Training School Counselors and Nurses to Enhance Collaboration Through Animal-Assisted Therapy.

PURPOSE/AIMS: The school nurse and school counselor serve an important role to foster student academic achievement, physical and mental health, and connectiveness. Each is paramount to student success; therefore, efforts should be made to further enhance collaborative efforts. Researchers sought to determine if an online training course centered on integrative methods would enhance collaboration between the school nurse and counselor. DESIGN: This study used a quasi-experimental design with 3 data points (pretest, posttest, and 6-month follow-up), assessing the impact of educational content and knowledge application based on an online training module incorporating animal-assisted therapy (AAT) concepts and the school counselor and school nurse collaboration model. METHODS: The continuing professional development questionnaire was used to evaluate professionals' behavior, specifically focusing on how knowledge translates into practice. The intervention included a training course designed for school nurses and counselors. Researchers analyzed data to determine how their collaboration and endorsement of AAT changed over time. RESULTS: School counselors endorsed collaboration and intention of AAT application in schools at a higher rate than school nurses. However, after the intervention, differences between school counselors and nurses diminished over time. CONCLUSION: The findings provide recommendations for the clinical nurse specialist to implement evidence-based programs targeting school nurse and school counselor collaboration.

Safety of a Novel Dialyzer Containing a Fluorinated Polyurethane Surface-Modifying Macromolecule in Patients with End-Stage Kidney Disease.

BACKGROUND: By inhibiting the adsorption of protein and platelets, surface-modifying macromolecules (SMMs) may improve the hemocompatibility of hemodialyzers. This trial aims to assess the performance and safety of a novel dialyzer with a fluorinated polyurethane SMM, Endexo™. METHODS: This prospective, sequential, multicenter, open-label study (NCT03536663) was designed to meet regulatory requirements for clinical testing of new hemodialyzers, including assessment of the in vivo ultrafiltration coefficient (Kuf). Adults prescribed thrice-weekly hemodialysis were eligible for enrollment. After completing 12 hemodialysis sessions with an Optiflux® F160NR dialyzer, patients received 38 sessions with the dialyzer with Endexo. Evaluated parameters included the in vivo Kuf of the dialyzer with Endexo extent of removal of urea, albumin, and ß2-microglobulin (ß2M), as well as complement activation. RESULTS: Twenty-three patients received 268 hemodialysis treatments during the Optiflux period, and 18 patients received 664 hemodialysis treatments during the Endexo period. Three serious adverse events were reported, and none of them were considered device related. No overt complement activation was observed with either dialyzer. Both dialyzers were associated with comparable mean increases in serum albumin levels from pre- to posthemodialysis (Optiflux: 7.9%; Endexo: 8.0%). These increases can be viewed in the context of a mean increase in hemoglobin of approximately 5% and a mean ultrafiltration volume removed of approximately 2.2 L. The corrected mean ß2M removal rate was 47% higher during the Endexo period (67.73%). Mean treatment times (208 vs. 205 min), blood flow rates (447.7 vs. 447.5 mL/min), dialysate flow rates (698.5 vs. 698.0 mL/min), urea reduction ratio (82 vs. 81%), and spKt/V (2.1 vs. 1.9) were comparable for the Endexo and Optiflux periods, respectively. The mean (SD) Kuf was 15.85 (10.33) mL/h/mm Hg during the first use of the dialyzer with Endexo (primary endpoint) and 16.36 (9.92) mL/h/mm Hg across the Endexo period. CONCLUSIONS: The safety of the novel dialyzer with Endexo was generally comparable to the Optiflux dialyzer, while exhibiting a higher ß2M removal rate.

Plasmapheresis in the management of severe hypertriglyceridemia.

Plasmapheresis can benefit a variety of critically ill patients. A woman with diabetic ketoacidosis and severe hypertriglyceridemia was treated with plasmapheresis when conventional treatments did not markedly reduce her triglyceridemia. The patient was admitted to a medical intensive care unit because of diabetic ketoacidosis with severe lipemia. The lipemia-associated interference in laboratory studies made treatment of electrolyte abnormalities extremely difficult. The hypertriglyceridemia was initially treated with insulin, antilipidemic medications, and heparin, but the levels of triglycerides remained elevated, delaying results of needed laboratory studies for hours. After plasmapheresis, the serum level of triglycerides decreased by 77% in less than 24 hours. Severe lipemia interferes with photometric laboratory studies, yielding an underestimation of serum levels of electrolytes. Plasmapheresis is safe, rapid, and effective for emergent management of severe hypertriglyceridemia in critically ill patients. The impact of the procedure on critical care nursing is growing as nurses become involved in the treatment and follow-up care of patients who have plasmapheresis.

Well-being of individuals with late-deafness.

OBJECTIVE: The purpose of this study was to examine the relationships between disability factors and psychosocial outcomes in a sample of individuals with acquired hearing loss, specifically late-deafness (loss after age 12). METHOD: Participants (N = 277) completed the following measures at a single point in time: the Hearing Handicap Inventory for Adults, the Reactions to Impairment and Disability Inventory, the Ways of Coping Questionnaire, the Psychological Well-Being scale, and a demographic questionnaire. Structural equation modeling was conducted to determine whether coping style mediated the relationships between disability factors (i.e., age of onset, perceived severity of disability, and perceived adaptation to disability) and psychological well-being. RESULTS: Emotion-focused coping partially mediated the relationships between perceived severity of hearing loss and psychological well-being, and between perceived adaptation to disability and psychological well-being (B = -.36), and problem-focused coping partially mediated the relationship between perceived adaptation to disability and psychological well-being (B = .49). The model was a good fit for these data (comparative fit index and incremental fit index = .94; Tucker-Lewis index = .92; root mean square error of approximation = .09). CONCLUSION: Perceived adaptation to disability and perceived severity of disability acted as direct predictors of psychological well-being, and as indirect predictors through their relationship with coping. Implications for the process of adaptation and counseling for individuals with acquired hearing loss are discussed.