Depressive symptoms in adolescent girls at-risk for type 2 diabetes and their parents.

Few studies have characterized the relation between parent's depression symptoms and adolescent's depression symptoms in adolescents at-risk for type 2 diabetes (T2D). We evaluated the associations of parental depression symptoms with the depression symptoms and metabolic functioning of adolescent offspring at-risk for T2D. One-hundred sixteen parents and adolescent girls with a family history of diabetes completed surveys of depression symptoms. Adolescents' degree of metabolic risk for T2D was estimated from body mass index (BMI; kg/m2) standard score, percent adiposity from dual-energy x-ray absorptiometry scan, and whole body insulin sensitivity index determined from glucose/insulin concentrations during a two-hour oral glucose tolerance test. Parents' and adolescents' depression symptoms were significantly associated, even after accounting for race/ethnicity, age, puberty, body composition, and parental diabetes/BMI. Adjusting for similar covariates, parent depression symptoms also were positively related to adolescents' BMI standard score and had a trend-level association with adiposity. There was an inverse relation between parental depression symptoms and adolescent insulin sensitivity, which was entirely accounted for by adolescent body composition. The associations of parental depression symptoms with more elevated depression symptoms and higher BMI in adolescents at-risk for T2D has potential implications for interventions addressing these co-morbid health conditions.

Improving Telehealth Knowledge in Nurse Practitioner Training for Rural and Underserved Populations.

BACKGROUND: Telehealth is an emerging technology for the delivery of health care services. Providers need to be trained to maximize the potential benefits for rural and underserved populations. METHOD: A quality improvement approach to curricular redesign was used to integrate telehealth in a family nurse practitioner program. The intervention consisted of telehealth learning outcomes and a lecture-style presentation in a role transition course. A Plan-Do-Study-Act cycle informed faculty decision making in a small test of change. Self-reported confidence in telehealth knowledge was measured with a knowledge survey to determine whether the change was an improvement. RESULTS: Student confidence in telehealth knowledge increased following the intervention. The change provided an opportunity for faculty to consider additional approaches to integrating telehealth learning experiences in practicum courses. CONCLUSION: This project provided an improvement framework on which faculty can build and test effective pedagogical approaches to training graduate nursing students on the use of telehealth technology. [J Nurs Educ. 2019;58(1):57-60.].

Association of bacterial colonization at the time of presentation to a combat support hospital in a combat zone with subsequent 30-day colonization or infection.

U.S. casualties have developed multidrug-resistant (MDR) bacterial infections. A surveillance project to evaluate U.S. military patients for the presence of MDR pathogens from wounding through the first 30 days of care in the military healthcare system (MHS) was performed. U.S. military patients admitted to a single combat support hospital in Iraq during June-July of 2007 had screening swabs obtained for the detection of MDR bacteria and a subsequent retrospective electronic medical records review for presence of colonization or infection in the subsequent 30 days. Screening of 74 U.S. military patients in Iraq found one colonized with methicillin-resistant Staphylococcus aureus. Fifty-six patients of these were screened for Acinetobacter in Germany and one found colonized. Of patients evacuated to the U.S., 9 developed infections. Carefully obtained screening cultures immediately after injury combined with look-back monitoring supports the role of nosocomial transmission. Consistent infection control strategies are needed for the entire MHS.