School health activities have been very important in improving adolescent health in Sweden for almost 200 years. In the 1800s, emphasis was on medical services. Vaccination programs and medical examinations became the key issues. Deterioration of adolescent health in the 1960s changed the objectives of both school education and health services to health promotion. Important members of the community followed suit and involvement of the local community has remained a hallmark, even though the extent and direction varies. The subsequent period was characterized by substantial improvement in adolescent health behavior. The latter years of the 1980s and the 1990s saw deterioration of adolescent health behavior. Less emphasis on health promotion, decentralization of school health responsibility from physicians to administrators, and heavy savings directed toward schools were important mediators. Adolescents were also more engaged in international youth cultures with liberal practices, such as drug use. Community surveys of adolescent health behaviors have proven to be important in mobilizing broad local involvement in adolescent health promotion. The lesson learned is that health promotion has to involve as many community members as possible. Coordinating resources and having unified objectives is cost efficient
To evaluate the effect of previous AIDS education on AIDS knowledge and sex behaviour among Danish adolescents, a survey was carried out in April-May 1988 amongst 15-16 year-old school children of 9th grade elementary school. Through a cluster-sampling procedure, 45 school classes in nine geographical areas around the country were selected representing various degrees of urbanisation. A questionnaire was handed out and collected by the local school physician during a class session. The 728 pupils responding corresponded to a response rate of 89% of the pupils enlisted and 99% of the pupils present. The results demonstrate that AIDS education has been widely introduced in Danish schools and is well accepted. However, school health services have only rarely been involved. The educational activities seem to have a positive effect on knowledge about HIV-transmission and AIDS, attitudes towards the use of condoms and actual sexual behaviour, although risk-behaviour is still prevalent. The respondents express positive attitudes towards more AIDS education--especially among those with very little or no previous educational experiences.
To characterize adolescent drug use in terms of a risk continuum and to explore the rationale for harm reduction as a potential approach for school-based drug prevention.
Self-reported surveys, in 1991 and 1996, of adolescent students concerning their use of drugs, especially alcohol, tobacco and cannabis, and the harmful consequences of such use.
A total of 3452 (in 1991) and 3790 (in 1996) junior and high school students in randomly selected classes in the public school system.
Prevalence of drug use and patterns of multiple drug use and of alcohol- and drug-related problems; independent risk factors for multiple drug use. The risk continuum for the response to alcohol problems was used as a policy framework.
The prevalence of cigarette smoking and the use of hallucinogens and stimulants was markedly higher in 1996 than in 1991. Over one-fifth (21.9%) of the students reported multiple drug use of alcohol and tobacco and cannabis in the 12 months before the 1996 survey. The 3 main subgroups--nonusers, users of alcohol only and users of multiple drugs--had distinct patterns of use, numbers of problems and risk factors. In all, 27.1% of the students had experienced at least 1 alcohol-related problem and 6% had experienced at least 1 drug-related problem in the 12 months before the 1996 survey.
There is a need for integrated school- and community-based drug prevention programs, with goals, strategies and outcome measures capturing the full spectrum of patterns of use and levels of risk among subgroups of the adolescent student population.
Comment In: CMAJ. 1997 May 15;156(10):1397-99164397
In this article we critically analyze the disconnect between much of the contemporary discourse and practice in Canadian community health nursing (CHN) that has contributed to the slow progress of strengths-based, health-promoting nursing practice. Appreciative inquiry philosophy and methods are introduced as a bridge to traverse this disciplinary gap. Two exemplars show how appreciative, strengths-based CHN research and action can move policies and programs toward more socially just practices congruent with CHN values. Exciting potential for nursing knowledge may arise from incorporating more strengths-based approaches into practice, education, policy, and research.
This article describes results of the immunological study of school-aged children residing in cities with different levels of the technogenic air pollution. Children from cities with the highest level of the technogenic pollution had a high number of immature neutrophils (band cells) and eosinophils. The children living in these ecologically unfavorable areas have presented a reduction of T-cell antigen receptor CD3, CD4, CD8, CD20, CD16, CD95. This indicates to that both T-cell and B-cell immunity is suppressed. The decline of the phagocytic function in neutrophils indicates to the suppression of the nonspecific host defense mechanisms also.
The mortality and morbidity resulting from serious trauma in adolescence, particularly head and spinal cord injury, constitutes a health problem of major proportions. Although many community-based prevention programmes have been reported in this last decade, few of these describe an evaluation component. In this study, a school-based prevention programme was developed by a peer group and presented by them to high-risk adolescents. The study aimed to test the efficacy of this intervention compared to the delivery of a prevention presentation to a similar group by a health care professional and compared to a control group. Measures of health locus of control, self-efficacy and behavioural intent were supplemented by open-ended items related to risk-taking behaviour change. At post-test and at 4-month follow-up, there was little evidence in the quantitative measures to support the effectiveness of the intervention for reducing injury risk factors. More encouraging findings were seen in the qualitative data. Explanations for why the intervention did not result in the expected outcomes are offered.
The authors discuss an outcome-based management framework for evaluating a community-based program for children requiring health support. Application of the framework is delineated both generically and specifically. Examples illustrate the process of global outcomes analysis and identification of critical outcomes, activities, and strategies.