Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy lifestyle changes. OBJECTIVE: Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes.
BACKGROUND: Members of the lesbian, gay, bisexual, and transgender (LGBT) community suffer from disproportionate rates of physical and mental illness. This population experiences enhanced vulnerability to illness as a result of societal marginalization, known as minority stress, which is compounded by insufficient LGBT education for health care professionals and stigmatizing experiences within medical institutions. AIMS: The aims of this study were to review the literature on LGBT cultural competence interventions; evaluate the effect of a 4-hour pilot workshop, “Converging Cultures,” on the development of cultural competence; and make recommendations for best practices in developing LGBT cultural competence among health care providers. METHOD: The study used a repeated-measures pre-/posttest design among a sample of 130 hospital employees and undergraduate nursing students. The GAP (Gay Affirmative Practice scale) scale, a measure of LGBT-affirmative practice beliefs, and an objective Knowledge Quiz were administered before and directly following the training. The posttest included three open-ended questions to elicit self-reflection and capture the development of cultural competence according to Campinha-Bacote’s theory, the process of cultural competence in the delivery of healthcare services. RESULTS: Paired sample t tests revealed significant improvement on the GAP and Knowledge Quiz. Open-ended responses reflected the five constructs of Campinha-Bacote’s theory. CONCLUSIONS: Self-reflection is an essential component of LGBT cultural competence education to uncover personal biases that affect clinical behavior. Future educational efforts for sexual and gender minorities should strive to avoid inadvertent marginalization of LGBT people through integration of concepts with existing curricula and workplace training.
A usability study of a Virtual Reality Sterile Urinary Catheter Insertion Game (VR SUCIG) was conducted to understand user needs in regards to this game. Background: Learning and retention of psychomotor skills in health care is essential to safe clinical practice. Bauman suggests games are most useful when they are part of a layered-learning approach; in other words, they support various forms of learning and serve as cognitive aids ( Bauman et al., 2014 ). Intervention: The VR Sterile Urinary Catheter Insertion Game (VRSUCIG) was created by nurses and a computer gaming developer to provide nursing students with a cost-effective way to practice sterile catheter insertion skills in a systematic, evidence-based manner. A usability study and user reaction survey were conducted to gain a deep understanding of user’s needs. Methods: Three hundred nursing students, from 9 US nursing schools participated. Participants played the VR SUCIG and completed the System Usability Scale (SUS) and a User Reaction Survey (URS). Results: The SUS for the 2nd generation of the VR SUCIG was 57, or medium usability. The URS demonstrated the game motivated them to keep practicing. The VR SUCIG promoted repetitive practice of the skill and visually accentuated the concept of sterility. Conclusions. User reactions indicate that nursing students were eager and excited to utilize this technology. Usability scores indicate further refinement of technology is needed.
Opiate addiction is a serious global health issue that profoundly impacts the welfare of populations around the world. Opioid addiction affects an estimated 1.9 million individuals in the United States alone, stimulating a rise in treatment options such as medication-assisted treatment with buprenorphine. When combined with counseling and relapse prevention groups, medication-assisted treatment has proven to be an effective office-based opioid treatment for opiate dependence. Office-based opioid treatment has broadened access to treatment of opioid dependence, has decreased the risk for overdose, and is effective for reducing cravings and opioid use at proper dosing levels. However, treatment retention and relapse remain significant challenges. The purpose of this study was to identify characteristics predictive of retention in treatment time of opioid-dependent individuals receiving office-based buprenorphine treatment. The records of individuals enrolled in a public health office buprenorphine clinic (n = 350) were analyzed to determine retention time in treatment and whether retention time varied by selected individual variables. Participants in the study had a cumulative predicted retention time on buprenorphine of 65% at 30 days, 35% at 6 months, 25% at 12 months, and 18% at 18 months.
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