, parental alcoholism and number of previous placements have important long‐term effects on children's development. Some behavioural problems appear when 2 or 3 groups of siblings are reared together. The proportion of behaviour problems for such children reared in a mono‐parental foster care is equivalent to those of children reared in working‐class‐families whether adopted quite early or remaining in their natural families.     

Listening and facilitating all forms of communication: disabled children and young people in residential care in England

ABSTRACT

Little research has been undertaken into how children with complex communication needs living in residential care are encouraged to express their views, be involved in decision-making, and importantly, make it known when they are unhappy. This group are often placed a long distance from home and can be some of the most vulnerable children in the care system. Ensuring they have access to a communication method, people who understand their communication and support to empower them to grow their capacity is not only a right and a safeguarding mechanism, it is also important in preparation for adulthood and for leaving care. This unique paper reports on the English arm of a European project, which aimed to devise the first international monitoring system to prevent abuse of disabled children in residential settings. Trained professionals examined how disabled children were heard, and encouraged to be involved in decision-making within 10 case-study residential settings. To aid international development of good practice, this paper focuses on positive aspects of practice. Examples are used to illustrate how all forms of communication can be encouraged and used positively to both protect and empower disabled children in residential care. Implications for practice are presented to support practitioners to create positive communication environments.     

NEWS AND VIEWS: Breakfast clubs: availability for British schoolchildren and the nutritional,social and academic benefits

Breakfast clubs are not a new resource for parents and children, but interest in them has heightened, because of both the need for improvement in school food and political interest in their availability across the devolved countries. It has been suggested that concrete scientific evidence as to their benefits to academic performance be required before a breakfast club should be available for children across the UK. It is inappropriate to correlate crude measures such as Standard Assessment Test (SAT) scores and exam results with breakfast club provision, and the focus of analysis should be individual pupil benefit (both scholastically and socially), nutrient intake, meal provision and even assisting working parents with child care. There is limited data available to investigate the adequacy of food provision in school breakfast clubs, but there is now sufficient information available for breakfast club organisers to provide a nutritionally balanced breakfast. A body of evidence is emerging that demonstrates the benefits of breakfast club attendance to mental performance and social development. However, it is unclear whether such benefits are derived from the consumption of breakfast per se, the environment or a combination of the two. It is reasonably safe to conclude that the benefits of breakfast clubs are more pronounced in deprived areas, and efforts of charities to support breakfast clubs should focus in these areas. Given the role and importance of school breakfast clubs, ContinYou, a leading national charity, pledged support in establishing 200 more school breakfast clubs over 2009 and 2010.     

Primary health care: a training experience with the community

In 1982-83 we organized training schemes for various people involved in primary health care at local authority level. These schemes were part of the pattern of similar activity carried out with trained professional staff of the mother-and-child care and school health services. What was new was the participation of non-professional users (or their representatives) of health services, i.e. local politicians, representatives of associations, etc. The training sessions brought together 20-25 participants for two or three days and there were occasionally follow-up meetings of one or two days. The participants, divided into small groups of five or six, played an active part in the meetings, which were based on known information about the local authority area and the participants' own contributions. The initial task was the identification of health problems. For this to be a relevant exercise, the many political, cultural and personal factors which influence people's lives had to be considered. The fact is that the usual epidemiological data are inadequate if they are based solely on a review of symptoms and their distribution among the population as a whole. The procedure begins with the group concerned, and priority in selecting problems is decided with and within the group itself. The solutions that are required will thus be based on the experience and reasoning of the people themselves. A procedure of this type ought to show the factors which affect the community (working conditions, environment, habitat, cultural background, etc.) and which influence health. If we understand the structures of the community and the resources at its disposal, we can adapt our response accordingly. In assessing our experiment, we found that the training sessions produced a local awareness and a mutual recognition of the various participants, both professional and non-professional. Each person began to understand his limits since his role was constantly being reviewed. At the same time the requirements voiced by health care users became more apparent to the professionals with their preconceived ideas about people's needs and requirements.     

The effects of solvent exposure on memory and motor dexterity in working children

OBJECTIVES: Children working in vehicle spray-painting, mechanical, and other trade workshops are at significant risk of exposure to organic solvents and, as a result, may be at significant risk of developing clinical and subclinical signs of neurotoxicity. This study reports on the association between exposure to solvents and neurobehavioral performance on a number of non-computerized tests for working children exposed to solvents in comparison with nonexposed working children and nonexposed children at school. METHODS: A convenience cross-sectional sample of 300 male children aged 10-17 years was recruited for study. The exposed working group and the two nonexposed groups (working and nonworking school) were matched, as far as possible, on geographic location of residence and age. Neurotoxic effects were assessed through a questionnaire and the child's performance on a selection of neurobehavioral tests. RESULTS: Exposed working children scored worse on the overall neurotoxicity symptoms score (mean=6.8; standard deviation [SD]=3.6) compared with the nonexposed working children (mean=1.3; SD=2.0) and school children (mean=1.2; SD=1.8). Analysis of the non-computerized neurobehavioral tests demonstrated that exposed working children performed significantly worse than the two nonexposed groups on the motor dexterity and memory tests. Results of the mood test showed that exposed working children were more angry and confused than the nonexposed groups. CONCLUSION: There is an association between exposure to solvents and lower neurobehavioral performance, with significant neurobehavioral deficits among children exposed to solvents in comparison with working children not exposed to solvents and nonworking school children. Memory and motor dexterity appear to be particularly affected in solvent-exposed working children.     

Working children and accidents: understanding the risks

Recent research suggests that a significant proportion of school children aged 10-16 years are employed outside the home during the school term. Delivery work represents only a minority of such employment and children are found working in a wide range of 'adult' jobs, particularly in the service sector. This raises concerns about health and safety hazards faced by working children. There is an absence of data on the effects of different kinds of work and working conditions on child health and development, which is thus a barrier to defining goals, policies and effective action. This paper aims to address these issues through presenting some research findings on child employment and incidences of accident. The study is based on surveys of school children in North Tyneside and Norfolk. Our analysis shows that there is a high level of accidents occurring at work among children aged 10-16 years old. While legislation exists in the UK to prevent children from working in the most hazardous environments and to prohibit young children from undertaking any employment, it is clear that such work does take place. Our findings indicate that it is time to look at the occupational health of children as a major concern.     

Forms of knowledge, the curriculum and the young child

Children need to learn many matters, but not all their learning is of the same epistemological kind.There are something like eight fundamental and fundamentally different ways in which human beings encounter the world: Knowledge of Mathematics and Logic, Empiricist Knowledge, Scientific Knowledge, Knowledge of Persons and their Minds, Moral Knowledge, Knowledge and Experience in the Aesthetic Domain, Religion, Philosophy. These Forms structure children's learning, understanding, and experience both formal and informal, at all ages.Moreover they structure not just “scholarly knowledge and experience”, but also, “commonsense knowledge and experience”.

A suitable curriculum will be one which in one way or another provides diverse experiences of these Forms. Because there is no “transfer of training” between Forms as such, children need to be introduced to them all and to be shown how they differ. To say this is not to beg any questions about the best way in which to teach young children: no matter how we decide to organize a curriculum,we are still able to use a range of modern methods.

Although much learning in pre-school and early elementary school ought not to be directly concerned for the deliberate acquisition of the Forms as such, much of the casual learning in schools (and outside them) does indeed involve the Forms-with examples drawn from the child world.

In introducing children to the Forms, those who care for and who teach young children have an enormous responsibility.     

Perceptions of child labour among working children in Ibadan, Nigeria

BACKGROUND: The adverse effects of child labour on the children's psychological development continue to raise concerns about this public health problem worldwide. Several views have been presented by child health authorities, non-governmental organizations (NGOs) and international agencies. Few studies have focused on the children themselves. This study sought to determine working children's perspective of child labour, its benefits and disadvantages and the working children's perceptions of themselves, and their aspirations for the future. METHODS: A cross-sectional study was carried out among working children in a large market in Ibadan, south-west Nigeria. Questionnaires were administered to all consenting children. RESULTS: A total of 225 children, 132 females and 93 males, participated in the survey. Their age range was 8-17 years. A total of 103 respondents (46%) were currently in school while 117 (52%) were out of school. Five respondents (2%) had never attended school. A total of 104 (46%) thought that children should not work. However, when asked about the benefits of working, 81 working children (36%) felt that work provided a source of income for them, 52 (23%) indicated that it was a way of helping their parents and 39 (17%) thought it was part of their training to be responsible adults. Bad company, ill health and road traffic accidents were the perceived ill effects of child labour. The majority of the children interviewed were aspiring towards artisan trades and very few towards professional or office jobs. A total of 106 (47%) children perceived themselves as less fortunate than their peers. Fifty-five children (24%) thought that child labour was a sign of deprivation. The perception that child labour is a sign of deprivation was more prevalent among child workers whose highest educational attainment was primary school, child workers who had worked for more than 6 months and those whose earnings were small. CONCLUSION: We recommend that school education for children should be a priority even when the harsh economic realities in their families force parents to send them to work outside the home.     

Rickets: concerns over the worldwide increase

Rickets is a childhood disease that causes a softening of the bones, potentially leading to fractures and deformity. Eighty years ago it was thought to have largely been eradicated from the U.K. However a recent increase in cases of rickets, not just in Britain but around the world, has proven this isn't the case. Today the disease affects children from all types of socio-economic backgrounds, not just the poorer ones, and it is primarily caused by low levels of vitamin D and certain foods. In January 2011 the government's chief medical officer Dame Sally Davies recommended all children aged six months to five should be given vitamin D supplements, particularly during winter months when natural sunshine is limited. The irony is that the advice in recent years for children to wear a high factor sunscreen and remain covered up while playing outdoors are partly felt to be behind the reason for its re-emergence. Parents and health professionals alike were shocked when it was revealed that a school girl living on the Isle of Wight developed rickets precisely because of her mother's vigilance at following sun safety rules. NICE, in their latest report (Jan 2011) stated that: "Exposure to the sun has a number of benefits. For example, it increases people's sense of wellbeing, allows them to synthesise vitamin D and provides opportunities for physical activity". A tendency for children to stay indoors and watch TV or play on computer games, rather than play outside when the sun is shining, is arguably also another contributing factor.     

长期住院患儿的社会生活能力调查

目的：为进一步了解因长期住院患儿的社会生活能力。方法：采用婴儿－初中生社会生活能力量表对208例长期住院患儿（甲组）及150例健康儿童（乙组）进行了社会生活能力调查对照研究。结果;长期住院患儿社会生活能力明显低于对照组。影响因素分别为躯体疾病、环境改变、父母溺爱、活动受限、对疾病担心、父母情绪。结论：长期住院对社会生活能力可产生影响,应改进医护人员及家长管理长期住院患儿观念和教育形式,在培养儿童良好的社会生活能力时,进行相应的适应调适,加强训练,其对促进社会生活能力的提高有积极作用。     

The importance of language development for the success in school for children from immigrant families

Almost 46% of the foreign pupils leaving vocational training colleges do not take their final exams. This alarming trend, which can be observed nationwide, raises the question as to which conditions are crucial for the school career of children and teenagers of immigrant families and which conditions affect their success at school. Attitudes have been influenced by the assumption that by extending the length of stay of the immigrant families the problems of integration would diminish; consequently it could be assumed that unhindered access to the institutions of education would automatically promise success. This expectation is mainly responsible for the fact that teaching has not been aligned with the specific needs of these children. Extracurricular support, e. g. like helping with the homework, was seen as a completion of and support for a school system which was considered apt for teaching children from other ethnic backgrounds and was not questioned except for special model projects. Precisely these model projects demonstrated that all children, both foreign and German, profit from a way of teaching which has been adjusted to the intercultural conditions of a class rather than denying them. Health care services for youngsters can essentially support the process of internal school reforms as doctors point out the excessive demands on the immigrated families by traditional teaching, which actually impairs the efficiency of performing well at school. Furthermore, health care can also explain that the proper development of a child can be impaired if its specific learning structures--based on the linguistic and cultural background--are ignored by the school.     

Experiences and perceived roles of occupational therapists working with children with special learning needs during transition to school: A pilot study

Occupational therapists provide support to children with special learning needs and their families during the child's transition from early childhood to mainstream school. Little has been documented regarding the role and experiences of occupational therapists working with children, families and teachers during transition in an Australian context. Six paediatric occupational therapists from one geographical area in New South Wales were interviewed and asked to relay their role and experiences when providing a service to children with special learning needs during their transition to school. Participants described their role to include: preparing the child for school; working with school personnel; and providing parental support. Although participants described both positive and negative experiences, among the negative experiences were: limited time to provide a service; recommendations to school personnel not being followed; school personnel not being supportive; feeling uncomfortable in the classroom; and limited involvement in planning. Participants described a role which is consistent with current school-based occupational therapy practice; however, in the participants' experience, there was a gap between the ideal service and what participants were able to provide. This included limited collaboration with teachers.