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The Adequacy of PA Didactic Psychiatric Education
Get PDFWith a shortage of mental health specialists, primary care providers, which increasingly include physician assistants (PAs), must be able to adequately recognize, diagnose, and treat common mental health disorders. Unfortunately, providers are not currently able to meet this challenge and frequently underdiagnose and undertreat psychiatric conditions. This paper examined the amount of didactic education in psychodiagnostics PA students receive compared to the amount of didactic psychodiagnostics training psychotherapists students receive in graduate school. Results indicated that while psychotherapists have, on average, more classroom time, the difference in seat time between PAs and psychotherapists is less than double, but the assigned readings are more than triple for psychotherapists. Moreover, PA programs are not taught directly from the industry standard, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). This suggests that PAs have adequate time to be taught psychodiagnosis, but that that the reading assignments are not sufficient. Following from the research, the differences between the biomedical and the biopsychosocial model of health and wellness are explored. Finally, suggestions for further and future research are discussed
Nursing Improvisation: Improving Team Communication Through Creativity
No full textCommunication and teamwork are essential competencies required to navigate the complex and ever-changing health care environment. However, inefficient communication and teamwork practices can lead to adverse events and low staff satisfaction. Delivering effective patient care requires a coordinated effort by a diverse multidisciplinary team. As valued members of the multidisciplinary team, a registered nurse case manager (RNCM) and a clinical social worker (CSW) collaborate with patients, colleagues, and community services to ensure quality, patient-centered care. Because of their many interactions, RNCMs and CSWs will benefit from a communication and teamwork skill development course. Therefore, this paper describes the development of a project to enhance communication and teamwork skills with a team of hematology-oncology RNCMs and CSWs at a hospital within a large Midwest medical center using Newman’s Health as Expanding Consciousness theory as a theoretical framework. This project creates an interactive learning environment where RNCMs and CSWs feel safe to explore their interaction patterns within their team. The RNCMs and CSWs will participate in 6-monthly improvisation game sessions. Through improvisation participation, RNCMs and CSWs will develop enhanced consciousness of their interactions, which will increase staff satisfaction and patient outcomes. With continuous practice and a supportive environment, RNCMs and CSWs will use skills developed through participation in improvisation games to improve their professional interpersonal interactions
Person-environment fit and retention of racially minoritized college students: Recommendations for faculty, support staff, and administrators
Get PDFAlthough colleges in the United States have become increasingly racially and ethnically diverse, degree attainment remains disproportionately low among students from underrepresented and minoritized racial backgrounds. In this paper, we discuss the interactive influence of both person and environment factors in shaping academic persistence and argue that college administrators, faculty, and student support staff can intervene and take specific steps to improve the academic experience of racially minoritized college students. To this end, we offer specific evidence-based recommendations for campus leaders and stakeholders on how to adapt their campus community to facilitate the requisite person-environment fit to maximize academic persistence
Nighttime Magnetic Perturbation Events Observed in Arctic Canada: 3. Occurrence and Amplitude as Functions of Magnetic Latitude, Local Time, and Magnetic Disturbance Indices
Get PDFRapid changes of magnetic fields associated with nighttime magnetic perturbation events (MPEs) with amplitudes |ΔB| of hundreds of nT and 5–10 min duration can induce geomagnetically induced currents (GICs) that can harm technological systems. This study compares the occurrence and amplitude of nighttime MPEs with |dB/dt| ≥ 6 nT/s observed during 2015 and 2017 at five stations in Arctic Canada ranging from 64.7° to 75.2° in corrected geomagnetic latitude (MLAT) as functions of magnetic local time (MLT), the SME (SuperMAG version of AE) and SYM/H magnetic indices, and time delay after substorm onsets. Although most MPEs occurred within 30 min after a substorm onset, ∼10% of those observed at the four lower latitude stations occurred over two hours after the most recent onset. A broad distribution in local time appeared at all five stations between 1700 and 0100 MLT, and a narrower distribution appeared at the lower latitude stations between 0200 and 0700 MLT. There was little or no correlation between MPE amplitude and the SYM/H index; most MPEs at all stations occurred for SYM/H values between −40 and 0 nT. SME index values for MPEs observed \u3e1 h after the most recent substorm onset fell in the lower half of the range of SME values for events during substorms, and dipolarizations in synchronous orbit at GOES 13 during these events were weaker or more often nonexistent. These observations suggest that substorms are neither necessary nor sufficient to cause MPEs, and hence predictions of GICs cannot focus solely on substorms
Measurement report: Sulfuric acid nucleation and experimental conditions in a photolytic flow reactor
Get PDFNucleation rates involving sulfuric acid and water measured in a photolytic flow reactor have decreased considerably over a time period of several years. Results show that the system flow reactor, gas supplies and lines, flow meters, valves, H2SO4 photo-oxidant sources has reached a baseline stability that yields nucleation information such as cluster free energies. The baseline nucleation rate is punctuated by temporary bursts that in many instances are linked to cylinder changes, delineating this source of potential contaminants. Diagnostics were performed to better understand the system, including growth studies to assess H2SO4 levels, chemiluminescent NO and NOx detection to assess the HONO source, and deployment of a second particle detector to assess the nanoparticle detection system. The growth of seed particles shows trends consistent with the sizes of nucleated particles and provides an anchor for calculated H2SO4 concentrations. The chemiluminescent detector revealed that small amounts of NO are present in the HONO source, 10% of HONO. The second condensation-Type particle counter indicates that the nanoparticle mobility sizing system has a bias at low sulfuric acid levels. The measured and modeled nucleation rates represent upper limits to nucleation in the binary homogeneous system, H2SO4-H2O, as contaminants might act to enhance nucleation rates and ion-mediated nucleation may contribute. Nonetheless, the experimental nucleation rates, which have decreased by an order of magnitude or larger since our first publication, extrapolate to some of the lowest rates reported in experiments with photolytic H2SO4. Results from experiments with varying water content and with ammonia addition are also presented and have also decreased by an order of magnitude from our previous work; revised energetics of clusters in this three-component system are derived which differ from our previous energetics mainly in the five-Acid and larger clusters
Walking the journey side by side with the adolescent parent
No full textAdolescent pregnancy affects the future emotional and physical health, as well as long term economic welfare of the young person and child. With research around infant mental health, and the effect of Adverse Childhood Experiences (ACE) on the adult’s physical and mental health, it is important to intervene during infancy and adolescence to improve the long term outcomes for the young person and child. St. Paul Public School (SPPS) District 625 has provided services for over 60 years to help students who are pregnant and/or parenting. A project to update the job description for the AGAPE Licensed School Nurse (LSN) and create a job description for the proposed Adolescent Parent Resource Nurse position, based on the knowledge of the effects of adolescent parenting, and recent research of early childhood brain development and ACE, was guided by Anne Boykin and Savina O. Schoenhofer’s Nursing as Caring Theory. These job descriptions will provide clarity in their roles to improve the outcomes of the adolescent parent and child. Evaluation of the job descriptions was done with former and current staff using a non-Lickert scale (1, 2, 3, 4) and narrative questions. The feedback was taken into consideration when making changes to the job descriptions. A conceptual model of the AGAPE LSN or Adolescent Parent Resource Nurse walking the journey side by side with the adolescent parent provides a visual of the nurse caring through a nurturing relationship and authentic presence within the caring situation. This project demonstrated that these nurse positions provide support to the adolescent parents and their children, and leadership to the school support staff
Platelet-Rich Plasma vs. Traditional Surgical and Nonsurgical Interventions for Rotator Cuff Tendinopathies
Get PDFBackground: Rotator cuff tendinopathies present as one of the most common musculoskeletal injuries of the upper extremity. The rotator cuff consists of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis with the supraspinatus the most injured of the group. Over time, variations regarding treatment through surgical or nonsurgical interventions have remained constant. In recent years, the use of platelet-rich plasma (PRP) as an additional alternative has become popular to promote healing and improve functionality of the shoulder. The purpose of this clinical review using various study designs is to assess if the platelet-rich plasma injections are more effective when used with traditional surgical or nonsurgical interventions for the long- term outcomes of adult patients with rotator cuff tendinopathies.
Methods: A systematic database search was conducted for peer-reviewed articles and studies dated from 2018 to present using Google Scholar, PubMed, and ScienceDirect. Information pertinent to this clinical review consisted of 20 articles allowing for an all-encompassing comparative foundation to determine the most effective long-term treatment for rotator cuff tendinopathies. CURRENT Medical Diagnosis & Treatment was also used.
Conclusion: After evaluating all of the data collected to determine if platelet-rich plasma is effective in improving pain, range of motion, and functionality for patients with rotator cuff tendinopathies, results widely varied. At this time, it seems as if more research needs to be conducted because although it has been proven to show improvements, there are still variable results for both pre and post-operative intervention use of PRP.
In Patients With Cardiac Arrest, Does Early Defibrillation Reduce Mortality?
Get PDFBackground: Cardiac arrest is a devastating disorder that affects millions of people each year. Often having a sudden onset, cardiac arrest is almost certainly lethal if prompt treatment is not started. In hopes to both better understand how treatment of cardiac arrest has evolved and to quantitatively measure the outcome of defibrillation, multiple pieces of literature have been reviewed.
Methods: Articles were found that were pertinent by using PubMed and Google Scholar. Literature was obtained that researched a wide spectrum of topics relating to defibrillation and cardiac arrest that did not focus on traumatic cardiac arrests as it is beyond the scope of this paper.
Conclusion: The use of defibrillation has been thoroughly researched for decades, showing a reduction in mortality. Evidence-based research has continuously concluded the benefits of early defibrillation far outweighs any potential adverse outcome. Although algorithms used during treatment in cardiac arrest have varied significantly over the past 100 years, defibrillation remains a staple in the treatment. Governing agencies like the American Heart Association have consistently advocated for early defibrillation over the last few decades as more data has become available, specifically the data on the reduction of mortality. With the rapid adaptation of using Automated External Defibrillators in public locations, we can safely conclude that mortality rates will continue to decline. Further research is needed to determine the ideal order of interventions during cardiac arrest, as there is much debate on the correct ratio of compressions to ventilations and the use of medications to help ‘jump start’ the heart
Exploring Challenges Experienced by Culturally and Linguistically Diverse Nursing Students in the United States
No full textThe diversity of the United States (US) population is rapidly increasing while the diversity of the Registered Nurses (RNs) workforce is not keeping up with the demographic makeup of the population. Attracting, educating, and graduating culturally and linguistically diverse nursing students is essential in providing safe, quality health care to a culturally and linguistically diverse patient population now and in the future. Nursing faculty have a crucial role in implementing teaching strategies that effectively promote culturally and linguistically diverse students\u27 learning and success in nursing programs. Guided by Madeleine Leininger\u27s Culture Care Diversity & Universality Theory, along with her Sunrise Enabler, this project holistically explored challenges that were faced by culturally and linguistically diverse RNs at a hospital in the Midwest when they attended nursing school in the US. The project aims to improve the understanding of culturally and linguistically diverse nursing students\u27 experiences and identify interventions that effectively facilitate their learning. Recommendations are offered which address learning accommodations and blended student groups that expand learning opportunities for both culturally diverse students and native English-speaking students
Rise in Mesoamerican endemic Nephropathy (MeN) in Migrant Population in Exchange for Work; Is it Worth the Trade-Off?
Get PDFThe increased demand of sugarcane in Costa Rica and the lack of occupational opportunities in Nicaragua has resulted in an increase in migrant sugarcane workers. Because many individuals cannot afford proper documentation for immigration, a significant number cross the border undocumented looking for financial stability. The vast availability of sugarcane work in Costa Rica provides Nicaraguan migrants with an opportunity for work, however, they are often paid less than minimum wage due to their undocumented immigration status. Migrant workers are subject to harsh working conditions including extreme physical exertion, dehydration, and heat exposure. The combination of this trifecta seen in the Nicaraguan migrant population employed in sugarcane harvestation is thought to be correlated with the significant increase in incidence and prevalence of renal pathology, namely, MeN. Although those at highest risk for acquiring MeN are undocumented Nicaraguan migrant sugarcane workers, this population does not have access to the public health insurance or healthcare provided by Costa Rica. This has inhibited implementation of preventative measures, delayed diagnosis and treatment, and allowed for disease progression to ESKD and death