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The article presents a study that evaluated a nursing intervention program directed toward high absence school children in Palm Beach County, Florida. The public health nurses are responsible for providing generalized nursing services to the community as well as services to children in the schools. Services provided as part of school related responsibilities are frequently limited to episodic encounters with individual children who are referred by teachers and principals. A uniform record of contact was designed to record the activities of nurses and to increase the possibility of describing the relationship between input and patient progress.

Objectives. We reviewed the complexities of school-related immunization policies, their relation to immunization information systems (IIS) and immunization registries, and the historical context to better understand this convoluted policy system. Methods. We used legal databases (Lexis-Nexis and Westlaw) to identify school immunization records policies for 50 states, 5 cities, and the District of Columbia (Centers for Disease Control and Prevention “grantees”). The original search took place from May to September 2010 (cross-referenced in July 2013 with the list on http://www.immunize.org/laws). We describe the requirements, agreement with IIS policies, and penalties for policy violations. Results. We found a complex web of public health, medical, and education-directed policies, which complicates immunization data sharing. Most (79%) require records of immunizations for children to attend school or for a child-care institution licensure, but only a few (11%) require coordination between IIS and schools or child-care facilities. Conclusions. To realize the full benefit of IIS investment, including improved immunization and school health program efficiencies, IIS and school immunization records policies must be better coordinated. States with well-integrated policies may serve as models for effective harmonization. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to a previous article regarding a school health program by McCollum E. Brasfield, in the January 1973 issue.

The article discusses the provisions on health of school-age children by the American Public Health Association in the U.S. The organization asserted that the basic purpose of school health services is to boost the educational operations by improving the health conditions of children and youth. It also recognizes the need for physical, emotional, psychological and educational growth of individuals aged 3 to 21 years. Among the influential factors include comprehensive school health care providers, parents and community

The article reports on the development of a model for the reorganization of child health services within an urban community by researchers from Cambridge, Massachusetts. The many shortcomings of contemporary medical care have received much attention in recent years. Efforts to provide improved care have often resulted in greater fragmentation, duplication, and cost. The increasing lack of physicians available to large urban populations has led to a dramatic rise in the number of patient visits to hospital outpatient departments and emergency wards. In response to these concerns, a coordinated system of health care for children has been designed.

A letter to the editor is presented in response the article "Desegregating Health Statistics," by M. Terris in the June 1973 issue.

Objectives. We evaluated the effectiveness and spillover of an after-school health education and physical activity program among Hispanic elementary school children. Methods. In fall 2008, students in third through fifth grades in 6 schools in El Paso, Texas (n=901), were randomized to intervention (n=292 participants) or control (n=354) classrooms (4 unknown). Intervention classrooms also contained a spillover group (n=251) that did not join the after-school program but that completed measurements and surveys. The intervention was a 12-week culturally tailored after-school program meeting twice a week. Four-month outcomes were body mass index, aerobic capacity, and dietary intentions and knowledge. We calculated intervention exposure as the proportion of afterschool participants per classroom. Results. Intervention exposure predicted lower body mass index (P=.045), higher aerobic capacity (P=.012), and greater intentions to eat healthy (P=.046) for the classroom at follow-up. Intervention effectiveness increased with increasing proportions of intervention participants in a classroom. Nonparticipants who had classroom contact with program participants experienced health improvements that could reduce their risk of obesity. Conclusions. Spillover of beneficial intervention effects to nonparticipants is a valuable public health benefit and should be part of program impact assessments. [ABSTRACT FROM AUTHOR]

Communication plays an important role in all aspects of the development and use of policy. We present a communication-centered perspective on the processes of enacting public health policies. Our proposed conceptual framework comprises 4 communication frames:orientation, amplification, implementation, and integration. Empirical examples from 2 longitudinal studies of school-based health policies show how each frame includes different communication processes that enable sustainable public health policy practices in school-based health initiatives. These 4 frames provide unique insight into the capacity of school-based public health policy to engage youths, parents, and a broader community of stakeholders. Communication is often included as an element of health policy; however, our framework demonstrates the importance of communication as a pivotal resource in sustaining changes in public health practices. [ABSTRACT FROM AUTHOR]

Objectives. We assessed the impact of legislation that established nutrition standards for foods and beverages that compete with reimbursable school meals in California. Methods. We used documentation of available foods and beverages, sales accounts, and surveys of and interviews with students and food service workers to conduct 3 studies measuring pre- and postlegislation food and beverage availability, sales, and student consumption at 99 schools. Results. Availability of nutrition standard--compliant foods and beverages increased. Availability of noncompliant items decreased, with the biggest reductions in sodas and other sweetened beverages, regular chips, and candy. At-school consumption of some noncompliant foods dropped; at-home consumption of selected noncompliant foods did not increase. Food and beverage sales decreased at most venues, and food service à la carte revenue losses were usually offset by increased meal program participation. Increased food service expenditures outpaced revenue increases. Conclusions. Regulation of competitive foods improved school food environments and student nutritional intake. Improvements were modest, partly because many compliant items are fat- and sugar-modified products of low nutritional value. Additional policies and actions are needed to achieve more substantive improvements in school nutrition environments and student nutrition and health. [ABSTRACT FROM AUTHOR]

Although research shows that education and health are closely intertwined, health professionals have difficulty using this evidence to improve health and educational outcomes and reduce inequities. We call for a social movement for healthy high schools in the United States that would improve school achievement and graduation rates; create school environments that promote lifelong individual, family, and community health and prevent chronic illness, violence, and problems of sexual health; and engage youths in creating health-promoting environments. Achieving these goals will require strengthening and better linking often uncoordinated efforts to improve child health and education. Only a broad social movement has the power and vision to mobilize the forces that can transform educational and health systems to better achieve health and educational equity. [ABSTRACT FROM AUTHOR]

Objectives. We used a participatory process to develop an obesity intervention appropriate for elementary school personnel. Methods. A randomized controlled trial included 16 school worksites (8 intervention, 8 control). Intervention schools formed committees to develop and implement health promotion activities for employees. Anthropometric and self-report data were collected at baseline and postintervention (2 years later). The primary outcome measures were body mass index (BMI), waist-hip ratio, physical activity, and fruit and vegetable consumption. Results. After adjustment for age, ethnicity, and job classification, employees in intervention schools reduced their BMI by an average of 0.04 kg/m[sup 2], and those in control schools increased their BMI by an average of 0.37 kg/m[sup 2]. Comparisons for waist-hip ratio, weekly physical activity minutes, and fruit and vegetable consumption were not significant. Conclusions. The participatory process appeared to be an effective means for stimulating change. The intervention may have slowed and perhaps reversed the tendency of adults to gain weight progressively with age. [Am J Public Health. 2010;100:327-333. doi:10.2105/AJPH.2008.154153) [ABSTRACT FROM AUTHOR]

OBJECTIVES: We assessed hand-washing behaviors and intentions among school children in Bogotá, Colombia, to help identify and overcome barriers to proper hygiene practices. METHODS: Data on hand-washing behavior and intentions and individual and contextual factors were collected from 2042 sixth- through eighth-grade students in 25 schools in Bogotá via anonymous questionnaires. A member of the school administration or teaching staff completed a questionnaire about the school environment. Site inspections of bathroom facilities were conducted. RESULTS: Only 33.6% of the sample reported always or very often washing hands with soap and clean water before eating and after using the toilet. About 7% of students reported regular access to soap and clean water at school. A high level of perceived control was the strongest predictor of positive hand-washing intentions (adjusted odds ratio [AOR]=6.0; 95% confidence interval [CI]=4.8, 7.5). Students with proper hand-washing behavior were less likely to report previous-month gastrointestinal symptoms (OR=0.8; 95% CI=0.6, 0.9) or previous-year school absenteeism (OR=0.7; 95% CI=0.6, 0.9). CONCLUSIONS: Scarcity of adequate facilities in most schools in Bogotá prevents children from adopting proper hygienic behavior and thwarts health promotion efforts. The current renovation program of public schools in Bogotá provides a unique opportunity to meet the challenges of providing a supportive environment for adoption of healthy behaviors. [ABSTRACT FROM AUTHOR]

Objectives. Many adolescent girls fail to meet national guidelines for physical activity, and the prevalence of obesity is increasing among this group. Our study examined the effects of a comprehensive school-based intervention on physical activity among high-school girls. Methods. A group-randomized controlled field trial was conducted at 24 high schools. A school-based sample of 2744 girls (48.7% African American, 46.7% White) participated in a measurement protocol when they were in eighth and then ninth grade. A comprehensive physical activity intervention was designed to change the instructional program and the school environment to increase support for physical activity among girls. Results. At follow-up, 45% of girls in the intervention schools and 36% of girls in the control schools reported vigorous physical activity during an average of 1 or more 30-minute time blocks per day over a 3-day period. Conclusions. A comprehensive school-based intervention can increase regular participation in vigorous physical activity among high-school girls. [ABSTRACT FROM AUTHOR]

Objectives. We sought to assess the effects of a school-based intervention program on cardiovascular disease risk factors in urban girls. Methods. We compared heart health knowledge, health behaviors, cardiovascular risk factors, and physical fitness among a group of 442 multiethnic teenaged girls (310 experimental participants vs 132 control participants). Testing was conducted before and after a 12-week program of vigorous exercises integrated with lectures and discussions on diet, exercise, stress, and smoking. Results. Significant differences in body fat, systolic and diastolic blood pressure, heart health knowledge, and whether breakfast was eaten were observed between experimental participants and control participants. Conclusions. An integrated program of exercise and heart health-related lectures and discussions had a beneficial effect on health knowledge, health behaviors, and onset of risk factors for coronary artery disease among urban girls. (Am J Public Health. 2004;94:1538-1543). [ABSTRACT FROM AUTHOR]

Objectives. We examined the extent to which schools in the United States have health-promoting policies, programs, and facilities. Methods. We analyzed data from the School Health Policies and Programs Study 2000. Results. We found that public schools (vs private and Catholic schools), urban schools (vs rural and suburban schools), and schools with larger enrollments (vs smaller schools) had more health-promoting policies, programs, and facilities in place. On average, middle schools had 11.0 and middle/junior and high schools had 10.4 out of a possible 18 policies, programs, and facilities. Conclusions. Although some schools had many healthy physical environment features, room for improvement exists. Resources are available to help schools improve their health-promoting policies, programs, and facilities. (Am J Public Health. 2003;93: 1570-1575) [ABSTRACT FROM AUTHOR]

The 'rediscovery' of poverty, as echoed in concepts of social inequality, has contributed to the goal of eliminating racial/ethnic and social class disparities in the United States. This commentary focuses on what we know about the pressing health care needs and issues relevant to Latino children and families and how extant knowledge can be linked to priority policy recommendations to ensure the inclusion of Latino health issues in the national discourse. A systematic review of the literature on Latino children and of expert opinion revealed 4 evidence-based themes focused on poverty: economic factors, family and community resources, health system factors, and pitfalls in Latino subgroup data collection. Consensus was found on 4 priority policy recommendations: (1) reduce poverty and increase access to health care coverage, (2) increase funding in targeted primary and preventive health care services, (3) provide funds needed to fully implement relevant health legislation, and (4) improve measurement and quality of data collection. If these recommendations are not instituted, the goals of Healthy People 2010 will not be achieved for the Latino population. [ABSTRACT FROM AUTHOR]

The "rediscovery" of poverty, as echoed in concepts of social inequality, has contributed to the goal of eliminating racial/ethnic and social class disparities in the United States. This commentary focuses on what we know about the pressing health care needs and issues relevant to Latino children and families and how extant knowledge can be linked to priority policy recommendations to ensure the inclusion of Latino health issues in the national discourse. A systematic review of the literature on Latino children and of expert opinion revealed 4 evidence-based themes focused on poverty: economic factors, family and community resources, health system factors, and pitfalls in Latino subgroup data collection. Consensus was found on 4 priority policy recommendations: (1) reduce poverty and increase access to health care coverage, (2) increase funding in targeted primary and preventive health care services, (3) provide funds needed to fully implement relevant health legislation, and (4) improve measurement and quality of data collection. If these recommendations are not instituted, the goals of Healthy People 2010 will not be achieved for the Latino population. (Am J Public Health. 2000;90:1827-1833) [ABSTRACT FROM AUTHOR]

The article discusses the provisions on glaucoma screening by the American Public Health Association in the U.S. Since glaucoma is considered a major cause of blindness in the U.S., the association believed that glaucoma screening may be conducted by qualified health care providers, who are experts of the procedure and techniques. It also recognizes the need to dissemenate awareness among public and health providers. Furthermore, it encourages continuing researh to improve existing processes of glaucoma screening.

The article discusses the provisions on the right to second trimester abortion by the American Public Health Association. The organization stressed its advocacy for women's right to abortion, physicians' freedom to execute abortion and state and legal legislation for legal abortion. The support, which is designed for poor women, aims to encourage opposition to misleading local and state ordinances, endorses educational program for physicians and health care personnel and assists clinics that performs such operation. However, women seeking such procedure and abortion providers have received pressure from anti-abortion groups.

The article discusses the provisions on the adoption of standard immunization record formats by the American Public Health Association in the U.S. The organization believes that immunization records can protect the health of vulnerable and resistant children and young adults through identification. Standardization of such records can lessen costs of record-keeping, avoid unnecessary demand for immunization data, assist in the transfer of information between schools and providers and allow school and health authorities to conduct evaluation on protection levels.

The article presents a resolution by American Public Health Association relative to the crisis in public hospitals in the U.S. Due to the awkward current reimbursement policies under Titles XVIII and XIX of the Social Security Act, the association resolved that needed public hospitals remain open. They also resolved to review the current litigative efforts being undertaken in this area and suitably join in collaborative efforts. Further, they urged the Congress to address the issues of Medicare and Medicaid reimbursement policy and the special problems of public hospitals, and revise such policies to adequately fund the special services and populations served by public hospitals.

Objectives. This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. Methods. Dental fluorosis and dental caries data were collected on 7- to 14-year-old lifelong residents (n = 1493) of Newburgh and Kingston, NY. Results. Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. Conclusions. The prevalence of dental fluorosis has not declined fri Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline. [ABSTRACT FROM AUTHOR]

The article presents information on the program schedule of the 1996 annual meeting of the American Public Health Association. The Annual Meeting Program follows a definite format: day order, by time slot and alphabetical by first sponsor. On Monday, November 18, 1996, there are sessions on the topics like The Preventive Medicine Residency Practicum: Innovations in Teaching Public Health Practice to Physicians, Service-Learning in Health Professions Education: Lessons Learned in Medicine, Nursing and Public Health, Accreditation in Public Health, Issues and Innovations In Alcohol and Other Drug Treatment, Clean Indoor Air: Policies and Issues, Is Certificate of Need Alive and Well?, Incorporating Spirituality and Traditional Healing Concepts into Public Health Programs, Trade Agreements: How Are They Impacting Public Health?, Assessing the Health of Asian and Pacific Islander Populations, Advocating for Women: Research and Practice in Women's Health, Public Health and Faith Community Alliances: Concepts and Philosophies and Immigrant Health Care: Legal and Economic Issues.

The article offers information on the 114th Annual Meeting of the American Public Health Association Preliminary Program to be held on September 28 to October 2, 1986 in Las Vegas, Nevada.

The article offers information on the 112th Annual Meeting of the American Public Health Association to be held on November 11-15, 1984 in Anaheim, California.

One hundred twenty-four children identified as needing care in Two elementary schools by a routine department of public health screening were randomly assigned to either a standard treatment group (notification to parents by a form letter) or an experimental group that added personal contact to the standard treatment. Overall. 53 per cent of the subjects in the experimental condition who needed treatment at the initial screening had received this treatment at follow-up, while only 12 per cent of the subjects in the control group had received needed treatment. [ABSTRACT FROM AUTHOR]

Abstract: This study examines the school health room visiting behavior, over two school years, of a random sample (N = 671) of urban children, grades K-5. Excluding eight students who visited regularly for medication (and who alone accounted for 25 per ¢ of all visits). 94 per ¢ of the students made at least one visit. Girls visited more frequently than boys (5.1 visits/year vs 4.1 visits/year). Girls were more likely to be in the frequent visitor group (P = 0.01); to have presented five or more different complaints (P = 0.02): and to have visited for stomachache (P is < or equal to 0.001). These sex differences were observed as early as first grade. Almost 58 per ¢ of the variance in visiting in the second year was predicted by frequency of visiting in the first year. These data raise questions about the influence of the school in either reinforcing or modifying the health services utilization behavior of individuals. (Am J Public Health 1981: 71:416-419.) [ABSTRACT FROM AUTHOR]

The article focuses on the development of preventive medical practice. The author explained that sanitary science aims to teach people the causes of diseases to avoid them or prevent them. During the Boer War, the low standard of physical fitness among recruits called the attention of authorities. In the U.S. the American Medical Association and other organizations have passed resolutions to support the practice. However, the author claimed that fringe movements and the distortions of the media, medical spokespersons for prevention today are far less rhetorical and more cautious than their predecessors.

The article evaluates and describes the computer control of school nursing records for the purposes of health planning and follow-up in the U.S. It represents an experiment in making school health records more responsive to the needs of school nurses, for them to be more responsive to the needs of the children. The authors stress that the availability of modern computer technology and the obsolete systems of record keeping in some school health programs indicated an obligation to bring these two areas together. Significant information relative to the matter are presented.

The article presents the findings of a research on the attitudes of health maintenance organization (HMO) project directors regarding HMO delivery issues in the U.S. This national survey was conducted to gather data about HMO planning development and delivery areas. Major health delivery issues have emerged from an extensive discussion of the HMO system that include prepayment mechanism, quality of care, federal regulation, consumer participation, public and private funding, physicians' attitudes, and consumer recruitment. HMO directors tended to favor the prepayment mechanism, although they were aware of potential abuse. They agreed that prepayment is an incentive for physicians to promote cost effectiveness. Other significant findings are presented.

A computerized network of Health Education and Referral Centers is being developed in Los Angeles County. To assist in evaluating this network, a method for assessing the effectiveness of referrals was needed. This four-part report focuses on the construction of a conceptual model for measuring referral outcomes, a system for classifying health problems and services, a system for tracking referrals, and factors related to outcomes. [ABSTRACT FROM AUTHOR]

The article focuses on the issues related to urbanization and health planning in the American Indian Community. In the past decade, large segments of previously rural land have become urbanized through the mass migration of Americans to suburbia. Many communities are critically short of recreational space. Health facilities and services are frequently inadequate if they are available at all. Current trends toward support for Indian programs in education, housing. Health, and economic development provide an opportunity for Indian leaders to apply the experience gained from others' mistakes and bring about the best possible community development for the Indian people. The proposal to establish a health department indicates a desire for the formal planning structure. Land use must be recognized as a major factor influencing public health. In recent years, the ineffectiveness of water-quality management has become apparent with disturbing frequency. Maintaining the health of a population requires a well-organized preventive program. While most planning authorities verbally acknowledge the need for health care planning and environmental quality protection, their record of inaction is more revealing.

Objectives. We examined the effects of same-sex orientation on suicide risks for Guam's Asian/Pacific Islander adolescents. Methods. We used a probability sample and logistic regression analysis to identify suicide risk factors. Results. Same-sex orientation was associated with a greater risk of suicide attempt, especially for boys. Adolescents who reported suffering physical abuse in the context of a romantic relationship, engaging in binge drinking, and experiencing feelings of hopelessness were at greater risk for suicidal ideation and attempts. Race/ethnicity was associated with suicide risk for both boys and girls, and patterns suggest that membership in the same racial/ethnic group decreased suicide risk for girls and increased risk of suicide for boys. Conclusions. Gay, lesbian, and bisexual Asian/Pacific Islander adolescents in Guam deserve intervention and counseling programs to reduce suicide risk. (Am J Public Health. 2004;94:1204-1206). [ABSTRACT FROM AUTHOR]

The article calls for U.S. public health officials to implement realistic HIV prevention strategies based on the success of European public health officials in protecting their young people from HIV. While youths in Switzerland and other European countries reduce their risk for HIV by adopting realistic HIV prevention messages for youths, youths in the U.S. increasingly demonstrate self-defeating patterns of sexual risk taking. One of the reasons behind the phenomenon is the cultural fear of adolescent sexuality and the limited scope of messages which that fear generates among U.S. legislators.

The article discusses the lessons that can be learned from the experience of Long Beach Memorial Medical Center, a University of California, Irvine-affiliated institution, in implementing a restricted smoking policy since 1989 until it went completely smoke-free on May 1, 1991. The policy was in response to the smoking prohibitions set by the Joint Commission on Accreditation of Healthcare Organizations at accredited hospitals. The key elements of the policy, which include implementation of a smoke-free consult service designed to help smoking patients make it through their hospitalization, are explained in this article.

The author reflects on the President's Commission on AIDS and what it did. As a member of the Presidential Commission on the HIV Epidemic, he finds it educational to reflect on the process several months after. The Commission is composed of 13 individuals from different backgrounds. He believes that the Commission did not do much to bring the President into the HIV response. However, it also did translate the epidemic into a language which is accessible for many citizens. Overall, the author thinks that the Commission did an incredible job by giving the opportunity to correct some flaws in the system revealed through the lens of epidemic.

Several letters to the editor are presented in response to articles in previous issues including "Health Hazards of Obesity and Weight Control in Children: A Review of Literature," by M.J. Mallick and "What Good is Legislation—or Planning—if We can't Make it Work?," by A.W. Snoke.

The article talks about the municipal health services in Cambridge, Massachusetts. The author believes that the outcome of municipal health services will depend upon the ability of municipal services to define their goals and the ability to deliver these services with sensitivity and excellence. Municipal hospitals, which have traditionally offered a full range of medical and surgical services, need not and probably should not offer all the highly technical, costly and infrequently utilized services that are available in the teaching hospitals in large cities. The author recounts his experience, since joining the staff of the Cambridge City Hospital in 1964.

The article discusses the issue of administration and supervision of school nurses in the U.S. The administration and management of school nursing services presents a dilemma to those education professionals who are charged with responsibility for coordinating the various supportive services which are designated as Pupil Personnel Services encompass such disciplines as guidance, school psychology, school social work, speech therapy and school nursing. Despite the fact that the role and function of the supportive services differ from place to place which promotes educational administrative structure.

The article reflects on the reduction of increasing illegitimate birth problems in the U.S. The author states that the reduction of illegitimacy benefits the women and children involved, and the society as a whole. It is argued that two major differences between whites and nonwhites explain the differences in illegitimacy rates. He suggests that economic differentials may be explained in terms of the economic position of low-income persons measured in relative terms.