Chicopee and Springfield School Collaboration with UMass Amherst (UMA): Alcohol and Opioid Screening, Brief Intervention and Referral to Treatment

The UMA nursing undergraduate training program, SBIRT: The Power of Nursing to Change Health, builds on a SAMHSA curriculum that is integrated into existing psychiatric/mental health, pediatric/young adult and community nursing courses that incorporate alcohol and substance abuse disorders. Student nurses will apply these new skills in their community and medical/surgical rotations in partnership with the Chicopee and Springfield Public Schools. High School survey data indicate that on average 67.5% of high school students have consumed alcohol with 40.1% indicating one drink in the last 30 days, and another 22.2% having five or more drinks in the last 30 days. Use typically begins during early adolescence and the first alcohol exposure peaking during grades 7 to 9. The SBIRT project has the potential to significantly impact early intervention and treatment for youth in Massachusetts by increasing the number of nurses trained in SBIRT and practicing in the public school. The UMA SBIRT Team completed the first training session October 2016 incorporating EBP into training and evaluation. Subsequent to the first training efforts, the team invited state and regional SAMHSA officials, the MA School Nurses organization and the MA Office of Elder Affairs to participate in SBIRT trainings. Community collaboration is critical to the success of the Power of Nursing to Change Health

Bi-allelic Loss-of-Function CACNA1B Mutations in Progressive Epilepsy-Dyskinesia.

The occurrence of non-epileptic hyperkinetic movements in the context of developmental epileptic encephalopathies is an increasingly recognized phenomenon. Identification of causative mutations provides an important insight into common pathogenic mechanisms that cause both seizures and abnormal motor control. We report bi-allelic loss-of-function CACNA1B variants in six children from three unrelated families whose affected members present with a complex and progressive neurological syndrome. All affected individuals presented with epileptic encephalopathy, severe neurodevelopmental delay (often with regression), and a hyperkinetic movement disorder. Additional neurological features included postnatal microcephaly and hypotonia. Five children died in childhood or adolescence (mean age of death: 9 years), mainly as a result of secondary respiratory complications. CACNA1B encodes the pore-forming subunit of the pre-synaptic neuronal voltage-gated calcium channel Cav2.2/N-type, crucial for SNARE-mediated neurotransmission, particularly in the early postnatal period. Bi-allelic loss-of-function variants in CACNA1B are predicted to cause disruption of Ca2+ influx, leading to impaired synaptic neurotransmission. The resultant effect on neuronal function is likely to be important in the development of involuntary movements and epilepsy. Overall, our findings provide further evidence for the key role of Cav2.2 in normal human neurodevelopment.MAK is funded by an NIHR Research Professorship and receives funding from the Wellcome Trust, Great Ormond Street Children's Hospital Charity, and Rosetrees Trust. E.M. received funding from the Rosetrees Trust (CD-A53) and Great Ormond Street Hospital Children's Charity. K.G. received funding from Temple Street Foundation. A.M. is funded by Great Ormond Street Hospital, the National Institute for Health Research (NIHR), and Biomedical Research Centre. F.L.R. and D.G. are funded by Cambridge Biomedical Research Centre. K.C. and A.S.J. are funded by NIHR Bioresource for Rare Diseases. The DDD Study presents independent research commissioned by the Health Innovation Challenge Fund (grant number HICF-1009-003), a parallel funding partnership between the Wellcome Trust and the Department of Health, and the Wellcome Trust Sanger Institute (grant number WT098051). We acknowledge support from the UK Department of Health via the NIHR comprehensive Biomedical Research Centre award to Guy's and St. Thomas' National Health Service (NHS) Foundation Trust in partnership with King's College London. This research was also supported by the NIHR Great Ormond Street Hospital Biomedical Research Centre. J.H.C. is in receipt of an NIHR Senior Investigator Award. The research team acknowledges the support of the NIHR through the Comprehensive Clinical Research Network. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, Department of Health, or Wellcome Trust. E.R.M. acknowledges support from NIHR Cambridge Biomedical Research Centre, an NIHR Senior Investigator Award, and the University of Cambridge has received salary support in respect of E.R.M. from the NHS in the East of England through the Clinical Academic Reserve. I.E.S. is supported by the National Health and Medical Research Council of Australia (Program Grant and Practitioner Fellowship)

The relationship of nursing work environment to empowerment

This is an exploratory study of nurses\u27 (~= 268) perceptions of work conditions. The theoretical framework was developed from Rogers\u27 nursing model and Kanter\u27s organizational theory. The principle of integrality from Rogers\u27 nursing model was utilized. Integrality predicts changes in life process through the interaction of the individual and environment. Kanter\u27s theory is more specific to the work areas with similar assumptions to Rogers specifically: The interaction between the individual and the work environment produces work behaviors. The sample was from two hospitals of similar size, purpose, and location in northeast Utah. The nurses were informed of the study through presentations by the investigator and by mail. Each voluntary participant received an Effective Work Conditions Questionnaire and a demographic data form. The questionnaire included five subscales (opportunities, supplies, job activities, information, and support) each rated on two 5-point scales. One scale addressed what there is now ll and the second addressed what I would like. 1I The first research question addressed whether nurses would perceive the five factors made up of the same components as Kanter\u27s factors. The results of the factor analysis and reliability coefficients indicated nurses perceived three factors as important to effective work conditions: Support, Information, and Opportunity. In response to research questions two and three regarding the relationship between the demographic variables and the three factors a multiple analysis of variance was performed. There were no significant differences found between the individual variables and the three factors. There were significant differences between the hospitals, practice areas, and work time. Hospital 2 was significantly higher on the Support factor. The descriptive data from interviews with the chief nursing administrator and the nursing management team support this result. A multiple analysis of variance determined there was a difference between practice areas within Hospital 1. The difference was in the Support and Information factors. A Tukey\u27s Honestly Significant Difference test was performed to determine on what units Support and Information differed. The results revealed that the critical care nurses perceived they had more support and information than the medical, surgical, or obstetrics units. The interview data validated this perception. There were no significant differences between practice areas within Hospital 2. A multiple analysis of variance was used to determine if there was a significant difference between part-time and full-time workers. In Hospital 1 there was a significant difference with full-time workers perceiving they had more support, information, and opportunity than part-time workers. In Hospital 2 the full-time workers perceived they had more information than the part-time workers. A discussion of the results and the relationship to the literature was presented. The results indicated that there was a correlation between the work environment and the individual which suggests support for Kanter\u27s theory of interaction between individual and environment and Rogers\u27 principle of integrality. Implications for nursing and limitations of this study were given

Reducing restraints and seclusion to create a culture of safety

The purpose of this article is to describe the structure that empowered staff of a locked community hospital unit to reduce the use of restraints and seclusion to create a culture of safety. Themes garnered from interviews with and observations of key informants fit into the categories of a structural empowerment model, with leadership creating opportunities available for staff to develop new knowledge, information on trauma-informed care, support for feedback, and resources for the unit; thus, relationships with patients flourished. In turn, staff engaged in relationships with patients to provide opportunities to develop new knowledge and offer information, support, and resources