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(CHAPTER 1)Tj
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(hEALTH cLINIC ENVIRONMENTS IN GEORGIA ELEMENTARY SCHOOLS)Tj
15.836 -2 Td
(2005)Tj
0.584 -2 Td
(by)Tj
-5.945 -2 Td
(SUSAN ROGERS SIMPSON)Tj
-4.084 -2 Td
(\(Under the Direction of C. KENNETH TANNER\))Tj
7.89 -2 Td
(ABSTRACT)Tj
-29.283 -2 Td
(Schools seem to be the logical place to serve the health needs of studen\
ts, since children spend a majority of their time there.)Tj
( Design standards )Tj
0 -2 TD
(were not available for health clinics in Georgia elementary schools; the\
refore, this study examined key characteristics of an el)Tj
(ementary school )Tj
T*
(clinic in order to determine the importance of each design element. Elev\
en design classifications and 12 specific design element)Tj
(s were )Tj
T*
(determined through a review of related literature. Characteristics inclu\
ded: components \(rooms\), space, and size; general design)Tj
( elements; )Tj
T*
(location; accessibility; the waiting area; the nurse\355s office; the tr\
eatment room; the isolation area; the restroom \(toilet\); se)Tj
(curity, storage, and )Tj
T*
(safety elements; and furnishings/treatments. Specific design elements in\
cluded: lighting; windows; integrating nature elements i)Tj
(nto design; )Tj
T*
(promoting a sense of well-being for users; security and privacy/confiden\
tiality elements; electrical/plumbing elements; doors an)Tj
(d wayfinding )Tj
T*
(\(signage\); walls and ceilings; acoustics; use of color; heating/ventil\
ation/air conditioning; and flooring elements. This inform)Tj
(ation was )Tj
T*
(incorporated in a survey of 12 experts involved with designing, building\
, and managing school facilities and 104 school nurses. )Tj
(An item analysis )Tj
T*
(was completed on each design statement. Descriptive statistics and ANOVA\
s were completed on characteristics and specific design )Tj
(elements. )Tj
T*
(Statistical significance between the groups was found for design charact\
eristics: components \(rooms\), space and size; the waitin)Tj
(g area; the )Tj
T*
(nurse\355s office; and the treatment room. School nurses perceived these\
characteristics to be more important to clinic design than)Tj
( the advisory )Tj
T*
(panel did. )Tj
(In addition, statistical significance between groups was found for these\
specific design elements: integrating nature elements; )Tj
T*
(promoting a sense of well-being; security and privacy/confidentiality; a\
nd heating/ventilation/air conditioning. Again, school n)Tj
(urses perceived )Tj
T*
(these specific design elements to be more important to clinic design tha\
n the advisory panel of architects, builders, consultant)Tj
(s, and facility )Tj
T*
(planners did. School nurses commented that the survey statements present\
ed an ideal clinic design. The advisory panel commented )Tj
(that many )Tj
T*
(of the survey statements were not cost effective. Establishing design gu\
idelines for health clinics in Georgia elementary school)Tj
(s were )Tj
T*
(recommended, and the guidelines should be written using the professional\
judgment of school nurses, representatives of users of )Tj
(the clinic, and )Tj
T*
(the findings of this study. )Tj
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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11.6414 0 0 11.6414 27.9392 577.9695 Tm
( )Tj
7.2 -1.2 Td
(INDEX WORDS: School Facilities, School Design, Health Clinic, Desi\
gn Elements, Elementary School, School Nurse)Tj
-7.2 -1.6 Td
( )Tj
0 -2 TD
( )Tj
29.144 -2 Td
(CHAPTER 1)Tj
-3.056 -2 Td
(NATURE OF THE STUDY)Tj
-26.088 -2 Td
(Health and learning have intertwined throughout history \(The Center for\
Health and Healthcare in Schools, n.d.a; Symons, Cinelli)Tj
(, James, & )Tj
T*
(Groff, 1997\). Therefore, schools seem to be the logical place to serve \
the health needs of students since children spend a major)Tj
(ity of their time, )Tj
T*
(about 14,000 hours, in schools \(Barnett, Niebuhr, & Baldwin, 1998; Brad\
ley, 1997; Carlson, Paavola, & Talley, 1995; Gump, 1978; )Tj
(Koenning et )Tj
T*
(al., 1995; Pena, 2000\). As a result, the school became the link between\
education, health, social services, and other support se)Tj
(rvices that )Tj
T*
(children and families needed \(Bush, 1997; Dryfoos, 1994\). )Tj
T*
(Controversy surrounds the issue of offering health care services in scho\
ols \(Francis, Hemmat, Treloar, & Yarandi, 1996; Institut)Tj
(e of Medicine, )Tj
T*
(1997\). A number of developments have weakened the argument against heal\
th care delivery in schools. The literature suggests that)Tj
( the )Tj
T*
(physical and psychological health of children has a direct impact on the\
ir academic and social development in school \(Bush, 1997)Tj
(; Dryfoos, )Tj
T*
(1997; Hacker & Wessel, 1998; Jang, 1994; Morgan, 1987; Ouellette, 2001; \
Passerelli, 1994; Symons, et al., 1997; Tyson, 1999\). )Tj
(Pena \(2000\) )Tj
T*
(stated:)Tj
2.4 -1.6 Td
(Conditions of poverty, emotional and psychological distress, child abuse\
, poor nutrition, disease, inadequate preventive and hea)Tj
(lth )Tj
0 -1.2 TD
(maintenance practices \326weaken and imperil the academic and future liv\
es of students. Hence, health care\326in public schools probab)Tj
(ly )Tj
0 -1.2 TD
(starts with administrators and school personnel becoming aware of the he\
alth status of students and continues with their recogni)Tj
(zing that )Tj
T*
(health care assistance is not charity. It is a right that students are \
entitled to by law. \(p. 200\))Tj
T*
( )Tj
-2.4 -1.6 Td
(The concept and practice of inclusion are putting significant numbers of\
students with disabilities in the regular classroom \(Ba)Tj
(rtlett, Parette, & )Tj
0 -2 TD
(Holder-Brown, 1994\). Existing federal legislation mandates that health \
services be provided for children with disabilities and h)Tj
(ealth problems )Tj
T*
(\(Americans with Disabilities Act, 1990; Individuals with Disabilities E\
ducation Act, 1990 & 1997; Section 504 of the Rehabilitat)Tj
(ion Act, 1973\). )Tj
T*
(School nurses are key players in the delivery of health services in the \
school setting \(Passarelli, 1994\). Some school nurses ar)Tj
(e itinerant staff )Tj
T*
(members, some nurses are full-time sole staff members of the school heal\
th clinic, and some nurses are integral staff members of)Tj
( full-service )Tj
T*
(health centers located in a school setting. The past and current roles o\
f the professional school nurse are described throughout)Tj
( the professional )Tj
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6.9848 0 0 6.9848 18 8.6993 Tm
(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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(CHAPTER 1)Tj
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/Article <>BDC
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0 18 792 576 re
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/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 579.3805 Tm
(literature \(Brindis et al., 1998; Clemen-Stone, Eigsti & McGuire, 1991;\
Costante & Smith, 1997; Cromwell, 1946, 1963; Dryfoos, 1)Tj
(998; Edwards, )Tj
0 -2 TD
(1987; Fryer & Igoe, 1996; Hacker & Wessel, 1998; Nelson, 1997; Oda, 1979\
; Passarelli, 1995; Small et al., 1995; Smiley, 1958; Wo)Tj
(ld & Dagg, )Tj
T*
(1978; Woodfill & Beyrer, 1991\). School nurses provide \354health counse\
ling, health instruction, and health services on an individu)Tj
(al or small group )Tj
T*
(basis\356 \(Woodfill & Beyrer, 1991, p. 57\).)Tj
T*
(Often, health-related procedures are performed in inadequate conditions \
and facilities in public schools. School settings for th)Tj
(e health clinic vary )Tj
T*
(from clinics operating from hallways and closets \(Woodfill & Beyrer, 19\
91\) to full-service clinics supported by a hospital or ot)Tj
(her medical )Tj
T*
(organization \(Dryfoos, 1997\). )Tj
(Public schools need additional funding to hire school nurses and, in som\
e instances, to remodel existing or build )Tj
T*
(new facilities to accommodate the needs of medically fragile children an\
d the increasing health needs of students. The American )Tj
(Federation of )Tj
T*
(Teachers \(AFT\) manual \(1992\) states:)Tj
2.4 -1.6 Td
(The placement of\326medically fragile children in public schools and the\
responsibilities for care these placements require have gi)Tj
(ven rise )Tj
0 -1.2 TD
(to\326the need for adequate funding, availability of appropriate facilit\
ies, new roles and responsibilities for school personnel, a)Tj
(ppropriate )Tj
T*
(training, and legal and liability issues. \(p. 9\))Tj
T*
( )Tj
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465.881 312.281 l
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/TT0 1 Tf
11.6414 0 0 11.6414 333.8798 313.9577 Tm
(Statement of the Problem)Tj
-26.28 -2 Td
(Since the introduction of the first school nurse in 1902, schools have p\
rovided some access to health education and care for stu)Tj
(dents \(Kellogg )Tj
0 -2 TD
(Foundation, 2000\). Barnett, et al. \(1998\) stated that schools were \354\
a natural setting for the co-location of integrated communit)Tj
(y health and social )Tj
T*
(services\356 \(p. 99\). Other researchers reported that providing health\
services to students in schools affected student achievement)Tj
( \(Bush, 1997; )Tj
T*
(Igoe, 1998; Jang, 1994; Koenning et al., 1995; Passerelli, 1994\).)Tj
T*
(Planners for new schools and for renovations of existing school building\
s have explored designs that)Tj
/TT1 1 Tf
( )Tj
/TT0 1 Tf
(encouraged and stimulated learning. )Tj
0 -2.027 TD
(Planners may explore adding clinics to school designs to assist students\
in learning. While design standards are necessary for e)Tj
(ach component )Tj
0 -2 TD
(of the school building, clinic design standards and characteristics are \
not available for Georgia schools. According to R. Nance)Tj
( \(personal )Tj
T*
(communication, July 1, 2002\), an architect with the Georgia Department \
of Education, \354There are no DOE standards for clinics at )Tj
(this time. The )Tj
T*
(design decisions are left to the local system and their architect.\356 J\
. Allers \(personal communication, July 23, 2001\), the manag)Tj
(er for the School )Tj
T*
(Health Department of Children\355s Healthcare of Atlanta, wrote:)Tj
2.4 -1.6 Td
(We are happy right now when nurses get running water, soap, paper towels\
, a private toilet for sick children, and a place to loc)Tj
(k up meds, )Tj
0 -1.2 TD
(i.e. a locking file cabinet. We have nurses in GA without a health room \
of any kind. Phones and computers are nice.)Tj
-2.4 -1.6 Td
(Literature about successful classroom and school design existed and lite\
rature about successful designs for hospital and ambulat)Tj
(ory care )Tj
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0 18 792 576 re
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11.6414 0 0 11.6414 27.9392 579.3805 Tm
(facilities was available; however, research and literature on design for\
school clinics and health clinics in elementary schools)Tj
( was very limited. )Tj
0 -2 TD
(Sanoff \(1994\) wrote that the people who actually used the school build\
ing rarely assisted in the design process. Instead, archit)Tj
(ects, builders and )Tj
T*
(others who did not use the building designed schools. This study offered\
professional school nurses, as well as architects, buil)Tj
(ders, consultants, )Tj
T*
(and planners of school facilities, an opportunity to express their perce\
ptions about design characteristics for an elementary sc)Tj
(hool health care )Tj
T*
(clinic.)Tj
ET
0 0 0 RG
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345.521 461.291 m
454.24 461.291 l
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/TT0 1 Tf
11.6414 0 0 11.6414 345.5211 462.967 Tm
(Purpose of the Study)Tj
-27.28 -2 Td
(The purpose of this study was to compare perceptions of school nurses, a\
rchitects, builders, consultants, and planners for schoo)Tj
(l facilities )Tj
T*
(regarding design characteristics of an elementary school health care cli\
nic. To accomplish this purpose, this study included a r)Tj
(eview of the )Tj
T*
(major literature on the relationship between health and learning, on fac\
tors that affect the health of students, on using school)Tj
(s as a healthcare )Tj
T*
(delivery system, on the status of school facilities, on the history of s\
chool nurses, and on the design characteristics of an el)Tj
(ementary health care )Tj
T*
(clinic. Based on the responses, key clinic design elements items were id\
entified and were utilized to develop recommendations fo)Tj
(r facility )Tj
T*
(guidelines for an elementary school health care clinic.)Tj
ET
27.939 304.132 m
31.176 304.132 l
S
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/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 305.8087 Tm
( )Tj
ET
347.151 286.67 m
452.61 286.67 l
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BT
/TT0 1 Tf
11.6414 0 0 11.6414 347.1509 288.3467 Tm
(Research Questions)Tj
-27.42 -2 Td
(The research question that guided this study was: What were the percepti\
ons of architects, builders, consultants, planners of sc)Tj
(hool facilities )Tj
T*
(and school nurses concerning the key design elements for an elementary s\
chool health clinic? )Tj
7.2 -2 Td
(1.)Tj
/TT1 1 Tf
6.7908 0 0 6.7908 121.4659 218.4986 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 143.5359 218.4986 Tm
(Is there a statistically significant difference between the perspectives\
of practicing school nurses \(practitioners\) and the )Tj
-2.73 -2 Td
(advisory panel regarding the 11 design classifications?)Tj
T*
(a\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 122.1061 171.9332 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 144.1762 171.9332 Tm
(Components, space, and size elements)Tj
-2.785 -2 Td
(b\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 122.1061 148.6505 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 144.1762 148.6505 Tm
(General design elements)Tj
-2.785 -2 Td
(c\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 121.4542 125.3678 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 143.5243 125.3678 Tm
(Location of the clinic)Tj
-2.729 -2 Td
(d\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 122.1061 102.0851 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 144.1762 102.0851 Tm
(Accessibility to the clinic)Tj
-2.785 -2 Td
(e\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 122.1061 78.8024 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 144.1762 78.8024 Tm
(Waiting area)Tj
-2.785 -2 Td
(f\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 118.8698 55.5197 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 144.3353 55.5197 Tm
(Nurse\355s station/office )Tj
-2.799 -2 Td
(g\))Tj
/TT1 1 Tf
6.7908 0 0 6.7908 122.1061 32.237 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 144.1762 32.237 Tm
(Examination/treatment room)Tj
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( )Tj
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(k\))Tj
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( )Tj
/TT0 1 Tf
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(Participants)Tj
-29.338 -2 Td
(The advisory panel included architects, builders, consultants, and facil\
ity planners of elementary schools. The second group of )Tj
(survey )Tj
0 -2 TD
(participants was a small group of four school nurses. The survey was adm\
inistered to 100 school nurses attending the annual Geor)Tj
(gia )Tj
T*
(Association of School Nurses\355 conference.)Tj
ET
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/TT0 1 Tf
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(Instrumentation)Tj
-28.504 -2 Td
(The researcher generated a demographics sheet for the survey. A comprehe\
nsive survey on 100 health clinic design elements was de)Tj
(veloped )Tj
T*
(based on the findings of the literature review. Spaces for comments or c\
oncerns for each design element were provided for the su)Tj
(rvey )Tj
T*
(participants. A 10-point Likert Scale indicating the degree of importanc\
e for the design element, ranging from very low to very )Tj
(high, was used to )Tj
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(rate each survey statement. )Tj
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(Method)Tj
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(A select group of four school nurses completed the survey for reliabilit\
y, readability, and clarity. The survey was mailed to 12)Tj
( selected members )Tj
0 -2 TD
(of the advisory panel to provide comparison data for the survey. Finally\
, the researcher attended the annual school nurses\355 conf)Tj
(erence in )Tj
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(Savannah on July 25, 2004. One hundred school nurses attending the confe\
rence completed the survey.)Tj
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(Statistical Treatment)Tj
-27.393 -2 Td
(Descriptive procedures were used to produce means and standard deviation\
s for the 11 design classifications and the 12 specific )Tj
(design )Tj
T*
(elements. Likert scale questions were appropriate to print means for sin\
ce the number that was coded for a question gave a direc)Tj
(tion for the )Tj
T*
(average answer. A minimum and maximum value showed the range of answers \
given by the survey population. An item analysis was com)Tj
(puted )Tj
T*
(for each of the 100 design statements or variables.)Tj
T*
(According to SPSS, a Cronbach\355s alpha was computed to \354measure how\
well a set of items \(or variables\) measure a single unidimens)Tj
(ional )Tj
T*
(latent construct. Cronbach\355s alpha is not a statistical test but is a\
coefficient of reliability \(or consistency\). In this study)Tj
(, identification of key )Tj
T*
(design classifications for the health clinic was the latent construct. C\
ronbach\355s alpha was a function of the number of items an)Tj
(d the average )Tj
T*
(inter-correlation among these items. As the inter-item correlation incre\
ased, Cronbach\355s alpha increased as well and there was e)Tj
(vidence that )Tj
T*
(the items were measuring the same underlying construct producing high re\
liability. The survey instrument provided a large number)Tj
( of )Tj
T*
(statements for review. The high alpha for the 11 design classifications \
indicated consistency in measuring these classifications)Tj
(.)Tj
T*
(Tests for homogeneity of variances were computed for the 11 design class\
ifications and the 12 specific design elements. To find )Tj
(out if there )Tj
T*
(were significant differences between the means of the two groups\363Grou\
p 1, practicing school nurses; and Group 2\363architects, buil)Tj
(ders, )Tj
T*
(consultants, and planners for school facilities\363 an analysis of varia\
nce \(ANOVA\) was computed for the 11 design classifications )Tj
(and for the 12 )Tj
T*
(specific design elements.)Tj
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( )Tj
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(CHAPTER 4)Tj
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(FINDINGS)Tj
-29.561 -2 Td
(This chapter presents the results of the surveys completed by seven memb\
ers of the advisory panel and 104 practicing school nurs)Tj
(es. The )Tj
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(results, an analysis of the results, and a summary are included in this \
chapter.)Tj
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(surveys were )Tj
0 -2 TD
(used. Respondents were divided into two groups\363architects, builders, \
consultants, and planners for school facilities and school )Tj
(nurses. )Tj
T*
(Demographic data were coded and entered as variables 1\36131. Design ele\
ment statements on the survey were considered individually,)Tj
( as )Tj
T*
(design cluster variables, and as cluster variables for a specific design\
element.)Tj
T*
(A Likert scale of 1 to 10 was used to indicate the respondent\355s perce\
ption of the importance of the statement to the design of a)Tj
( health clinic in )Tj
T*
(an elementary school. This analysis reported the degree of importance fo\
r each statement and for each cluster in the survey. Res)Tj
(ults for each )Tj
T*
(cluster, for specific design elements clusters, and differences between \
groups are discussed and presented in tables in this cha)Tj
(pter.)Tj
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(Design Cluster Variables)Tj
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rting purposes. These design cluster variables occurred )Tj
(naturally on the )Tj
T*
(survey instrument with the first statement on the survey coded as variab\
le 32. Assigned variable numbers are in parentheses at t)Tj
(he end of each )Tj
T*
(statement on the survey in Appendix A. An item analysis in Appendix B wa\
s completed on each of the 100 variables.)Tj
T*
(The first design cluster for components, size and space requirements \(C\
SSR\), had five statements, variables 32--36. The general )Tj
(design )Tj
T*
(elements \(GDR\) cluster had 13 statements, variables 37--49. Location o\
f the health clinic \(LOC\) had 7 statements, variables 50--)Tj
(56. )Tj
T*
(Accessibility \(ACC\) had three statements, variables 57--59. The waitin\
g area \(WAIT\) had six statements, variables 60--65. The nu)Tj
(rse\355s office )Tj
T*
(\(NOFF\) had 16 statements, variables 66--81. The treatment room \(TRRM\)\
had 26 statements, variables 82--107. The rest/isolation a)Tj
(rea \(ISOL\) )Tj
T*
(had five statements, variables 108--112. The restroom or toilet room \(R\
ESTR\) had nine statements, variables 113--121. Security, )Tj
(storage and )Tj
T*
(safety \(SSS\) had six statements, variables 122--127. Furnishings and t\
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(Reliability)Tj
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(The internal consistency of the survey statements was calculated with an\
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(administered only one time to the expert group and the group of practici\
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(he items. The )Tj
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ster variable. Since the inter-item correlations were hi)Tj
(gh, there was )Tj
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T*
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(ts \(CSSR\) )Tj
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(Analysis for Design Cluster Variables)Tj
T*
(The research question was stated as follows: Is there a statistically si\
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(ing school nurses )Tj
T*
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s and standard deviations for the perspectives of the tw)Tj
(o groups are )Tj
T*
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(, and planners of )Tj
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(school facilities. )Tj
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(Table 2 also shows the variances for the tests of homogeneity. Since all\
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(s were found to )Tj
T*
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(qual)Tj
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(Table 3 displays the statistically significant differences between the t\
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(T, NOFF, and )Tj
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(p <)Tj
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(ory panel )Tj
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(Number)Tj
5.19 1.2 Td
(Standardized)Tj
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(N Valid/)Tj
-0.444 -1.2 Td
(N Missing)Tj
9.014 1.2 Td
( )Tj
-1.111 -1.2 Td
(Mean)Tj
5.805 1.2 Td
(Standard)Tj
-0.055 -1.2 Td
(Deviation)Tj
-50.224 -1.242 Td
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(Size Requirements \(CSSR\))Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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(.74)Tj
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( )Tj
-1.112 -1.2 Td
(111/0)Tj
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( )Tj
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( )Tj
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(1.30)Tj
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( )Tj
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( )Tj
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( )Tj
11.486 0 Td
( )Tj
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( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
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(Within Groups)Tj
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(347.19)Tj
6.47 0 Td
(108)Tj
4.661 0 Td
(3.22)Tj
5.634 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
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( )Tj
11.486 0 Td
( )Tj
5.775 0 Td
( )Tj
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( )Tj
4.8 0 Td
( )Tj
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( )Tj
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(109)Tj
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( )Tj
4.8 0 Td
( )Tj
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( )Tj
-43.661 -1.242 Td
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( )Tj
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( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
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6.47 0 Td
(1)Tj
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4.8 0 Td
(1.59)Tj
5.078 0 Td
(.21)Tj
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( )Tj
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( )Tj
11.486 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
4.8 0 Td
( )Tj
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( )Tj
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(Total)Tj
10.096 0 Td
(380.70)Tj
6.47 0 Td
(110)Tj
5.495 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
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(1.99)Tj
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(.16)Tj
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( )Tj
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( )Tj
11.486 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
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(Within Groups)Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
11.486 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
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(110)Tj
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( )Tj
4.8 0 Td
( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
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( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
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( )Tj
-43.661 -1.2 Td
( )Tj
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( )Tj
11.486 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
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( )Tj
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( )Tj
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(1,109)Tj
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(ts \(variables )Tj
0 -2 TD
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(\(WINDOWS\) contained four statements \(variables 37, 38, 79, and 100\).\
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(egrating )Tj
T*
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(\(variables )Tj
T*
(64, 65, 106, 108, 110, 128, 129, and 130\). The cluster for use of color\
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(ariables 43, )Tj
T*
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(es 63, 66, 68, )Tj
T*
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(. Electrical and )Tj
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T*
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T*
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(.41)Tj
4.8 0 Td
(.53)Tj
-43.105 -2.4 Td
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
10.8 0 Td
(Within )Tj
T*
(Groups)Tj
8.596 1.2 Td
(394.51)Tj
8.473 0 Td
(99)Tj
5.358 0 Td
(3.99)Tj
5.634 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -2.4 Td
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
10.8 0 Td
(Total)Tj
8.596 0 Td
(396.13)Tj
8.195 0 Td
(100)Tj
6.47 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.242 Td
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
(Heating, Ventilation )Tj
T*
(and Air Conditioning )Tj
T*
(\(HVAC\))Tj
10.8 2.4 Td
( )Tj
T*
(Between )Tj
T*
(Groups)Tj
9.986 2.4 Td
( )Tj
-1.112 -1.2 Td
(27.64)Tj
8.612 1.2 Td
( )Tj
-0.139 -1.2 Td
(1)Tj
5.914 1.2 Td
( )Tj
-1.112 -1.2 Td
(27.64)Tj
5.912 1.2 Td
( )Tj
-0.834 -1.2 Td
(7.28)Tj
5.634 1.2 Td
( )Tj
-0.88 -1.2 Td
(.01)Tj
9.7011 0 0 9.7011 542.1475 265.3462 Tm
(**)Tj
11.6414 0 0 11.6414 27.9392 237.407 Tm
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
10.8 0 Td
(Within )Tj
0 -1.2 TD
(Groups)Tj
8.596 1.2 Td
(394.89)Tj
8.195 0 Td
(104)Tj
5.636 0 Td
(3.80)Tj
5.634 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -2.4 Td
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
10.8 0 Td
(Total)Tj
8.596 0 Td
(422.53)Tj
8.195 0 Td
(105)Tj
6.47 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.242 Td
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
(Flooring \(FLOOR\))Tj
10.8 0 Td
(Between )Tj
0 -1.2 TD
(Groups)Tj
9.152 1.2 Td
(3.14)Tj
8.195 0 Td
(1)Tj
5.08 0 Td
(3.14)Tj
5.078 0 Td
(.93)Tj
4.8 0 Td
(.34)Tj
-43.105 -2.4 Td
( )Tj
16.522 0 Td
( )Tj
4.264 0 Td
( )Tj
7.5 0 Td
( )Tj
5.775 0 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -1.2 Td
( )Tj
10.8 0 Td
(Within )Tj
0 -1.2 TD
(Groups)Tj
8.596 1.2 Td
(336.29)Tj
8.473 0 Td
(99)Tj
5.358 0 Td
(3.40)Tj
5.634 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -2.4 Td
( )Tj
10.8 0 Td
( )Tj
T*
(Total)Tj
9.986 1.2 Td
( )Tj
-1.39 -1.2 Td
(339.43)Tj
8.89 1.2 Td
( )Tj
-0.695 -1.2 Td
(100)Tj
6.47 1.2 Td
( )Tj
4.8 0 Td
( )Tj
4.8 0 Td
( )Tj
-43.661 -2.4 Td
(________________________________________________________________________\
___________________ )Tj
/TT1 1 Tf
9.7011 0 0 9.7011 27.9392 39.1416 Tm
(*p< .05, **p < .01)Tj
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 23.1091 Tm
( )Tj
ET
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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/Article <>BDC
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0 18 792 576 re
W* n
0 0 0 RG
0.559 w 10 M 0 j 0 J []0 d
219.32 577.704 m
226.119 577.704 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 579.3805 Tm
(windows \(WINDOWS\) F)Tj
7.7609 0 0 7.7609 152.7578 576.897 Tm
(1,95)Tj
9.3131 0 0 9.3131 167.8605 576.4003 Tm
( )Tj
11.6414 0 0 11.6414 170.4496 579.3805 Tm
(= 7.54, p < .01. Nurses perceived this element to be significantly more \
important than did the advisory panel \(Mean )Tj
ET
666.46 549.03 m
673.258 549.03 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 550.706 Tm
(for Nurses = 8.78; Mean for Panel = 6.32\). The cluster adding nature el\
ements into clinic design \(NATURE\) F)Tj
7.7609 0 0 7.7609 589.5414 548.2225 Tm
(1,104 )Tj
11.6414 0 0 11.6414 611.1167 550.706 Tm
(= 13.23, p < .00. Again, )Tj
-50.095 -2.345 Td
(nurses perceived this design element significantly more important than t\
he advisory panel did \(Mean for Nurses = 7.29; Mean for )Tj
(Panel = 4.10\). )Tj
ET
583.833 498.445 m
590.632 498.445 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 500.1211 Tm
(For the cluster of design items that promoted a sense of well-being for \
clinic users \(WELLBE\) F)Tj
7.7609 0 0 7.7609 517.7026 497.6376 Tm
(1,95 )Tj
11.6414 0 0 11.6414 534.9628 500.1211 Tm
(= 5.91, p < .02. Practicing school nurses )Tj
-43.554 -2.345 Td
(perceived these items significantly more important than the advisory pan\
el did \(Mean for Nurses = 6.91; Mean for Panel = 5.16\). )Tj
ET
457.036 447.86 m
463.834 447.86 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 449.5362 Tm
(Privacy, security, and confidentiality \(PSC\) design elements had an F)Tj
7.7609 0 0 7.7609 384.4324 447.0527 Tm
(1,96 )Tj
11.6414 0 0 11.6414 401.6926 449.5362 Tm
(= 10.39, p < .00. Nurses perceived these item significantly more )Tj
-32.106 -2.345 Td
(important that the advisory panel did \(Mean for Nurses= 7.27; Mean for \
Panel = 5.09\). The last design element that showed a stat)Tj
(istically )Tj
0 -2 TD
(significant difference between the advisory panel and nurses was heating\
, ventilation, and air conditioning statements \(HVAC\) wi)Tj
(th an F)Tj
7.7609 0 0 7.7609 725.4425 396.4679 Tm
(1,104 )Tj
11.6414 0 0 11.6414 747.0178 398.9514 Tm
(= )Tj
ET
66.775 369.973 m
73.573 369.973 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 371.6492 Tm
(7.28, p <)Tj
( .01. Practicing nurses perceived this design element significantly more\
important that the panel did \(Mean for Nurses = 8.15; M)Tj
(ean for )Tj
T*
(Panel = 6.10\).)Tj
ET
27.939 323.407 m
187.752 323.407 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 325.0838 Tm
(Demographics of Respondents)Tj
T*
(Twelve surveys were sent to the selected panel of experts. Seven surveys\
were returned. All respondents to the clinic design sur)Tj
(vey for the )Tj
T*
(advisory panel group were males and included two architects, a builder, \
two facilities planners, and two Georgia Department of E)Tj
(ducation )Tj
T*
(facilities consultants. All panel members were actively designing, const\
ructing, or managing new construction or renovation of s)Tj
(chools.)Tj
T*
(Surveys were given to 110 school nurses at the annual conference with 10\
0 surveys completed and returned to the researcher. Four)Tj
( practicing )Tj
T*
(school nurses completed the survey before the conference .All 104 respon\
dents were females who were practicing nurses in schools)Tj
(. )Tj
T*
(A coded demographic sheet is shown in Appendix C. Demographic data for o\
ccupation, age, ethnicity, marital status, income, years)Tj
( as a nurse, )Tj
T*
(years as a school nurse and educational degree are reported in Appendix \
D. Data for work setting, hours worked, size of school, )Tj
(and availability )Tj
T*
(of clinic or nurse\355s office were inconsistent or not completed for al\
l 104 respondents. For gathered data, the researcher for re)Tj
(porting purposes )Tj
T*
(tabulated frequencies and percents.)Tj
T*
(Of the 104 school nurse surveys, 72 respondents \(69%\) worked in a scho\
ol setting including an elementary school. Of these 72 res)Tj
(pondents, )Tj
T*
(49 nurses \(68%\) worked in an elementary school only. The remaining 23 \
respondents \(32%\) worked in a combination setting of eleme)Tj
(ntary/)Tj
T*
(middle school, elementary/high school, or elementary/middle school/high \
school. )Tj
T*
(School setting choices were rural, suburban, or inner-city. For nurses \(\
72\) that worked in an elementary school, 32 respondents )Tj
(\(44%\) worked )Tj
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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0 18 792 576 re
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/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 575.1259 Tm
(in a rural setting, 18 respondents \(25%\) worked in a suburban setting,\
15 respondents \(21%\) worked in an inner-city setting, and)Tj
( seven nurses )Tj
0 -2 TD
(\(10%\) did not respond to the question. )Tj
T*
(The number of hours worked for all practitioners ranged from eight hours\
per week or part-time employment to 40 hours per week o)Tj
(r full time )Tj
T*
(employment. Data for the size of the school setting and the setting havi\
ng a clinic or nurse\355s office were not tabulated due to )Tj
(lack of responses )Tj
T*
(or incomplete responses.)Tj
0 -1.5 TD
( )Tj
31.811 -1.5 Td
( )Tj
0 -2 TD
( )Tj
-2.667 -2 Td
(CHAPTER 5)Tj
-10.223 -2 Td
(SUMMARY, RECOMMENDATIONS, AND IMPLICATIONS)Tj
-18.921 -2 Td
(This chapter presents a summary of the study and reviews the findings of\
the research. The chapter concludes with recommendation)Tj
(s for )Tj
T*
(enhancing or adding health clinics to elementary schools in the state of\
Georgia, and implications for further research.)Tj
ET
0 0 0 RG
0.559 w 10 M 0 j 0 J []0 d
342.297 305.698 m
457.464 305.698 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 342.2965 307.3748 Tm
(Summary of the Study)Tj
-27.003 -2 Td
(Schools seem to be the logical place to serve the health care needs of s\
tudents and to provide access to the health services, si)Tj
(nce students are )Tj
T*
(located in schools for a majority of each day. The school becomes the li\
nk between education, health, social services, and other)Tj
( support )Tj
T*
(services that children and families need. Existing federal legislation m\
andated that health services be provided for children wi)Tj
(th disabilities and )Tj
T*
(health problems \(American with Disabilities Act, 1990; Individuals with\
Disabilities Education Act, 1990, & Amendments, 1997; Se)Tj
(ction 504 of )Tj
T*
(the Rehabilitation Act, 1973\).)Tj
T*
(The literature suggested that the physical and psychological health of c\
hildren had a direct impact on their academic and social)Tj
( development in )Tj
T*
(school \(Bush, 1997; Dryfoos, 1997; Hacker & Wessel, 1998; Jang, 1994; M\
organ, 1987; Ouellette, 2001; Passerelli, 1994; Symons, e)Tj
(t al., 1997; )Tj
T*
(Tyson, 1999\). School nurses were key players in the delivery of health \
services in the school setting, but inadequate conditions)Tj
( and facilities in )Tj
T*
(public schools were problems for nurses. Clinic design standards were no\
t available for Georgia schools. This study suggested th)Tj
(at the )Tj
T*
(planners and users of a facility have expertise to offer regarding facil\
ity needs; hence, it provided professional school nurses)Tj
(, as well as )Tj
T*
(architects, builders, consultants, and planners of school facilities an \
opportunity to express their ideas about their facility )Tj
(needs. )Tj
ET
27.939 26.306 m
168.974 26.306 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 27.9824 Tm
(Clustered Design Elements)Tj
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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0 18 792 576 re
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/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 579.3805 Tm
(Based on the review of the literature and the perceptions indicated by a\
panel of experts and by practicing school nurses who pa)Tj
(rticipated in )Tj
0 -2 TD
(this study, clustered design elements and specific design elements were \
identified for the health clinic. All of the clustered d)Tj
(esign elements )Tj
T*
(were perceived as having at least a medium degree of importance to clini\
c design. )Tj
T*
(An office for the nurse, a treatment room, a waiting area, a rest area, \
and a restroom were identified in the literature review )Tj
(as necessary )Tj
T*
(components or rooms of the health clinic \(Hawkins & Lilley, 1998; Huble\
r, 1996; McKibben & DiPaolo, 1997; Perkins, 2001\). Size a)Tj
(nd space )Tj
T*
(requirements varied in the literature, but the size of the clinic should\
be determined by the use and primary purpose of the cli)Tj
(nic \(Jelliffe & )Tj
T*
(Schipp, 2002; Johnston, 1977\). The components, size and space elements \
were viewed as the most important design element by all )Tj
T*
(respondents to the survey; however, nurses perceived these elements to b\
e more important than did the advisory panel of architec)Tj
(ts, builders, )Tj
T*
(consultants, and planners of school facilities. )Tj
T*
(Practicing nurses, or practitioners, perceived three additional design e\
lements more important than the advisory panel did: \(a\) )Tj
(the waiting area )Tj
T*
(cluster, \(b\) the nurse\355s office cluster, and \(c\) the treatment ro\
om cluster. These three design elements directly impact the per)Tj
(formance of )Tj
T*
(needed services by nurses for users of the clinic. The literature review\
revealed that the nurse\355s responsibilities and duties, )Tj
(the types of )Tj
T*
(procedures to be performed, plus the needs and ages of the students who \
will be using the spaces should determine design needs \()Tj
(Butin, )Tj
T*
(2000; Frasca-Bellieu, 1999; Johnston, 1977; Ulrich, 1990\).)Tj
T*
(Having an isolation room or separate rest area in the clinic received th\
e lowest score from all respondents, but was rated as of)Tj
( medium )Tj
T*
(importance overall. The advisory panel noted in the comment section for \
this design element on the survey that providing a separ)Tj
(ate rest/)Tj
T*
(isolation area in an elementary clinic was not cost effective. Architect\
s, builders, consultants, and planners perceived the res)Tj
(t/isolation area as a )Tj
T*
(dedicated area in the nurse\355s office or treatment area rather than a \
separate room. This perception differed from the review of )Tj
(the literature )Tj
T*
(which recommended a separate room \(Castaldi, 1994; Chaney, 1973; Davini\
, 1952; Hawkins & Lilley, 1998; Jelliffe & Schipp, 2002; )Tj
(Medical )Tj
T*
(Center of Georgia, 2000; Perkins, 2001\).)Tj
T*
(As reported in the review of literature, consideration for the location \
and accessibility of the clinic must be given in relatio)Tj
(n to the location of the )Tj
T*
(administrative offices, the playground, and access for medical emergency\
vehicles \(Butin, 2001; Carpman, Grant, & Simmons, 1986;)Tj
( Castaldi, )Tj
T*
(1994; Hawkins & Lilley, 1998; Hubler, 1996; Krent, Cairns, & Dodge, 1993\
; Jelliffe & Schipp, 2002; McKibben & DiPaolo, 1997; Per)Tj
(kins, 2001\). )Tj
T*
(The advisory panel and the school nurses agreed with the literature\355s\
view on this design element.)Tj
T*
(The remaining design clusters received similar scores from nurse and adv\
isory panel respondents: \(a\) the restroom \(toilet\); \(b\) )Tj
(security, )Tj
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(storage, and safety features; and \(c\) furnishing and treatments. Acces\
s to a restroom \(toilet\) was important to nurses as noted )Tj
(in comments for )Tj
0 -2 TD
(this section of the survey. Both groups commented that the restroom desi\
gn with a shower and washer/dryer area were ideal but ha)Tj
(ving access )Tj
T*
(to a sink with hot and cold running water in the clinic was more importa\
nt. The advisory panel and the school nurses agreed that)Tj
( having safe, )Tj
T*
(secure storage for medical files and medications was important. All resp\
ondents gave a low degree of importance for the use of a)Tj
( music system )Tj
T*
(as a necessary furnishing in the clinic. )Tj
ET
0 0 0 RG
0.559 w 10 M 0 j 0 J []0 d
27.939 455.223 m
159.917 455.223 l
S
BT
/TT0 1 Tf
11.6414 0 0 11.6414 27.9392 456.8994 Tm
(Specific Design Elements)Tj
T*
(The specific design elements identified in the review of the literature \
were: \(a\) lighting and daylighting elements; \(b\) window )Tj
(elements; \(c\) )Tj
T*
(integrating nature elements into design; \(d\) promoting a sense of well\
-being for the users; \(e\) privacy, space, and confidential)Tj
(ity elements; \(f\) )Tj
T*
(electrical and plumbing elements; \(g\) doors and wayfinding elements; \(\
h\) walls and ceilings; \(i\) acoustics; \(j\) color; \(k\) heati)Tj
(ng, ventilation, and )Tj
T*
(air conditioning elements; and \(l\) flooring elements \(AIA, 1987; Buti\
n, 2000; )Tj
/TT1 1 Tf
(Floor Plan, )Tj
/TT0 1 Tf
(2003; Frasca-Bellieu, 1999; Gappell, 1991; Center for )Tj
0 -2.001 TD
(Health and Health Care in Schools, 2004a & b; Johnston, 1977; Malkin, 19\
90; Ulrich, 1990\). Clusters of survey statements were gr)Tj
(ouped to )Tj
0 -2 TD
(provide data for analysis. )Tj
T*
(Automatic emergency lighting, use of indirect lighting close to natural \
sunlight, and use of a portable high intensity light rec)Tj
(eived moderately )Tj
0 -2 TD
(high scores from all respondents in the item analysis. The use of light \
close to natural sunlight was supported by the review of)Tj
( literature \(Boyce, )Tj
0 -2 TD
(1981; Gappell, 1991; Hathaway, 1994; Tanner, 2000; Torrice, 1988\). The \
remainder of the lighting statements were scored in the m)Tj
(edium )Tj
T*
(importance range except for the use of a light fixture with a dimmer ove\
r a cot. While the literature supported the use of dimme)Tj
(rs and controls )Tj
T*
(for lighting in the clinic, the statement concerning the use of a dimmer\
in the rest area was rated moderately low for importanc)Tj
(e for all )Tj
T*
(respondents.)Tj
T*
(The use of windows in the clinic was supported in the review of the lite\
rature \(Carpman et al., 1986; Gappell, 1991; Malkin, 199)Tj
(0; McKibben & )Tj
T*
(DiPaolo, 1997; Ulrich, 1990\). Respondents in the item analysis scored w\
indows used between rooms to provide supervision and to p)Tj
(rovide )Tj
T*
(natural light and ventilation as a moderately high level of importance t\
o clinic design. Practicing school nurses perceived the )Tj
(window element )Tj
T*
(cluster more important to clinic design than the advisory panel did.)Tj
T*
(Lighting and window elements were used to represent elements that integr\
ated nature into design. The literature supported design)Tj
( that brought )Tj
T*
(the outdoors into facilities \(Pinto, 1996; Renzi, 2001; Ulrich, 1990\) \
to reduce stress and promote recovery. The use of windows )Tj
(to provide )Tj
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(natural light and views of nature\363trees, plants, water\363 as well as\
indirect lighting close to natural sunlight were rated medium)Tj
( to moderately high )Tj
0 -2 TD
(in importance to clinic design by all respondents in the item analysis. \
In the analysis between groups, the advisory panel did n)Tj
(ot perceive this )Tj
T*
(element to be as important as practicing nurses did.)Tj
T*
(Promotion of a sense of well-being for users encompassed the use of furn\
iture, wall coverings, artwork that reflected specific p)Tj
(opulations and )Tj
T*
(cultures, and design that fosters a sense of control for users \(Carpman\
et al., 1986; Kantrowitz & Associates, 1993; Simeonova, )Tj
(2003\). Again, )Tj
T*
(practicing nurses perceived this cluster of statements to be more import\
ant to clinic design than the advisory panel did.)Tj
T*
(Color elements\363light paint colors; washable, semi-gloss paint; and co\
ntrasting colors on walls and baseboards\363were suggested in )Tj
(the literature )Tj
T*
(review \(Carpman et al., 1986; Day, 1980; Rouk, 1997; Smith, 1980\). All\
respondents rated these elements in the medium to moderat)Tj
(ely high )Tj
T*
(range of importance to clinic design in the item analysis. The differenc\
e in perceptions between the groups was not significant.)Tj
T*
(Nurses and the advisory panel perceived privacy, space and confidentiali\
ty elements differently. Nurses responded that having se)Tj
(parate rooms, )Tj
T*
(use of curtains to separate patients, use of movable partitions, and acc\
ess to telephones, intercoms, and other communication eq)Tj
(uipment in the )Tj
T*
(clinic were of moderately high importance to the design of the clinic. A\
rchitects, builders, consultants, and planners of school)Tj
( facilities rated )Tj
T*
(these elements as of medium importance. The review of the literature rev\
ealed that ample space and added privacy reduced tension)Tj
( and stress )Tj
T*
(for users \(Butin, 2000; Carpman et al., 1986; Frasca-Beaulieu, 1999; Ga\
ppell, 1991\).)Tj
T*
(In the area of heating, ventilation, and air conditioning the two groups\
responded differently on the importance of these elemen)Tj
(ts. Nurses )Tj
T*
(perceived windows for ventilation, having a set of controls for the clin\
ic, and ventilation for the bathroom more important to c)Tj
(linic design that the )Tj
T*
(advisory panel did. Again, the literature review reported that control o\
f the thermal environment in a building was important to)Tj
( the occupants )Tj
T*
(\(Day, 1980; Center for Health and Health Care in Schools, 2001\). Optim\
al temperatures as well as correct moisture, dryness, and )Tj
(movement of )Tj
T*
(air were necessary for performance of tasks \(Day, 1980\).)Tj
T*
(Several statements concerning electrical and plumbing elements were scor\
ed very high for importance on the item analysis. Having)Tj
( a sink with )Tj
T*
(hot and cold water, having a refrigerator/freezer, and having connection\
s for phones, fax, computers and modems were rated as ve)Tj
(ry high in )Tj
T*
(importance to clinic design. The review of the literature supported the \
item analysis scores \(Hawkins & Lilley, 1998; Center for)Tj
( Health and )Tj
T*
(Health Care in Schools, 2004b\). However, the cluster of variables used \
for this design element was found to lack homogeneity so )Tj
(the design )Tj
T*
(element was not used for further tests between groups. )Tj
T*
(Acoustic elements were revealed in the review of the literature. Noise i\
n a healthcare facility produced stress and changes in b)Tj
(lood flow in )Tj
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(patients and staff, and decreased productivity of staff \(Frasca-Beaulie\
u, 1999; Gappell, 1991; Rouk, 1997\). Separate ceilings, c)Tj
(arpeting, )Tj
0 -2 TD
(movable partitions, and other acoustical treatments were recommended \(D\
ay, 1980; Johnson, 2001; Lyons, 2002; Malkin, 1990\). All )Tj
T*
(respondents on the item analysis rated locating the treatment room away \
from phones moderately high. The difference in perceptio)Tj
(ns of the two )Tj
T*
(groups for this cluster of variables was not significant. )Tj
T*
(The review of the literature reported that separate ceilings for rooms, \
light paint colors for walls, epoxy paint, and smooth, m)Tj
(oisture resistant )Tj
T*
(surfaces for walls and ceilings were recommended \(AIA, 1987; Alexander,\
1972; Malkin, 1990; Noskin & Peterson, 2001\). Item analy)Tj
(sis )Tj
T*
(revealed that respondents agreed with the literature since all variables\
were rated medium to moderately high in importance to c)Tj
(linic design. )Tj
T*
(Differences between groups of respondents were insignificant.)Tj
T*
(All respondents rated the use of carpeting in clinic design as moderatel\
y low in importance. The literature review showed that c)Tj
(arpeting )Tj
T*
(received mixed reviews from researchers \(Carpman et al., 1986; Day, 198\
0; McKibben & DiPaolo, 1997; Simmons, Reizenstein, and Gr)Tj
(ant, )Tj
T*
(1982\). Vinyl composition tile, seamless resilient flooring and ceramic \
tiles received recommendations from the literature review)Tj
( \(All in a Day\355s )Tj
T*
(Work, 1999; AIA, 1987; Jelliffe & Schipp, 2002; Malkin, 1990; McKibben &\
DiPaolo, 1887\). Both groups had similar ratings for thi)Tj
(s design )Tj
T*
(cluster, so differences between groups were not significant.)Tj
T*
(In the area of doors and wayfinding elements for clinic design, all resp\
ondents scored doors wide enough for emergency equipment)Tj
( as very )Tj
T*
(high in importance on the item analysis. Scores between groups were simi\
lar and not significant. The findings of the literature )Tj
(review were in )Tj
T*
(agreement with the respondents\355 ratings for use of solid core doors, \
using signage to mark the way to the clinic, and using safe)Tj
(ty glass in doors )Tj
T*
(\(AIA, 1987; Frasca-Beaulieu, 1999; Kennedy, 2002b; Malkin, 1990\).)Tj
T*
(Comment and concern sections on the survey reflected enumeration of the \
areas included in the survey. The most often occurring r)Tj
(esponses )Tj
T*
(centered on issues that the survey statements reflected an ideal clinic \
in an elementary school. Architects, builders, consultan)Tj
(ts, and planners )Tj
T*
(commented that many of the design statements were not cost effective. Nu\
rse comments were that every statement on the survey was)Tj
( ideal, )Tj
T*
(but many of the statements were necessary design elements or characteris\
tics needed to perform their tasks. The findings reporte)Tj
(d in the data )Tj
T*
(analysis were supported by the literature review.)Tj
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(Recommendations)Tj
-27.782 -2 Td
(The literature review shows that the school continues to be an efficient\
site for health care delivery for students with special)Tj
( needs and removes )Tj
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(some barriers for students needing access to health care. The role and t\
he responsibilities of the school nurse continue to be d)Tj
(ependent on the )Tj
0 -2 TD
(needs of the student served and the availability of funding sources of t\
he community and local board of education. Clinics in el)Tj
(ementary schools )Tj
T*
(should be designed to support the school nurse in meeting the needs of t\
he students being served. The following recommendations )Tj
(are )Tj
T*
(presented for planning and designing health clinics in elementary school\
s:)Tj
4.8 -2 Td
(1.)Tj
/TT1 1 Tf
6.7908 0 0 6.7908 93.5266 486.2497 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 115.5967 486.2497 Tm
(The Department of Education in the state of Georgia should write facilit\
y guidelines for health clinics in elementary schools. )Tj
-2.73 -2 Td
(The guidelines issued by the Department of Education in Maryland could b\
e used as a starting point for those in Georgia.)Tj
T*
(2.)Tj
/TT1 1 Tf
6.7908 0 0 6.7908 93.5266 439.6843 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 115.5967 439.6843 Tm
(The professional judgment of school nurses should be considered when est\
ablishing facility guidelines. Their perceptions in )Tj
-2.73 -2 Td
(this study correlated with the concepts presented in the review of liter\
ature.)Tj
T*
(3.)Tj
/TT1 1 Tf
6.7908 0 0 6.7908 93.5266 393.1189 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 115.5967 393.1189 Tm
(The school nurse and representatives of the students, parents, and schoo\
l staff who will be using the health clinic should be )Tj
-2.73 -2 Td
(involved in the planning and designing of the facility.)Tj
T*
(4.)Tj
/TT1 1 Tf
6.7908 0 0 6.7908 93.5266 346.5535 Tm
( )Tj
/TT0 1 Tf
11.6414 0 0 11.6414 115.5967 346.5535 Tm
(The finding in each of the areas of this study should be considered whil\
e establishing guidelines in the state of Georgia.)Tj
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485.922 321.594 l
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/TT0 1 Tf
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(Implications for Further Research)Tj
-24.559 -2 Td
(While collecting data at the Georgia Association of School Nurses\355 co\
nference, attendees expressed a strong interest in the surv)Tj
(ey and asked )Tj
T*
(that the results of the survey be presented to their organization. It is\
recommended that similar studies be conducted concentra)Tj
(ting on the )Tj
T*
(middle school and high school level so that facility guidelines can be e\
stablished that address the individual uses of health cl)Tj
(inics in different )Tj
T*
(levels of educational facilities.)Tj
T*
(The unequal numbers in the groups of nurse respondents compared to the n\
umber of respondents for the advisory panel should be no)Tj
(ted. )Tj
T*
(Future researchers should attempt to achieve equity in the number of res\
pondents for the selected groups. )Tj
T*
(In addition, the review of the literature revealed the growing trend of \
more medically fragile students attending schools, more )Tj
(medications being )Tj
T*
(given at school, and more students coming to school needing medical atte\
ntion. The literature suggested that the physical and ps)Tj
(ychological )Tj
T*
(health of children had a direct impact on their academic and social deve\
lopment in school \(Bush, 1997; Hacker & Wessel, 1998; Ja)Tj
(ng, 1994; )Tj
T*
(Morgan, 1987; Ouellette, 2001; Passerelli, 1994; Symons, et al., 1997; T\
yson, 1999\). Guidelines are needed to aid in designing h)Tj
(ealth clinics in )Tj
T*
(elementary schools to meet the needs of the students being served. )Tj
0 -1.5 TD
( )Tj
31.811 -1.1 Td
( )Tj
0 -1.2 TD
( )Tj
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( )Tj
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( )Tj
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(APPENDIX A: LITERATURE REVIEW TABLE)Tj
10.086 -1.2 Td
( )Tj
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( )Tj
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(Design Element: )Tj
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( )Tj
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( )Tj
-1.722 -1.2 Td
(Source:)Tj
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0 -1.2 TD
(work effectively.)Tj
19.985 1.2 Td
(Day,1980; Gappell, 1991; )Tj
0 -1.2 TD
(Grocoff, 1995)Tj
-19.985 -1.242 Td
(Warm fluorescent or incandescent light )Tj
0 -1.2 TD
(provided more home-like atmosphere.)Tj
19.985 1.2 Td
(Alexander, 1972; Birren, )Tj
T*
(1979; Carpman, Grant, & )Tj
T*
(Simmons, 1986; Rosenfield, )Tj
T*
(1972)Tj
-19.985 -1.242 Td
(High CRI lights needed to judge color )Tj
T*
(correctly.)Tj
19.985 1.2 Td
(Boyce, 1981)Tj
-19.985 -2.442 Td
(Full-spectrum lighting that comes close to )Tj
T*
(natural sunlight recommended.)Tj
19.985 1.2 Td
(Torrice, 1988)Tj
-19.985 -2.442 Td
(Compact fluorescent or halogen lamps )Tj
T*
(needed for task lighting.)Tj
19.985 1.2 Td
(Moscher, 2003)Tj
-19.985 -2.442 Td
(Indirect lighting needed for work areas.)Tj
19.985 0 Td
(Rosenfeld, 1971)Tj
-19.985 -1.242 Td
(Dimmers for control of lighting in medical )Tj
T*
(settings recommended.)Tj
19.985 1.2 Td
(Center for Health in )Tj
T*
(Schools, 2004; Malkin, )Tj
T*
(1990; Rosenfeld,1971; )Tj
T*
(Veitch & Newsham, 1996 )Tj
-19.985 -1.242 Td
(Natural light from windows, skylights, )Tj
T*
(suntubes, and atriums recommended.)Tj
19.985 1.2 Td
(American Institute of )Tj
T*
(Architects \(AIA\), 1987; )Tj
T*
(Grocoff ,1995; Hathaway, )Tj
T*
(1994; Heschong Malone )Tj
0 -1.2 TD
(Group, 2001; Payne, 2000;)Tj
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( )Tj
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(Design Element: )Tj
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(Windows)Tj
22.486 1.227 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -1.296 Td
(Windows admitted light, permitted )Tj
T*
(ventilation, and framed a view.)Tj
19.985 1.2 Td
(Alexander,1972)Tj
-19.985 -2.442 Td
(Brightness control needed for windows. )Tj
19.985 0 Td
(Dorsey,1980)Tj
-19.985 -1.242 Td
(Windows associated with thermal, visual, )Tj
T*
(and psychological aspects of comfort. Light )Tj
T*
(and views from windows associated with )Tj
T*
(relaxation and faster healing. )Tj
19.985 3.6 Td
(Carpman)Tj
/TT2 1 Tf
(, )Tj
/TT0 1 Tf
(Grant, & )Tj
0 -1.201 TD
(Simmons, 1986; Gappell, )Tj
0 -1.2 TD
(1991; Ulrich, 1990)Tj
-19.985 -2.44 Td
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T*
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19.985 1.2 Td
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(Windows recommended between the office )Tj
0 -1.2 TD
(area, rest area for ill students, and waiting )Tj
T*
(area for the clinic to allow for supervision of )Tj
0 -1.2 TD
(students by the office staff when the nurse )Tj
0 -1.2 TD
(was not present. )Tj
19.985 4.8 Td
(Carpman, Grant, & )Tj
0 -1.2 TD
(Simmons, 1986)Tj
-19.985 -4.842 Td
(Outside window or skylight needed for )Tj
0 -1.2 TD
(lighting and ventilation.)Tj
19.985 1.2 Td
(McKibben & DiPaolo, 1997)Tj
-20.027 -2.342 Td
( )Tj
0 -1.1 TD
( )Tj
9.874 -1.242 Td
( )Tj
-5.391 -1.2 Td
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19.985 0 Td
(Pinto, 1996)Tj
-19.985 -1.242 Td
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0 -1.2 TD
(quite subtle and informal.)Tj
19.985 1.2 Td
(Renzi, 2001)Tj
-19.985 -2.442 Td
(Positive distractions\363happy and caring )Tj
T*
(faces, pets or unthreatening animals, and )Tj
T*
(nature elements like trees, plants, and )Tj
T*
(water\363used. )Tj
19.985 3.6 Td
(Ulrich , 1990)Tj
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T*
(health.)Tj
19.985 1.2 Td
(Frasca-Bellieu, 1999)Tj
-19.985 -2.442 Td
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T*
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19.985 1.2 Td
(Croswell, 2000)Tj
-19.985 -2.442 Td
(Soft lighting environments were best for )Tj
T*
(mental tasks.)Tj
19.985 1.2 Td
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-19.985 -2.442 Td
(Indirect lighting, upholstered furniture, )Tj
0 -1.2 TD
(magazines and access to nature through )Tj
T*
(windows or artwork softened the room and )Tj
T*
(relaxed the patient. )Tj
19.985 3.6 Td
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T*
(Simmons, 1986)Tj
-19.985 -3.642 Td
(Feng shui principles used. Exam rooms )Tj
T*
(faced the north side of the building, )Tj
T*
(Administration offices were on the south )Tj
T*
(side of the building. )Tj
19.985 3.6 Td
(Renzi, 2001)Tj
-19.985 -4.842 Td
(Spaces were comfortable, light, and )Tj
T*
(welcoming.)Tj
19.985 1.2 Td
(Kantrowitz & Associates, )Tj
T*
(1993)Tj
-19.985 -1.242 Td
(Privacy and abundant natural light provided.)Tj
19.985 0 Td
(Kantrowitz & Associates, )Tj
T*
(1993)Tj
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(There was integration between lighting and )Tj
0 -1.2 TD
(an array of auditory, fragrance, and other )Tj
T*
(sensory experiences.)Tj
19.985 2.4 Td
(Simeonova, 2003)Tj
-19.985 -3.642 Td
(Aquariums, interactive water fountains, light )Tj
0 -1.2 TD
(hardwood paneling, outdoor views, and )Tj
0 -1.2 TD
(original artwork used. )Tj
19.985 2.4 Td
(Croswell, 2000)Tj
-19.985 -3.642 Td
(Floral arrangements and bowls of sachet )Tj
T*
(used. )Tj
19.985 1.2 Td
(Gappell, 1991)Tj
-10.152 -2.442 Td
( )Tj
-5.112 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Color)Tj
21.597 1.227 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -1.296 Td
(Lighting influenced colors of a room.)Tj
19.985 0 Td
(Dorsey, 1980; Malkin, 1990; )Tj
0 -1.2 TD
(Rosenfield, 1972)Tj
-19.985 -1.242 Td
(No specific guidelines to color selections )Tj
T*
(existed for an ACF \(Ambulatory Care )Tj
T*
(Facility\).)Tj
19.985 2.4 Td
(Frasca-Beaulieu, 1999)Tj
-19.985 -3.642 Td
(Color influenced human emotions and )Tj
T*
(physiology.)Tj
19.985 1.2 Td
(Alexander, 1972; Chaney, )Tj
T*
(1973; Day, 1980; Dorsey, )Tj
T*
(1980; Malkin, 1990)Tj
-20.027 -1.142 Td
( )Tj
0 -1.1 TD
( )Tj
0.042 -1.242 Td
(Red, orange and pink colors stimulated the )Tj
0 -1.2 TD
(sympathetic nervous system, increased )Tj
T*
(brain wave activity, and sent blood to the )Tj
T*
(muscles, accelerating heart rate, blood )Tj
T*
(pressure, and respiration.)Tj
19.985 4.8 Td
(Alexander, 1972; Birren, )Tj
T*
(1979; Burr, 2000; Chaney, )Tj
T*
(1973; Dorsey, 1980; Malkin, )Tj
T*
(1990; Rosenfield, 1972)Tj
-19.985 -2.442 Td
(Blue and green colors triggered the )Tj
T*
(parasympathetic nervous system and had a )Tj
T*
(tranquilizing effect.)Tj
19.985 2.4 Td
(Alexander, 1972; Birren, )Tj
T*
(1979)Tj
-19.985 -2.442 Td
(Warm colors seemed to advance. Cool )Tj
0 -1.2 TD
(colors seemed to recede.)Tj
19.985 1.2 Td
(Chaney, 1973; Rouk, 1997\).)Tj
-19.985 -2.442 Td
(Cool colors caused participants to )Tj
T*
(underestimate time, weight, and size. Warm )Tj
T*
(colors produced the opposite effect.)Tj
19.985 2.4 Td
(Chaney, 1973; Day, 1980; )Tj
T*
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Choice of color depended upon the source )Tj
T*
(of light, the size, location and shape of the )Tj
T*
(space, the number of occupants, and the )Tj
T*
(use of the space.)Tj
19.985 3.6 Td
(Birren, 1979; Gappell, 1991; )Tj
T*
(Rice, 1953; Smith, 1980)Tj
-19.985 -3.642 Td
(Lighter colors had higher reflective values)Tj
19.985 0 Td
(Day, 1980)Tj
-19.985 -1.242 Td
(Contrasting color values used especially in )Tj
T*
(flooring, baseboards, and walls.)Tj
19.985 1.2 Td
(Carpman, Grant, & )Tj
T*
(Simmons, 1986)Tj
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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(CHAPTER 1)Tj
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27.939 55.239 m
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411.735 97.632 l
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261.077 55.239 m
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(Painting one wall a different color reduced )Tj
0 -1.2 TD
(monotony and relaxed the eyes.)Tj
19.985 1.2 Td
(Rouk, 1997)Tj
-19.985 -2.442 Td
(A variety of colors and shades used to )Tj
0 -1.2 TD
(provide needed interest and stimulation, to )Tj
0 -1.2 TD
(increase heart and breathing ratios, and to )Tj
T*
(affect the cortex of the brain.)Tj
19.985 3.6 Td
(Birren, 1979; Gappell, 1991)Tj
-19.985 -4.842 Td
(Light salmon, warm yellow, pale yellow or )Tj
0 -1.2 TD
(orange recommended in elementary )Tj
T*
(schools.)Tj
19.985 2.4 Td
(Rouk, 1997; Smith, 1980)Tj
-10.152 -3.642 Td
( )Tj
-7.615 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Privacy, Space, )Tj
4.281 -1.2 Td
(Confidentiality)Tj
/TT0 1 Tf
3.334 -1.227 Td
( )Tj
/TT1 1 Tf
16.484 3.654 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -3.696 Td
(Visual privacy, acoustical privacy, social )Tj
T*
(contact, and solitude provided by design. \356)Tj
19.985 1.2 Td
(Carpman, Grant, & )Tj
T*
(Simmons, 1986)Tj
-19.985 -1.242 Td
(Ample space and added privacy provided to )Tj
T*
(avoid tension and stress.)Tj
19.985 1.2 Td
(Gappell, 1991; Frasca-)Tj
T*
(Beaulieu, 1999)Tj
-19.985 -1.242 Td
(Privacy for communication \(phone )Tj
T*
(conversations, fax transmissions, patient/)Tj
T*
(nurse conversations\) increased by reducing )Tj
T*
(noise.)Tj
19.985 3.6 Td
(Butin, 2000; Carpman, )Tj
T*
(Grant, & Simmons, 1986 )Tj
-19.985 -3.642 Td
(Privacy for communication increased by )Tj
T*
(spatially arranging furniture.)Tj
19.985 1.2 Td
(Butin, 2000; Carpman, )Tj
T*
(Grant, & Simmons, 1986 )Tj
-19.985 -1.242 Td
(Location of phones, computers, faxes, and )Tj
T*
(intercoms in areas with acoustic controls )Tj
T*
(provided. )Tj
19.985 2.4 Td
(Butin, 2000; Carpman, )Tj
T*
(Grant, & Simmons, 1986 )Tj
-19.985 -2.442 Td
(Exam rooms had movable walls, cubicle )Tj
0 -1.2 TD
(curtains, or partitions.)Tj
19.985 1.2 Td
(Butin, 2000; Carpman, )Tj
0 -1.2 TD
(Grant, & Simmons, 1986)Tj
-19.985 -1.242 Td
(Areas for ill students physically separated )Tj
0 -1.2 TD
(from the rest of the nurse\355s office.)Tj
19.985 1.2 Td
(Butin, 2000; Carpman, )Tj
T*
(Grant, & Simmons, 1986)Tj
-10.152 -1.242 Td
( )Tj
-9.586 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Heating, Ventilation, Air )Tj
6.642 -1.2 Td
(Conditioning)Tj
19.428 2.427 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -2.496 Td
(Use of windows for ventilation and lighting )Tj
T*
(reduced heat gain.)Tj
19.985 1.2 Td
(American Institute of )Tj
T*
(Architects, 1987)Tj
-19.985 -1.242 Td
(Health room/clinic had a separate control )Tj
T*
(that was operated outside of school hours if )Tj
T*
(necessary. )Tj
19.985 2.4 Td
(Health in Schools, 2001)Tj
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27.939 480.435 m
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(Optimal temperatures as well as correct )Tj
0 -1.2 TD
(moisture, dryness, and movement of air )Tj
T*
(were necessary for effective learning or )Tj
0 -1.2 TD
(performance of tasks.)Tj
19.985 3.6 Td
(Day, 1980)Tj
-19.985 -4.842 Td
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(perceived through the skin. )Tj
19.985 1.2 Td
(Gappell, 1991)Tj
-19.985 -2.442 Td
(Indoor irritants and indoor air pollution were )Tj
0 -1.2 TD
(adverse environmental conditions in schools.)Tj
19.985 1.2 Td
(Lyons, 2002)Tj
-19.985 -2.442 Td
(Faulty room temperatures and poor air )Tj
T*
(circulation caused by poor design, )Tj
T*
(inadequate maintenance, and inefficient and )Tj
T*
(outdated heating, ventilation, and air-)Tj
T*
(conditioning systems in schools.)Tj
19.985 4.8 Td
(Lyons, 2002)Tj
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(Asthma, drowsiness, lethargy, and the )Tj
0 -1.2 TD
(inability to concentrate linked to indoor air )Tj
0 -1.2 TD
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(EPA, 2004; Lara, et al., 2002)Tj
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(Ordinary houseplants effective in removing )Tj
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(toxic pollutants\363formaldehyde, benzene, )Tj
T*
(and trichloroethylene-- from air inside )Tj
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(buildings.)Tj
19.985 3.6 Td
(Gappell, 1991)Tj
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( )Tj
-9.614 -1.2 Td
(Design Element: )Tj
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(Needs)Tj
17.846 2.427 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -2.496 Td
(Outlets provided in all spaces as required )Tj
T*
(by code.)Tj
/TT2 1 Tf
19.985 1.2 Td
( )Tj
/TT0 1 Tf
(AIA, 1987)Tj
-19.985 -2.442 Td
(Automatic emergency lighting provided for )Tj
T*
(safe egress from the building in event of a )Tj
0 -1.2 TD
(power failure.)Tj
/TT2 1 Tf
19.985 2.4 Td
( )Tj
/TT0 1 Tf
(AIA, 1987)Tj
-19.985 -3.642 Td
(A fire alarm system installed.)Tj
/TT2 1 Tf
19.985 0 Td
( )Tj
/TT0 1 Tf
(AIA, 1987)Tj
-19.985 -1.243 Td
(Dimmer switches placed on lights.)Tj
19.985 0 Td
(Center for Health in )Tj
T*
(Schools, 2004b)Tj
-19.985 -1.242 Td
(Electrical circuit for the refrigerator and the )Tj
T*
(ice machine active at all times.)Tj
19.985 1.2 Td
(Center for Health in )Tj
T*
(Schools, 2004b)Tj
-19.985 -1.242 Td
(School\355s intercom system was available to )Tj
T*
(clinic staff.)Tj
19.985 1.2 Td
(Center for Health in )Tj
T*
(Schools, 2004b)Tj
-19.985 -1.242 Td
(Additional outlets, seating, and counter )Tj
T*
(spaces provided for students to use )Tj
T*
(personal nebulizers.)Tj
19.985 2.4 Td
(McKibben & DiPaolo, 1997)Tj
-19.985 -3.642 Td
(12 accessible outlets provided throughout )Tj
T*
(the nurse\355s office and the bathroom area.)Tj
19.985 1.2 Td
(McKibben & DiPaolo, 1997)Tj
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h
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261.077 565.364 m
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h
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27.939 522.97 m
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h
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EMC
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h
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EMC
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260.592 481.061 l
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h
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27.939 480.576 m
261.077 480.576 l
260.592 481.061 l
28.424 481.061 l
h
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EMC
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412.22 480.576 l
411.735 481.061 l
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h
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412.22 480.576 l
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261.077 481.061 l
h
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EMC
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27.939 424.213 l
28.424 424.698 l
28.424 480.576 l
h
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261.077 480.576 m
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260.592 424.698 l
260.592 480.576 l
h
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27.939 424.213 m
261.077 424.213 l
260.592 424.698 l
28.424 424.698 l
h
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EMC
q
0 18 792 576 re
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412.22 480.576 m
412.22 424.213 l
411.735 424.698 l
411.735 480.576 l
h
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261.077 424.213 m
412.22 424.213 l
411.735 424.698 l
261.077 424.698 l
h
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EMC
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0 18 792 576 re
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27.939 424.213 m
27.939 395.788 l
28.424 396.273 l
28.424 424.213 l
h
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261.077 424.213 m
261.077 395.788 l
260.592 396.273 l
260.592 424.213 l
h
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27.939 395.788 m
261.077 395.788 l
260.592 396.273 l
28.424 396.273 l
h
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EMC
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0 18 792 576 re
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412.22 424.213 m
412.22 395.788 l
411.735 396.273 l
411.735 424.213 l
h
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261.077 395.788 m
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261.077 396.273 l
h
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EMC
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27.939 367.048 l
28.424 367.534 l
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h
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261.077 395.788 m
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27.939 367.048 m
261.077 367.048 l
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h
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27.939 338.624 m
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h
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EMC
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h
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h
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h
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261.077 338.624 m
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261.077 282.261 l
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EMC
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h
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412.22 282.261 l
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h
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261.077 282.261 m
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27.939 239.867 m
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h
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h
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h
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h
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261.077 211.442 l
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h
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0 18 792 576 re
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h
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h
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h
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h
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EMC
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EMC
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BT
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11.6414 0 0 11.6414 28.4243 583.8254 Tm
(Sinks in exam rooms or patient areas )Tj
0 -1.2 TD
(equipped with single lever blade handles.)Tj
19.985 1.2 Td
(AIA, 1987)Tj
-19.985 -2.442 Td
(Enclosing plumbing pipes behind a false )Tj
0 -1.2 TD
(wall created a smooth hard surface easier )Tj
0 -1.2 TD
(to clean.)Tj
19.985 2.4 Td
(Leckie, 1999)Tj
-19.985 -3.642 Td
(Pipe penetrations and joints were tightly )Tj
T*
(sealed to prevent or minimize entry of )Tj
T*
(rodents or insects.)Tj
19.985 2.4 Td
(AIA, 1987; Noskin & )Tj
T*
(Peterson, 2001)Tj
-19.985 -2.442 Td
(Shower space provided in the clinic to )Tj
0 -1.2 TD
(accommodate students with special needs. )Tj
T*
(A sink provided in the treatment area and in )Tj
T*
(the restroom.)Tj
19.985 3.6 Td
(Jelliffe & Schipp, 2002)Tj
-19.985 -4.842 Td
(Eye wash located on the sink in the )Tj
T*
(treatment area.)Tj
19.985 1.2 Td
(McKibben & DiPaolo, 1997)Tj
-10.152 -2.442 Td
( )Tj
-6.197 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Acoustics)Tj
22.681 1.227 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -1.296 Td
(Noise in a healthcare facility produced a )Tj
T*
(generalized stress reaction.)Tj
19.985 1.2 Td
(Gappell, 1991; Rouk, 1997)Tj
-19.985 -2.442 Td
(Rhythmic and soothing music in the )Tj
T*
(healthcare environment controlled heart )Tj
T*
(rate, lowered blood pressure, and masked )Tj
T*
(normal conversation.)Tj
19.985 3.6 Td
(Frasca-Beaulieu, 1999; )Tj
T*
(Malkin, 1990)Tj
-19.985 -3.642 Td
(Sound of bubbling water in a fish tank )Tj
T*
(provided distractions from noise and )Tj
T*
(reduced restlessness in children.)Tj
19.985 2.4 Td
(Frasca-Beaulieu, 1999)Tj
-19.985 -3.642 Td
(Sound control was important in examination )Tj
T*
(room.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Carpet, wall coverings, draperies and )Tj
0 -1.2 TD
(acoustic ceiling tiles used.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Solid-core doors used.)Tj
19.985 0 Td
(Malkin, 1990)Tj
-19.985 -1.242 Td
(Fiberglas batting used inside walls. )Tj
19.985 0 Td
(Malkin, 1990)Tj
-19.985 -1.242 Td
(\354Acoustical holes\356 created by pocket doors, )Tj
T*
(electrical outlets, plumbing pipes, and )Tj
T*
(heating ducts avoided. )Tj
19.985 2.4 Td
(Malkin, 1990)Tj
-19.985 -3.642 Td
(A separate ceiling for each room provided. )Tj
19.985 0 Td
(Malkin, 1990)Tj
-19.985 -1.242 Td
(Special attention provided for rooms for )Tj
T*
(hearing tests. )Tj
19.985 1.2 Td
(Malkin, 1990)Tj
ET
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
html \(38 of 51\)5/20/2005 1:56:48 PM)Tj
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(CHAPTER 1)Tj
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(Noise affected elementary students more )Tj
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(High-density vinyl barriers installed inside )Tj
T*
(walls and vinyl barriers above suspended )Tj
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( )Tj
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( )Tj
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(gloss paint that withstands washing with )Tj
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(modern cleaning products used.)Tj
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(Alexander, 1972)Tj
-19.985 -4.842 Td
(Epoxy paint used for concrete block walls.)Tj
19.985 0 Td
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(minimal likelihood of dust accumulation.)Tj
19.985 2.4 Td
(AIA, 1987; Noskin & )Tj
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(Peterson, 2001)Tj
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(Vinyl or woven wall coverings used that )Tj
T*
(were mildew resistant and can be cleaned )Tj
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(Malkin, 1990)Tj
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(Stucco and sand-finished textured walls not )Tj
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(and were difficult to clean.)Tj
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(waiting areas.)Tj
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-19.985 -2.442 Td
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(equipment.)Tj
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(Ceramic tile recommended for wet areas. )Tj
0 -1.2 TD
(Sheet vinyl was less expensive, had fewer )Tj
T*
(seams, and provided a self-coved base.)Tj
19.985 2.4 Td
(AIA, 1987; All in a Day\355s )Tj
T*
(Work, 1999; Malkin, 1990)Tj
-19.985 -2.442 Td
(Clinic area flooring had a nonslip surface, )Tj
0 -1.2 TD
(was durable, had antibacterial properties or )Tj
T*
(was not affected by germicidal or cleaning )Tj
T*
(solutions, was easy to clean and maintain, )Tj
T*
(and had attractive patterns and colors.)Tj
19.985 4.8 Td
(AIA, 1987; Designer Floors, )Tj
T*
(2000; Jelliffe & Schipp, )Tj
T*
(2002; McKibben & DiPaolo, )Tj
T*
(1997)Tj
-19.985 -2.442 Td
(Natural materials and replenished or )Tj
0 -1.2 TD
(recycled products \(such as vegetable-dyed )Tj
T*
(wool, cork, and wood fiber acoustical tiles or )Tj
T*
(concrete, limestone, and linoleum floors\) )Tj
T*
(used in flooring. )Tj
19.985 4.8 Td
(Burr & Sullivan, 2000; )Tj
T*
(Renzi, 2001)Tj
-10.152 -4.842 Td
( )Tj
-5.251 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Doors)Tj
21.736 1.227 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -1.296 Td
(Folding or pocket doors suggested to )Tj
T*
(provide flexibility in school settings.)Tj
19.985 1.2 Td
(Alexander, 1972 )Tj
-19.985 -2.442 Td
(Use of pocket doors discouraged for privacy )Tj
T*
(issues. Solid core doors recommended. )Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Doors were durable to withstand use by )Tj
T*
(children, and doors met federal accessibility )Tj
T*
(guidelines and local fire/building codes. )Tj
19.985 2.4 Td
(Kennedy, 2002b)Tj
-19.985 -3.642 Td
(Minimum door width of 2 feet 10 inches or )Tj
T*
(86 cm recommended for patient use, and )Tj
T*
(flush threshold and expansion joints )Tj
T*
(recommended facilitating use of )Tj
T*
(wheelchairs, carts and stretchers in the )Tj
T*
(clinic area.)Tj
19.985 6 Td
(AIA, 1987)Tj
-10.152 -7.242 Td
( )Tj
-6.501 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
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/TT0 1 Tf
6.501 -1.227 Td
( )Tj
16.484 2.427 Td
( )Tj
/TT1 1 Tf
-1.722 -1.173 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -2.496 Td
(Wayfinding elements included special )Tj
0 -1.2 TD
(lighting, use of different colors on walls, )Tj
T*
(special artwork, signage, and/or furniture.)Tj
19.985 2.4 Td
(Frasca-Bellieu, 1999)Tj
-19.985 -3.642 Td
(Patterning and designs in flooring added to )Tj
T*
(the well-being of patients and aided in )Tj
T*
(wayfinding.)Tj
19.985 2.4 Td
(Burr & Sullivan, 2000; )Tj
T*
(Designer Floors, 2000)Tj
-10.152 -2.442 Td
( )Tj
-9.308 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Components, Size and )Tj
4.501 -1.2 Td
(Space Requirements)Tj
21.291 2.427 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
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(Environmental design of the facility fostered )Tj
0 -1.2 TD
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T*
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T*
(patients.)Tj
19.985 3.6 Td
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-19.985 -4.842 Td
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19.985 1.2 Td
(Malkin, 1990)Tj
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27.939 452.425 m
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27.939 410.031 m
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261.077 410.031 m
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T*
(administrative offices.)Tj
19.985 1.2 Td
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T*
(Hawkins & Lilley, 1998; )Tj
T*
(Hubler, 1996; Jelliffe & )Tj
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(Schipp, 2002; McKibben & )Tj
T*
(DiPaolo, 1997; Perkins, )Tj
T*
(2001)Tj
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T*
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T*
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(buildings and with new buildings.)Tj
19.985 2.4 Td
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T*
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T*
(extensive design standards.)Tj
19.985 3.6 Td
(Uniform Federal )Tj
T*
(Accessibilities Standards )Tj
T*
(\(UFAS\), 1984; American )Tj
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(with Disabilities Act )Tj
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261.077 325.695 l
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h
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h
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EMC
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h
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h
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EMC
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h
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261.077 169.119 m
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h
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27.939 126.725 m
261.077 126.725 l
260.592 127.21 l
28.424 127.21 l
h
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EMC
q
0 18 792 576 re
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/Artifact <>BDC
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412.22 169.119 m
412.22 126.725 l
411.735 127.21 l
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h
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261.077 126.725 m
412.22 126.725 l
411.735 127.21 l
261.077 127.21 l
h
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EMC
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0 18 792 576 re
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/Artifact <>BDC
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27.939 56.392 l
28.424 56.877 l
28.424 126.725 l
h
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261.077 126.725 m
261.077 56.392 l
260.592 56.877 l
260.592 126.725 l
h
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27.939 56.392 m
261.077 56.392 l
260.592 56.877 l
28.424 56.877 l
h
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EMC
q
0 18 792 576 re
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412.22 126.725 m
412.22 56.392 l
411.735 56.877 l
411.735 126.725 l
h
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261.077 56.392 m
412.22 56.392 l
411.735 56.877 l
261.077 56.877 l
h
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EMC
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( )Tj
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(Design Element; )Tj
/TT1 1 Tf
(Nurse\355s Office/Station)Tj
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( )Tj
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( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -2.496 Td
(Light colors in cool or warm colors and )Tj
0 -1.2 TD
(bright accents in the nurse\355s area provided. )Tj
19.985 1.2 Td
(Davini, 1952)Tj
-19.985 -2.442 Td
(Pumpkin color for the nurse\355s station )Tj
T*
(suggested. )Tj
19.985 1.2 Td
(Chaney, 1973)Tj
-19.985 -2.442 Td
(A work counter, communication system, )Tj
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(provisions for charting patients, and a space )Tj
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(for needed supplies provided in the nurse\355s )Tj
T*
(station. )Tj
19.985 3.6 Td
(AIA, 1987)Tj
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(The nurse\355s office was equipped with )Tj
T*
(access to an intercom, cable connections )Tj
T*
(for a telephone, fax and computer, modem )Tj
T*
(access to the Internet, and electrical )Tj
T*
(connections to support a computer and )Tj
T*
(other needed equipment. )Tj
19.985 6 Td
(Butin, 2000)Tj
-19.985 -7.242 Td
(Built-in fluorescent lighting for the medicine )Tj
T*
(cabinet at the nurse\355s station provided. )Tj
19.985 1.2 Td
(Rosenfeld, 1971)Tj
-19.985 -2.442 Td
(A drug distribution area was part of the )Tj
T*
(nurse\355s station.)Tj
19.985 1.2 Td
(AIA, 1987)Tj
-19.985 -2.442 Td
(Nurse\355s station was equipped with a work )Tj
T*
(counter, sink, refrigerator, and locked )Tj
T*
(storage for biologicals and drugs.)Tj
19.985 2.4 Td
(AIA, 1987)Tj
-19.985 -3.642 Td
(A maintained illumination of 100 foot-)Tj
T*
(candles for the nurse\355s station provided. )Tj
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(Malkin, 1990)Tj
-19.985 -2.442 Td
(Indirect lighting was used in the nurse\355s )Tj
T*
(station. )Tj
19.985 1.2 Td
(Grocoff, 1995)Tj
-19.985 -2.442 Td
(Recessed 2 X 2 pendants recommended )Tj
0 -1.2 TD
(around computers. )Tj
19.985 1.2 Td
(Rouk, 1997; Mosher, 2003)Tj
-19.985 -2.442 Td
(Nurse\355s station had a cot for every 300 )Tj
T*
(students and had chairs for students waiting )Tj
T*
(for treatment.)Tj
19.985 2.4 Td
(McKibben & DiPaolo, 1997)Tj
-19.985 -3.642 Td
(The privacy area, an enclosed multipurpose )Tj
T*
(area that had a cot for isolating a student, a )Tj
T*
(chair, telephone or telephone jack, should )Tj
T*
(have a window that provides a view out of )Tj
T*
(and into this room.)Tj
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(McKibben & DiPaolo, 1997)Tj
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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(CHAPTER 1)Tj
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h
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EMC
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h
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h
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27.939 522.406 m
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h
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EMC
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0 18 792 576 re
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h
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261.077 522.406 m
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EMC
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h
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h
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h
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h
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h
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h
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h
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h
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h
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EMC
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h
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h
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EMC
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h
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h
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EMC
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0 18 792 576 re
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28.424 56.242 l
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h
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261.077 98.151 m
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260.592 56.242 l
260.592 98.151 l
h
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27.939 55.757 m
261.077 55.757 l
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28.424 56.242 l
h
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EMC
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0 18 792 576 re
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412.22 98.151 m
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h
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261.077 56.242 l
h
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EMC
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28.424 27.818 l
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h
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260.592 27.818 l
260.592 55.757 l
h
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27.939 27.333 m
261.077 27.333 l
260.592 27.818 l
28.424 27.818 l
h
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EMC
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0 18 792 576 re
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412.22 55.757 m
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411.735 27.818 l
411.735 55.757 l
h
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412.22 27.333 l
411.735 27.818 l
261.077 27.818 l
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(A desk placed in either the waiting area or )Tj
0 -1.2 TD
(privacy area could serve as the office area )Tj
T*
(for the nurse.)Tj
19.985 2.4 Td
(McKibben & DiPaolo, 1997)Tj
-19.985 -3.642 Td
(The nurse\355s office had its own set of )Tj
0 -1.2 TD
(controls for heating and air conditioning.)Tj
19.985 1.2 Td
(McKibben & DiPaolo, 1997)Tj
-10.152 -2.442 Td
( )Tj
-9.475 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Examination/Treatment )Tj
8.197 -1.2 Td
(Room)Tj
/TT0 1 Tf
17.762 2.4 Td
( )Tj
/TT1 1 Tf
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(Source:)Tj
/TT0 1 Tf
-24.594 -2.496 Td
(Exam room located away from corridors and )Tj
0 -1.2 TD
(phone/work areas to minimize noise and to )Tj
T*
(facilitate hearing tests.)Tj
19.985 2.4 Td
(Butin, 2000)Tj
-19.985 -3.642 Td
(A minimum of 80 square feet for the exam )Tj
T*
(room provided. )Tj
19.985 1.2 Td
(AIA, 1987)Tj
-19.985 -2.442 Td
(If the exam room and office area were )Tj
0 -1.2 TD
(combined then the room should be at least )Tj
0 -1.2 TD
(120 sq. ft. to provide adequate office and )Tj
T*
(exam space)Tj
19.985 3.6 Td
(Johnston, 1977)Tj
-19.985 -4.842 Td
(The examination room was at least 22 feet )Tj
T*
(long.)Tj
19.985 1.2 Td
(Butin, 2000; Center for )Tj
T*
(Health in Schools, 2004)Tj
-19.985 -1.242 Td
(Artificial light with special attention given to )Tj
T*
(the lighting and ballasts was selected for the )Tj
T*
(space used for vision and hearing testing.)Tj
19.985 2.4 Td
(Butin, 2000; Center for )Tj
T*
(Health in Schools, 2004)Tj
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(A corridor at least 20 feet in length could )Tj
T*
(serve for vision testing and a small 8x8 foot )Tj
T*
(sound-proofed space could serve as a )Tj
T*
(hearing test room.)Tj
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T*
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(Johnston, 1977)Tj
-19.985 -3.642 Td
(Lighting for the exam room had a high CRI )Tj
T*
(to obtain correct skin tones and truer colors.)Tj
19.985 1.2 Td
(Boyce, 1981)Tj
-19.985 -2.442 Td
(Two four-lamp \(2 x 4 ft.\) recessed or )Tj
T*
(surface mounted lights recommended for )Tj
T*
(the exam room to maintain a light level of )Tj
T*
(100 foot-candles.)Tj
19.985 3.6 Td
(Malkin, 1990)Tj
-19.985 -4.842 Td
(Vinyl composition tile or seamless resilient )Tj
T*
(flooring was used in the exam/treatment )Tj
T*
(room. )Tj
19.985 2.4 Td
(All in a Day\355s Work, 1999)Tj
T*
(AIA, 1987; Johnston, 1977;)Tj
T*
(Malkin, 1990)Tj
-19.985 -1.242 Td
(The exam room door was at least 2 ft. 10 )Tj
T*
(inches to accommodate wheel chairs.)Tj
19.985 1.2 Td
(Johnston, 1977)Tj
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(The exam room was equipped with a sink )Tj
0 -1.2 TD
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T*
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19.985 2.4 Td
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T*
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(wall near the sink.)Tj
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(A wall hung writing shelf was provided at )Tj
T*
(the end of the sink cabinet with a rolling )Tj
T*
(stool stored underneath the shelf and a )Tj
T*
(trash slot cut into the face of the sink )Tj
T*
(cabinet.)Tj
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-19.985 -6.042 Td
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T*
(room.)Tj
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T*
(1990)Tj
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(\(For dermatology use\) Windows, 42 inches )Tj
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T*
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T*
(light or view.)Tj
19.985 2.4 Td
(Malkin, 1990)Tj
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(Glass-block windows were recommended in )Tj
T*
(exam rooms.)Tj
19.985 1.2 Td
(Fogarty, 1998)Tj
-19.985 -2.442 Td
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T*
(wall.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
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T*
(pediatric patients.)Tj
19.985 1.2 Td
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261.077 311.203 l
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261.077 282.463 l
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28.424 281.978 l
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411.735 281.978 l
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412.22 253.554 l
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261.077 254.039 l
h
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261.077 40.784 m
412.22 40.784 l
411.735 41.269 l
261.077 41.269 l
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(Doors with obscure glass were )Tj
0 -1.2 TD
(recommended in the treatment area to )Tj
T*
(provide privacy)Tj
19.985 2.4 Td
(Jelliffe & Schipp, 2002)Tj
-19.985 -3.642 Td
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(provided privacy for conversations between )Tj
0 -1.2 TD
(patient and provider.)Tj
19.985 2.4 Td
(Center for Health in )Tj
0 -1.2 TD
(Schools, 2004)Tj
-19.985 -2.442 Td
(Pediatric exam rooms required two )Tj
0 -1.2 TD
(electrical outlets\363one over the sink )Tj
T*
(cabinetry and one near the exam table or )Tj
T*
(bed.)Tj
19.985 3.6 Td
(Malkin, 1990)Tj
-19.985 -4.842 Td
(Outlets were located out of reach of small )Tj
T*
(children.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Exam table placed against the wall for )Tj
T*
(pediatric patients.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(The exam table was 27 inches wide and 54 )Tj
T*
(inches long with a pullout footboard.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Patterned tile or sheet vinyl floors, use of )Tj
T*
(colorful wall coverings, and artwork )Tj
T*
(appropriate for children were placed in the )Tj
T*
(exam room.)Tj
19.985 3.6 Td
(Malkin, 1990)Tj
-10.152 -4.842 Td
( )Tj
-6.141 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Rest Area)Tj
22.625 1.227 Td
( )Tj
-1.861 -1.2 Td
(Source: )Tj
/TT0 1 Tf
-24.455 -1.296 Td
(Curtains around the bed created a snug, )Tj
T*
(secure and self-contained environment.)Tj
19.985 1.2 Td
(Chaney, 1973)Tj
-19.985 -2.442 Td
(Rest area for ill students had cots with vinyl-)Tj
T*
(coated cubicle curtains and a dimmable )Tj
T*
(light fixture for each cot.)Tj
19.985 2.4 Td
(Jelliffe & Schipp, 2002)Tj
-19.985 -3.642 Td
(Recliners rather than beds in the rest area )Tj
0 -1.2 TD
(recommended. )Tj
19.985 1.2 Td
(Medical Center of Georgia, )Tj
T*
(2000)Tj
-10.152 -1.242 Td
( )Tj
-6.141 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Restroom)Tj
/TT0 1 Tf
6.141 -1.227 Td
( )Tj
/TT1 1 Tf
16.484 2.454 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -2.496 Td
(Restroom is essential.)Tj
19.985 0 Td
(Hawkins & Lilley, 1998)Tj
-19.985 -1.242 Td
(Washable, semi-gloss paint in soft greens, )Tj
T*
(blues, or pinks with darker accent colors )Tj
T*
(were recommended for the lavatory area. )Tj
19.985 2.4 Td
(Davini, 1952)Tj
-19.985 -3.642 Td
(Ceramic mosaic tiles which were resilient )Tj
T*
(and easy to clean and maintain provided a )Tj
T*
(safe floor option for restrooms.)Tj
19.985 2.4 Td
(All in a Day\355s Work, 1999;)Tj
T*
( AIA, 1987; )Tj
T*
(Malkin, 1990)Tj
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(CHAPTER 1)Tj
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27.939 254.665 m
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27.939 155.908 m
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27.939 45.509 m
261.077 45.509 l
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(The bathroom was well-lighted, ventilated )Tj
0 -1.2 TD
(and wheelchair accessible with grab bar )Tj
T*
(next to toilet.)Tj
19.985 2.4 Td
(Bar & Galluzzo, 1999; )Tj
T*
(McKibben & DiPaolo, 1997)Tj
-19.985 -2.442 Td
(A changing table, washer, dryer, and )Tj
0 -1.2 TD
(shower area with a seat were provided in )Tj
T*
(the bathroom area along with equipment )Tj
T*
(and a storage area for supplies for special )Tj
T*
(needs students.)Tj
19.985 4.8 Td
(McKibben & DiPaolo, 1997)Tj
-10.152 -6.042 Td
( )Tj
-9.086 -1.2 Td
(Design Element: )Tj
/TT1 1 Tf
(Security, Storage and )Tj
7.725 -1.2 Td
(Safety)Tj
/TT0 1 Tf
1.361 -1.227 Td
( )Tj
/TT1 1 Tf
16.484 3.654 Td
( )Tj
-1.722 -1.2 Td
(Source:)Tj
/TT0 1 Tf
-24.594 -3.696 Td
(Medical records were kept in a separate )Tj
0 -1.2 TD
(room if records were kept on open )Tj
0 -1.2 TD
(shelves. )Tj
19.985 2.4 Td
(Johnston, 1977)Tj
-19.985 -3.642 Td
(Locking file cabinets for records and locking )Tj
0 -1.2 TD
(storage were provided. )Tj
19.985 1.2 Td
(AIA, 1987; Butin,2000; )Tj
T*
(Center for Health in )Tj
T*
(Schools, 2004 a & b; )Tj
T*
(Hubler, 1996; Jelliffe & )Tj
T*
(Schipp, 2002)Tj
-19.985 -1.242 Td
(Equipment and storage cabinets had )Tj
T*
(fluorescent lights mounted in them.)Tj
19.985 1.2 Td
( )Tj
-19.985 -2.442 Td
(Lockable areas for staff and student )Tj
T*
(personal items were provided. )Tj
19.985 1.2 Td
(Frasca-Beaulieu, 1999)Tj
-19.985 -2.442 Td
(A refrigerator with locking compartments )Tj
T*
(was recommended to store medicine )Tj
T*
(requiring refrigeration.)Tj
19.985 2.4 Td
(Jelliffe & Schipp, 2002)Tj
-19.985 -3.642 Td
(The disposal and removal of medical )Tj
0 -1.2 TD
(wastes, in accordance with the MOSHA law, )Tj
T*
(and a separate security system were )Tj
T*
(available for the clinic area.)Tj
/TT2 1 Tf
19.985 3.6 Td
(Floor Plan, )Tj
/TT0 1 Tf
(2003; Health in )Tj
0 -1.201 TD
(Schools, 2004b)Tj
-20.027 -3.54 Td
( )Tj
0 -1.1 TD
( )Tj
0.042 -1.242 Td
(Safety glass, wired glass, or plastic glazing )Tj
0 -1.2 TD
(material that resisted breakage and created )Tj
T*
(no cutting edges when broken were )Tj
T*
(recommended for doors, sidelights, and )Tj
T*
(windows glazed to within 18 inches or 46 )Tj
T*
(cm of the floor.)Tj
19.985 6 Td
(AIA, 1987)Tj
ET
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(http://www.coe.uga.edu/sdpl/researchabstracts/health/HealthEnvironments.\
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5.141 -1.2 Td
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( )Tj
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(Source:)Tj
/TT0 1 Tf
-24.594 -3.696 Td
(Hooks for opening and closing doors, flush )Tj
0 -1.2 TD
(door saddles, and blade faucet controls )Tj
T*
(were recommended. )Tj
19.985 2.4 Td
(Bar & Galluzzo, 1999; )Tj
T*
(Rosenfield, 1972)Tj
-19.985 -2.442 Td
(Surface areas in a health care facility were )Tj
0 -1.2 TD
(aesthetically appealing but easily cleanable )Tj
T*
(and water resistant.)Tj
19.985 2.4 Td
(Center for Health in )Tj
T*
(Schools, 2004; Noskin & )Tj
T*
(Peterson, 2001)Tj
-19.985 -1.242 Td
(Wall coverings, walls and ceilings were fluid )Tj
T*
(resistant and easily cleanable in areas )Tj
T*
(where contact with blood and body fluids )Tj
T*
(occurred.)Tj
19.985 3.6 Td
(Noskin & Peterson, 2001)Tj
-19.985 -4.842 Td
(Changes in lighting, accent walls, and )Tj
T*
(artwork were present. )Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Healthcare facility reflected an )Tj
T*
(understanding of the specific population and )Tj
T*
(cultures by using cultural artwork, artifacts )Tj
T*
(and furnishings, and ease of access, )Tj
T*
(comfort, convenience, and efficiency were )Tj
T*
(considered.)Tj
19.985 6 Td
(Frasca-Beaulieu, 1999)Tj
-19.985 -7.242 Td
(Warm colors and residential type )Tj
T*
(furnishings brought an inviting, homelike, )Tj
T*
(user friendly, familiar and relaxing d\310cor for )Tj
T*
(the medical facility.)Tj
19.985 3.6 Td
(Frasca-Beaulieu, 1999)Tj
-19.985 -4.842 Td
(\354Visual noise\356 or the use of too many wall )Tj
0 -1.2 TD
(decorations was avoided. )Tj
19.985 1.2 Td
(Grangaard, 1993; Rouk, )Tj
0 -1.2 TD
(1997)Tj
-19.985 -1.242 Td
(Sunlight, clean, fresh air, and the colors of )Tj
0 -1.2 TD
(earth and sky were present. )Tj
19.985 1.2 Td
(Grangaard, 1993)Tj
-19.985 -2.442 Td
(Televisions in waiting rooms, use of abstract )Tj
T*
(art, and close-up pictures of animals staring )Tj
T*
(directly at the observer were avoided. )Tj
19.985 2.4 Td
(Ulrich, 1990)Tj
-19.985 -3.642 Td
(A variety of fabrics and finishes and using )Tj
T*
(differing scale in furnishings were present. )Tj
19.985 1.2 Td
(Gappell, 1991)Tj
-19.985 -2.442 Td
(Furnishings with rounded corners and )Tj
T*
(ergonomically designed furniture insured )Tj
T*
(bodily comfort, and an environment )Tj
T*
(including furniture scaled for young children )Tj
T*
(enhanced their sense of independence.)Tj
19.985 4.8 Td
(Gappell, 1991)Tj
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(Use of real photos of children of diversity, )Tj
0 -1.2 TD
(painted ceiling tiles, vinyl wall coverings, )Tj
T*
(and sophisticated colors were )Tj
0 -1.2 TD
(recommended. )Tj
19.985 3.6 Td
(Fogarty, 1998)Tj
-20.027 -4.742 Td
( )Tj
0 -1.1 TD
( )Tj
0.042 -1.242 Td
(Recommended furnishings for a school )Tj
0 -1.2 TD
(based health center were: bulletin boards, )Tj
0 -1.2 TD
(desks, tables, chairs, bookcases, display )Tj
T*
(cases, cots or beds, locked storage )Tj
T*
(cabinets for medications, syringes, etc., file )Tj
T*
(cabinets, magazine racks, display racks for )Tj
T*
(brochures, marker boards/chalkboards, )Tj
T*
(children's toy chest, computer terminals and )Tj
T*
(printers, telephones, photocopier, wall )Tj
T*
(clocks, refrigerator, freezer, and specialized )Tj
T*
(medical/dental equipment.)Tj
19.985 12 Td
(Center for Health in Schools )Tj
T*
(\(2004b\))Tj
-19.985 -12.042 Td
(Additional recommended equipment was: )Tj
T*
(medications, oxygen tank with stand, xmas )Tj
T*
(tree connector/O2 key, drinking cups, soap, )Tj
T*
(arm boards, arm sling, Kleenex, bio-hazard )Tj
T*
(container, gloves, syringes, bleach, heating )Tj
T*
(pad, batteries, telephone, copier, computer, )Tj
T*
(printer, fax, and calculator.)Tj
19.985 7.2 Td
(Medical Center of Georgia, )Tj
T*
(2000)Tj
-19.985 -7.242 Td
(A portable high-intensity light was provided )Tj
T*
(for examinations.)Tj
19.985 1.2 Td
(Malkin, 1990)Tj
-19.985 -2.442 Td
(Furnishings and equipment recommended )Tj
T*
(in a clinic in Maryland were: a desk, chairs, )Tj
0 -1.2 TD
(bookcase, locking file cabinet, answering )Tj
T*
(machine, and supply cabinets with locks. )Tj
T*
(Additional medical equipment was a wall )Tj
T*
(mount blood pressure gauge or cuffs \(adult/)Tj
T*
(child\), wall mount otoscope-)Tj
T*
(opthamaloscope, wall mount sharps )Tj
T*
(container, thermometer, peak flow meter, )Tj
T*
(accucheck, scoliometer, tympanogram, )Tj
T*
(hemocue, refrigerator/freezer, microscope, )Tj
T*
(nebulizer, eye chart & eye cover, single )Tj
T*
(container for crash cart supplies, and step-)Tj
T*
(on garbage cans.)Tj
19.985 15.6 Td
(Center for Health in )Tj
T*
(Schools, 2004a)Tj
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