Violence Toward and by Youth: Part I: Looking for the "Whys".

Violence is a public health crisis. It is especially concerning when it involves youth, whether they be victims, perpetrators, or observers. Part 1 of this two-part series categorizes the types of violence toward and by youth. There is a great deal of information on the prevalence of violence, mostly related to school shootings. However, the literature provides limited information on the antecedents of violent behaviors, and there is a dearth of information on "why" youth engage in violence. This is the unanswered question that drives Part 1 of this series. The beginning steps to understand "why" are viewed through the lens of a modified ABC Model (antecedent, behavior, consequence). Interventions for youth violence will be explored in Part 2.

Violence Toward and by Youth: Part II: Recommendations for Violence Interventions in the School Setting.

Violence toward and by youth is a public health crisis that can partially be addressed by the modified Antecedent, Behavior, Consequence (ABC) Model. Part I of this two-part series discussed the types of violence and the risk and protective factors that affect the prevalence of violence; it also addressed the emotions and thoughts that occur before the behaviors to help explain "why" youth engage in violence. Part II focuses on possible interventions by the school nurse and school staff. The modified ABC Model allows school nurses to focus on interventions that address the emotions and thoughts resulting from the antecedents as well as promote protective factors. Through their role in primary prevention, school nurses can also address risk factors for violence and participate in school and the wider community's efforts to mitigate violence.

Barriers and Facilitators Influencing Parental Transition of College-Bound Youth with Type 1 Diabetes Mellitus: An Integrative Review.

PURPOSE OF REVIEW: The purpose of this review was to synthesize current research about potential barriers impacting parents as they transition their college-bound youth with type 1 diabetes mellitus (T1DM) to college. RECENT FINDINGS: Seven studies, 5 qualitative and 2 quantitative, met the qualifications for inclusion in this study by focusing on parents and were included in this review. Three potential barriers impacting the parental experience during the transition of their youth with T1DM to college were identified: developing and promoting autonomy, evolving relationships and roles in the parent/youth dyad, and distress. Parents consistently indicated concern about their youth's ability to self-manage their T1DM and lack of support for their own transition. This review indicates that several barriers may influence parents of adolescents with T1DM as they transition to becoming the parent of a college-bound youth with T1DM. The parental transition of launching their youth to college is more complex and unique for parents of youth with T1DM parents of youth without chronic conditions. Additional research focusing on the identification of desired supports for parents and the development of specific interventions to assist parents as they transition with their college-bound youth with T1DM is recommended.

Are college students told by health care providers about their risk factors for developing diabetes?

BACKGROUND AND PURPOSE: Communication about risk factors for diabetes between nurse practitioners and college students may not be occurring as the prevalence of Type 2 diabetes increases. The purpose of this secondary analysis was to evaluate if college students are being told of their risk for diabetes based on known risk factors of weight, sleep, and depressive symptoms. METHODS: Descriptive, cross-sectional study was completed using National Health and Nutrition Examination Survey 2011-2012. Using listwise deletion for all variables in the analyses, the sample (N = 313) included college participants aged 18-25 years. Logistic regression model found that body mass index (BMI), sleep quantity, and gender were significant predictors of not being told one was at risk for diabetes. In those with a BMI >25 kg/m (n = 159), only 22% were told about their risk for diabetes by a health care provider. CONCLUSIONS: Nurse practitioners may not be recognizing the factors that affect on the development of prediabetes in college-age students or not providing guidance for measures to prevent the morbidity related to diabetes. IMPLICATIONS FOR PRACTICE: Nurse practitioners are in a prime position to identify individuals with overweight/obesity, poor sleep, and depressive symptoms and recommend lifestyle changes to prevent the onset of disease.

Maternal Experiences of Transitioning Their Emerging Adult With Type 1 Diabetes to College.

Purpose The purpose of this study was to gain a deeper understanding about mothers' experiences of transitioning their emerging adult with type 1 diabetes mellitus to college. Methods A descriptive, qualitative study was conducted with 9 mothers of high school seniors with type 1 diabetes (T1DM) using semi-structured questions via recorded telephone interviews. Results Among the 9 participants, 8 had daughters, and 1 had a son. The thematic analysis resulted in 4 themes: (1) concern for health and safety at college, (2) evolving roles of the parent and emerging adult dyad, (3) communication dynamics, and (4) social support systems. Conclusions Results indicate that mothers of emerging adults with T1DM experience heightened levels of concern during the college transition. These concerns are above and beyond those that are experienced by mothers of emerging adults without T1DM. Findings indicated that increasing levels of support for both parents as well as emerging adults with T1DM during the college transition may serve to decrease maternal stress and enhance the development of preparedness for diabetes self-management. Recommendations for diabetes educators in clinical practice include a family-centered approach focusing on the transition before the late adolescent period, interventions from colleges to promote a smooth transition, and interventions that address concerns of both the emerging adult with T1DM and the parent. Further research is necessary to identify barriers and facilitators to support parent/emerging adult dyads during the college transition period.

Planning for a Violent Intruder Event: The School Nurse's Role.

School shootings occur too frequently and often with devastating results. The key to prevention and mitigation of these events is to have a plan that is simple, up-to-date, disseminated, and practiced. This article discusses the steps that school nurses can take to work with school administration to prepare themselves, their staff, and their students.

Students With Chronic Conditions: Experiences and Challenges of Regular Education Teachers.

School nurses have observed the increasing prevalence of children with chronic conditions in the school setting; however, little is known about teacher experiences with these children in their regular classrooms. The purpose of this mixed-method study was to describe the experiences and challenges of regular education teachers when they have students with chronic conditions in their classroom and implications for the school nurse. The national sample consisted of regular education teachers. The methodologies consisted of focus groups and an online survey. Seven themes emerged: Teachers want to be informed about their students with chronic conditions, teachers lack information about the conditions, there is a lack of preparation in preteacher education programs about students with chronic conditions, teachers feel frustration and stress in working effectively with these students, teachers shared concerns about their students, teachers are asked to perform health-related tasks for students, and teachers made recommendations of what they need from the school nurse.

What Data Do States Collect Related to School Nurses, School Health, and the Health Care Provided?

School nurses collect data to report to their school district and state agencies. However, there is no national requirement or standard to collect specific data, and each state determines its own set of questions. This study resulted from a joint resolution between the National Association of State School Nurse Consultants and the National Association of School Nurses. The study sought to determine whether similar data points were collected so that comparisons could be made among states and to develop a framework to incorporate the data. Thirty-two states provided their questionnaires or reports. There were 855 data points that could be divided into data related to staff and to students. No categories were measured by all states. The most common data points were the number of students, health screenings, and the number of students with particular conditions for whom the district provided services. A framework for data collection is proposed.

Interprofessional Education Using a Palliative Care Simulation.

This quasi-experimental pretest-posttest study measured self-efficacy, attitudes toward physician-nurse collaboration, and interprofessional competencies as outcomes of a palliative care simulation. Based on experience level, teams of participants, 1 consisting of nursing/medical students and the other of nursing/medical health care professionals, completed a palliative care simulation as part of their education. Self-efficacy and attitudes toward physician-nurse collaboration were measured before and after simulation. Interprofessional competency was measured during the simulation. The results revealed a significant improvement in the previously mentioned measures, and interprofessional competency scores varied by profession and evaluator.

The new DSM-5 and its impact on the mental health care of children.

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the premier resource in the diagnosis of mental health conditions, was published in June 2013. It contains many new diagnoses as well as changes to both the names and criteria for longstanding conditions. It is essential for pediatric nurses to understand the changes so that they can communicate effectively and advocate responsibly for their patients and families. This article discusses the changes, the criticisms voiced about them, and the implications for the pediatric nurse.

Breaking the silence: addressing skin issues in obese and overweight children.

Skin irritation and breakdown can cause considerable physical and psychological pain, yet skin alterations and hygiene issues are often not addressed during routine healthcare visits for children who are overweight and obese. The number of children with obesity has increased significantly, yet there is limited literature to assist children with the private physical symptoms and inconveniences that accompany obesity. Healthcare professionals focus on nutritional intake and activity and treat comorbidities related to obesity, since comorbidities affect quality of life, but so can the pain and embarrassment of skin issues. This article addresses skin issues related to being overweight and obese.

Gambling: normal adolescent activity or pathologic addiction?

A 15-year-old comes to the school counselor. He owes $4,000 in gambling debts to a sports-betting bookie, and he doesn't have the money. He is afraid. Yet, 2 weeks later, he bet on the Super Bowl and won $3,000. A 14-year-old limits his betting to $20 and $30; he only bets what he has and he is happy with his successes. A 17-year-old was born with a malformed arm and cannot play sports; instead, he makes bets on sports games. He sells his belongings to get the money he needs; right now, he owes $700. Are the behaviors of these teens unusual?