Becoming Advocates for Battered Women

Through her research, an advanced practice nurse has identified five stages through which abused women proceed on their way to freedom. The author calls on all clinicians to become advocates for battered women by recognizing them in clinical practice and helping them find the road to a life of safety, peace, and restored self-esteem

APRN: What Does it Stand For?

The American Nurses\u27 Association (ANA) has advocated that all advanced practice nurses have one title, APRN. The various titles have been confusing for not only lay people, but also health professionals. Educational programs and requirements for advanced practice obviously are quite different, depending on what degree and certification one is aiming for

HIV: Make the Diagnosis and Take the Next Step

With the CDC urging screening for all willing patients, providers will be testing and managing a growing number of HIV-positive individuals. The CDC estimates that with more than 40,000 new infections annually, more than 1.2 million people in the United States are living with HIV-and 24% to 27% may not be aware of their infection status.1 Studies have shown that HIV is often diagnosed late in the disease process, when the individual has already developed AIDS, which typically occurs 8 to 11 years after HIV infection.2 Research also points to missed opportunities to offer HIV testing and diagnose the infection before AIDS develops, which would enable the newly diagnosed individuals to employ precautions to protect their partners from becoming infected.3,4 Almost half of HIV transmissions studied by Brenner et al were attributed to transmission by newly infected persons. In response to these issues, the CDC put forth revised recommendations for HIV testing that encourage screening for patients in all healthcare settings after the person is notified that testing will be performed, unless he or she declines (opt-out screening).4 Primary-care providers need a better understanding of trends in HIV infection and what to do when an HIV test is positive. In a recent survey of 1,165 primarycare providers, 54% of the respondents reported treating HIV-positive individuals, with 43% indicating an increased or a dramatically increased caseload over the past year

Emotional Intelligence and Spiritual Well-Being

Understanding factors that influence spiritual well-being may improve nurses’ spiritual caregiving. This study examined relationships between emotional intelligence (EI) and spiritual well-being (SWB) in undergraduate and graduate nursing students. Using the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) and the Spiritual Well-Being Scale (SWBS), relationships were found between managing emotion and spiritual well-being, and managing emotion and existential well-being. Implications for education and practice are discussed

Identifying and Co-managing the HIV-infected Adult: A Guidebook for Primary Care Clinicians

This guidebook was designed to help primary care clinicians improve their performance in terms of HIV identification and co-management. Surmounting barriers to opt-out screening, making an HIV diagnosis, and preventing transmission and opportunistic infections will be discussed, as will selection of initial therapy and considerations for patients receiving antiretroviral therapy (ART)

Collaborative Management of HIV Infection in the Community: An Effort to Improve the Quality of HIV Care

Our hospital led a multidisciplinary community team to improve the quality of care delivered to HIV-infected clients utilizing a disease management approach in a US metropolitan community of 150,000 people. Community needs assessment and client and community surveys were used to define the problems. Patient care flowcharting and the creation of an electronic patient database facilitated patient tracking across the entire community. Clinical guidelines and a consultation and referral immunology clinic standardized care practices. Measurable improvements in the quality of care were noted in multiple areas. Flowchart completion rates rose from 44% to 100%; medication adherence assessment rose from 82% to 100%; immunization rates rose from a mean of 72% to a mean of 87%; PPD screening rose from a low of 35% to a high of 87%; perinatal transmission rates fell from 31% to 4%; and Emergency Department utilization decreased. Two essential components of the effort were the establishment of a full-time leadership position in the form of a clinical nurse practitioner and the creation of an electronic database with flowcharting to standardize the measurement, delivery and tracking of care. The programme has become an example of successful disease management through hospital-community collaboration

Factors Related to Academic Success Among Nursing Students: A Descriptive Correlational Research Study

Background:The current rise in employment is improving forecasts for the future supply of registered nurses; however sizeable shortages are still projected. With the intention of improving academic success in nursing students, related factors need to be better understood. Objectives: The purpose of the correlational study was to describe the relationship between emotional intelligence, psychological empowerment, resilience, spiritual well-being, and academic success in undergraduate and graduate nursing students. Design/setting: A descriptive correlational design was utilized. The study was set in a private Catholic university. Participants: There were 124 participants. There were 59% undergraduate and 41% graduate students. Methods: Background data, in addition to the Spreitzer Psychological Empowerment Scale, the Wagnild and Young Resilience Scale, and the Spiritual Well-Being Scale and the Mayer –Salovey–Caruso Emotional Intelligence Test, was collected from students who met study criteria. Results: In a combined sample, academic success was correlated with overall spiritual well-being, empowerment and resilience. Although academic success was not correlated with overall emotional intelligence, it was correlated with the emotional intelligence branch four (managing emotions) score.When undergraduate and graduate students were considered separately, only one correlation was found to be significantly related to academic success in the undergraduate sample, namely, emotional intelligence branch one (perceiving emotions). When examining the data from just graduate level nurses, significant relationshipswere found between total emotional intelligence with academic success, resilience with academic success, and psychological empowerment with academic success. Conclusion: The significant relationship between psychological empowerment, resilience, spiritual well-being and academic success in this study supports the statements in the literature that these concepts may play an important role in persistence through the challenges of nursing education. Research is needed to examine if strategies to enhance empowerment, resilience, and spiritual well-being can increase academic success in a test-retest design

State Mandated Prenatal Human Immunodeficiency Virus Screening at a Large Community Hospital

Purpose: To describe the initial experience of state mandated prenatal HIV screening at a large community hospital.Methods: HIV screening was provided to all pregnant women as of October 1, 1999. All HIV-positive women identified received aggressive antiretroviral therapy to reduce the likelihood for vertical transmission. Neonates were screened for HIV at zero, six, and 12 months of age.Results: Seven pregnant women (0.3%) and two additional family members tested positive for HIV. All seven infants born to the identified HIV-positive women have tested negative for infection. We estimated that six of nine cases of HIV infection identified would have been missed under a policy of voluntary HIV screening.Conclusions: Universal screening for HIV in pregnancy is achievable and desirable and provides the best opportunity to minimize the number of new neonatal HIV infections

Impact of an Adherence Program on the Health and Outlook of HIV-Infected Patients Failing Antiretroviral Therapy

Background: We prospectively studied the impact of an adherence counselor on the outcome of patients failing antiretroviral therapy because of nonadherence. Methods: Forty-six patients, identified as chronically nonadherent were enrolled. Individual attention was provided using the information, motivation and behavioral methodology. HIV RNA (viral load, in copies/mL), CD4 count (in cells/[mm.sup.3]), and body weight before and after the adherence counselor were measured. Qualitative outcome and patient satisfaction were assessed by deidentified third-party interviews. Results: Over half completed at least 1 year; only 8 patients were lost to follow-up. Mean CD4 counts increased significantly (P \u3c .05) for completers at 6 and 12 months. Viral loads decreased between baseline and 6 months. Most clients reported subjective benefit from working with the adherence counselor. Conclusion: Although few clients showed complete virologic suppression, the value of an adherence counselor was validated. Longer term adherence programs should be evaluated

Tissues and industrial co-products formed during alginate extraction from <i>Laminaria hyperborea</i> provide different metabolite profiles depending on harvest season

The metabolic profiles of different tissues and industrially relevant co-products of alginate extraction from Laminaria hyperborea samples harvested in different seasons were assessed using Hydrophilic Interaction Liquid Chromatography – Mass Spectrometry (HILIC-MS). Positive and negative mode MS data, predicted exact mass data and matching with database and literature searches, allowed the putative identification of 57 major metabolites. The metabolites ranged from known and abundant components (e.g., iodide, mannitol, and various betaines) to components not previously noted in this species and 11 major components which could not be identified. The levels of these components varied between tissues and co-products with some metabolites seemingly specific to certain samples. The components also varied between winter and summer harvested material, perhaps reflecting seasonality in their biosynthesis and accumulation in the tissues and co-products. The approach applied in this work could assess when components of potential specific commercial interest were maximally accumulated and help plan the most efficient exploitation of the harvested biomass. It could also be used to define variation in components in L. hyperborea from different locations or potential biotopes of this species. This initial work extends our ability to understand the phenotype of seaweeds whilst also identifying new components and new commercial opportunities