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The purpose of this study was to determine factors associated with cervical cancer screening compliance and noncompliance among Chinese, Korean, Vietnamese, and Cambodian women aged 18 years and older.A cross-sectional design was used. The sample consisted of 1049 women aged 18 or older, of whom 37.94% reported never having been screened for cervical cancer, 23.55% reported noncompliance, and 38.51% were in compliance with screening guidelines. The sample was comprised of Chinese, 50.58%; Koreans, 17.50%; Vietnamese, 16.15%; and Cambodians, 15.77%.Education was significantly associated with never having been screened for cervical cancer for Cambodians. Low income ($10000) was significantly associated with never having been screened for Cambodian and Chinese women. Not having health insurance was significantly correlated with not getting screened for all ethnic groups. Age and living in the United States less than 15 years were significantly correlated with never having been screened for Vietnamese, Korean, and Chinese women. Marital status was significantly correlated with not getting screened for Korean and Chinese women. English fluency was significantly associated with screening for Cambodians, Koreans, and Chinese. Barriers associated with women who were never screened compared to those barriers for women who were screened and were compliant included lack of knowledge, psychosocial, no insurance, language, transportation, and lack of time, but these barriers were different among the 4 ethnic groups.Compliance with cervical cancer screening guidelines among Asian American women can be enhanced significantly by providing culturally and linguistically appropriate educational and early intervention programs.

Several initiatives in the past 20 years have been implemented in Los Angeles County to improve service delivery across the mental health and substance abuse treatment systems, with the goal of increasing access to and coordination of services for individuals with co-occurring substance abuse and mental disorders. To examine the current status of service delivery to this population, a survey was conducted with administrators of mental health and substance abuse programs that provide services to dually diagnosed patients and with the treatment staff in those programs. Administrators (n = 15) and staff (n = 99) in substance abuse programs rated the accessibility and coordination of services to dually diagnosed patients significantly lower than the mental health administrators (n = 10) and staff (n = 136). Efforts to coordinate service delivery across the two systems need to address these divergent perceptions between staff in programs that are increasingly called upon to work together to jointly deliver services.

Smoking is the most preventable cause of death in our society. Tobacco use is responsible for nearly one in five deaths in the United States and the cause of premature death of approximately 2 million individuals in developed countries. Smoking accounts for at least 30% of all cancer deaths and is a major cause of heart disease, cerebrovascular disease, chronic bronchitis, and emphysema. The North Carolina Triangle Oncology Nursing Society applied for a competitive grant through the national Oncology Nursing Society and Cancer Care, Inc., in partnership with the Wellness Community and Bristol-Myers Squibb. The grant could be used for any lung cancer issue or project. Because North Carolina is deep in the tobacco belt, it was decided to focus on the largest group of new smokers in the United States, children and teens, for the project. Over 80% of adult smokers surveyed in 1991 had begun smoking by the age of 18. The oncology nurses wanted to focus on prevention, not cessation. Therefore, grade school children were the population selected for this project. This age group is impressionable and able to understand the negative consequences of smoking. This article outlines the content of the educational intervention and evaluation of the program.

Exercise is beneficial for women of all ages and is associated with long-term health benefits and enhanced well-being. Nevertheless, active women and girls are at risk for conditions resulting from sports and exercise participation. Because of their unique physiology, children are more susceptible to heat illness than adolescents and younger adults. Childhood sports injuries tend to involve the growth plate. Adolescents share some concerns with child athletes but have injuries more similar to those that occur in adults, especially ligament and tendon injuries. Adolescents and adult women are at risk for anterior cruciate ligament injuries, patellofemoral pain syndrome, and stress fractures. For athletes in these age groups, physicians should screen for pelvic floor dysfunction and the female athlete triad, especially in patients with a history of stress fractures. In adult women, exercise can contribute to disease prevention and management. Continuation of an appropriate exercise routine helps older women maintain independence and prevent falls.

School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic assessment guidelines, and various treatment options to assure proper management of students with injuries to the ankle. The benefits of adhering to these guidelines are that students will receive better, cost-effective treatment and the nurse will make appropriate referral recommendations to parents and other school personnel.

When attempting to locate guidelines for designing school nurses’ offices, one finds there are minimal resources that address this need. In an effort to solve this concern, the authors were instrumental in writing an article for The Journal of School Nursing published in April 1997. The current article is an updated perspective that defines recommendations to be utilized in new construction or renovation of school nurses’ offices. It encompasses information on square footage, design, utilization of space, location, and necessary equipment. Prototypes are provided that apply to elementary, middle school, and high school settings. The article outlines the importance of continued collaboration between the school nurse and key people involved in the planning and construction process, such as the school principal, administrators, and the district engineer.

Neck injuries can be some of the most serious and anxiety-producing injuries that occur during sporting events. It is important for the team physician to be prepared for the care of these injuries and be able to identify some of the more serious injuries. Proper care of these injuries can be life saving and prevent further injury and permanent disability. This article reviews the principles of management and latest evidence for acute neck injuries.

The results of the Diabetes Control and Complications Trial revolutionized the care of people with Type 1 diabetes mellitus (DM). The era of “tight control” of blood sugars to decrease microvascular complications dawned. The subsequent technological development of insulin pumps has made it possible for individuals with Type 1 DM, as well as those with Type 2 who are insulin dependent, to keep their blood sugars in a more normal range. Children of all ages with Type 1 DM have been switching from multiple daily injections of insulin to insulin pumps. School nurses who have not had a child with a pump certainly will in the near future. It is important for school nurses to understand the function and possible complications of using an insulin pump to assist and support children in their transition to pump therapy. School nurses need to be aware of available technical support resources for insulin pumps should problems arise at school with pump management.

This article focuses on the important role of the school nurse in promoting healthy lifestyle choices through networking, resource identification, and working with community partners. “Everyone Is Healthy at Northeast” was a health promotion program designed and presented in two ways: classroom lessons and a health fair. There were interactive health promotion classroom lessons on topics such as proper hand washing, the effects of tobacco, and keeping one’s heart healthy. These lessons were enhanced by community partners in delivering the healthy lifestyle message through a variety of teaching methods: music, interactive games, and hands-on visuals. The health promotion education program culminated in a schoolwide health fair that showcased the healthy lifestyle choice information at various stations. “Everyone Is Healthy at Northeast” was a success and promoted healthy lifestyle choices through creativity, collaboration, and support from the entire school community.

Every year, school nurses have the responsibility for developing and presenting a bloodborne pathogen presentation to the education and clerical staff of their buildings. Although the information is similar from year to year, the manner in which the information is presented can be altered. Teachers are using active learning strategies in a variety of learning environments, engaging students in the learning process by having them play an active role. With some planning, preparation, and imagination, active learning strategies can be incorporated into bloodborne pathogen presentations. The purpose of this article is to define active learning, describe how to develop a program using active learning strategies, and provide some examples of bloodborne pathogen presentations that have already been developed. Several sources are identified that can provide the school nurse with information regarding bloodborne pathogens. Information about how computers can be integrated into the bloodborne pathogen presentation is also presented.

Developing a national position on competencies for school nurses can directly in-fluence professional practice, which ultimately affects the well-being and academic success of students. Collaboration between national experts, such as school nurse educators and school nurse consultants, interested in moving this development forward is key. Closely aligning the work done by the Southern Regional Education Board Council on Collegiate Education for Nursing on entry-level competencies with the Standards of Professional School Nursing Practice provides a framework to carry the school nurse competency initiative forward. Continued competency development will provide guidance for the academic programs that design curricula to prepare school nurses and for the practice settings that hire school nurses.

Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Results In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. Conclusions CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.