Issues of medication administration and control in Iowa schools.

Who is responsible for medication administration at school? To answer this question, a descriptive, self-administered survey was mailed to a random sample of 850 school principals in Iowa. The eight-page, 57-item, anonymous survey was mailed first class, and a follow-up reminder post card was mailed two weeks later. Descriptive analyses were conducted, with type of respondent (principal versus school nurse), grade level, and size of school examined to explore differences. A 46.6% response rate was obtained; 97% of respondents indicated their schools had written guidelines for medication administration. Principals (41%) and school nurses (34%) reported that they have the ultimate legal responsibility for medication administration. Policies for medication administration on field trips were available in schools of 73.6% of respondents. High schools were more likely to allow self-medication than other grade levels. "Missed dose" was the most common medication error. The main reasons contributing to medication administration errors included poor communication among school, family, and healthcare providers, and the increased number of students on medication. It remains unclear who holds ultimate responsibility for medication administration in schools. Written policies typically exist for medication administration at school, but not field trips. Communicating medication changes to schools, and ensuring medications are available at school, likely can reduce medication administration errors.

Guilt in young children: development, determinants, and relations with a broader system of standards.

In this comprehensive study of the early development of guilt, 106 children were observed in laboratory paradigms in which they were led to believe that they had damaged valuable objects, during two separate sessions at each of the assessments at 22, 33, and 45 months. The behavioral and affective components of guilt cohered significantly across the sessions, converged with each other, were stable across all the assessments, and corresponded modestly with maternal reports. Most components decreased with age, except for bodily tension, which increased. At 33 and 45 months, girls displayed more guilt than did boys. Children who were more fearful in typical fear-inducing paradigms also displayed more guilt. Children of mothers who relied on more power-assertive discipline, observed and self-reported, displayed less guilt. Guilt related positively to the development of self at 18 months and to moral self at 56 months. Children who displayed more guilt were less likely to violate rules of conduct at 56 months. A mediational model was supported: Fearful temperament contributed to guilt proneness, which in turn served to inhibit children's tendency to violate rules.