Nursing and Dental Students' Reflections on Interprofessional Practice After a Service-Learning Experience in Appalachia.

Nowhere is the discrepancy between good and poor oral health status more pronounced in the U.S. than in the Appalachian region, where there is a high incidence of dental problems related to non-flouridated water, limited access to care, and tooth loss. To address these disparities, in 2016 University at Buffalo dental and nurse practitioner faculty members led a group of dental and nursing students on a two-day service-learning experience in rural Tennessee. The aim of this study was to assess the dental and nursing students' reflections on this interprofessional service-learning experience in Appalachia. After the program, all 36 students who took part in it were invited to complete a survey with open-ended questions about the experience and their attitudes about interprofessional practice. Of the students, 34 (94.4%) returned the surveys, and 23 completed all the questions. Thematic analysis was used to code and analyze the student comments, which were then organized into themes. Five themes emerged: facilitating care through teamwork, gaining mutual respect, gaining confidence, understanding dental role in overall health, and relieving suffering. The overarching pattern was the link among all the themes: that everyone has a part to play in ensuring that patients get the best care. The themes and overarching pattern corresponded to the Interprofessional Education Collaboration (IPEC) competencies and the overall goal of delivering patient-centered care to a population that is underserved. These findings suggest that exposure to patients who lack dental care and have severe oral health problems can impact developing nursing and dental professionals in ways that can increase their appreciation of interprofessional practice and their future willingness to provide care in underserved settings.

Identification and Treatment of Adolescents With Perinatal Anxiety and Depression.

Perinatal mood and anxiety disorders (PMAD) are the most common, yet under-diagnosed and undertreated complication of pregnancy, affecting up to 50% of pregnant and parenting teens. PMAD are a global health issue that can have devastating effects on the mental, physical, emotional, developmental health, and social life of the mother, infant, and family. Adolescents present with similar symptoms of PMAD as their adult counterparts, but also experience isolation from their peer group and lack of resources and coping strategies, as well as difficulty sleeping and lack of concentration and ability to focus. Nurses and nurse practitioners are in an ideal position to assess preexisting risk factors for PMAD. The current applied evidence-based article addresses the diagnosis of PMAD, provides a conceptual framework for understanding the intra- and interpersonal dynamics affecting teens with PMAD, and suggests a new screening tool to guide diagnosis. An easy to recall mnemonic for diagnosis and referral (SAIL AHEAD) is proposed. By using the SAIL AHEAD mnemonic, providers will impact adolescents' parenting success and resiliency, thereby enhancing their future success in life. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 23-29.].

Understanding Intimate Partner Violence in Jordan: Application of the Ecological Model.

PURPOSE: To compare and contrast the Heise "ecological model of gender-based violence" with factors related to "intimate partner violence" (IPV) in Jordan. METHODS: Findings of empirical studies examining IPV against Jordanian women were analyzed using the Heise ecological model (1998). CONCLUSION: Factors identified in the literature were generally consistent with the ecological model. However, the literature on IPV in Jordan rarely examined the role of community-level factors in the exosystem and sociopolitical factors in the macrosystem. Consequently, little is known about how these exosystem and macrosystem factors affect IPV in Jordan. The Heise model was then adapted to reflect identified factors in the Jordanian cultural context. PRACTICAL IMPLICATION: More research aimed at uncovering barriers to identification and treatment of IPV targeting the exosystem and macrosystem is needed.

Using Standardized Patients to Teach Interprofessional Competencies to Dental Students.

The aims of this study were to develop, implement, and evaluate a novel interprofessional standardized patient exercise (ISPE) with oral-systemic and interprofessional collaborative practice (IPCP) components. Dental students and doctor of nursing practice (DNP) students at one U.S. university participated in the simulation, which was primarily designed to test their teamwork skills. In spring 2014, DNP students worked in the dental clinics with dental students under the supervision of nursing and dental faculty members. To test the teamwork outcomes for both groups of students, a standardized patient (SP) scenario was designed to include multiple chronic medical diagnoses and an oral-systemic component. The exercise was filmed for later review. Outcomes measures included SP and student self-evaluations and faculty evaluation of student documentation. The primary outcome of interest from a dental standpoint was faculty evaluation of IPCP competencies derived from the Core Competencies of Interprofessional Collaborative Practice and were deemed to be observable by faculty when viewing the videotaped scenario. Eight teams of students participated with an SP trained in the scenario. Each team consisted of a DNP student, a fourth-year dental student, and a second-year dental student. All eligible students in the DNP class (n=20) and eight students from each dental class (approximately 110 each) participated. The results showed that the teams scored highest on the role/responsibilities subscale, indicating students were respectful of each other's roles and expertise and effectively engaged each other to develop strategies to meet the patient's needs. Scores on the three other subscales (values/ethics, interprofessional communication, and teams/teamwork) were also high. These findings appeared to support IPCP as a method to foster knowledge and respect for other roles and responsibilities, improve appreciation of teamwork, and encourage better communication among health care providers. The ISPE scenario provided an effective way to evaluate IPCP competencies.

Outcomes of a One-Time Telephone Intervention for Smoking Cessation in Adults.

Tobacco use is the single greatest cause of disease and premature death in America today. To address this major public health concern, states are required to provide smoking cessation services. The purpose of this article is to examine the effectiveness of a one-time telephone adult smoking cessation program designed by a certified addictions registered nurse-advanced practice and conducted over an 11-month period by the State of Nevada. Specifically, the program included a telephone-based counseling session and distribution of a 2-week supply of nicotine replacement therapy patches. The sample population consisted of 1471 Nevada residents, men and women, aged 18 years and over who called the Quitline for smoking cessation help. All participants in the program provided consent for a follow-up call to report on their quit rates and satisfaction with the intervention at 7 months postintervention. Although everyone who participated in the interventions was called, only 373 (25.4%) were actually reached via telephone contact. Of this group, quit rates showed that 34.6% reported continuous abstinence at 7 months, whereas 35.1% were abstinent at the 7-day point prevalence and 31.9% were abstinent at the 30-day point prevalence. Patient satisfaction with the program revealed that 87.6% (n = 373) of the participants reported being very or mostly satisfied. This program evaluation study shows that short-duration telephone counseling plus nicotine replacement therapy was associated with helping at least one third of the participants to quit using tobacco for all of the prevalence points-7 and 30 days and at 7 months postintervention.

Substance abuse prevention and treatment within the criminal justice system: an overview of the issues.

Many nurses, especially those in addictions, work directly in the prison system and or relate to inmates before or after institutionalization for criminal activity. This connection led to the theme of the 2009 Annual Education Conference held in Albuquerque, New Mexico, entitled "Substance Abuse Prevention and Treatment: Working with the Criminal Justice Systems." The conference was partially funded through an award from the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (grant # SP015963) and focused on identifying the special risk factors for and barriers to the treatment of addictions for those who enter the criminal justice system. The conference, presented in collaboration with the American Association of Nurse Attorneys (AANA) highlighted the tremendous need for more access to addictions and mental health providers in the criminal justice system. Papers presented at that conference confirmed that nurses can make a real difference in the health of inmates, especially those of us engaged in addictions and mental health practices, and inspired this specially focused edition of the Journal of Addictions Nursing. The purpose of this editorial is to provide an overview of the addictions problems affecting individuals under supervision in the criminal justice system, barriers to treatment within this system, and the cost-benefits of evidence based treatment.

High-risk situations related to relapse of methamphetamine use among Taiwanese adolescents: an instrumentation study.

Methamphetamine is the leading illicit substance used by adolescents in Taiwan and the rise of its production and use is a major public health concern in Southeast and East Asia. The purpose of this study was to develop and test a new instrument to identify high-risk situations related to methamphetamine relapse among incarcerated Taiwanese adolescents. Participants in this study were arrested for methamphetamine use and mandatorily held at an abstinence center. In the instrument development phase, an item pool was generated from a qualitative study and further revised based on content evaluations by 6 clinical content experts. In the instrument analysis phase, the new tool was psychometrically tested. The intra-class correlation coefficient showed high stability of the instrument (r = .92). Factor analysis resulted in a 6-factor solution accounting for 66.68% of the variance in the 16-item model. Although this instrument was developed for use with Taiwanese adolescents, it needs further testing to confirm its usefulness in other cultural groups. The identified risky situations provide a beginning assessment tool that is easy to administer and can be used to identify teens at particular risk for relapse before being released from incarceration or other mandatory treatment programs. More research is needed to target specific and culturally determined triggers that can improve the validity of this tool for non Asian adolescents at risk for methamphetamine relapse.

Survey on addictions: toward curricular change for family nurse practitioners.

The purpose of this paper is to describe the results of a survey of advanced practice nurses (APNs) to determine the activities they perform related to caring for patients with addictions and or co-occurring mental health disorders, the amount of addictions education in their graduate programs, and their perceptions of the value of addictions education for their role. Data were obtained from 233 APNs in New York State using a tool adapted from a previous job analysis survey. APNs reported the greatest amount of experience in history taking for various types of addictions and co-occurring mental health disorders and least amount of experience in performing objective exams, using standardized screening tools, ordering related diagnostic tests, prescribing pharmacological treatments, and making referrals for addiction treatment. Respondents reported a mean of less than three hours addictions education in their graduate programs in contrast to their high perceived importance of this clinical area.

The Effect of Positive Adolescent Life Skills Training on Long Term Outcomes for High-Risk Teens.

This paper reports on long term follow-up data-12 months post intervention-from a clinical trial of an intervention designed to enhance teen resilience by supporting the development of social skills needed to make positive connections and overcome the influence of negative environmental influences. Sixteen adolescents aged 12 to 16 (10 boys and 6 girls) attending an inner city urban secondary school participated in a 32 week intervention study. Subjects were randomly assigned within sex to Teen Club plus Positive Adolescent Life Skills (PALS) or Teen Club intervention groups. The Problem Oriented Screening Instrument for Teenagers (POSIT) was used to measure the dependent variables (problems related to substance use, health, mental health, family relations, peer relations, education status, vocational status, social skills, leisure and recreation, and aggression). The small sample size limited the ability to determine statistical differences between the POSIT subscale scores for PALS plus Teen Club or Teen Club only interventions. Descriptive data suggest mixed results for both interventions and sex groups. Most important were reductions in mental health problems for all boys in both groups and only slightly increased numbers of problems in substance use for PALS boys and girls over time. Other trends by group and sex are reported.

Connecting with guidance counselors to enhance recruitment into nursing of minority teens.

The purpose of this article was to describe the design, implementation, and outcomes of one strategy used to promote careers in nursing among minority high-school-aged teens-namely, a workshop for guidance counselors in a large urban school system. All guidance counselors in an urban inner city school system were invited to attend a workshop on careers in nursing as part of their monthly continuing education requirements. Thirty-nine (39%) participated in the half-day workshop held at a school of nursing. Most informative were the guidance counselor comments about perceptions of nursing careers that create barriers to recruitment. Guidance counselors reported that (a) many students and parents view nursing as a "dangerous field," (b) negative stereotypes about nursing persist, (c) many students do not plan for the prerequisites for baccalaureate entrance, (d) nursing is perceived as a "narrow" field with few opportunities for advancement, and (e) there is a preference of 2-year programs to get "quick income" over baccalaureate programs and long-term career planning. Faculty and students addressed these issues. Faculty collaboration with guidance counselors is an excellent mechanism to uncover barriers to minority recruitment at the local level. Nursing recruitment activities should be tailored to address these community concerns. In the last 4 years, 24 students from the targeted high school system were offered admission to the University at Buffalo and of this group 17 enrolled in nursing.

Positive adolescent life skills training for high-risk teens: results of a group intervention study.

INTRODUCTION: This study tested the addition of a cognitive-behavioral skill-building component called Positive Adolescent Life Skills (PALS) training to an existing intervention for urban adolescents to enhance resiliency. In previous pilot work with the existing intervention, called "Teen Club," it was found that participants in group meetings and intensive case management reported an enhanced ability to connect with positive resources. METHOD: Sixteen adolescents aged 12 to 16 years (10 boys and 6 girls) attending an urban secondary school were randomly assigned to Teen Club or Teen Club plus PALS. Boys and girls met separately in one of the two conditions for 30 weeks. The Problem-Oriented Screening Instrument for Teenagers (POSIT) subscale scores were measured at baseline and at the completion of the program. RESULTS: The sample consisted of 11 Black and five Hispanic teens. Between-group differences in the POSIT subscale scores were not significantly different in this small sample. Group interviews conducted at the conclusion of the intervention revealed that participants found the PALS intervention to be relevant and useful. DISCUSSION: Results suggest that the PALS component strengthened the existing intervention and lend preliminary support for the continuation of this combination of interventions. Future research with larger numbers is needed.

The evolution and evaluation of videoconferencing technology for graduate nursing education.

The Integrated Services Digital Network H.323 (ISDN), which has been in use for the past 20 years often requires a dedicated telephone line and other equipment to implement. Consequently, expansion of ISDN-based videoconferencing requires infrastructure not always accessible in those areas that are most in need of technological connections. New H.323 technology using Internet Protocol H.320 (IP) connectivity can accommodate the use in a variety of videoconferencing software and fill this void as demonstrated by an experiment conducted live at the Syllabus Web '99 conference. When a faculty group were unable to secure ISDN connections to demonstrate their clinical evaluation of Family Nurse Practitioner (FNP) students using videoconferencing technology, an ad hoc group of computer experts, educators, instructional design specialists, and corporate sponsors collaborated to design a multipoint PC-based connection using IP connectivity. This article describes the first application of this technology, the evolution of ISDN and IP systems in nursing education and practice, and suggests appropriate future trends for their utility in nursing.