Male, Female, Other: Transgender and the Impact in Primary Care

Transgender includes patients at various stages of their journey. It is important that providers care for transgender patients with a culturally sensitive approach, awareness, and competent skill. There are new terms to learn. There may be mental health issues or substance use issues. Hormone therapy can have an impact on a person’s health. As a primary care provider, it is important to be alert to these potential issues, addressing the patient’s individual needs. In this study we discuss the transgender patient and outline basic care and issues that can arise in a primary care setting

Starting your own primary care NP pratice--lessons learned

The recently passed Modernization Act in New York (NY) eliminates the mandatory collaborative physician requirement for nurse practitioners (NPs) with 3600 hours of experience. Although NPs must provide referral sources upon request, the new law eliminates the barrier of filing written signed agreements. These changes could facilitate the process for NPs to start their own practice. This article provides some insight into this process from the lens on one who started a primary care FNP practice in Western New York (WNY), including barriers encountered and lessons learned

Functional Behavioral Analysis and Social Scripting for the Older Patient with Schizophrenia: A Staff Development Program

Executive functioning is the ability to plan, strategize, organize, and focus on details. Impaired executive functioning plays a significant role in behavior disturbances. Lack of inhibition, impaired abstract reasoning, thought perseverance, rigidity in routine, and lack of insight disrupt social skills and daily life. Autism and schizophrenia present some similar behaviors, including impaired executive functioning, often resulting in pharmacological management as many healthcare professionals receive limited training in executive functioning. Non-pharmacological tools used in autism for behavior management include functional behavioral analysis and social scripting, which help to identify causes of behavior and teach more appropriate behavioral responses. Described here is an educational program for healthcare workers in a long-term care skilled nursing facility, to help them understand the basis for behaviors in individuals with impaired executive function, to use these same tools for behavioral modification techniques, and to help patients learn more appropriate social skills. Program evaluation suggested the educational program was successful in increasing the staff\u27s knowledge and comfort level in addressing the behavioral issues that arise with this population and staff also reported less use of medication as first-line treatment for behavioral issues

Fluoxetine reverses the memory impairment and reduction in proliferation and survival of hippocampal cells caused by methotrexate chemotherapy

RATIONALE: Adjuvant cancer chemotherapy can cause long-lasting, cognitive deficits. It is postulated that these impairments are due to these drugs targeting neural precursors within the adult hippocampus, the loss of which has been associated with memory impairment. OBJECTIVES: The present study investigates the effects of the chemotherapy, methotrexate (MTX) on spatial working memory and the proliferation and survival of the neural precursors involved in hippocampal neurogenesis, and the possible neuroprotective properties of the antidepressant fluoxetine. METHODS: Male Lister hooded rats were administered MTX (75 mg/kg, two i.v. doses a week apart) followed by leucovorin rescue (i.p. 18 h after MTX at 6 mg/kg and at 26, 42 and 50 h at 3 mg/kg) and/or fluoxetine (10 mg/kg/day in drinking water for 40 days). Memory was tested using the novel location recognition (NLR) test. Using markers, cell proliferation (Ki67) and survival (bromodeoxyuridine/BrdU), in the dentate gyrus were quantified. RESULTS: MTX-treated rats showed a cognitive deficit in the NLR task compared with the vehicle and fluoxetine-treated groups. Cognitive ability was restored in the group receiving both MTX and fluoxetine. MTX reduced both the number of proliferating cells in the SGZ and their survival. This was prevented by the co-administration of fluoxetine, which alone increased cell numbers. CONCLUSIONS: These results demonstrate that MTX induces an impairment in spatial working memory and has a negative long-term effect on hippocampal neurogenesis, which is counteracted by the co-administration of fluoxetine. If translatable to patients, this finding has the potential to prevent the chemotherapy-induced cognitive deficits experienced by many cancer survivors

Circles of healing around the world: an exploration of the association between spiritual healing and circles in art

Inspired by the strong visual presence of the circle in this author’s prior research\ud into spiritual vibration as a formative influence in art, this thesis extends existing\ud research into the shape’s spiritual associations. The pioneering work of Jung on\ud Mandala Symbolism (1973) highlights the opportunity to achieve this in the search for\ud an answer to why, above all other shapes, it is the circle which is associated with\ud spiritual healing.\ud \ud This thesis thus traces the trajectory of the circle’s spiritual healing associations\ud around the world, and documents such ascribed associations in the key cultural contexts\ud of its employment for healing as a visual art form, supported by unique contributions\ud from contemporary spiritual practice. From these cultural contexts, on the primary\ud criterion of availability of documentation, selection of a case study is made for the\ud purpose of conducting an in depth analysis of the circle at work – specifically the case\ud of Hildegard of Bingen.\ud \ud The visual drivers of this research are informed by the inter-disciplinary overlap\ud of art documentation and history, architecture, art therapy, psychology, alternative\ud healing, medicine, spirituality, sociology and anthropology. The implications of the\ud research include a reappraisal of the originality of Jung’s psychological theories\ud regarding the mandala, the observation, from a group of different cultures, of points of\ud congruence in the beliefs surrounding the circle for which academic comparison is\ud novel, and the identification of possible answers to the question of why it is the circle\ud which associated with spiritual healing

Male, Female, Other: Transgender and the Impact in Primary Care

Transgender includes patients at various stages of their journey. It is important that providers care for transgender patients with a culturally sensitive approach, awareness, and competent skill. There are new terms to learn. There may be mental health issues or substance use issues. Hormone therapy can have an impact on a person’s health. As a primary care provider, it is important to be alert to these potential issues, addressing the patient’s individual needs. In this study we discuss the transgender patient and outline basic care and issues that can arise in a primary care setting

A comparison of teaching methods for a baccalaureate nursing health assessment course.

New teaching methods are designed and implemented to ensure student success and application of knowledge. One of these designs is the flipped classroom. Nursing programs are also integrating technology, including simulation, into nursing education in order to enhance student engagement. Although several research studies support flipped classroom methodology, no studies have compared traditional and flipped classroom teaching methods, as well as the use of a technology-enhanced classroom, in a baccalaureate nursing health assessment course. The purpose of this study was to compare learning outcomes and student satisfaction in an undergraduate health assessment course across three teaching methods: traditional lecture, flipped classroom, and a technology-enhanced interactive flipped classroom. All three methods incorporated virtual patient simulation. Using a quasi-experimental design, formative and summative assignment grades were compared. Student course evaluations were compared to assess satisfaction with each teaching method. Significant differences in mean grades were found in 12 of the 23 assignments. The technology-enhanced interactive flipped classroom section outperformed the traditional and flipped classroom sections on most of these assessments. Only one difference was noted in student satisfaction. The results showed that a technology-enhanced interactive flipped classroom design supported student learning. A longitudinal analysis of student performance is recommended