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"Addressing Grief: Tips for Teachers and Administrators"

This article offers tips and advise to teachers and administrators to address grief for students of all ages. The article includes general tips including discussing death in developmentally appropriate terms for students and using words such as death or dying to avoid euphemisms such as "they went away". Tips also include being sensitive to cultural differences of students and understanding a variety of feelings are normal. Maintaining a normal routine and engaging students in regular activities are also advised.

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National Association of School Psychologists (NASP)

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Addressing Grief: Tips for Teachers and Administrators

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School-based support and increased understanding are essential when a student experiences the death of a friend or loved one.

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"Sexual Health Education in Schools"

This article discusses and summarizes what a sexual health education should look like and mentions that the program should include characteristics including building personal and social competence, addressing social pressures and influences, and focusing on specific behavioral outcomes. The article also mentions that incorporating learning strategies, teaching methods and materials that are culturally inclusive is important. Ultimately, a model with a focus on human rights, gender equality, access to healthcare services, and critical thinking will create an emerging model for sexual health education.

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Position Statement SUMMARY
It is the position of the National Association of School Nurses (NASN) that developmentally appropriate evidence-based sexual health education should be included as part of a comprehensive school health education program and be accessible to all students. NASN recognizes the role of parents and families as the primary source of education about sexual health. The registered professional school nurse (hereinafter referred to as school nurse) is a valuable resource to parents and educators in this area and supports the implementation of evidence-based sexual health education programs that promote healthy sexual development for all students.
BACKGROUND
The social and health risks of adolescent sexual activity are well known (Dee et al., 2017). While teen pregnancy and birth rates in the United States continue to decline, rates remain higher than in other industrialized countries; and racial, ethnic and geographic disparities persist (Centers for Disease Control and Prevention [CDC], 2016a). In addition, the rates of sexually transmitted infections (STIs) are at an unprecedented high in the United States, and more than half of newly acquired infections occur among adolescents and young adults (CDC, 2016b).

Sexual health as defined by the World Health Organization (WHO) is "... a state of physical, emotional, mental and social well-being in relation to sexuality..." (WHO, 2015, pp. 5), suggesting a whole child approach to sexual health education and not merely the absence of unplanned pregnancy or sexually transmitted infections. For decades, studies have shown that the majority of parents in the United States support sexual health education in schools. In addition, findings indicated that most parents supported abstinence-based rather than abstinence-only programs (Barr, Moore, Johnson, Forrest , Jordan , 2014). Finally, a May 2016 nationwide survey of middle and high school parents found that 70% believe sex education and pregnancy prevention should "definitely be covered" in sexual health education programs (Singer, 2016).

According to the 2014 School Health Policies and Practices Study (CDC, 2015a), 72% of high schools in the United States required students to receive education on pregnancy prevention, and 83.1% required instruction on STI prevention. Topics listed as part of required instruction by order of frequency included abstinence as the most effective method to avoid pregnancy and STIs, the relationship between alcohol or other drug use and risk for STIs and pregnancy, and resisting peer pressure to engage in sexual behavior. A worrisome trend is that the percentage of schools in which students are required to receive instruction on human sexuality, pregnancy, and STI prevention has steadily declined since 2000 (CDC, 2015a)

Healthy students are more likely to achieve academic success (CDC, 2014). Szydlowski (2015b) asserts that when teens receive accurate sexual health education information and skills, they can reduce health risk factors that may impact their success in school. Data from the 2015 Youth Risk Behavior Surveillance Survey (YRBSS) indicated that, among high school students, 41% have had sexual intercourse at least once; and 30% had sexual intercourse in the three months prior to participating in the survey, reflective of a decline from previous surveys (CDC, 2015b). Although teens may be having less sex, condom use and HIV testing are declining (CDC, 2015b). Of those who had intercourse in the past three months, 43% did not use a condom the last time they had sex; 14% did not use any method to prevent pregnancy; and 21% used substances before last sexual intercourse (CDC, 2015b).

For the first time, the CDC analysis of national data gathered from the 2015 YRBS included information on the health risks of lesbian, gay, and bisexual (LGB) high school students. These findings demonstrate that LGB youth report a higher incidence of bullying at school or online, physical and sexual dating violence, drug and alcohol use, and suicide-related behaviors than their straight peers (Kann, Olsen, & McManus, 2016). In the most recent Gay, Lesbian, and Straight Network (GLSEN) National School Climate Survey, over 31% of LGBTQ students reported missing at least one day of school during the past month due to safety concerns. Students who attended schools with LGBTQ-inclusive curriculum were less likely to miss school (18% vs. 35%) for safety reasons (Kosciw, Greytak, Giga, Villenas, & Danischewski, 2016). Although not a direct measure of school performance, absenteeism has been linked to low graduation rates, which can impact future success in life (CDC, 2014).

In addition to the disparities of risk for sexual minority youth, there are racial/ethnic differences. Black high school students are more likely to have had intercourse than white and Latino students; and more black high school students and Latino students initiated sex before the age of 13 compared to white students (Kaiser Family Foundation, 2014).

Students with disabilities defined as "... a physical or mental impairment that substantially limits one or more major life activities" (Americans with Disabilities Act of 1990 [ADA], Title II Regulations, 2016, p. 187), and those with intellectual disabilities (ID) as characterized by "...signiﬁcant limitations both in intellectual functioning and in adaptive behaviour as expressed in conceptual, social, and practical adaptive skills" (Luckasson & Schalock, 2013, pp. 96) benefit from sexual health information. Low levels of knowledge can impede the recognition of sexual abuse situations, safe sex practices, and the development of positive attitudes toward sexuality (Schaafsma, Kok, Stoffelen, & Curfs, 2015). Szydlowski (2016) compiled general guidelines for sexual health educators for those with disabilities. Sexual health education needs to be tailored to the students with disabilities based on their ability, learning style, and maturity, in addition to parent values and beliefs (Szydlowski, 2016).
RATIONALE
School nurses support sexual health education that is accessible, inclusive, and developmentally and culturally appropriate for all students. Academic achievement is linked to student health (CDC, 2014). Health risk behaviors, such as early sexual initiation, are associated with lower grades and test scores, and lower educational attainment (CDC, 2016c). Evidence-based sexual health education provides accurate, complete, and developmentally appropriate information and skill development that allow young people to make decisions that are informed, responsible, and healthy (Szydlowski, 2015b). Evidence-based sexual health education can improve academic success; prevent dating violence, and bullying; help youth develop healthier relationships; delay sexual initiation; reduce unplanned pregnancy, HIV, and other STIs; and reduce sexual health disparities among LGBTQ youth (Szydlowski, 2015b). Evidence-based sexual health education reduces sexual risk behavior by delaying sexual initiation, reducing pregnancy and STIs, and increasing contraceptive use -- thereby protecting student health (Szydlowski, 2015b).

The National Sexuality Education Standards (Future of Sex Education Initiative [FOSE],2012) support a strategic and coordinated approach that includes family and community involvement, skill development and school health services. Furthermore, the Sexuality Information and Education Council of the United States (SIECUS) (2017) supports sexual health education that is appropriate to the student's age, developmental level, cultural background, and community values. SIECUS further advocates for sexual health education to augment the sexual health education provided by the family and their healthcare professionals. SIECUS specifies that sexual health education provided in an educational setting needs to be taught by an instructor trained on the principles, content and best practices of sexual health education. On behalf of Advocates for Youth, Szydlowski (2015a) emphasizes youth friendly sexual health education to assist with the positive development of sexual health, beginning in youth and continuing throughout adulthood.>

The National Sexuality Education Standards recommend that an evidence-based sexual health education program include the following characteristics (FOSE, 2012, p.9):

Focuses on specific behavioral outcomes;

Addresses individual values and group norms that support health‐enhancing behaviors;

Focuses on increasing personal perceptions of risk and harmfulness of engaging in specific health risk behaviors, as well as reinforcing protective factors;

Addresses social pressures and influences;

Builds personal and social competence;

Provides functional knowledge that is basic, accurate and directly contributes to health‐promoting decisions and behaviors;

Uses strategies designed to personalize information and engage students;

Provides age‐ and developmentally appropriate information, learning strategies, teaching methods and materials;

Incorporates learning strategies, teaching methods, and materials that are culturally inclusive;

Provides adequate time for instruction and learning;

Provides opportunities to reinforce skills and positive health behaviors;

Provides opportunities to make connections with other influential persons; and

Includes teacher information and plan for professional development and training to enhance effectiveness of instruction and student learning.

In addition, in terms of specific content, an emerging model for sexual health education is the rights-based approach, which employs a vast, comprehensive sexual education program with a focus on human rights, gender equality, access to healthcare services, and critical thinking (Constantine et al., 2015). Preliminary findings have supported that education based on theories of human rights, gender equality, and sexual development can positively impact healthy sexual behavior among adolescents (Constantine et al.).
CONCLUSION
Health education and promotion, disease prevention, and risk reduction are essential practice components for the 21st century school nurse to help students stay healthy, safe and ready to learn (NASN, 2016). School nurse leaders advocate for and support the delivery of evidence-based sexual health education that is "...medically accurate, developmentally appropriate, and ... provides students with the skills and resources that help them make informed and responsible decisions" (FOSE, 2012, p.8). School nurses -- working in collaboration with parents, students, health educators, curriculum specialists, and other school and community stakeholders -- strive to dismantle barriers and support access to evidence-based sexual health education that allows all students to make informed, responsible, and healthy decisions.
REFERENCES
Americans With Disabilities Act of 1990, Pub. L. No. 101-336, 104 Stat. 328 (1990), Title II Regulations. (2016). Part 35 Nondiscrimination on the Basis of Disability in State and Local Government Services (as amended by the final rule published on August 11, 2016). Retrieved from https://www.ada.gov/regs2010/titleII_2010/titleII_2010_regulations.htm

Barr E., Moore M., Johnson T., Forrest J., Jordan M. (2014). New evidence: Data documenting parental support for earlier sexuality education. Journal of School Health, 84(1), 10-17. doi:http://dx.doi.org/10.1111/josh.12112

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. (2014). Health and academic achievement. Retrieved from https://www.cdc.gov/healthyyouth/health_and_academics/pdf/health-academic-achievement.pdf

Centers for Disease Control and Prevention. (2015a). Results from the school health policies and practices study 2014. Retrieved from https://www.cdc.gov/healthyyouth/data/shpps/results.htm

Centers for Disease Control and Prevention. (2015b). Youth risk behavior surveillance system (YRBSS). Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/results.htm

Centers for Disease Control and Prevention. (2016a). About teen pregnancy: Teen pregnancy in the United States. Retrieved from http://www.cdc.gov/teenpregnancy/about/index.htm

Centers for Disease Control and Prevention. (2016b). Sexually transmitted diseases surveillance 2015. Retrieved from https://www.cdc.gov/std/stats15/default.htm

Centers for Disease Control and Prevention. (2016c). Adolescent and school health: Health and academics. http://www.cdc.gov/HealthyYouth/health_and_academics/

Constantine, N. A., Jerman, P., Berglasi, N. F., Angulo-Olaiz, F., Chou, C., & Rohrbach, L. A. (2015). Short-term effects of a rights-based sexuality education curriculum for high-school students: A cluster-randomized trial. BMC Public Health, 15(293),1-13. doi:10.1186/s12889-015-1625-5

Dee, D.L., Pazol, K., Cox, S., Smith, R.A., Bower, K., & Kapaya, M. (2017). Trends in repeat births and use of postpartum contraception among teens-United States, 2004-2015. Morbidity Mortality Weekly Report, 4/28/2017; 66(16), 422-426, 5. doi: http://dx.doi.org/10.15585/mmwr.mm6616a3

Future of Sex Education Initiative. (2012). National sexuality education standards: Core content and skills, K-12 [a special publication of the Journal of School Health]. Retrieved from http://www.futureofsexeducation.org/documents/josh-fose-standards-web.pdf

Kaiser Family Foundation. (2014). Sexual health of adolescents and young adults in the United States. Menlo Park, CA: Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/womens-health-policy/fact -sheet/sexual-health-of-adolescents-and-young-adults-in-the-united-states/

Kann, L., Olsen, E.O., & McManus, T. (2016). Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9-12 - United States and selected sites, 2015. MMWR Surveillance Summary 2016,65(No. SS-9), 1-202. doi: http://dx.doi.org/10.15585/mmwr.ss6509a1

Kosciw, J. G., Greytak, E. A., Giga, N. M., Villenas, C. & Danischewski, D. J. (2016). The 2015 national school climate survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation's schools. New York: GLSEN.

Luckasson, R., & Schalock, R. L. (2013). What's at stake in the lives of people with intellectual disability? Part II: Recommendations for naming, defining, diagnosing, classifying, and planning supports. Intellectual and Developmental Disabilities, 51(2), 94-101. doi: 10.1352/1934-9556-51.2.094

National Association of School Nurses. (2016). Framework for 21st century school nursing practice. NASN School Nurse, 31(1), 45-53. doi: 10.1177/1942602X15618644

Schaafsma, D., Kok, G., Stoffelen, J. M. T., & Curfs, L. M. G. (2015). Identifying effective methods for teaching sex education to individuals with intellectual disabilities: A systematic review. Journal of Sex Research, 52(4), 412-432. doi: 10.1080/00224499.2014.919373.

Sexuality Information and Education Council of the United States. (2017). Human sexuality (Position Paper). Retrieved from http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&pageId=494

Singer, D.C. (Ed.). (2016). Beyond sex ed: Parents want more health topics covered in school. Retrieved from http://mottnpch.org/reports-surveys/beyond-sex-ed-parents-want-more-health-topics-covered-school

Szydlowski, M.B. (2015a). Sexual health education; research and results. School Health Equity/Advocates for Youth. Retrieved from http://www.advocatesforyouth.org/storage/advfy/documents/school-health-equity/sexual-healthed-research-and-results.pdf

Szydlowski, M.B. (2015b). Sexual health education and academic success: Effective programs foster student achievement. School Health Equity/Advocates for Youth. Retrieved from http://www.advocatesforyouth.org/school-health-equity-resources

Szydlowski, M. B. (2016). Sexual health education for young people with disabilities - Research and resources for educators. School Health Equity/Advocates for Youth. Retrieved from http://www.advocatesforyouth.org/publications/publications-a-z/2559

World Health Organization. (2015). Sexual health, human rights and the law. Retrieved from http://apps.who.int/iris/bitstream/10665/175556/1/9789241564984_eng.pdf?ua=1

Acknowledgement of Authors:
Lisa Kern MSN, RN, NCSN
Gina Emge MSN, RN
Kathy Reiner BSN, MPH, RN
Darla Rebowe BSN, RN

Adopted: October 2002
Revised: November 2005, June 2012, June 2017

(Formerly titled "School Health Education about Human Sexuality")

Suggested Citation: National Association of School Nurses. (2016). Sexual health education in schools (Position Statement). Silver Spring, MD: Author.
All position statements from the National Association of School Nurses will automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time.

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Position Statement SUMMARY It is the position of the National Association of School Nurses (NASN) that developmentally appropriate evidence-based sexual health education should be included as part of a comprehensive school health education program and be accessible to all students. NASN recognizes the role of parents and families as the primary source of education about sexual health.

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Ch. 11 - Promoting a Tobacco-Free Lifestyle

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Ch. 11 - Promoting a Tobacco-Free Lifestyle

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"How Schools Can Help Students Stay Tobacco-Free"

This article mentions several ways that schools can act to reduce youth smoking and other tobacco use. Strategies can include forbidding tobacco use by students, staff and visitors on school grounds, providing comprehensive tobacco prevention education, providing program-specific training for teachers, involving parents and families in school efforts, offering interactive tobacco-free projects for students, helping tobacco-using students and staff quit, adopting a firm school policy of not accepting any funding, curricula, or other maters from tobacco companies, and evaluating the school's tobacco-free programs at regular intervals.

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Ch. 8 - Promoting Safety & Preventing Injury

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Ch. 8 - Promoting Safety & Preventing Injury

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"Child Safety and Injury Prevention"

This article focuses on reducing the risk of injuries by making changes to your environment. Child safety strategies include areas in preventing drowning, falls, window safety, preventing burns, preventing poisoning, preventing scalds, microwave safety, choking and harm caused by swallowing objects, and safety with button batteries, blinds and curtain rods. The article also includes information regarding child first aid courses, fire safety courses, and where to get help.

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You can never completely 'child-proof' your home. You can, however, dramatically reduce the risk of injuries by making a few changes to your home and keeping your child under constant supervision.

Emergency medical treatment for young children or babies isn't always the same as for adults. If you are a parent or carer, make sure you have current training in child (paediatric) first aid.

Plan to do a CPR (cardiopulmonary resuscitation) refresher course once a year - first aid practices sometimes change and it's easy to forget how to do something when you don't use the skills regularly.
Call triple zero (000) for an ambulance if your child is severely injured, has collapsed, stopped breathing, is fitting or is suffering an anaphylactic reaction.
Triple zero (000) is the emergency number to ring from anywhere in Australia.

Child safety - preventing drowning

Drowning is one of the leading causes of unintentional injury death for children under five years of age. One- and two-year-olds are most at risk as they are more mobile than infants, but are still developing motor skills and cannot judge hazards.

Swimming pools, baths and rivers, creeks and streams are the most common locations where toddler drowning deaths occur. For every Victorian toddler who drowns, there are ten non-fatal drowning or immersion incidents requiring hospital treatment. All Australian swimming pools with a depth greater than 30 cm are required by law to be fenced - this includes portable or toddler pools.

Safety measures to prevent drowning include:

Never leave your child alone in the bath. Children can drown quickly and silently in a few centimetres of water.

Actively supervise. Make sure children are in constant visual eye contact and within arm's reach of an adult at all times when in and around water.

Be prepared. When your child is in the bath, be within arm's reach of them with all of your attention, all of the time. Be prepared with everything you need for bathing your child before entering the bathroom.

Empty water from the bath and from buckets and wading pools immediately after use, and close the bathroom door when it is not in use.

At the beach, teach children to swim between the flags.

It is illegal for pools and spas not to have a barrier around them. The type of barrier required depends on when the pool or spa was installed. Remove any objects which can be used to climb over the barrier and keep the gate closed at all times.

Always watch your children at the public swimming pool. An adult must be within arm's reach of children under five years of age at all times. Remember, lifeguards are not babysitters.

Secure wire mesh of an appropriate rigid gauge over fishponds and aquariums.

Teach your child to swim. Water familiarisation and awareness classes are offered for children from six months of age.

Have a resuscitation chart by the phone and in the pool or spa area.

if you are a parent or caregiver, do a first aid course, and learn infant and child cardiopulmonary resuscitation (CPR) in case of an emergency.

Child safety - preventing falls

Falling is the most common cause of injury for children of all ages. The seriousness of an injury depends on the height the child falls from, the surface the child falls onto and what the child may hit as they fall. A standing and toddling baby has frequent minor falls. To minimise fall injuries, look at the environment from your child's level.

Safety suggestions include:

Remove tripping hazards. Create a clear area for play by removing tripping hazards from the floor, such as toys, rugs and electrical cords. Pad sharp corners of benches and tables or remove them from the play area.

Never carry your baby around in a bouncinette or rocker chair. Put bouncinettes on the floor, not on a table or high surface.

Make sure your change table has ends and sides that are raised at least 10 cm to prevent your baby from falling. Keep one hand on your baby at all times. Have everything ready before you place your baby on the change table.

Never leave a baby unsupervised on a change table. Consider changing your baby on a large towel on the floor.

Do not use baby walkers. They give a young child the mobility to put themselves in danger quickly and unexpectedly.

Always use a full-body (five-point) safety harness in prams, strollers, high chairs and shopping trolleys.

Don't allow a child to walk or run while carrying sharp objects such as scissors.

Safety gates help prevent falls. Use a safety gate at the top and bottom of stairs.

Use a sensor light for stairs and steps.

Put non-skid rubber mats in the bath and shower.

Make sure swings, slides and climbing equipment have soft fall material underneath, to a depth of at least 30 cm. Only use bunk beds for children over nine years.

Window safety - preventing falls

Make sure that children can't open and fall out of any windows. Safety suggestions to prevent falls from windows include:

Keep furniture away from windows.

Install window locks to prevent windows from opening wide enough for a child to fit through.

Install window guards. Insect screens do not prevent children from falling.

Child safety - preventing burns

By law, all homes must have working smoke alarms installed. Change the batteries in smoke alarms every year at the end of the daylight saving period and test them monthly. Replace smoke alarms every 10 years. Keep children away from fires, flames, hot surfaces and hot liquids.

Safety suggestions include:

Install a fixed guard at least 70 cm high around all heaters, open fires, radiators and potbelly stoves.

Lock matches, cigarette lighters and flammable liquids away and out of reach of children.

Keep a fire blanket and a dry powder extinguisher in the kitchen, and make sure you know how to use them. Fire blankets must be stored at least one metre from the stove. Your fire extinguisher is best located near the kitchen entrance. It is important to always have the extinguisher between your exit point and source of possible fire. If you are not confident or able to use either the extinguisher or fire blanket and you experience a fire, evacuate immediately, closing the door behind you as you go.

Install a safety switch to prevent electrocution.

Use power boards as they are safer than double adapters.

Choose close-fitting nightwear for children with the label 'styled to reduce fire danger' or 'low fire danger'.

Teach your child that if their clothing catches fire they should:

stop running

drop to the floor

cover their face with their hands

roll on the floor to put the fire out.

Teach your child that if there is a fire they should crawl low through the smoke to the nearest exit (get down low and go, go, go). This will help to avoid smoke and poisonous gases. Reinforce this with your child when you are practising a fire drill.

In an emergency, call triple zero (000). For information about fire safety in your home, call the on or the on .

In case of burns and scalds, hold injured area under cool running water for a minimum of 20 minutes - never use ice, oil, butter or ointments. Seek medical attention if clothing is stuck to the burn site, the burn is on the face, hands, lap or feet, or if the burn is bigger than a 50 cent piece.

Child safety - preventing poisoning

Young children tend to put every object they find into their mouths. In Victoria, at least two children a day are treated in hospital due to poisoning. Children under five years of age are most at risk, especially those between one and three years.

Household products and medicines are the most common cause of poisoning in children. (Dangerous products include drain cleaners, oven cleaners, dishwasher tablets and powders, bleaches, paints, many gardening products and other household chemicals.) The most serious poisonings usually involve medicines.

Safety suggestions to prevent poisoning in children include:

Keep all medicines and household products out of the reach and out of sight of children.

Put all chemicals, medicines and cleaning products away immediately after use.

Store medicines and dangerous household products in cabinets or cupboards with a child-resistant lock at least 1.5 m above the ground. Child-resistant locks can be installed on most cupboards.

Only remove a medicine from its packaging when you are just about to take or administer it - do not leave medicines unattended on benches or other places your child could reach.

Read warning labels and directions for use carefully.

Leave medicines and chemicals in their original containers - do not transfer them into other containers such as drink bottles.

Child resistant caps are not child proof - they are designed to be difficult for children to open but not impossible. Products using these caps still need to be stored up high out of the sight and reach of children, in a locked cupboard.

Clean out your medicine cupboard regularly. Take unwanted and out-of-date medicines to your nearest pharmacy for proper disposal.

Rinse empty containers of liquid medicines and household products with water before throwing them out.

Refer to medicines by their proper names. They are not lollies.

Avoid taking medicines in front of children. Children tend to imitate adults.

Visitors' bags may contain medicines. Keep them well out of the reach of children.

Avoid distractions when administering medicines; double check before administering them.

If there are two or more people caring for a child, establish a 'checking system' with each other to avoid giving double doses of medicine to children. Note the time and dose of medication given and keep this information with the medication pack or bottle.

Be aware that the incidence of childhood poisoning increases when usual household routines are disrupted, such as moving house, being on holiday or having visitors.

Teach your children never to pick up or touch any insects they find in the garden (such as bees, wasps or spiders).

If you think you or someone in your care may have been poisoned, given the wrong medicine or the wrong dose of medicine, or been bitten or stung by a bee, wasp, spider, jellyfish or other poisonous creature, try to stay calm.

Immediately call the for advice on (24 hours a day, seven days a week). Have the child with you, as well as the container for the substance you think they have been poisoned with. If they were bitten or stung by a creature, try to capture it in a jar for identification (if you can do so safely).

Child safety - preventing scalds

Burn injuries, including scald and flame burns, can result in permanent scarring, disfigurement and disability.

Hot liquids cause two out of three burns in small children. More serious scalding injuries may result in long and repeated periods of hospital treatment, many skin graft operations and ongoing psychological trauma. A severe scald can kill a small child, since their skin is much more sensitive than the skin of an adult.

Safety suggestions include:

Keep children's play areas away from your kitchen.

Keep hot drinks away from children and never hold a child while you have a hot drink.

Keep children away from hot foods and liquids.

Put all hot liquids and food in the centre of the table, or to the back of the bench away from the edges. Don't use a tablecloth - children can pull the edge of the tablecloth and spill hot fluids over themselves. Use non-slip placemats instead.

Don't carry hot drinks when children are playing on the floor. When busy in the kitchen, use a playpen or safety gate to avoid your child getting underfoot.

When running a bath for your child, run the cold water first and then add hot water to a safe temperature of 37-38 °C. Run the cold water last, as well, to cool the spout.

Limit the hot water delivery temperature in bathroom outlets to a maximum of 50°C - if you are unsure of your hot water delivery temperature, a licenced plumber can assist in checking and setting this.

Don't leave electrical cords from electric kettles and other appliances hanging in reach of children. Keep all cords well away from the edge. Use short or curly cords or a cordless jug.

Turn all pot handles in and away from the edge of the stove. Use the back hotplates whenever possible.

Install a stove guard around hotplates to protect young children from scalds.

Microwave safety and children

Microwaving causes uneven heating within fluids and the temperature continues to rise for a short time after food is removed from the microwave. This makes it easy to misjudge the temperature of food or drink.

Safety suggestions include:

Make sure the microwave is out of reach of children.

Take care when heating liquids in a microwave. If no alternative is available, heat the bottle standing up without a cap for around 30 seconds (for a full bottle at full power). Replace the cap and teat, shake gently and allow the bottle to stand for 10 to 20 seconds.

Test the temperature before offering a bottle to your baby. Remember, if the liquid feels very warm to you, it is too hot for your baby to drink.

Choking and harm caused by swallowing objects

Child safety to prevent swallowing and choking on objects includes:

Be aware of foods that children can choke on, such as lollies, apple, meat and nuts.

Do not give your child objects smaller than a 20 cent coin - children under three years can choke on things of this size.

Be mindful of other household items which can pose a choking hazard including pen tops, hair ties, batteries and coins.

Encourage children to sit calmly and not eat their meal too quickly.

Check toys regularly for any small parts that can become a choking hazard.

Button batteries

Button batteries are found in many common household items including remote controls, calculators, bathroom scales, car keys, toys, watches, talking books or cards and flameless candles.

These coin-sized batteries can cause severe, life-threatening injuries in less than two hours if swallowed by children.

Take the following steps to protect children from swallowing button batteries:

identify - identify items with button batteries in them

secure - secure the battery compartment of those items

elevate - keep loose or spare batteries and items containing button batteries out of reach of children

eliminate - dispose of button batteries and items containing them (including packaging) safely.

If you think your child has swallowed or inserted a button battery into part of their body, take urgent action. Don't wait for them to show symptoms. Call the on for advice immediately.

More information about button battery safety is available on the .

Child safety - blinds and curtain cords

Go through every room in your home and check for any blinds or curtains with long cords that are either loose or looped. This includes any cords that are within children's reach at floor level or near furniture they can climb on. Remember:

Make sure blind and curtain cords are not hanging anywhere within children's reach. Loose cords can easily wrap around and strangle children who are jumping, playing or climbing nearby.

Do not put children's cots, beds, highchairs or playpens near a window where they can reach the blind or curtain cords. The cords can get around children's necks and strangle them while they are playing or sleeping.

Do not place sofas, chairs, tables, shelves or bookcases near windows with corded blinds or curtains. Young children often like to climb onto furniture to look out the window. If they can reach the cords, they may quickly become entangled in them, lose their footing and suffer strangulation or serious injuries.

Always supervise children in any rooms with reachable blind or curtain cords. Accidental strangulation can happen very quickly, so never leave children alone in these rooms, even for a short while. Secure any loose cords as soon as possible with cleats or tension devices.

Child first aid courses

For information about first aid courses contact:

Fire safety courses

For information about fire safety contact:

Where to get help

In an emergency, always call triple zero (000)

Your

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By making a few practical changes to your home, you can dramatically reduce the risk of injury to your child.

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Ch. 5 - Promoting Mental/Emotional Health 

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Ch. 5 - Promoting Mental/Emotional Health 

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"How Can Schools Promote Positive Mental Health"

This article talks about focusing on young people's mental health around the world. While specifically focusing on mental health in UK schools, strong points were made about the issues affecting young people in 2018, including exam pressures, the modern technological world, growing social media, LGBTQ+, and demands on young people. The article encourages teachers and staff in schools to promote positive mental health by encouraging social time, running lunchtime clubs, having an open-door policy,  making mental health know, and organizing a wellness week.

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Promoting Mental Health in Schools | Tips for Teachers

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For #ChildrensMentalHealthWeek, we’re looking at promoting positive mental health in schools. Find ideas you can easily add to the school routine, here.

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"School-Based Programs to Increase Physical Activity"

Increasing physical activity in schools, as mentioned in this article, can include programs like daily recess, incorporating physical activity into regular classroom lessons, offering before and after school programs. Additionally, PE class length can be extended and fitness activities can be increased and expanded upon. The article also comments on how to increase opportunities for physical activities, state-level or district level can make changes to the school day.

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What are school-based programs to increase physical activity?

School-based programs to increase physical activity can include programs to enhance physical education (PE) [1,2], provide daily recess,[3], incorporate physical activity into regular classroom lessons[4] and offer before and after school programs.[5] Physical education may be expanded by increasing the length of PE classes and increasing the number and types of fitness activities during PE classes.[1,2] Recess can help students get more physical activity to help them achieve the recommended 60 minutes of activity every day.Physical activity also may be incorporated into classrooms through physically active academic lessons or activity breaks.[6] Coordination between school day and before/after school program staff and administrators can help provide students with consistent messaging and opportunities related to physical activity while they are on school grounds. Programs may be combined with other school- and community-based interventions such as health education about physical activity, activities that foster family involvement, and community partnerships to increase opportunities for physical activity.[1,7]

Changes to the school day to increase opportunities for physical activity can be adopted and implemented at the state-level or at the local school district level.[1,2,8] An example of a state moving towards this goal is Mississippi, where staff and administrators made improvements to school health environments across the state, including adding walking trails to school campuses, integrating five-minute movement breaks into the classroom, implementing fitness assessments, and adding an additional 15 minutes of physical activity at the beginning of each school day.

The purpose of these school-based programs is to increase students' physical activity levels, and thereby help improve their fitness levels, help them maintain a healthy weight, and potentially improve their health outcomes over time.[1,2,4]

What's the public health issue?

Physical activity is an important contributor to overall health, and engaging in regular physical activity can decrease the risk for numerous adverse health outcomes, including hypertension, diabetes, heart disease and some cancers.[9,10] Physical activity also is an important factor in achieving a healthy weight and maintaining it over time.[9] In 2008 the U.S. Department of Health and Human Services (HHS) recommended that young people aged 6-17 years participate in at least 60 minutes of physical activity daily.[9] In its 2012 report, HHS recommended that programs in school settings should be included as a key component of strategies to increase physical activity and address childhood obesity.[11] However, in 2017, only 26 percent of high school students surveyed had participated in at least 60 minutes of physical activity per day during the week before the survey, and only 30 percent attended physical education class daily while in school.[12]

What is the evidence of health impact and cost effectiveness?

Multiple systematic reviews of school-based programs to increase physical activity have found that these interventions are associated with increased physical activity among students. [1,13-15] Reviews also found evidence that these interventions are associated with positive effects on BMI [13] and obesity prevention.[16]

A 2017 benefit-cost analysis by the Washington State Institute for Public Policy (WSIPP) on school-based programs to increase physical activity found that they were associated with a positive benefit to cost ratio.[17] The WSIPP analysis estimated that elementary or middle school programs that added additional physical activity to the school day for students could result in a benefits to cost ratio of approximately $33.28 over a lifetime (in 2016 dollars, the base year for this analysis).[18] These benefits were calculated from decreased health care costs due to reductions in obesity and increased labor market earnings due to the positive impact of physical activity on academic achievement.

For questions or additional information, email healthpolicynews@cdc.gov.

1. The Guide to Community Preventive Services. Behavioral and social approaches to increase physical activity: Enhanced school-based physical education. The Community Guide: What Works to Promote Health 2013; Available at: http://www.thecommunityguide.org/pa/behavioral-social/schoolbased-pe.htmlexternal icon . Accessed September 6, 2018.

2. Robert Wood Johnson Foundation, The University of Wisconsin Population Health Institute. County health rankings & roadmaps: School-based physical education. 2014; Available at: http://www.countyhealthrankings.org/policies/school-based-physical-educationexternal icon . Accessed September 6, 2018.

3. Institute of Medicine. Educating the student body: Taking physical activity and physical education to school. Washington, DC: The National Academies Press;2013. Available at: https://doi.org/10.17226/18314external icon .

4. Robert Wood Johnson Foundation, The University of Wisconsin Population Health Institute. County health rankings & roadmaps: Physically active classrooms. 2015; Available at: http://www.countyhealthrankings.org/policies/physically-active-classroomsexternal icon . Accessed September 6, 2018.

5. McCombs J, Whitaker A, PY Yoo. The value of out-of-school time programs. Santa Monica, CA: RAND Corporation;2017. Available at: https://www.rand.org/pubs/perspectives/PE267.htmlexternal icon .

6. Donnelly JE, Lambourne K. Classroom-based physical activity, cognition, and academic achievement. Preventive medicine. 2011;52:S36-S42.

7. Centers for Disease Control Prevention. School health guidelines to promote healthy eating and physical activity. MMWR Recommendations and reports: Morbidity and mortality weekly report Recommendations and reports/Centers for Disease Control. 2011;60(RR-5):1.

8. Slater SJ, Nicholson L, Chriqui J, Turner L, Chaloupka F. The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of us public elementary schools. Arch Pediatr Adolesc Med. 2012;166(4):311-316.

9. U.S. Department of Health and Human Services. Physical activity guidelines for americans. In: U.S. Department of Health and Human Services, ed2008.

10. Centers for Disease Control Prevention. Barriers to children walking to or from school-united states, 2004. MMWR: Morbidity and mortality weekly report. 2005;54(38):949-952.

11. Physical Activity Guidelines for Americans Midcourse Report Subcommittee of the President's Council on Fitness SN. Physical activity guidelines for americans midcourse report: Strategies to increase physical activity among youth. In: Services USDoHaH, ed. Washington D.C.2012.

12. Kann L, McManus T, Harris W, et al. Youth risk behavior surveillance - united states, 2017. MMWR Surveillance Summaries. 2018;67(No. SS-8):1-114.

13. Demetriou Y, Höner O. Physical activity interventions in the school setting: A systematic review. Psychology of sport and exercise. 2012;13(2):186-196.

14. Dobbins M, Husson H, DeCorby K, LaRocca RL. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev. 2013(2):CD007651.

15. Norris E, Shelton N, Dunsmuir S, Duke-Williams O, Stamatakis E. Physically active lessons as physical activity and educational interventions: A systematic review of methods and results. Preventive medicine. 2015;72:116-125.

16. Wang Y, Cai L, Wu Y, et al. What childhood obesity prevention programmes work? A systematic review and meta‐analysis. Obesity Reviews. 2015;16(7):547-565.

17. Washington State Institute for Public Policy. Benefit-cost technical documentation: Washington state institute for public policy benefit-cost model. Washington State Dec 2017. Available at: http://wsipp.wa.gov/TechnicalDocumentation/WsippBenefitCostTechnicalDocumentation.pdfpdf icon external icon .

18. Washington State Institute for Public Policy. Benefit-cost results Washington State Dec 2017. Available at: http://wsipp.wa.gov/BenefitCost/Program/574external icon .

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office of the associate director for policy and strategy

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School-based Programs to Increase Physical Activity

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School-based programs to increase physical activity can include programs to enhance physical education (PE) [1,2] , provide daily recess,[3], incorporate physical activity into regular classroom lessons[4] and offer before and after school programs.[5] Physical education may be expanded by increasing the length of PE classes and increasing the number and

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Ch. 9 - Promoting Personal Health & Wellness

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Ch. 9 - Promoting Personal Health & Wellness

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"Promoting Students' Physical Health and Wellness"

This article details examples on how to promote students' physical health and wellness and also includes what to avoid. Examples on how to promote physical health and wellness include encouraging hand washing, encouraging students to cover their mouths when they cough or sneeze but also leading by example and doing this as well. The article also mentions that tissues and hand sanitizer can also be readily available. Teachers should also recognize signs of sickness as early as possible. The CDC also advises that students should not be rewarded with junk food and that they should also have water bottles as a way to encourage hydration.

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It's flu season, which means that classrooms around the country are stocked full of tissues and hand sanitizer. Teachers are on the lookout for any cough or sneeze - the first sign of the flu.

As a teacher, you're (hopefully) diligent in helping your students stay healthy during this beast of a flu season. But promoting good health extends further than just preventing sickness. Students' overall health and wellness affect everything from their academic performance to success later in life. Even if you're not your school's physical education teacher, there is still a lot you can do to make sure your students live healthy lives.

In this article, we'll review some best practices that you can use to promote physical health and wellness before diving into some ways that you can help your students stay healthy before, during, and after flu season.
Set a Good Example

Encourage hand washing.

Encourage students to cover their mouths when they cough or sneeze (and make sure you lead by example)

Have plenty of tissues and hand sanitizer.

Recognize the first signs of sickness so that you can send home affected students.

So beyond the no-nonsense tidbits on setting a good example, how can you encourage your students to adopt healthy habits? Tissues, hand washing, and sanitizer are only half the battle. You students' overall health determines how often and how severe they will experience colds and the flu. Also, students who lack access to healthcare professionals are at a greater risk this time of year. In the following sections, review expert advice on how to promote health and wellness throughout the school year.
The CDC
The Centers for Disease Control has plenty of advice on how to promote student health. Here are some highlights:

Don't reward students with junk food.

Let student have water bottles. Hydration is key to staying well. (And encourage students to use reusable bottles to cut down on waste .)

Use movement as a learning tool. Exercise and fun are both great for immune system function. And after all, some of your students are kinesthetic learners --it may be great for learning too.

Explore the CDC website to learn more about best practices. Also, the CDC has links to many additional resources, so be sure to check it out!
Healthy Schools Campaign
The Healthy Schools Campaign has many ideas for teachers committed to improving their students' health. Here you can find the following (and more!):

Advice for teachers: The hurdles some students face when looking for health services outside of school can be frustratingly complex. If you want to help these students, start here to learn what you can do.

Lists of local events: In March, for example, the Healthy Schools Campaign will host a cooking challenge in Dallas where students will face off in creating healthy dishes. Check the site to see what's going on in your area!

Although many of the ideas presented by the Healthy Foods Campaign promote school and district-wide initiatives, you can easily cherry pick ideas to use in your classroom.
Action for Healthy Kids
Since 2002, Action for Healthy Kids has worked diligently to battle childhood obesity through promoting physical activity and responsible food choices. On this site you will find:

Tools for Schools: A list of activities and ideas all teachers can use

Events: National events that teachers may attend. Action for Healthy Kids awards grants to cover teachers' travel expenses.

In Your State: Links to local trainings and conferences.

The organization also has many volunteer opportunities in which interest teachers may participate. In summary, Action for Healthy Kids is a great organization for teachers who are fed up by unhealthy food choices in their schools' vending machines and lunchrooms.
Final Thoughts
The three organization we've discussed in this article are only the tip of the iceberg. Even when flu season has tapered off, I encourage you to continue researching best practices: healthy habits that your students will practice for the rest of their lives.
Read more:

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Promoting Students' Physical Health and Wellness

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As a teacher, you're (hopefully) diligent in helping your students stay healthy during this beast of a flu season. But promoting good health extends further than just preventing sickness. Students' overall health and wellness affect everything from their academic performance to success later in life.

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"What can I do as a teacher or school to encourage healthy eating habits and to be active?"

This article focuses on how school communities can encourage healthy eating for their students. Strategies for schools to encourage good nutritional habits can include, but are not limited to developing a whole school food policy, offering healthy foods in school canteens, providing clean, cool-water fountains, developing a school vegetable garden, and offering regular snack breaks for students to eat fruit and vegetables.

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What can I do as a teacher or school to encourage healthy eating habits and to be active? | SA Health

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How primary school teachers and schools can help children and teens to develop healthy eating habits and to be active.