Ainat Koren

Behind Closed Doors: School Nurses and Sexual Education.

School nurses can play a key role in providing sexual education in schools. However, they often face barriers from the school administration and concerned parents. Additionally, school nurses may have limited formal preparation in managing sexual health issues. This study used a descriptive qualitative method to explore the school nurses’ experiences with facilitators and barriers to providing sexual education. Eighteen nurses from 12 Massachusetts high schools were interviewed. Results showed that the school nurses do not provide formal sexual education at their schools but frequently conduct informal sessions. School nurses reported that students needed more sexual health information, yet there was no collaboration with the school health teachers. Common barriers included lack of privacy and time, confidentiality issues, and fear of conflict. Nurses working in communities with high teen pregnancy rates reported more barriers. The findings can inform the development of policies and practices for sexual education by school nurses.

The context of unintended pregnancy among married women in the USA

Background and methodology Unintended pregnancy is a concern in the USA due to its association with adverse physical, mental, social and economic outcomes. Few studies have examined this issue among married women from a social and contextual perspective. This study targeted married women to examine factors associated with unintended pregnancy using the ecological model of health promotion that focuses attention on both individual and social environmental factors. Data from the National Survey of Family Growth (NSFG) were merged with NSFG contextual files to examine the major predictive factors. Results Multilevel logistic regression modelling revealed that married women of lower socioeconomic status, higher parity, who lived in communities with a high rate of marital dissolution had a higher probability of an unintended pregnancy. Women reported that their husbands were likely to concur with the unintended designation of the pregnancy. Discussion and conclusions This study utilised a unique perspective to examine contextual factors related to unintended pregnancy among married women. The results support the need to focus on the couple as a unit for prevention efforts. Social policies to enhance access to family planning services are necessary to improve outcomes and prevent unintended pregnancies.

Health Disparities Among Health Care Workers

In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field.

Examining Childhood Obesity From Infancy: The Relationship Between Tummy Time, Infant BMI-z, Weight Gain, and Motor Development—An Exploratory Study

INTRODUCTION This exploratory study investigated the infant time spent in tummy time (TT) in relation to body mass index z score (BMI-z), weight gain, and motor development in infants from birth to 4 months. METHOD Mothers and their infants were telephone surveyed at 2 and 4 months. Mother demographics; TT; feeding practices; and infant length, and height, and development were collected each time. RESULTS Results from Cochran-Mantel-Haenszel and single logistic regression showed a significant association between development, level of BMI-z, and time spent in TT at 2 months of age (p < .0001). The threshold model showed there was a decline in BMI-z at 4 months as daily time in TT increases past the threshold value of approximately 12 minutes per day. Mother education and TT at 2 months were significant predictors of BMI-z at 4 months. DISCUSSION Study outcomes suggest that infant positioning and time in TT promote infant motor development and may moderate rapid infant weight gain.

It’s Part of the Job: Healthcare Restructuring and the Health and Safety of Nursing Aides

The theme of this conference is ‘speaking truth to power’. This chapter describes how restructuring of the healthcare system in America during the 1990s facilitated on-going exploitation of nursing aides in longterm care facilities. Many nursing aides suffer significant physical and psychological injuries by patients. We question why these came to be generally accepted as ‘part of the job’ by both nursing assistants and management. This was a truth known to those in power but a burden carried by those who had little or no power to remedy the situation.