Thesis (M.Ed.), Memorial University of Newfoundland, 1999. / Bibliography: p. 74-76.

Thesis (M.Ed.)--Ohio University, June, 2005. / Title from PDF t.p. Includes bibliographical references (p. 49-53)

abstract: Active transportation to school (ATS) has received an increasing amount of attention over the past decade due to its promising health contributions. Most of the existing research that surrounds ATS investigates factors from the physical environment as well as factors from the individual perspective that influence walking and biking to school. This research attempts to add to the existing knowledge by exploring the impact that social relationships within the neighborhood have on ATS. A model, based on social ecological theory, was presented and tested to examine elements thought to influence ATS. A logistic regression analysis was run to determine the odds of students walking or biking based on the influence of each construct within the model. Results indicated that the physical and socio-cultural constructs were directly and significantly related to ATS behavior while the construct of safety had an indirect effect. These findings support the idea that there are several factors that operate within and across different ecological levels to influence the mode of transportation to school. Therefore, programs to promote ATS should involve multi-level strategies. In addition to the physical environment, interventions should address interpersonal relationships within the family, school, and neighborhood. / Dissertation/Thesis / Doctoral Dissertation Community Resources and Development 2015

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O presente estudo abordou os fatores de risco cardiovascular na populaÃÃo especÃfica de crianÃas e adolescentes, no ambiente escolar, investigando a prevalÃncia destes fatores de risco. O enfermeiro, pode atuar neste ambiente e contribuir para o desenvolvimento de hÃbitos promotores da saÃde cardiovascular, representando a possibilidade de prevenÃÃo mais efetiva da ocorrÃncia de eventos cardiovasculares. Estudo do tipo transversal, com cenÃrio composto pelas escolas da rede pÃblica de Fortaleza, populaÃÃo: crianÃa e adolescentes com idades entre 7 e 14 anos. Amostra nÃo-probabilÃstica, aleatÃria, com um total de 204 estudantes. Notou-se que o grupo apresentou predominÃncia masculina; 70,6% foram classificados como eutrÃficos; 11,3% estavam com sobrepeso. Quanto à porcentagem de gordura corporal, as faixas normal e sobrepeso foram as mais identificadas. Quanto à classificaÃÃo segundo os valores de pressÃo arterial, o grupo foi predominantemente normotenso. A maioria (74,5%) dos estudantes realizava atividade fÃsica. A mediana de escolaridade foi de 05 anos de estudo. Os estudantes tinham mediana de 12 anos de idade. Os estudantes do sexo feminino apresentaram maior frequÃncia de valores alterados de pressÃo arterial, de gordura corporal, colesterol total, LDL, HDL, triglicerÃdeos, realizavam com menos frequÃncia atividade fÃsica adequada. Os estudantes do sexo masculino alimentavam-se com mais frequÃncia à TV (35%). Dos 204 estudantes avaliados, 51 (24%) apresentavam alteraÃÃo da pressÃo arterial, destes, 32 (5,7%) tinham familiar diagnosticado com hipertensÃo, sendo 20 (9,8%) de segundo grau e 14 (6,9%) de primeiro grau. Acredita-se que estudar fatores de risco possibilita ao enfermeiro traÃar planos de aÃÃo e estratÃgias comunitÃrias dentro da EstratÃgia SaÃde da FamÃlia como no Programa SaÃde da Escola. O impacto destas intervenÃÃes seriam visualizados à longo prazo, quando a populaÃÃo apresentasse reduÃÃo de casos novos ou retardo na apresentaÃÃo de sequelas e complicaÃÃes associadas. / The present study addressed the cardiovascular risk factors in specific populations of children and adolescents in the school environment, investigating the prevalence of these risk factors. The nurse can work in this environment and contribute to the development of habits of cardiovascular health promoters, representing the possibility of more effective prevention of cardiovascular events. Cross-sectional study, with scenery composed of the public schools in Fortaleza, population: children and adolescents aged 7 to 14 years. Non-probability sample, random, with a total of 204 students. It was noted that the group presented predominantly male, 70.6 % were classified as normal, 11.3 % were overweight. As for the percentage of body fat, normal and overweight ranges were the most identified. Regarding the classification according to the values of blood pressure, the group was predominantly normotensive. The majority (74.5 %) of students performed physical activity. The median education level was 05 years of study. The students had a median age of 12 The female students had a higher frequency of abnormal values of blood pressure, body fat, total cholesterol, LDL, HDL, triglycerides, performed less frequently adequate physical activity. The male students fed up with the TV more often (35 %). Of the 204 students assessed, 51 (24 %) had blood pressure change, of these, 32 (5.7 %) had a family diagnosed with hypertension, 20 (9.8%) of high school and 14 (6.9%) first degree. It is believed that studying risk factors allows nurses to draw up action plans and strategies within the Community Health Strategy as a Family Health Program in the School. The impact of these interventions would be viewed in the long term, when the population of new cases present reduction or delay in the presentation of sequelae and complications.

As doenÃas sexualmente transmissÃveis (DST), o vÃrus da imunodeficiÃncia humana (HIV) e a sÃndrome da imunodeficiÃncia adquirida (Aids) constituem significativos problemas de saÃde pÃblica no Brasil e no mundo. Qualquer pessoa sexualmente ativa pode adquirir DST/HIV/Aids. Entretanto, o adolescente à considerado sujeito bastante vulnerÃvel. O estudo apresenta como objetivo geral avaliar a atuaÃÃo de enfermeiros na prevenÃÃo de DST/Aids com adolescentes no Programa SaÃde na Escola. Pesquisa de avaliaÃÃo com abordagem quanti-qualitativa, realizada de janeiro a novembro de 2013. Os sujeitos do estudo foram setenta e oito enfermeiros que atuavam no Programa SaÃde na Escola (PSE) de Fortaleza, CearÃ, Brasil. Para coleta de dados, foi adotada a entrevista semiestruturada e o checklist. Para organizaÃÃo e anÃlise dos dados, foi tomado por referÃncia o MÃtodo de InterpretaÃÃo dos Sentidos e a anÃlise estatÃstica descritiva por meio do software Excel. A pesquisa foi aprovada pelo Comità de Ãtica em Pesquisa da Universidade Federal do CearÃ, conforme parecer de n 209.337 de 28/02/2013. Os resultados apresentam que a grande maioria dos sujeitos da pesquisa nÃo realizou satisfatoriamente as aÃÃes preconizadas pelo MinistÃrio da SaÃde para o PSE e, por conseguinte, nÃo alcanÃaram os resultados esperados na linha de aÃÃo EducaÃÃo para SaÃde Sexual, SaÃde Reprodutiva e PrevenÃÃo das DST/Aids e de Hepatites Virais. Assim, por meio do checklist, a maioria afirma que nÃo foram realizados e alcanÃados as seguintes aÃÃes e resultados: nÃo houve, de forma contÃnua, encontros de mobilizaÃÃo e sensibilizaÃÃo na Ãrea; atividades que utilizassem metodologias participativas; formaÃÃo de estudantes nos temas; envolvimento dos educandos no planejamento, execuÃÃo e avaliaÃÃo das atividades; debates com a comunidade escolar sobre a importÃncia da participaÃÃo juvenil; inclusÃo das temÃticas nos projetos polÃtico-pedagÃgicos das escolas; aÃÃes educativas e participativas sobre os temas; adesÃo dos educandos e da comunidade escolar Ãs atividades desenvolvidas e disponibilizaÃÃo de preservativos nas escolas. Contudo, à oportuno destacar que alguns sujeitos do estudo afirmaram por meio de depoimentos que tais aÃÃes foram desenvolvidas com a periodicidade devida, utilizando-se de estratÃgias apropriadas. Todavia, importantes obstÃculos foram encontrados para a nÃo efetivaÃÃo dessas aÃÃes pela maioria dos profissionais, que perpassam por aspectos profissionais (habilidades e competÃncias), administrativos e gerenciais (papel das instÃncias gestoras envolvidas no programa) e do pÃblico envolvido (adolescentes e famÃlias). Neste sentido, o estudo obteve informaÃÃes fundamentais que sugerem a necessidade de modificaÃÃes urgentes no programa, a fim de que a atuaÃÃo do enfermeiro venha ser capaz de colaborar, de fato, na promoÃÃo da saÃde sexual e reprodutiva de adolescentes assistidos pelo PSE. E, nÃo somente isso, mas para que estes e os demais atores envolvidos consigam cumprir o objetivo central do programa de promover formaÃÃo e atenÃÃo integral a estudantes, levando a uma melhoria da qualidade de vida e saÃde destes sujeitos. / Sexually transmitted diseases (STDs), human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (Aids) represent significant public health problems in Brazil and the whole world. Any sexually active person is susceptible to contract STD/HIV/AIDS. Nonetheless, adolescents are considered very vulnerable subjects. The main objective of this study is to assess the performance of nurses in the prevention of STD/AIDS with adolescents in the School Health Program. This is an evaluation research with quantitative and qualitative approach, conducted from January to November 2013. The subjects in study were 78 nurses working in the School Health Program (SHP) in Fortaleza, CearÃ, Brazil. For data collection, we applied the semi-structured interview and the checklist. For data organization and analysis, we used the Method of Meanings Interpretation as reference and the descriptive statistical analysis through the Excel software. The Research Ethics Committee of the Universidade Federal do CearÃ, under protocol No. 209.337 of February 28, 2013, approved the study. The results show that the vast majority of the subjects in study did not satisfactorily perform the actions recommended by the Ministry of Health for the SHP and therefore did not achieve the expected results in the course of action on Education for Sexual Health, Reproductive Health, and Prevention of STD/AIDS and Viral Hepatitis. Thus, through the checklist, most people reported they did not perform nor achieve the following actions and results: continuous mobilization and sensitization meetings in the area; activities that used participatory methodologies; students training on the themes; students involvement in planning, implementation and evaluation of activities; discussions with the school community about the importance of adolescents participation; inclusion of themes in the political-educational school projects; educational and participatory activities on the themes; adherence of students and school community to the activities developed; and the provision of condoms in schools. However, it is worth mentioning that some subjects in study, through the interviews, reported that such actions happened with the proper periodicity, using appropriate strategies. Nevertheless, we identified several barriers for the non-implementation of these actions by most professionals, involving professional aspects (skills and competencies), administrative and managerial aspects (role of management levels involved in the program), and aspects of the public in question (adolescents and families). In this sense, the study obtained essential information that point to the need for urgent modifications in the program, so that the nursesâ performance collaborates effectively to the promotion of sexual and reproductive health of adolescents assisted by the SHP. Also, for these and the other actors involved fulfill the main objective of the program, which is promoting education and comprehensive care for students, thus leading to an improved quality of life and health of these subjects.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Objetivou-se comparar a realizaÃÃo do autoexame ocular por estudantes com suporte das cartilhas virtual e impressa. Pesquisa avaliativa com dois grupos comparativos, desenvolvida em uma escola pÃblica em Fortaleza-CE, cuja amostra foi composta por 100 estudantes. A coleta de dados ocorreu de dezembro de 2012 a dezembro de 2013, mediante dois instrumentos: o primeiro para identificaÃÃo e avaliaÃÃo do conhecimento prÃvio dos estudantes acerca do autoexame ocular. O segundo foi utilizado pelos juÃzes para a anÃlise das filmagens referentes à execuÃÃo do autoexame, assim dividido: a) exame da acuidade visual â longe; b) acuidade visual â perto; c) exame das estruturas oculares externas; d) exame do campo visual â visÃo perifÃrica e visÃo central; e movimento ocular. Foram os Testes χ2 e o Exato de Fisher para comparaÃÃo entre proporÃÃes, e o Teste χ2 de TendÃncia Linear. Adotou-se o nÃvel de significÃncia estatÃstica de 5%. O projeto foi aprovado pelo Comità de Ãtica em Pesquisa da Universidade Federal do Cearà conforme parecer n 118.180/12. As queixas mais referidas pelos alunos, para ambos os grupos, teste e comparaÃÃo, foram: dores de cabeÃa (24%); aproxima-se muito da televisÃo ou do papel para ver melhor (19%); sensibilidade à luz (26%). A cartilha virtual apresentou maior proporÃÃo de itens classificados como adequados intrajuÃzes quando comparada a versÃo impressa. DiferenÃas estatisticamente significantes foram encontradas para os seguintes passos: posicionamento da tabela de Snellen (p˂0,000) e da Escala de Jaegger (p=0,003); avaliaÃÃo da conjuntiva e esclera (p=0,001); avaliaÃÃo das pÃlpebras (p˂0,000); avaliaÃÃo da pupila e Ãris (p=0,001); avaliaÃÃo do campo visual (p=0,004) e visÃo central (p=0,027). Os Coeficientes de concordÃncia interjuÃzes apresentados para a cartilha impressa foram relativamente baixos quando comparados à cartilha virtual. Enquanto o Kappa estimado variou entre pobre (κ = -0,1 a 0,18) e nÃo concordante (κ = 0,0), os percentuais de concordÃncia assim variaram: interjuÃzes 1 e 2, 24,0 a 74,0, no par 2 e 3, 24,0 a 78,0, inter 3 e 1, 26,5 a 72,0. Conclui-se que embora nÃo tenha havido boa concordÃncia intra e interjuÃzes na avaliaÃÃo das cartilhas, a versÃo virtual demonstrou maior proporÃÃo de itens classificados como adequados. Ressalta-se que este resultado nÃo deve ser interpretado como evidÃncia de ausÃncia de efeito da cartilha impressa para o ensino do autoexame ocular. Hà a necessidade de realizar outros estudos com amostras maiores e controlando melhor as variÃveis idade e escolaridade.

The purpose of this study was to examine parents’ motivational beliefs for involvement in a Comprehensive School Health approach (locally called Healthy Active Schools, or HAS) at their child’s school. Literature suggests that parents’ role construction and parents’ self-efficacy are the most salient influences on parents’ decision to become involved at their child’s school. Twelve parents involved at two urban public elementary schools were interviewed. Questions were based on Hoover-Dempsey and Sandler’s model of parental involvement (1995, 1997, 2005c). Qualitative multiple case study analysis additionally utilized Penner’s (2002) model of sustained volunteerism and Bandura’s collective efficacy theory (1997, 2000; Goddard, Hoy, & Woolfolk-Hoy, 2004) to clarify findings. Results suggest most parents’ strong active role construction and negative valence grounded their parent-focused role orientation. School case study analysis revealed that the principal’s leadership, the structure of the HAS committee and the school’s climate uniquely influenced parents’ beliefs. Individual parent case analysis revealed four distinct patterns of parents’ motivational beliefs for HAS involvement. Future research is warranted to further examine the decisive impact of parents’ health and prosocial values on their decision to become involved specific to a CSH approach type of involvement. Additional case studies in local schools, school districts and provinces are recommended to illuminate unique contextual influences and the potential for the emergence of collective efficacy; including consideration for parents’ belief construct general invitations from the school would contribute to gaining a deeper understanding within this domain. Finally, the link between parents’ motivational beliefs of empowerment and their sustained motivation for involvement needs to be explored further.

Type 1 diabetes [T1D] is an autoimmune illness that results in insulin deficiency. Managing this illness during childhood requires maintaining blood glucose within a healthy range and is a constant challenge. This can result in increased stress for children and their caregivers. School attendance is one factor that may result in stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about the experiences of teachers of students with T1D, what is expected of them, what resources they have, and factors which they perceive as barriers or facilitators to education for students with T1D. Semi-structured interviews were conducted with two high school teachers in East Tennessee who had experience teaching students with T1D. The results of the interviews showed that teachers receive limited education regarding T1D, that they are expected to make accommodations such as having snacks on hand and allowing extra access to phones, and that there are perceived barriers to education of individuals with T1D due to the possibility of life-threatening events. The teachers reported that school nurses are involved in the care of students with T1D. Limitations of this study include that only two teachers were interviewed, and while the results are important to take into consideration, saturation was not reached. Future research could include more in-depth interviews or surveys with teachers, coaches, and school nurses.

No description available.

This thesis is an institutional ethnography (IE) examining the social organization of Community Care Access Centre School Health Support Services (CCAC SHSS) for children with diabetes in Ontario schools. More specifically, it explicates the social relations embedded in, and coordinating the work organization of mothering (parenting) and nursing in the school setting. The inquiry begins in my personal experience as a mother of a child with diabetes starting kindergarten, and the troubles I encountered in getting the care and attention needed to keep my child safe at school. Starting from experience, a place outside of theory and institutionalized categories and discourse, I set out on a journey to discover the social organization that coordinates my experience, and to seek answers to my query: how are school health supports put together in such a way that I, as a parent, am left feeling worried about my child’s safety when she is at school, have had to fight to secure the much needed ‘diabetes care’, and even then, am often called upon to provide voluntary supplementary healthcare work to ensure her safety at school? I have structured this thesis into two main parts. The first part provides the set-up for this thesis. First, I orient readers to this distinctive way of doing an IE, directing their attention to how I used the core IE concepts in this research and calling upon them to read the remainder of the thesis taking up this distinctive theoretical and conceptual lens. Indeed, what we know and how we know it has much to do with how knowledge is socially organized. Then, I go on to examine the different ways of knowing about ‘diabetes care’, how these distinctive ways of knowing create a disjuncture for me as a parent and how this disjuncture is used to establish the research standpoint to begin and direct the explication. The last chapter in this part situates health supports for children with diabetes within the services provided by public-funded home care. I sketch three decades of the history of reform and organizational restructuring of home care in Ontario, in particular, the introduction of privatizing relations into the local practices of community nursing and the creation of CCACs. These relations of privatization reorganized the home care sector, the workforce, and the relation between the ‘state’ and its citizens. What went on before sets the groundwork for what can happen next, and it is under this context and conditions in which my inquiry is set. The second part consists of four academic journal manuscripts. They are the descriptive analysis for this IE. These four chapters describe what I have learned and discovered in doing this research, and three of them in particular provide an empirical analysis showing how school health supports for children with diabetes are put together such that the troubles I experienced came into being. These four chapters are conventionally referred to as research ‘findings’ in traditional qualitative research methodology. Each of these chapters speaks to a particular way of knowing about ‘diabetes care’. One focuses on parents’ experiential ways of knowing based on the actualities of their daily and nightly everyday world to show the amount of work and knowledge required to care for and to keep their children with diabetes alive; while the other three underscore the CCACs’ institutional ways of knowing about ‘diabetes care’ in the school setting. I show how these objectified ways of knowing derived from institutional texts (Standardized CCAC Medial Orders, information technology software and the Diabetes Checklist for Independence) are used to determine a child’s eligibility to receive health supports at school. These objectified textual forms of knowing are removed from the actualities of people’s real life circumstances, and differ significantly with how and what parents know is needed for their children with diabetes to stay well and safe at school. It is precisely this form of text-mediated social coordination that leaves parents feeling worried and draws them in to doing voluntary healthcare work at school, without which the child’s safety and the continuity of care is not possible. Tracing the institutional relations organizing how health support services for children with diabetes actually happen in the classroom, I show the kind of work expected of parents, and demonstrate that the CCAC SHSS policy and practices only ‘work’ as they should with the incorporation of parents’ ‘unauthorized’ knowledge and their ongoing voluntary complementary healthcare work. While it is in parents’ interests to ensure their children’s safety and well-being at school, there are differences between parents in how, and if, they can deliver their knowledge and resources. / Thesis / Doctor of Philosophy (PhD) / Diabetes is a chronic health condition that requires individuals with diabetes or their families to maintain a daily well-coordinated and intensive diabetes self-care routine. Lapses in this complex daily regimen can have devastating immediate and long-term consequences. How children’s diabetes, that is children’s health and well-being, are cared for at school is of concern for parents. The inquiry begins in my personal experience as a mother of a child with diabetes starting kindergarten, and the troubles I encountered in getting the care needed to keep my child safe at school. Starting from experience, this thesis examines how the institutional context and routine practices of diabetes care in school affects the care children actually receive. Despite legislation that requires accommodations for students with disabilities, what I found in this study is that parental involvement (which is inequitably available) is essential to ensure diabetes care is adequate for children in schools.