Role of the School Nurse:School Nurses assess their population needs. They are influencers in the educational setting and play a major role in improving the health of individuals, the environment, and the school culture. Below are some of the main methods which can be integrated into the school program and enhance neurogenesis.

Significance in Schools:

References:

An optimally functioning brain is crucial to a learners success. Interventions and op-portunities for promoting brain health and for neurogenesis must be applied in order to improve and maintain the health of key areas responsible for learning.

Brain fitness has implications far beyond a school environment but can have implica-tions for a person’s overall health and wellbeing into adulthood. Students can achieve greater levels of success in school and in life. The significance goes beyond the individ-ual learner to the community at large. The effects of enhancing neurogenesis and edu-cating key adults on behalf of these children can have a positive impact on communi-ties and ultimately the world.

Adult neurogenesis. (n.d.). Retrieved February 6, 2019 from https://en.wikipedia.org/wiki/Adult_neurogenesisAmerican Academy of Pediatrics Committee on Nutrition (2016). Making Healthy Food Choices. Retrieved from http://www.ascd.org/publica-tions/educational-leadership/summer07/vol64/num09/The-Neuroscience-of-Joyful-Education.aspxAmerican Psychological Association. (2008). Children and Trauma: Update for Mental Health Professionals. Retrieved from https://ww-w.apa.org/pi/families/resources/children-trauma-updateBathina, S., & Das, U. N. (2015). Brain-derived neurotrophic factor and its clinical implications. Archives of medical science: AMS, 11(6), 1164-78. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697050/Bernstein, R. (2016, July 26). The Mind and Mental Health: How Stress Affects the Brain. Touro University Worldwide. Retrieved from https://www.tuw.edu/health/how-stress-affects-the-brain/Christensen, J. (n.d.). Food for Brain Development & Concentration for Preschoolers. Healthy Eating SF Gate. Retrieved from http://healthy-eating.sfgate.com/food-brain-development-concentration-preschoolers-11345.htmlHansen, F. (2015, March 29). Bad Stress vs. Good Stress. The Adrenal Fatigue Solution. Retrieved from https://adrenalfatiguesolt-ion.com/bad-stress-vs-good-stress/Harvard Health Publishing. (2011, March). Understanding the Stress Response. Retrieved from https://health.harvard.edu/stay-ing-healthy/understanding-the-stress-responseHarvard Health Publishing. (September 2016). Can You Grow New Brain Cells? Retrieved from https://www.health.harvard.edu/-mind-and-mood/can-you-grow-new-brain-cellsJensen, E. (2005). Teaching with the Brain in Mind (2nd ed.). Alexandria, VA: Association for Supervision and Curriculum Development.McEwen, B., Nasca, C., & Gray, J. (2016). Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex. Neuropsycho-pharmacology, 41(1), 3-23. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677120/Nakazawa, D. J. (2015). Childhood Disrupted How Your Biography Becomes Your Biology, and How You Can Heal. New York, NY: Atria Paper-back.Schmelzer, G. (2015, Jan 11). Understanding Learning and Memory: The Neuroscience of Repetition. Retrieved from http://gretchenschmel-zer.com/blog-1/2015/1/11/understanding-learning-and-memory-the-neuroscience-of-repetitionSelhub, E. (2015, Nov 16). Nutritional Psychiatry: Your Brain on Food. Harvard Health Publishing. Retrieved from https://www.health.har-vard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626Sippel, L., Pietrzak, R., Charney, D., Mayes, L., & Southwick, S. (2015). How Does Social Support Enhance Resilience in the Trauma-exposed Individual? Ecology and Society, 20(4): 10. http://dx.doi.org/10.5751/ES-07832-200410.The Kennedy Forum. (2015). Promoting Brain Health and Brain Fitness: A National Call for Action [pdf]. Retrieved from https://chp-wp-up-loads.s3.amazonaws.com/www.thekennedyforum.org/uploads/2017/06/issue-brief-Brain_Fitness_160725.pdfRice University (n.d.). Hippocampus. Retrieved from https://www.caam.rice.edu/~cox/wrap/hippocampus.pdfWillis, J. (2007). The Neuroscience of Joyful Education. Educational Leadership, 64. Retrieved from http://www.ascd.org/publications/educa-tional-leadership/summer07/vol64/num09/The-Neuroscience-of-Joyful-Education.aspx

Vigorous Play/ExerciseVigorous Play and Excercise are crucial due to their ability to:

The School Nurse Can:Advocate for brain breaks frequently

Increase production of BDNFIncrease baseline of neuron growthIncrease blood flow and oxygen in select areas of the brainIndirectly improve mood, sleep, stress levels, anxiety, and reduce inflammationStrengthen the basal ganglia cerebellum and corpus callosumImprove the transfer of data encoding synaptic structure activity and the plasticity of neurons

Advocate for longer recessEducate staff/administration on the importance of longer recess and the importance of play and exer-cise

Social SupportThe goal of social support is to:

The School Nurse Can:

Foster feelings of emotional support

Refer to counselors when needed and follow up

Create functional support that meets needs

Know ACES scores and assist teachers in knowing their studentsBe familiar with community resources

Extend the network of social support and the frequency of interactions

Provide material support - goods and services - that help solve practical problemsHelp students understand the crisis and adapt

Sufficient TimeBenefits of allowing for sufficient time include:

The School Nurse Can:

Weeks to months of repetitive and positive expe-riences cause myelination in key areas

Educate staff on the importance of persistence, perseverence, and patienceAdvocate for repetitive, quality experiences in learning

Repetition creates long term memories by eliciting strong chemical interactions at the synapse

Educate parents/guardians, teachers, and staff how repeated mental states become mental traits

It takes three to six weeks for a neuron to mature, and neuron growth is approximately 700 per day in the adult brain

Plasticity in the brain organizes and forms new connections

Stress ManagementWays to decrease stress include, but are not limited to, the following:

The School Nurse Can:Advocate for wellness programs for teachers and parents/guardiansAdvocate for a peace corner or calm down space in classrooms or somewhere in the school itselfTeach deep breathing especially during points of contactAdvocate and support mindfulness programs in schools and/or consistent social, emotional curriculum

Optimal NutritionFoods that allow for optimal nutrition include:

Practice clean eating habits

The School Nurse Can:

Healthy fats, fatty acids, and Omega 3Diets rich in antioxidantsComplex carbs that are needed for energy

Advocate for healthy school meals and gather change agentsEducate and involve parents/ guardiansFight to limit refined sugars and processed foods

Foods that supply B6, B12, tryptophan, phenylalanine, turmeric, and choline

PlayMindfulnessYogaDeep BreathingFostering a friendship and kindness culture in school

Joyful EducationThe goal is to create novelty and engagement that allows for:

The School Nurse Can:

A stronger opportunity for new learning path-ways in the brain (neural firing and wiring)

Advocate for outdoor classrooms and stimulating school environment

Opportunities for thinking and exuberant discovery

Educate staff on how to incorporate these types of learning environments Advocate for enrichment programs

Relevancy that promotes interest and motiva-tion

Coherent and challenging learning

Key Areas of The Brain That are Affected:

Function of the Amygdala:- Critical processing of the senses - Cognition and processing of emotional memories and mediates intense emotional events- Regulates our alert system prepares for emergencies *Gets larger and more reactive when exposed to chronic stress

Function of the Prefontal Cortex:- Working memory - Executive function - Personality Expression *Reduced cells in response to cortisol and chronic stress

Function of the Hippocampus:- Strong involvement with learning- Mood regulation- Mediates semantic and episodic memory*With chronic stress dendrites in this region shrink and certain neuro transmit-ters needed for learning and memory are depleted

This is not a complete list of functions

The Problem:According to the Center of Disease Control and Prevention, high ACES scores in children have adverse affects and stem from three main types of experiences: abuse, neglect, and household dysfunction. As a result, many of our students are continually caught in a stress response pattern. Consequently, these students un-dergo physical changes to key brain structures which are critical for learning. Some of these key areas include the prefrontal cortex, the hippocampus, and the amyg-dala. Neurogenesis in these areas is of the utmost importance if children are to learn. The death of neurons caused by chronic stress and trauma in these areas make learning a huge challenge due to the high reactivity of the amygdala, impulse control inhibited by a poorly functioning prefrontal cortex, and difficulty with memory and recall caused by cell damage in the hippocampus – just to name a few.

Know to GrowThe School Nurse’s Role in Promoting Neurogenesis

Wendy Lamparelli, BSN, MEd. RN CSN-NJ

Figure showing encoding, retrieval and new learning with and without neurogenesis. (A) left: immediate early gene activation (Arc, c-fos) in the dentate gyrus and CA3 region of the hippocampus during memory encoding (green cells). Right: During new learning, pre-dominantly new cells are being activated in the dentate gyrus and CA3 (yellow cells). (B) During memory retrieval, a subset of cells that were activated during encoding are recruited (red cells), and new cells are being activated (yellow cells). (C) Without neurogenesis, memory re-trieval is impaired and reactivation is decreased in CA3 but not in the dentate gyrus, as indicat-ed by less co-labeling (red cells) than in (B).

Neurotransmitters - a chemical substance that is released at the end of a nerve fiber by the arrival of a nerve impulse and, by diffusing across the synapse or junction, causes the transfer of the impulse to another nerve fiber, a muscle fiber, or some other structure

Eustress - a little stress; this keeps us alert, motivated, and helps us ac-complish a goal; gives fight or flight response; a test runDistress - chronic stress that is ongoing; elevated stress levels impairs brain function and mental health; hormones of cortisol and adrenaline are circulating which causes the body and the brain to stay revved up on high alert over a long period of time

Neurogenesis - the process of growing new neurons --can be anywhere from hundreds to thousands of new neuronal cells per day

Name

Cortisol

Dopamine

Serotonin

Epinephrine

Hormone

Hormone

Neurotransmitter

“UH-OH”supplies energy

“YIKES!!!”

“YAHOO!”

“aaahhhh...”

produces pleasure

induces calm

alerts all systems

Neurotransmitter

Type Function Semantic Memory Tool

Teaching with the brain in mind page 72, Figure 5.3 Eric Jensen

What is Neurogenesis?Key Terms and Tools:

PubMed Central. Regulation of hippocampal memory traces by neurogenesis: Figure 1. Neurogenesis (Austin)

Neurons in the dentate gyrus - Avila, J.