Development of an evidence-based online veteran healthcare course

Over 2 million Americans have served in the military since 9/11. Often civilian providers are these veterans only or primary source of health care. This presentation will discuss the development of a first-of-its-kind online veteran centric healthcare course aimed at educating nurses to care for veterans and their families

Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand

<p>Abstract</p> <p>Background</p> <p>Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand.</p> <p>Methods</p> <p>A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria.</p> <p>Results</p> <p>The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner.</p> <p>Conclusion</p> <p>We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.</p

Differences between seven measures of self-reported numbers of clients of female sex workers in southern India: implications for individual- and population-level analysis.

Quantifying sexual activity of sub-populations with high-risk sexual behaviour is important in understanding HIV epidemiology. This study examined inconsistency of seven outcomes measuring self-reported clients per month (CPM) of female sex workers (FSWs) in southern India and implications for individual/population-level analysis. Multivariate negative binomial regression was used to compare key social/environmental factors associated with each outcome. A transmission dynamics model was used to assess the impact of differences between outcomes on population-level FSW/client HIV prevalence. Outcomes based on 'clients per last working day' produced lower estimates than those based on 'clients per typical day'. Although the outcomes were strongly correlated, their averages differed by approximately two-fold (range 39.0-79.1 CPM). The CPM measure chosen did not greatly influence standard epidemiological 'risk factor' analysis. Differences across outcomes influenced HIV prevalence predictions. Due to this uncertainty, we recommend basing population-based estimates on the range of outcomes, particularly when assessing the impact of interventions

Motivational Interviewing as Evidence-Based Practice? An Example from Sexual Risk Reduction Interventions Targeting Adolescents and Young Adults

This paper critically examines sexual risk reduction interventions, more specifically how they are evaluated and the implications that this has for sexual health policy. The focus is on motivational interviewing (MI) interventions which aim to promote protective behaviors related to sexual risk on the part of young people. MI has become increasingly popular, largely due to it being a highly flexible counseling approach that may, with adequate staff training, and fidelity in implementation, be tailored to many different settings (e.g., health care, schools and in community work). Following a scoping review that comprised 34 papers, of which 29 were unique studies, the range and type of existing research were examined. The results show a wide range of study designs and evaluation procedures, MI conceptualizations, modes of MI delivery, and the particular sub-populations of youth and sexual risk behaviors targeted. While this makes it difficult to draw any generalized conclusions about “what works” in prevention, it provides important insights about the complexity of sexual risk behavior as well as complex behavioral treatment approaches like MI. We therefore problematize the political drive to implement evidence-based methods without adequate resource allocation and contextual adaptation

Winged scapula: an overview of pathophysiology, diagnosis and management

Patients commonly present to the emergency department (ED) with shoulder injuries and shoulder pain. Winged scapula is one potential underlying cause of shoulder pain which is often forgotten or ill-defined. This non-traumatic skeletal condition typically presents as a prominent protrusion of the medial border of the bone from its normal position in the back. It often results from damage to and/or compression of the long thoracic nerve, which innervates the serratus anterior muscle. History taking, physical examination and imaging are needed to correctly diagnose winged scapula. Conservative management is often sufficient to resolve the condition. However, in some cases further investigations and more invasive treatment modalities are needed. This article provides an overview of the pathophysiology of winged scapula and its diagnosis and management in the ED. © 2021 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers

Planning and executing a global health experience for undergraduate nursing students: A comprehensive guide to creating global citizens

The preparation of future baccalaureate-prepared nurses will require undergraduate students to have both cultural awareness and global or international health competencies in order to meet the increasingly complex health care needs of a diverse community. Additionally, the nursing accrediting bodies have identified global healthcare as an area of core knowledge for clinical nurses. In order to meet the workforce needs, and provide global education of the undergraduate student body, we designed an international clinical experience within the undergraduate Community/Population Health course. The purpose of this article is to provide a guide for faculty in the planning, infrastructure needs, and implementation of a global clinical experience for undergraduate nursing students, in the context of the United States with addressing university concerns for student safety and security while abroad. © 2016 Elsevier Ltd