Designing an impactful APRN residency program for rural communities.

ABSTRACT: The largest healthcare system in New Mexico, in collaboration with the University of New Mexico College of Nursing, identified an opportunity to increase and retain the number of family practice NPs and certified nurse midwives in rural communities by creating an immersive 1-year rural residency program for newly graduated advanced practice registered nurses (APRNs). This article describes the journey to design this program and build its infrastructure with the aim of addressing the needs of both APRNs during their transition to practice and patients in rural areas, while providing a return on the healthcare system's business investment. Program results are also reported. Program funding was provided by a Health Resources and Services Administration grant, the Presbyterian Healthcare Services executive team, and the Presbyterian Healthcare Foundation.

Developing and sustaining a practice-based research infrastructure in a hospital social work department: Why is it important?

The future of hospital social work departments depends on their ability to demonstrate their effectiveness, efficiency, and consequently, their value to their host organizations. In order to demonstrate and enhance social work's contribution, research activities of various kinds must be encouraged. These include research consumption as well as production and utilization by clinicians, supervisors, managers, and administrators. The authors sought to develop a sustainable research environment in a large social work department of an academic health system. Continued work is needed to understand practice-research "best practices" within hospitals and how to ensure their sustainability within an ever changing health care environment.

Challenging the exclusion of gambling disorder as a disability under the Americans with Disabilities Act.

The Americans with Disabilities Act explicitly excludes "compulsive gambling" from its definition of disability, thus denying gambling addicts protection from employer discrimination based on their disorder. Since the enactment of the ADA, however, scientific understandings of gambling disorder have evolved to view the condition as an addiction, rather than as a compulsion or impulse-control disorder. This move is mirrored in the DSM-5's reclassification of gambling disorder under the category of "substance-related and other addictive disorders." This Note contends that gambling disorder would qualify as a "disability" under the ADA, were it not for the disorder's current statutory exclusion. This Note therefore recommends that the ADA be amended to bring gambling disorder within its coverage. Such a change would not only reflect recent developments in the field of addiction psychology, but would also further the ADA's underlying purpose--to protect individuals with disabilities from workplace discrimination.

Experience of symptoms, sexual function, and attitudes toward counseling of women newly diagnosed with vulvodynia.

OBJECTIVE: This study aimed to assess health beliefs and behaviors, experience of pain, coping mechanisms, sexual function, and attitudes toward counseling of patients newly diagnosed with vulvodynia. MATERIALS AND METHODS: Participants were enrolled from all newly diagnosed vulvodynia patients seen at the University of Michigan Vulvar Disease Clinic at Chelsea. Participants completed a questionnaire assessing perceptions and beliefs about their vulvodynia, coping ability, sexual function, and interest in counseling. RESULTS: Thirty-one women were enrolled, ranging in age from 21 to 81 years; 68% had current partners. On a scale of 1 to 10 (low to high), participants rated their symptoms as severe-(mean [SD] = 7.42 [1.50]), perceived little control over symptoms (2.61 [2.64]); were very concerned about symptoms (8.77 [1.73]); and were very emotionally affected by their disorder (7.00 [2.82]). During the previous 4 weeks, 52% reported low to no sexual desire; 71% reported being dissatisfied with their overall sex life; 26% were not comfortable saying no to partner sex; 23% to 36% did not attempt penetration; and for 36%, their pain was rated as high or very high. Sixty-one percent of women indicated that they would consider counseling for coping with vulvar pain. In addition, 29% (9/31) said they "would" and 48% (15/31) said they "maybe would" consider seeing a sex therapist for their vulvar pain. CONCLUSIONS: Women with newly diagnosed vulvodynia report substantial impact of vulvar pain but feel little control over symptoms. Sexual desire and sexual satisfaction are low. Most of the respondents would consider counseling to help address these issues.

Practice-based research:changing the professional culture and language of social work.

Practice-based evaluation integrates research skills and techniques into the clinical process in order to correlate clinical interventions with treatment outcomes. Although most clinicians recognize the importance of some form of practice evaluation, barriers including lack of time, resources, expertise, and organizational support may deter such evaluation efforts. However, there are numerous advantages for clinicians and agencies to develop a culture that values and integrates practice evaluation into its daily work-life; these include opportunities for teamwork, collaboration, mentoring, and innovation. This paper defines practice evaluation research, identifies strategies for its implementation, and describes a framework for creating a "research friendly" culture. It further describes the implementation of such an innovative program in both a hospital and a mental health agency setting.