Short-Term Global Experiences: Reflections, Themes, and Implications.

BACKGROUND: Many schools of nursing offer international service-learning opportunities. Research on these experiences describes benefits to students, but the importance of building long-term relationships and community health capacity is seldom addressed. METHOD: The written posttravel reflections of 89 advanced practice nursing students, following brief global experiences over 9 years in developing areas, were analyzed to identify themes and implications for future work. RESULTS: Analysis of student reflections produced four themes and 13 subthemes. Students described accomplishments and challenges. Improvements were noted in clinical skills and linguistic abilities. Challenges included ethical issues of undermining the value of local providers, obstacles to appropriate follow-up care, and disruption of community life. An ongoing project that responds to community needs for education and training was offered as a better means to improving health. CONCLUSION: Global health service-learning experiences can be beneficial to both students and communities, especially if imbedded in structured academic courses designed to include long-term solidarity with the community and the development of health capacity and ethical nursing practices. [J Nurs Educ. 2016;55(7):379-384.].

Obesity in children with Down syndrome: background and recommendations for management.

Children with Down syndrome have a higher risk for developing obesity. The primary care provider can assist the family in preventing or managing obesity by recognizing the physiological and behavioral factors that place children and adolescents with Down syndrome at increased risk to become obese, and establishing a screening and management plan early to prevent or treat excess weight gain. By using adapted strategies, the negative physiological and psychological outcomes associated with obesity may be lessened or avoided in this specific population.

Developmental status of children of teen mothers: contrasting objective assessments with maternal reports.

INTRODUCTION: Descriptive study compared adolescent mothers' subjective perceptions of their children's development with objective developmental assessments. METHODS: A volunteer sample of mother/child pairs was recruited from an urban high school. Thirty-three mothers completed the Ages and Stages Questionnaire (A&SQ). The Bayley Scales of Infant Development (BSID) was administered to children. RESULTS: On the BSID, group mean scores all fell within the normal range. However, almost 20% of individual children had one or more delays. Almost 73% of mothers accurately assessed their children's development on the A&SQ when compared with BSID results. Eighteen percent of mothers suspected delays when no delays were objectively identified. A single mother identified delay in a different domain than that identified on the BSID. DISCUSSION: Findings that almost 20% of these children had developmental delays support other research that children of adolescent mothers are at risk for delays. Findings that teen mothers varied in their abilities to assess their children's development reinforce the need for education of teen mothers about child development. Further study is needed to determine the best models of this education in school and community settings.

Attention-deficit/hyperactivity disorder in children and adolescents: closing diagnostic, communication, and treatment gaps.

Nurses and nurse practitioners often play a key role in the management of children with attention-deficit/hyperactivity disorder (ADHD), a disorder that often persists into adolescence and adulthood. The diagnosis of ADHD requires careful history taking, use of standardized rating scales, and close attention to the patient's behavior and informants' reports. Stimulants appear to be most effective for patients with this diagnosis, but pharmacotherapy for ADHD should be combined with educational and behavioral interventions and careful follow-up to optimize treatment outcomes. Nurses and nurse practitioners must advocate to assist patients and families achieve goals at home and at school.

Establishing a school-based clinic in Managua, Nicaragua.

In May 2007, Yale University sent a team of nurse practitioner faculty and students to Managua, Nicaragua, as part of a five-year project to provide health care for children who attended a small school in a poor area of the city. Over the course of four days, 88 children were examined and treated. Although the Ministry of Health of Nicaragua theoretically provides health care for all, resources are often limited and difficult to access. By working with teachers and families, the team from Yale University is attempting to help the community establish a school-based clinic to meet the day-to-day needs of the children and establish health care contacts for more serious health care needs.

Sources of stress and support and maternal resources of homeless teenage mothers.

PROBLEM: Homeless families headed by young mothers are increasing. This preliminary study describes the characteristics of 17 homeless teenage mothers (HTM). METHODS: HTMs completed questionnaires researching depression, self-esteem, maternal competence, and sources of stress and support. FINDINGS: HTMs had positive maternal competence and self-esteem scores. When compared to housed mothers, HTMs were younger, had more depressive symptoms and negative life events, and fewer social supports. CONCLUSIONS: HTMs represent a high-risk group with fewer available supports and many complex life stressors. School-based programs can benefit HTMs by offering support, helping them continue their education, and assisting with on-site school-based childcare.

Promising outcomes in teen mothers enrolled in a school-based parent support program and child care center.

BACKGROUND: This study described a cohort of teen mothers and their children attending an urban high school with a parent support program and school-based child care center. Specific aims of the study were to describe maternal characteristics and outcomes, and child developmental and health outcomes. METHODS: A volunteer sample of 65 adolescent mothers enrolled in the parent support program and their children were interviewed, surveyed, and assessed. Fifty-three mothers had children enrolled in the school-based child care center and 12 mothers had their children cared for by family members. Maternal characteristics assessed included self-esteem and depressive symptoms, social stressors and support, self-perceived parental competence, parent-child teaching interactions, and subsequent childbearing and maternal educational outcomes. Child outcomes included child developmental assessments and health outcomes. RESULTS: About 33% of teen mothers were mildly to moderately depressed and 39% of the sample had experienced transitional homelessness. Social support networks were small; in the past 12 months, mothers experienced a mean number of 13.2 +/- 11.9 negative life events. Maternal self-report measures and mother-child observation measures indicated positive levels of parental competence. Maternal educational outcomes were positive, and only 6% of mothers had subsequent childbirths within 2 years. The mean scores on developmental assessments of children fell within the normal range, although there were 7 children identified with developmental delays. CONCLUSIONS: For at-risk teen mothers, this parent support program and school-based child care setting appears to offer promising opportunities to help young mothers with parenting, avoid rapid subsequent pregnancies, and stay engaged with school, while their children are cared for in a close and safe environment.

Mastering the preceptor role: challenges of clinical teaching.

This article aims to help both experienced and new preceptors become more effective teachers while maintaining their clinical workloads. A variety of strategies is essential to increase teaching effectiveness and decrease stress for the busy preceptor who juggles the roles of teacher and clinician. The article will begin with a review of role expectations and role strain factors for student, faculty, and preceptor. Principles of clinical teaching will be identified, followed by some strategies for teaching on busy days and concluding with suggestions for dealing with difficult students.

Supporting adolescent mothers and their children through a high school-based child care center and parent support program.

INTRODUCTION: A pilot study was conducted of adolescent parents and their children at a high school-based child care center to examine the influence of the program on parental competence, parent-child interaction, and child development. METHOD: A convenience sample of 18 urban adolescent mothers with children was interviewed at the end of one academic year. Mothers completed the Maternal Self Report Inventory (MSRI; short form) and the Parenting Daily Hassles Scale (PDHS). Parent-child teaching interactions were rated with the Nursing Child Assessment Teaching Scale (NCATS), and the Michigan Early Developmental Profile (MEDP) was used to evaluate child developmental outcomes. RESULTS: Mothers reported positive scores on the MSRI and PDHS. NCATS observations indicated ratings significantly higher when compared (assuming unequal variances) with a group matched for age range and length of time in school of adolescent mothers from the Nursing Child Assessment Satellite Training (NCAST) national database. The MEDP indicated that 77% of the children assessed were within normal limits for all domains (fine motor, cognition, language, gross motor, and self care). DISCUSSION: The results of this pilot study indicate that adolescent mothers and their young children in the sample benefited from the educational and support services offered at a school-based child care and parent support program. Further study is indicated to test the strength and duration of the effects.

Identify and manage marfan syndrome in children.

Marfan syndrome can reduce life expectancy and quality of life because of cardiac, orthopedic, ocular, and other system impairments. This article describes the syndrome from infancy through adolescence and our role in its identification and management.