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Publication The Physical and Mental Health Effects of Community Violence Exposure in Pre-Adolescent and Adolescent Youth(2013-07-14) Fairbrook, Sarah WThe purpose of this inquiry is to determine the impact of community violence exposure (CVE) on the physical and mental health of children and adolescents. Twelve research studies exploring this topic were found by conducting a search in Pubmed and the Cumulative Index of Nursing and the Allied Health Literature (CINAHL). The articles used in this inquiry were limited to those published in the United States after 2003. All studies directly assessed CVE and explored its association with psychological or physical symptoms. An increased risk of PTSD and internalizing symptoms were associated with CVE. Children with CVE were at a higher risk for somatic complaints. In addition, CVE was associated with higher morbidity in children with asthma. The literature was entirely self-report with both cross-sectional and longitudinal studies. These results indicate the need for further research to better understand CVE and health associations.Publication The Implications of Change on Advance Practice Psychiatric-Mental Health Nursing(2013-07-14) Schmidt, Scott CDiscussions regarding the certification of the psychiatric-mental health (PMH) clinical nurse specialist (CNS) resulted in its elimination by the American Nurses Credentialing Center (ANCC), effective 2014. The sole remaining advanced practice registered nurse (APRN) certification for providing psychiatric and mental health care will be the Family Psychiatric Nurse Practitioner (NP). Disagreement still lingers with the changes in certification, including fears that the role of the PMH-CNS, which include care for the child and adolescent patient population and psychotherapy, will no longer exist. Additional concerns include the loss of duties traditionally performed by PMH-CNS to other behavioral health disciplines. In contrast to these fears are the hopes that a single title will reduce confusion among consumers and professionals, allow for an improvement in the allocation of resources for roles with similar core functions, and better address the current needs of individuals seeking mental health care. This paper describes the implications of such a transition and how even with a change in title, the role of the CNS can and should survive.Publication Prenatal Care for Women with Serious Mental Illness(2013-07-14) DeCesaris, MarissaThe lifetime prevalence of serious mental illness (SMI) for women in the United States is nearly 6% (NIMH, 2012). Women in this group often have lifestyle and socioeconomic characteristics that lead to poor health status and delays in seeking heath care. While women with SMI are just as likely to have children as their non-mentally ill counterparts, they are more likely to experience pregnancy complications and negative birth outcomes. Prenatal care must take into consideration the unique needs of these women and the challenges they face. Recommendations for improving practice include increasing pregnancy screening, using multidisciplinary teams to provide holistic care, and involving the patient in shared decision-making. This care should be continuous throughout the woman’s childbearing years. Further research is needed to test the effectiveness of models of prenatal care tailored to women with SMI.Publication The Birth of an Intersex Infant: Exploring the Options and Ethics Behind Decision-Making(2013-07-14) Ovadia, DanaWhile joyous and miraculous, the birth of a healthy infant is an event laden with eustress, fear of inadequacies, and permutating visions of the future. Add to this the diagnosis of an intersex infant, and the family is catapulted into an abyss of unfamiliar questions and unexpected decision-making. Immediate surgical intervention to alter genitalia is a common decision, but is not the only option. An ethical debate stems around the core question of whether choosing the sex of a child is the responsibility of the parent, or of the child, as he or she ages. The psychological repercussions of sexual incongruencey resonates unabated throughout childhood and adolescence. The following paper explores the ethical considerations behind sex assignment surgery for intersex infants.Publication The Impact of Informational Materials on Psychosocial Responses to HPV Diagnosis and Management(2013-07-14) Palacios, JoselleCervical cancer screenings, colposcopy, and a diagnosis of human papillomavirus (HPV) increase anxiety in clients. Researchers have investigated several interventions to reduce emotional distress in clients, including disseminating informational leaflets and brochures, offering educational and counseling services, and hypnotherapy. There is insufficient evidence, however, for the effectiveness of informational leaflets in reducing anxiety and improving knowledge and client satisfaction. This article examines the utility of such an intervention and explores ones that may be more effective in reducing anxiety prior to, during, and after HPV and cervical cancer screening and management. Because HPV follow-up can involve several steps that take place over approximately two years, it is important to keep clients engaged in the system along the way. This article also examines if informational interventions increase client knowledge of cervical cancer and its cause, HPV and what impact this has on follow-up.Publication Ethical Perspectives Regarding Antidepressant Drug Therapy During Pregnancy(2013-07-14) Schmidt, Scott CA literature review was conducted to evaluate and understand the effects of antidepressant medication during pregnancy and the ethical issues surrounding the topic. Through the discussion of three articles, the review weighed the effects of antidepressants on maternal and child health. Antidepressant medication during pregnancy poses relative risks to cause fetal complications and defects, though the risk remains very small. However, untreated depression may significantly impact the childbearing family, including premature births, low birth weights, miscarriages, and suicide. Clinicians often have misconceptions of the risks of untreated depression during pregnancy and could benefit from an increased understanding of the current literature when making treatment decisions. Nevertheless, an individual’s history, symptomatology, and an understanding of medications known to be harmful to the fetus should guide the choice of treatment. Further research may help solidify understanding among clinicians and the public and ultimately lead to improved health outcomes for both mother and child.Publication Including Adolescents and Young Adults in Decisions at the End-of-Life(2013-07-15) Berger, Rebecca SOver 3000 young people die of chronic illnesses annually in the United States. Health care providers often struggle to include these patients in end-of-life planning. The purpose of this inquiry is to examine the current literature addressing the inclusion of adolescents and young adults in decision-making at the end-of-life. A systematic search of the electronic databases PubMed, Scopus, CINAHL, ISI, and Cochrane revealed 9 articles relevant to this topic. The results show that adolescents and young adults want to be included in end-of-life decisions and often have similar values as their parents and providers when making these decisions. The major limitations are the limited population sample of the studies, in terms of size and patient characteristics, and inconsistencies with the ages of participants in the studies. Ideas for further research, in addition to implications for clinical practice will be discussed in this paper.Publication Management of Chronic Non-malignant Pain in Nursing Homes Residents(2013-07-15) Parker, Therese YPain in nursing homes remains underassessed, underreported and undertreated, consequently, becoming a growing concern in the United States. The purpose of this inquiry is to review the current evidence guiding the management of chronic non-malignant pain among nursing home residents. Twelve articles relevant to this topic were obtained from a search of the electronic databases PubMed and Cumulative Index of Nursing and Allied Health (CINAHL). Findings underscore an urgent need to improve assessment, documentation, and management of pain in nursing home residents.Publication Nursing Advocacy for Optimal Palliative Care of Patients with Advanced Cancer(2013-07-15) Kossman, Debra AThe purpose of this paper is to review selected research findings about obstacles to palliative care for patients with progressive cancer and discuss the role that oncology and palliative care nurses play in helping to remove these obstacles.Publication End-of-Life Care for Individuals with Dementia(2013-07-15) Morgan, BriannaEnd-of-life care for individuals with dementia can be complicated and difficult for clinicians, families and the patient. This paper examines the current literature on end-of-life practices for individuals with dementia and discusses emerging trends to help inform clinicians about factors that influence end-of-life care for individuals with dementia. Research articles highlight nursing home care, hospice and palliative care, and decision-making as major themes influencing end-of-life care, and suggest recommendations for clinicians in improving practice in these areas.