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The college years are marked by major life changes, character development, decision making about the future, added responsibilities, and moving away from home. Nurse practitioners have the unique opportunity to facilitate this transition to adulthood by using the precollege examination to screen for potential problems and to encourage the development of responsible health-promoting behaviors.

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The ever-changing, dynamic practice environment coupled with increased consumer needs and awareness create an atmosphere that requires optimal professionalism from occupational therapists. Professionalism requires specific knowledge, attitudes, and values--all manifested by professional behaviours. The authors assume that professional behaviours mature through a natural developmental process; a process that requires careful nurturing on the part of educators and clinical supervisors. Based on this assumption, the authors propose this conceptual model based on Erikson's life cycle stages. The model implies that occupational therapy professional behaviours develop sequentially through stages that begin during the educational process of occupational therapists, and progress throughout their career. The purpose of this model is to provide a framework for educators and supervisors to nurture professional behaviours in students and novice clinicians, and to continue their own professional growth.

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Adolescence is the time when health risks can stem from lifestyle choices. According to the Centers for Disease Control and Prevention (CDC), only a few behaviors account for most of the mortality, morbidity, and social problems in adolescents. These behaviors are: behaviors that result in unintentional or intentional injuries; drug and alcohol use; sexual behavior; diet; tobacco use; and physical inactivity. This article provides nurses with baseline prevention strategies to use with adolescents, parents, and communities, as well as suggestions for minimizing the incidences of preventible health problems.

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Anorexia nervosa ranks third among common chronic disorders in adolescents, surpassed only by asthma and obesity. Unfortunately, recent changes in health care and insurance have resulted in fewer resources for these vulnerable clients Anorexia and bulimia are best managed by a treatment team, but frequently it is the nurse who manages much of the eating-disordered client's care, especially when there is no available team, or when the nurse is the primary care provider or therapist. Nurses can and do care for adolescents with anorexia and bulimia. All it takes is commitment, knowledge, and networking.

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Menarche, the first menstrual period, is a significant life event with important cultural, social, and personal implications. After noticing that several girls in a rural pediatric practice reached menarche at young ages, the researchers conducted a qualitative case study to investigate when menarche occurs and factors that may be associated with menarche onset. Four of the total of seven cases reached menarche before the average age of 12.8 years and had mothers who started at later ages. All four also experienced significant stressors just prior to onset. Lack of generalizability and the small sample disallow for any significant findings. However, the findings do indicate that menarche occurs in rural girls as young as age 9, creating implications for nurses in the areas of assessment, client teaching/counseling, and future research.

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Writing is both passion and pain. However, the pain can be easily modified with a better understanding of the writing process. With structure, a little know-how, and a lot of desire, eager nurse practitioners can soon write their first manuscript. The purpose of this article is to encourage pediatric nurse practitioners to write articles that pertain to their areas of clinical expertise. Examples are used to detail the writing process from idea formation to publication.

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This descriptive study investigated the health beliefs and behaviors of 709 high school juniors in two rural counties of Pennsylvania. The Adolescent Wellness Appraisal (AWA) was utilized to survey this population in an attempt to understand rural adolescent health so that appropriate interventions could be implemented. Results demonstrated the presence of the usual adolescent problems, such as violence, substance usage, and poor nutritional and exercise habits. It also established the presence of a striking number of stressful events, such as parental loss and relocation, experienced in just a one year period of time. The results of this survey are discussed in relation to those from earlier surveys conducted by the AWA, tool creators at the University of Michigan. Overall implications suggest the need for greater availability of health promotion in rural areas, as well as suggestions for future research specific to needs of rural adolescents.

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Adolescents with bulimia nervosa present a challenge to pediatric nurse practitioners. These adolescents have a disorder that is secretive and difficult to diagnose, chronic, multifaceted, and difficult to treat. However, armed with the proper knowledge and skills, pediatric nurse practitioners are the ideal primary health care providers for this population.

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The possible causes of acute abdominal pain in the adolescent female are varied and numerous. Some problems are self-limiting, while others can be life threatening. Etiologies include, but are not limited to, gastrointestinal, urinary, gynecologic, and psychosocial problems. Assessment requires taking an accurate history quickly, and includes assessing the characteristics of the pain, any associated symptoms, and the overall physical and psychosocial health status of the adolescent. Physical assessment begins with observing how the adolescent presents herself. Although the abdomen is the focus of the examination, the general examination should not be ignored. Laboratory and radiologic testing logically follow, yet in the case of acute abdominal pain, greater reliance is placed in the symptoms and signs.

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Pediatric nurse practitioner survival strongly depends on the implementation of nursing research. As active clinicians, pediatric nurse practitioners are always seeking ways to enhance health promotion, which should include research and practice. Case study research as praxis provides a method that enhances both health promotion and scientific knowledge. This article provides an overview and an example of research as praxis to give pediatric nurse practitioners an exciting research methodology alternative.

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Psychological problems associated with bulimia nervosa affect both the client and the family. The nurse practitioner is often in a position to refer the client to a therapist who has experience in treating clients with eating disorders. The nurse practitioner and the therapist, along with the nutritionist, if available, need to work from the beginning as a team. Each team member must have a distinct role regarding management of specific aspects of client care in order to avoid confusion and attempted manipulation by the client.

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