Improving Health through Action on Economic Stability: Results of the Finances First Randomized Controlled Trial of Financial Education and Coaching in Single Mothers of Low-Income.

OBJECTIVES: Evaluate the health impact of a novel financial education and coaching program in single mothers of low-income in Omaha, Nebraska. METHODS: Employed, single mothers earning no more than 200% of the 2017 Federal Poverty Level (n = 345) enrolled in the study between April 2017 and August 2020 and were randomized to receive a novel financial education and coaching program, the Financial Success Program (FSP) or no intervention control. Demographics, biometrics, financial strain, health behaviors and healthcare utilization were assessed at baseline and the 12-month study visits. RESULTS: Participants who completed the FSP demonstrated significantly reduced financial strain, an increased rate of smoking cessation, and a reduction in avoidance of medical care due to cost compared to participants in the control group. CONCLUSIONS: The FSP represents an effective model in promoting economic stability in vulnerable individuals through a reduction in financial strain. Health behavior changes including an increased rate of smoking cessation were demonstrated within the first 12 months of intervention.

Improved Bioavailability with Dry Powder Cannabidiol Inhalation: A Phase 1 Clinical Study.

Oral cannabidiol (CBD) is approved by the Food and Drug Administration (FDA) to treat patients with Dravet and Lennox-Gastaut syndromes and tuberous sclerosis complex. The therapeutic potential of oral CBD formulations is limited by extensive first-pass hepatic metabolism. Following oral administration, the inactive metabolite blood concentration is ∼40-fold higher than CBD. Inhalation bypasses the pharmacokinetic (PK) variability attributed to irregular gastrointestinal absorption and first-pass hepatic metabolism and may efficiently deliver CBD into systemic circulation. This phase 1 study compared the PK of a dry-powder inhaler (DPI) CBD formulation (10 mg powder containing 2.1 mg CBD) with an oral CBD solution (Epidiolex®, 50 mg) in healthy participants. Following a single dose of Epidiolex or DPI CBD (n=10 PK evaluable participants each), the maximum CBD concentration for the inhaled powder was 71-fold higher than that of Epidiolex while administering 24-fold less CBD. The mean time to reach maximum concentration was 3.8 min for the DPI CBD formulation compared with 122 min for Epidiolex. Both Epidiolex and DPI CBD were generally safe and well-tolerated. These data indicate that DPI CBD provided more rapid onset and increased bioavailability than oral CBD and support further investigations on the use of DPI CBD for acute indications.

Nurse Preceptor Perceptions of Nursing Student Progress Toward Readiness for Practice.

New nurses are often perceived as not meeting expectations for safe nursing practice. Nurse educators need to identify student learning and professional development needs as students progress toward practice. The purpose of the study was to determine the strengths and weaknesses of senior-level nursing students related to readiness for practice before graduation. Using a descriptive, exploratory design, nurse preceptors evaluated the degree to which their assigned senior nursing student was meeting expectations for readiness for nursing practice. Survey items were organized into affective, cognitive, and psychomotor domains and general readiness. This evaluation occurred at the beginning of the final practicum to assess student progress toward readiness for practice. Students scored highest in professional attributes but lowest in time management, prioritization, management of multiple patients, and pharmacology knowledge. Results can be used to inform teaching strategies, strengthen academic-clinical partnerships, and promote readiness for entry-level practice.

Impact of the dedicated education unit teaching model on the perceived competencies and professional attributes of nursing students.

The Dedicated Education Unit clinical teaching model is a strategy designed to create optimal teaching and learning environments. Evidence is lacking regarding the influence of the Dedicated Education Unit model on students' specific nursing competencies and professional attributes. This descriptive, comparative study took place in a private baccalaureate nursing program in the United States. The researchers compared evaluations of student competencies and attributes who participated in a Dedicated Education Unit model (n = 163) to students who participated in a traditional clinical teaching model (n = 147) immediately following the practicum in which the Dedicated Education Unit model was used. The Dedicated Education Unit group scored significantly higher in 26 of 33 specific competencies and professional attributes compared to students who participated in the traditional clinical teaching model. These data suggest that the Dedicated Education Unit model promotes knowledge, competency, and professional attribute development more effectively than the traditional clinical teaching model.

Defining Roles and Expectations for Faculty, Nurses, and Students in a Dedicated Education Unit.

The dedicated education unit (DEU) model of clinical nursing education is an innovative, evidence-based model for creating a more effective learning environment. Although nursing programs have used this model for years, the literature provides minimal direction to assist faculty in transitioning from traditional clinical teaching to the DEU model. This article reports the development and evaluation of 2 resources to help all involved understand teaching roles and desired learning outcomes in the DEU model.

Development and validation of a sensitive liquid chromatographic-tandem mass spectrometric method for the determination of cromolyn sodium in human plasma.

Cromolyn sodium is a safe compound with potent anti-allergic properties when used locally or topically. Clinical data from systemic exposure is not available because of the poor GI absorption when given orally. In order to evaluate a new approach to enhance the absorption and bioavailability of cromolyn sodium, a sensitive assay was needed to support an oral-dose study in humans. This paper describes a liquid chromatographic-tandem mass spectrometric (LC-MS-MS) method for the analysis of cromolyn sodium in human plasma. The method consists of a two-step extraction with subsequent analysis using a high-performance liquid chromatography electrospray tandem mass spectrometer system. The compounds were eluted isocratically on a C(18) column followed by a backflush. The total run time is 6 min. The standard curve of cromolyn sodium was over the range of 0.313 to 750 ng/mL with a lower limit of quantitation (LLOQ) of 0.313 ng/mL when 0.5 mL of plasma was used for analysis. The percent coefficient of variation (C.V.) for accuracy and precision (inter-assay and intra-assay) was less than 15% over the validated concentration range and the coefficients of determination, r(2), were >0.991577. The method is simple, sensitive, and selective, and has been successfully utilized for oral cromolyn sodium clinical studies.

Supporting clinical nursing leadership and professional practice at the unit level.

Professional practice models (PPMs) are innovative approaches for improving health care delivery. Implementation of these new practice models needs to be well planned and supported to ensure their success in producing desired outcomes. This article describes two programs used to implement a PPM in a health care organization, focusing mainly on a program design intended to support the implementation of a new PPM on a medical-surgical hospital unit. The program blends the concepts of the organization's PPM with the leadership concepts from the AACN's Clinical Nurse Leader role to help nurses further develop their professional behaviors and clinical leadership skills.