Thesis (M.S.P.H.)--University of Michigan, 1942.

Caffeine, a legal central nervous system stimulant, is commonly consumed by university students in a variety of ways with an implicit belief that it may increase cognitive function. The scientific literature on such benefits has been mixed. In low to moderate doses, caffeine has been shown to reduce fatigue and improve alertness and motor speed while high caffeine consumption is associated with undesirable effects including an inability to focus and increased generalized anxiety. Because the structure of caffeine closely resembles adenosine, it works as an antagonist to increase neuronal excitability. To clarify the effects of caffeine on the brain, this study will examine sensory stimulus-mediated neural synchrony within the prefrontal cortex, a region of the brain associated with executive decision-making as well as in coping with anxiety. When a train of clicks is presented at a particular frequency, neural networks in the brain show oscillatory entrainment at the same frequency. These oscillations represent neighboring neurons firing nearly simultaneously. Such synchronous activation of large networks of neurons is fundamental to the brain’s ability to process and respond to environmental cues and is conveniently measured by the technique of electroencephalography (EEG). EEG as an index of neural network function is well conserved across mammals and used as a translational biomarker to understand the pharmacological effects of drugs within preclinical and human drug development studies. Doses of caffeine mimicking the average range of consumption among college students (100-300 mg/day) are converted into doses suitable for SD rats (10.28 - 30.83 mg/kg) using the FDA’s allometric scaling tool. It is hypothesized that low and medium doses of caffeine may either improve or not affect prefrontal cortical synchrony while high doses may disrupt. The same group of rats will be used for all treatments, including vehicle, in a Latin square crossover design with at least 4 days of gap between dosing. The synchrony response will be evaluated at multiple time points, post-dose. Artifact-free EEG data is averaged to arrive at a synchrony response for each rat and these are further grouped based on treatment and time. Comparisons across treatment and time are done using a 2-factor repeated measures ANOVA, using well-known neural synchrony metrics like evoked power and intertrial phase coherence. These results should inform how caffeine affects the neurophysiological function of the rodent prefrontal cortex, a key region for prioritization, decision-making, and cognitive control. Findings from this study may explain why high doses of caffeine can be disruptive to mental function and performance and lay the groundwork for analogous future studies in humans. On the other hand, if synchrony is unaffected, a chronic regimen of caffeine exposure may be explored to mimic the human consumption pattern of this stimulant.

Syftet med undersökningen är att öka kunskapen om skolors elevhälsoarbete utifrån beskrivningar från medlemmar i tre elevhälsoteam. Det är medlemmarnas berättelser om elevhälsoarbetets organisation, meningsskapande insatser och utvecklingsområden som är utgångspunkten i studien. I undersökningen ingår tre skolors elevhälsoteam kallade X, Y och Z. Skolorna kommer från tre olika kommuner. Det är en undersökning med kvalitativ data från observationer, intervjuer och dokumentanalys av tre elevhälsoplaner. De teoretiska utgångspunkterna är teorin om praktikgemenskap samt det kommunikativa relationsskapande perspektivet, som är ett specialpedagogiskt perspektiv. Båda har sin grund i den sociokulturella teoribildningen, där samspel och kommunikation utgör grunden i lärandet. I den föreliggande studien visar resultatet både likheter och variationer i medlemmarnas beskrivningar av skolornas elevhälsoarbete. Det framkommer i undersökningen att tydliga mål, uppdrags- och ansvarsfördelning, samt samspel i elevernas lärmiljö är några av förutsättningarna för ett framgångsrikt elevhälsoarbete, vilket också överensstämmer med tidigare forskning. / The aim of this study is to increase the knowledge about schools' student health care work based on the experiences of members in three student health teams. The core of this study is the members' stories about the student health care´s organization, intentional actions and the areas of development. The study includes three schools' student health care teams called X, Y and Z. The schools are from three different municipalities. The empirical research consists of qualitative data from observations, interviews and document analysis of three student health plans. The theory of community of practice and the communicative relational perspective are the theoretical foundations in the study. Both of them are founded on the socio-cultural theory in which interaction and communication are basis for learning. In the study, the results show both similarities and variations in the members' stories of the schools' student health care work. The results show that clear goals, distribution of roles and responsibilities, as well as interaction in the students' learning environment are some of the conditions or a successful student health care, which is in line with previously conducted research.

Contemporary research into the health concerns of students is sparse, particularly in New Zealand. Overseas literature indicates that students in tertiary education institutions may be at increased risks for physical health problems, stress-related syndromes and emotional dysfunctions. Of particular concern are anxiety disorders as, in addition to their negative impact on quality of life, they are associated with impaired academic performance and poorer educational outcomes. Skilled, educated individuals are a social asset and it is therefore surprising that so little interest has been paid to the ways in which involvement with the tertiary education impacts on student welfare and anxiety levels. As a first step towards redressing the lack of health data for tertiary populations, this thesis investigates aspects of anxiety among students at a New Zealand university. The primary research aims were to establish an estimate of the levels of anxiety experienced by students and to outline the requirements of tertiary study that students perceive to be the most anxiety-inducing. To achieve the former, students (n = 1,082) were invited by e-mail to participate in an online psychometric survey; to explore the latter, discussion groups were arranged wherein students (n = 18) were asked to talk about their anxiety-related experiences. Anxiety has many forms and can be conceptualised in a number of different ways. In recognition of the diverse nature of tertiary study, it was decided that a broad framework would be needed to thoroughly investigate the ways in which it might manifest in tertiary student populations. Thus, a tripartite conceptualisation was constructed, viewing anxiety in cognitive, physiological and interpersonal terms. Specifically, the study assessed worry, stress and social anxiety among tertiary students and invited participants to comment on personal experiences in each of these areas. Comparing study data to norms for student populations in America revealed that New Zealand tertiary students report greater levels of worry, stress and social anxiety than their American counterparts. Within-group comparisons were made as a function of student gender, age, school of study, ethnicity and birth status. Significant differences on at least one survey measure were noted within each of these categories, with the exception of school of study. The possible implications of and explanations for these findings are discussed.

Titel: Ingen aning utan spaning – Skolsköterskors självmordspreventiva arbeteFörfattare: Eberhard, Charlotte; Lundgren, SannaInstitution: Institutionen för vård och natur, Högskolan i SkövdeProgram: Examensarbete i omvårdnad, 15 HpHandledare: Källerwald, SusanneExaminator: Westin, LarsSidor: 22Månad och År: juni, 2013Nyckelord: Skolsköterska, självmordsprevention, elevhälsa_________________________________________________________________________Bakgrund: I rapporter som Nationellt centrum för Suicidforskning och Prevention av psykisk ohälsa (NASP) tagit fram, framgår att självmord är ett stort samhällsproblem bland barn och ungdomar. Unga individer spenderar en stor del av sin tid i skolan och förutom själva undervisningen utgör skolan en social plattform. Självmord är för såväl män som kvinnor den vanligaste dödsorsaken i åldersgruppen 15-24 år. Självmordsnära människor långt in i skeendet är ambivalenta till om de egentligen vill dö. Skolsköterskan kan vara den första person som upptäcker de elever som mår dåligt.Syfte: Syftet var att belysa skolsköterskors erfarenheter av arbetet med självmordsnära ungdomar och att arbeta med självmordsprevention.Metod: Sex intervjuer genomfördes med skolsköterskor. Datamaterialet analyserades med kvalitativ manifest innehållsanalys med induktiv ansats.Resultat: Ur analysen av datamaterialet framträdde tre kategorier; Att fånga upp och möta eleverna, Att agera och överlämna och Att ge preventivt stöd till elever efter skett självmord.Konklusion: Självmord och självmordstankar förekommer hos gymnasieelever. Studien visar att skolsköterskan kan spela en mera aktiv roll än idag vad beträffar förebyggande arbete och krishantering för dessa elever. / Background: Reports made by National Centre for Suicide science and Prevention of physical illness (NASP) developed, shows that suicide is a major social problem among children and adolescents. Young people spend much of their time in school and in addition to actual teaching school is a social platform. Suicide is for both men and women, the most common cause of death in the 15-24 age group. Suicidal people is ambivalent as to whether they really want to die. The school nurse may be the first person who discovers the students who are depressed. Aim: The aim of this study was to highlight the school nurses ́ experiences of the work with suicide prone adolescents and to work with suicide prevention. Method: Six interviews were conducted with school nurses. Data were analyzed using qualitative manifest content analysis with an inductive approach. Results: From the analysis of the data emerged three categories; To catch up and meet the students, To act and communicate and To provide preventative support to students after suicide occurred. Conclusion: Suicide and suicidal ideation occurs in high school. The study shows that the school nurse can play a more active role than today in terms of prevention and crisis management for these students.

The last two decades have seen significant changes in organizational structures within higher education. Counseling centers are no exception and have been the target of reorganizations and mergers that often involve student health services. Outcomes of these efforts have varied; some being quite successful while others have resulted in failures and the re-creation of systems that are remarkably similar to the ones that existed in the first place. An examination of the positive and negative issues relevant to mergers and reorganizations of counseling centers can be helpful in the determination of whether or not to proceed with one. In the event the decision is made to proceed, a systematic process that encourages consideration of essential steps relevant to mergers or reorganizations can promote improved decision-making and outcomes.

Wellness educators have faced a great challenge to develop strategies to move people toward the adoption of positive lifestyle behaviours. This research explores concepts of self and the impact of Thai culture on the motivation of young college women to engage in health-promoting lifestyle behaviours (HPLBs) in the context of northeastern Thailand. A sequential mixed methods design enables an exploration of the relationships among sense of coherence, identity status, and HPLBs in the first phase, and an inductive analysis of the impact of Thai cultural context in the second phase. In study A, three instruments: the Health-Promoting Lifestyle Behaviors Profile II (HPLP II), the Extended Version of the Objective Measure of Ego Identity Status (EOM-EIS), and the Orientation to Life Questionnaire (SOC-29), were used with 350 senior college women. Sense of Coherence was significantly correlated with achieving a sense of identity, lessening diffusion identity and engaging in health-promoting behaviours. Although a considerable proportion of the variance (26.7 %) for engaging in HPLBs was accounted for by SOC, identity achievement, and identity moratorium, the magnitude of the unexplained variance was considerable. This led to inductive exploration of other variables influencing HPLBs in Study B. By data-driven thematic analysis, the Model of the Mindful Self emerged from in-depth interviews with 25 college women. The model describes three main themes: (a) the cultural background and the surrounding ongoing influences which impact on the development of Thai women's sense of self and their health-related behaviours, (b) the sense of self and identity formation in the Thai context, and (c) the health-related behaviours that stem from the sense of self. Sense of self and its behaviours are socially constructed within the specific culture in which individuals are embedded. The social phenomena and research outcomes are interpreted under the lens of social constructionism. The knowledge generated by this study provides guidance for teaching about health promotion in Thai undergraduate nursing programmes and also provides a basis for initiating health-promoting programmes based on the individual's sense of self for female adolescents in Thailand.

I denna studie med syftet att beskriva hur rektorer verksamma inom årskurs 7-9 upplever sitt arbete att leda och samordna elevhälsan kopplat till utbildningen mål, har 14 rektorer och biträdande rektorer deltagit i en enkätundersökning. De underliggande frågorna som utforskas i studien är hur rektorerna beskriver sin egen roll inom elevhälsan, vilka verktyg de använder för att styra mot utbildningens mål, hur beskriver de samverkan mellan elevhälsan och övrig personal och i vilken omfattning de upplever att elevhälsans kompetens används hälsofrämjande, förebyggande och åtgärdande. Studien har utformats utifrån ett systemteoretiskt perspektiv. Enkät har använts som metod där rektorerna med egna ord har fått beskriva sitt arbete kopplat till elevhälsa. Resultatet visar att det finns en stor variation hur elevhälsa organiseras i skolor och kommuner vilket påverkar rektors roll. Alla rektorer är inte chef för alla eller vissa av elevhälsans professioner och får då uppdrag från centralt håll som rektor inte kan påverka. Elevhälsans arbete är dock något som de prioriterar och anser vara viktigt, både för måluppfyllelse men även elevernas personliga utveckling. Det framkommer dock att begreppet elevhälsa har olika innebörder, då det kan tolkas som de lagstadgade professionerna inom elevhälsa men det kan även beskriva ett tillstånd som alla som arbetar i skolan ska försöka uppnå. För att skapa samverkan mellan elevhälsan och övrig personal beskrivs olika former av möten som kan ha både formell och informell karaktär. De hinder som beskrivs handlar om tid och bristande förståelse för varandras uppdrag. Rektorerna upplever att samtliga professioner inom elevhälsan främst används åtgärdande, även om de själva har intentionen att arbetet ska ha ett hälsofrämjande och förebyggande perspektiv. Den psykologiska kompetensen är den som beskrivs användas minst inom samtliga områden medan den specialpedagogiska kompetensen hamnar högst. / In this study, with the aim of describing how principals working in grades 7-9 experience their work to lead and coordinate student health linked to the educational goals, 14 principals and assistant principals have participated in a survey. The underlying intension is to explore how the principals describe their own role in student health, what tools they use to steer towards the goals of education, how they describe the interaction between student health teams and other personal and the extent to which they feel that the competence of student health is used for health promotion, prevention and remediation. The study has been designed from a system theoretical perspective. Questionnaires have been used as a method where the principals in their own word had to describe their work related to student health. The result shows that there is a great variety of how student health is organized in schools and municipalities, which affects the role of the principal. Not all principals are the head of all or some of the student health professions and are then commissioned from central sources which the principal cannot affect. The work of student health is, however, something that they prioritize and consider important, both goal effectiveness but also for the personal development of the students. However, it appears that the concept of student health has different meanings, as it can be interpreted as the statutory profession in student health, but it can also describe a condition that everyone who works in the school should try to achieve. To create interaction between student health and other staff, different forms of meetings are described that can have both a formal and informal character. The obstacles described are about time and a lack of understanding of each other’s tasks. The principals feel that all the professions in student health are primarily used remedying, although they themselves have the intention that the work should have a health promoting and preventive perspective. The psychological competence is the one described to be used least in all areas, while special education skills are used the most in all areas.

Introduction: The number of students with school refusal has remained at a constant level in Sweden since measurements began in 2006. School health service resources has been reduced since municipalisation which makes it difficult to intercept these students in time. Objective: To identify the tools of school health services, resources and professional skills with unauthorized absence, and the measures applied preventively. Method: A qualitative study based on seven semi-structured interviews with all professions within the school health services. Results: The school's responsibility affect both student health organization and the student's school structure. The new grades and subject schemes introduced in 2011 make higher requirements on today's students. It´s important that all of the school personell are aware of the problem and pursue the same objectives, for a good interaction. Discussion: School health services shared experiences around the concept school refusal behavior reflects the complexity of the problem. Knowledge and skills are important components. The school teams experience that they are self-taught regarding the subject but want further education and increased resources to be more preventive and relationship-building. Conclusion: Further Swedish research and knowledge is needed, as well as an improved definition of the concept in order to improve school health service’s work with school refusal students in student.Keywords:

The focus of this research was to: 1) study the perceptions of female students attending the university Student Health Center, concerning available services, 2) learn how they describe their decisions to obtain care, and 3) identify perceived barriers to reproductive health care and contraception. This exploratory study used a mixed-methods approach that included clinic public-space observations, interviews with health care providers and staff at Student Health Services (SHS), surveys distributed to clients of the campus clinic, and in-depth interviews to contextualize emergent themes. Topics addressed included sexual health behaviors and perceptions, influence of peers and partners, the propagation of health myths, and past experiences with SHS. Gathering practitioner perspectives on student barriers to care, goals of the clinic, and perceived health needs of the student community, allowed for measurement of incongruence between student and staff, thereby adding greater context to results. SHS sought recommendations in order to improve student's use of the Sexual Health and Gynecology clinic, increase accuracy of student's sexual health knowledge, and guide future clinic operations. SHS is now working with the College of Public Health to create improvement projects based on my results, including a peer education program. Research such as this can result in greater student awareness of available services, and more productive communication between patients and provide. Implications on the larger issues of gender and the search for health care, acceptance and knowledge of STI testing, and client comfort are addressed, and provide opportunity for future work in this area.