Tuesday, March 24, 2015

Five important things you might not know about strep throat

On the Richter Scale of childhood illness, strep throat ranks pretty low, but its little tremors can wreak a fair bit of havoc on the day-to-day lives of parents and children. It’s also one of those illnesses that’s so common that people often think they know everything there is to know about it. But I’ve discovered that parents really don’t know everything about this pesky and painful illness.
Here are five important things you might not know about strep–but should:
  1. Not all sore throats are strep. In fact, at most 30 percent of sore throats are caused by group A streptococcus, the bacteria that causes strep throat. The vast majority of sore throats are caused by viruses. And while you may think you know it’s strep from how it looks or your past experience, studies have shown that it simply isn’t as easy as it might seem; viruses and strep can look remarkably similar. To make the diagnosis, we need to do a rapid strep test or a throat culture. So if your pediatrician insists on seeing your child instead of calling in a prescription, they are doing the right thing.
  2. Not all strep throats are sore. Kids with strep throat can have headaches, stomachaches, vomiting and rash, or some combination of these symptoms—and sometimes these symptoms can bother them more than their throat does. I’ve seen lot of kids in the office with vomiting or headache and no sore throat who turned out to have strep, much to the surprise of their parents.
  3. Strep usually gets better without antibiotics, but we treat it anyway. This one often surprises people. Our immune system is actually pretty good at fighting group A streptococcus, and will generally get rid of it in a few days. But we give antibiotics, for three reasons:
    • To make kids feel better faster. If you’ve ever had strep, you know how miserable it can feel.
    • To prevent complications. Although it’s rare, strep throat can lead to problems in the heart, kidney and even the brain. By treating the infection, we make those complications far less likely.
    • To prevent spread of the infection. Strep is very contagious, as many parents and teachers will tell you. Once someone has been treated with antibiotics for 24 hours, the chances that they will give it to someone else go way down.
  4. Having a positive culture doesn’t necessarily mean you have an infection. Strep can live in our noses, mouths and throats and not make us sick. This is called being a carrier, and it’s more common than people realize. Sometimes it’s hard to tell whether someone actually has strep throat or whether they are sick with a virus and happen to be a carrier! Because of this, we don’t recommend doing another test after treatment unless the person is still feeling sick. Most of the time being a carrier doesn’t cause trouble. If it seems to be causing recurrent infections, stronger antibiotics can be used, and sometimes a tonsillectomy is recommended.
  5. Even though you may feel better after a day or two, it’s important to take the full course of antibiotics. It really can be tempting to stop once that fever is gone and your child is happy and eating again—after all, they look completely better, and most kids don’t like taking medicine—but if you do, there’s a good chance the infection won’t really be gone and in a few days you’ll be right back where you started. ~Author; Claire McCarthyo

Tuesday, March 17, 2015

Scabies~Health Alert Preschool Level

Dear Parents;
A student in the school district as been diagnosed with Scabies.
Please make a point of having your child seen should he/she complain of itching in the near future.
Scabies is a highly contagious skin disease caused by a parasite
The parasite that causes scabies is a mite that burrows under the skin.
Scabies is spread through personal contact
Scabies is usually spread from person to person by close, prolonged physical contact such as touching a person who has scabies or holding hands.  It can also be spread during sexual contact.  Clothes, towels, or bed sheets can spread the scabies mite if the items were recently in contact with a person who has scabies.  The mites will die within 48 hours if they are away from the human body.  Scabies can spread quickly in crowded situations where there is frequent skin-to-skin contact (such as hospitals, nursing homes, and child care centers).  People cannot catch scabies from animals.
The most common symptom is a rash that is very itchy, especially at night

The rash can be anywhere on your body but is most common on the hands, breasts, elbows, knees, wrists, armpits, genital area, and waistline.  Often the rash looks like red bumps or tiny blisters, which form a line.  Symptoms begin 2 to 6 weeks after the first exposure to scabies, or 1 to 4 days after re-exposure.  Scratching may cause skin to become infected with bacteria (germs).
See your doctor if you have symptoms of scabies
Your doctor can check to see if your rash is due to scabies.  Scabies is diagnosed by using a microscope to look for the mite in skin scrapings.
Scabies is treatable
Creams or lotions that kill the mite (such as 5% permethrin, lindane, and crotamiton) can be applied to the skin.  Follow your doctor's instructions for treatment.  Itching may continue for up to 1 to 2 weeks after treatment; it does not mean that the treatment did not work or that you have scabies again.  Sometimes, a second course of treatment is necessary.  Clothing and bed linens worn or used in the 48 hours before treatment should be washed and dried on hot cycles or professionally dry cleaned.  There is no need for treatment of rugs or fumigation of the house, other than vacuuming and general cleanliness.
Scabies can be prevented
  • Infested persons should be excluded from school or child care until after starting treatment, usually the overnight.
  • No one should share clothing, bedding, or other personal articles with an infested person. 
  • Clothing that cannot be laundered or dry cleaned should be stored for several days to avoid reinfestation.

All household members and close contacts of a person with scabies should be treated at the same time as the person with scabies.

Nurse Donna

Tuesday, March 10, 2015

Preventing Suicide With A 'Contagion Of Strength'

For Whitney Bischoff, high school was tough. On the first day of her freshman year, a childhood friend committed suicide. Things weren't any better at home — her father died when she was 7 and her mom was an alcoholic with an abusive boyfriend.
She had a hard time making friends.
And when all the stress threatened to overwhelm her, she, too, considered suicide.
"I thought family was everything," Bischoff says. "I thought, if I didn't have family support – what am I going to do? Suicide seemed like the only way out."
As the thoughts persisted, Bischoff started going to group counseling sessions organized by her school in Rapid City, S.D.
But then something changed. Rapid City Central High started using a suicide-prevention program called Sources of Strength. The 15-year-old effort is now in more than 250 schools and community centers in 20 states. Researchers and advocates point to it as one of few prevention programs that has research behind it showing it can it work.But it didn't help. "I felt like it was always so depressing every time we talked," she says. "Having all that negative put to your face as a freshman – it was just a lot to take in."
Strength Is Contagious
I first learned about Sources of Strength last month, when four high schools in the Washington, D.C., suburbs started the program. I headed to Thomas S. Wootton High School — a top performing school in Rockville, Md., with enrollment of just over 2,000 — to see the initial student training.
It's a cold Friday morning in January. There are about 60 students sitting in folding chairs in the school's gymnasium. They're circled up, clustered around Dan Adams, a national trainer with the program. They're talking about the many stresses of high school.
"The stress of boundaries in dating," offers Shelby Ting, a sophomore. "Like what you're willing to do in your first relationship."
"I think we overlook the stress of being social," says Noah Braunstein, a senior. "Finding that group you fit in with is hard, and it's really taken me until senior year to find it."
Adams, in a black T-shirt and jeans, shifts the conversation to strengths: "What are the strengths in your life that help you deal with stress?" he asks.
Music. Friends. Family. Mac and cheese.
The Sources of Strength suicide prevention program is based on eight strengths.
The Sources of Strength suicide prevention program is based on eight strengths.
Sources of Strength
This emphasis on strengths is what Sources of Strength is all about: promoting positive behaviors in teens.
The curriculum is rooted in eight "strengths" – factors that research has shown are protective against suicide risk.
Adams walks the Wootton students through these eight strengths — family support, positive friends, spirituality, healthy activities, medical access, mentors, mental health and generosity.
For each category, students offer up examples from their own lives. "I know my really good friends don't put me under peer pressure," says a student. Another shares about how her church family really helped her get through her grandmother's passing.
"Not one of these pieces is enough to save someone from taking their own life," says Adams. "But a bunch of them – now that can make a real difference."
Jeff Brown, the acting principal of Wootton, is watching the training. He says that, like many schools, Wootton has faced issues with suicide. In 2014, the 154,000 student district lost five students to suicide.
And though national suicide rates have remained flat in recent years, it's still the third most common cause of death for 15- to 19-year-olds. And nationwide, 17 percent of American high school students said they had seriously considered suicide, according to the Centers for Disease Control and Prevention's 2013 Youth Risk Behavior Surveillance.
Teens are highly influenced by their peers – social development, peer acceptance and personal identity are all part of growing up. Researchers note that adolescents look to their peers to define acceptable ways to deal with problems.
"Kids learn from each other a great deal. So when peers are offering each other solutions, there is a greater chance kids are going to try them," says Dr. Jill Harkavy-Friedman, who leads research for the American Foundation of Suicide Prevention. She praised the Sources of Strength program for its methods, naming it as one of the few comprehensive suicide prevention programs that's based on research.
"We knew we had to have a peer component ... to bring teens into the mix," says Scott LoMurray, who runs the Sources of Strength program with his father. Mark LoMurray, Scott's father, developed the program in the late 1990s after working with law enforcement as a crisis-response expert. In a three year period, he attended 30 funerals of teenagers — a number of them due to suicide.
"We couldn't just train adults and expect that to be effective," Scott LoMurry says.
But the peer mentors didn't replace the role of adults. Instead, Sources of Strength uses adult advisers – teachers, parents and administrators – as resources for the peer-leaders.
Harkavy-Friedman says having this combination of peer-to-peer communication with adult backing makes the program stronger.
Dan Adams, a national trainer with Sources of Strength, leads a discussion with student peer-leaders at Wootton High School in Rockville, Md.i
Dan Adams, a national trainer with Sources of Strength, leads a discussion with student peer-leaders at Wootton High School in Rockville, Md.
Elissa Nadworny/NPR
An Evidence-Based Approach
Over the next five months of school, Wooton High School's newly trained peer leaders will meet with their adult advisers and other students. They'll be talking about the power of positive support and sharing stories of how the eight pillars of strength play out in their own lives.
Administrators at the school are convinced Sources of Strength will have a strong impact on their school culture – and research tends to back that up.
"This is really the first peer-leader program that has shown impact on school-wide coping norms and influence on youth connectedness," says Peter Wyman, a psychiatry professor at the University of Rochester in New York.
Wyman has been studying suicide prevention for the last 12 years. He was one of the authors of a three-year study in theAmerican Journal of Public Health that looked at the effectiveness of Sources of Strength.
The researchers looked at 18 schools in Georgia, New York and South Dakota and found big changes in health-seeking behavior. Students, the study found, started to think that adults in school could be helpful, and peer leaders successfully encouraged friends to seek help from adults. The biggest changes in behavior occurred among students who were, or had been, suicidal.
"Telling their own life stories, about overcoming adversity and people who helped – that seems to be a very potent tool for having an impact on diverse teens, including teens that may not be receptive to other kinds of information," Wyman says.
Schools are catching on — Sources of Strength is expanding programs in Palo Alto, Calif., Idaho and in a number of rural Alaskan villages north of Fairbanks. They're also starting new programs in several communities in Washington state, including one in the Tulalip tribal community.
But the price tag can be a deterrent: It costs close to $5,000to bring the program to a new school. If a school chooses to spend $4,000 to certify a staff member as an official trainer, then it will cost a school about $500 each year to maintain it.
And despite the research — school counselors sometimes find it difficult to convince schools to make it a priority. Mary Hines-Bone, a prevention specialist for the Cobb County school district, near Atlanta, says it can be tough getting schools to implement it properly. The biggest obstacle in making the program successful: the time commitment.
"It's been a real challenge to get time during school days," says Hines-Bone. "And programs where students meet before and after school don't end up being as effective."
And so schools may turn to less costly and less time-consuming approaches, like suicide-prevention assemblies or presentations that discuss the warning signs and risks of suicide.
Some prevention experts warn that programs emphasizing risks might not work as well, and researchers say there is little evidence that such one-time lectures have any effect. And they say any sustained effort must include adults talking with kids: making students part of the the intervention and not the target of it.
"The biggest prevention piece that's out there is connection. When kids feel connected to somebody or their environment they're going to make fewer risky decisions, " says Tim McGowan, the school counselor who brought the Sources of Strength program to Rapid City Central High School.
After running the program there for seven years, he says he finally has a student body that has never experienced a fellow student who has died by suicide. He says he gets lots of calls asking for advice, asking how he turned his school around. His best advice: Listen to kids and trust them.
"Sometimes kids tell us things we don't want to hear," McGowan says. "But you have to be open to those – because if you're not open to those, then you lose that opportunity for growth."
Whitney Bischoff, now 21, says she's grateful for that openness. The program gave her a space to feel supported and the ability to recognize that, while her family support wasn't as strong, she had other strengths: her friends from theater, her spirituality and her school mentor — Mr. McGowan.
She says she's come a long way since freshman year. She's on track to graduate this spring from Black Hills State University in Spearfish, S.D., with a degree in Psychology.
"That program saved me," she says, "and it gave me the passion and the confidence to want to pass it on to others."
Written by Elissa Nadworny

Monday, March 9, 2015

Helping a child cope with the death of a parent~

This topic has been wearing heavy on my heart as of late as we have several students who recently lost a parent. I have been reading various articles trying to prep myself should they come to me for additional support. I thought I would share one of the articles with all of you.

Helping a child cope with the death of a parent Key points to remember

-after a death, many children want to share their story
-telling their story is a healing experience -one of the best ways adults can help young grievers is to listen to their stories
 -children also need continuity (normal activities), care (plenty of hugs and cuddles) and connection (to still feel connected to the parent who has died, and to you)

What do bereaved children need?

After a death, many children want to share their story. They may want to tell you what happened, where they were when they were told about the death, and what it was like for them. Telling their story is a healing experience. One of the best ways adults can help young grievers is to listen to their stories. Children also need continuity, care and connection.

It is important to maintain normal activities at home, at school and in the community wherever possible. Talk to your child’s school and teacher about what has happened as soon as you can so that they are able to provide extra support for your child.


Take time to give your child plenty of hugs and cuddles. Grief can be a very lonely experience for children and adults. It’s important that your child continues to feel looked after and cared for. It may help to ask other family members and friends to help you care for your child / children in the weeks following the death, when your own grief is overwhelming.


When an important family member dies, the whole family can feel fractured and incomplete. It’s quite natural to want to withdraw for a while and it is at this time that children can feel lonely and disconnected from their grieving parent. It’s important that your child is able to still feel connected to the parent who has died and to you. You can help them to do this in the practical ways listed below. Specifically, they need: adequate information about the death their fears and anxieties addressed reassurance that they are not to blame careful listening acknowledgement and acceptance of their feelings and grief a sense of safety in the world respect for their own way of coping people who will guide and help help with overwhelming emotions involvement and inclusion in rituals and anniversaries opportunities to remember the person who has died

Three important questions young children might not ask but you might help to answer 

Who will look after me?
Will I get sick?
Did I cause my parent to die?

The death of a parent can shake the foundations of a child’s belief in the world as a safe place. Your child will need plenty of reassurance and encouragement to begin to feel safe again. Some children may worry about getting sick and dying themselves and it may reassure them to visit your family doctor for a check-up. It’s a good idea to give the doctor a ring before you visit so that they can be prepared for any questions your child may ask.

Communicating with your grieving child

Keeping communication open with children and young people can be the greatest challenge for a grieving caregiver. Children may not necessarily wish to talk but they need to be able to express their grief and sadness. Below are some practical suggestions to help you with this.

How you can help children explore and express their grief: 

Practical ideas talk about the person who has died and use their name make a memory store / box and use this to store precious things that offer memories of the parent who has died pool the available photos and make copies for all the children concerned create an album of photographs and stories keep a journal of memories questionnaires - put together questions that build a portrait of the parent. These can be asked and answered together as a family before and / or after the death of a parent. For example: what was their favourite food? what was their favourite place? what was their favourite TV programme? linking objects and special things – it is important for children to have some of the special objects that belonged to their parent. These might be items of clothing, jewellery or other objects make time to sit down and listen – your child will talk when they are ready and usually in small bursts. These are precious windows to your child’s understanding of what has happened create special and unique rituals or remembrance activities

When can therapy help?

Children often protect their parents fearing that they will bring further sadness if they express their grief. Sometimes children experience difficulties with grief and may need professional help. The following are signs that your child may need help.

Many of these signs are normal following the death of a parent but may indicate a problem if they are prolonged and entrenched. persistent difficulty talking about the parent who has died aggressive behaviour and anger unexplained physical symptoms and discomfort; for example,
-stomach aches, headaches sleeping difficulties eating disturbance
– eating excessively or having very little appetite marked social withdrawal
– not wanting to socialise with friends or others outside the family school difficulties
- serious academic reversal, inability to concentrate or behavioural problems persistent blame or guilt self destructive behaviour
– engaging in at-risk behaviour, talking about wanting to hurt themselves

Therapy offers the older child or adolescent the opportunity to talk about very difficult things in a safe and non-judgemental environment. The therapist or counsellor may suggest that you come with your children and that you all talk together. Children under about eight years will need the opportunity for expression that play therapy offers.

Remember that very young children and infants are also deeply affected by the loss of a parent although their way of managing the feelings will not always be apparent. Information about child and family counsellors, psychologists and psychotherapists.

 It is very important to check, and okay to ask, whether the clinician has clinical training and experience in working with children and young people. (information from KidsHealth.org)

Nurse Donna