Psychiatric mental health nurse practitioners experiencing therapeutic alliance while using tele-mental health: A phenomenological study.

BACKGROUND: Psychiatric mental health nurse practitioners have rapidly adopted and implemented tele-mental health in their practice; however it is unclear how this modality of care affects the experiential quality of therapeutic alliance, simply defined as the interpersonal working bond between provider and patient. OBJECTIVE: This study is the first to explore how psychiatric mental health nurse practitioners experience therapeutic alliance while using tele-mental health. DESIGN: Husserlian phenomenological qualitative study. PARTICIPANTS: A purposive, convenience sample of 17 American psychiatric mental health nurse practitioners who engaged in tele-mental health care were recruited online and interviewed. METHODS: Phenomenological interview transcripts recorded and later thematically coded in the qualitative software MaxQDA. RESULTS: From 1426 individual codes, five major themes and 16 subthemes were discovered. Overall, themes illuminated that psychiatric mental health nurse practitioners could build therapeutic alliance over tele-mental health using inherent interpersonal skills that had to be adapted to the technology. Adaptions included working with patient environmental factors, individual patient considerations, provider ambivalence, and technological observation shifting awareness and communication patterns. CONCLUSIONS: When adapting for the tele-mental health environment, psychiatric mental health nurse practitioners experienced building and sustaining therapeutic alliance with most patients. Unparalleled aspects of tele-mental health allowed for a fuller clinical picture and logistical convenience to see patients more often with ease for both the provider and patient. However, experiential aspects of therapeutic alliance created during in-person care could not be replaced with tele-mental health. In conclusion, participants concluded that a hybrid care model would enhance therapeutic alliance for most patients.

A Theoretical Framework for Conducting Psychiatric Mental Health Nursing Virtual Care & Research.

Despite rapid adoption and implementation, theoretical research considerations for virtual care (VC), defined simply as healthcare delivered using technology, are lacking across psychiatric mental health nursing (PMHN) scholarship. By adapting Hildegard Peplau's Interpersonal Relations Theory (IRT) and Media Richness Theory (MRT) using an intermodern and emancipatory knowing approach, a new framework was created for guiding modern PMHN VC research. Using this theoretical framework, readers can gain awareness of how the art and science of PMHN practice can be applied to VC scholarly endeavors in the modern healthcare space.

Clear integration of nursing and media theories to inform modern psychiatric mental health nursing virtual care and respective clinical vignetteDetails how the art and science of psychiatric mental health nursing can be applied to virtual care and researchFuture research applications regarding psychiatric mental health nursing virtual care are providedAmple review of interpersonal relations theory in psychiatric mental health nursing practice.

Nurse practitioner educational preparation and confidence related to managing antipsychotic medications and associated drug-induced movement disorders.

BACKGROUND: Antipsychotic medications (APMs) have been used to treat multiple psychiatric disorders for decades. The conditions to use these medications have expanded from primarily psychotic disorders to Food and Drug Administration-approved uses as first-line mood stabilizers in bipolar disorder and adjunctive pharmacotherapy in unipolar depression. Antipsychotic medications can have serious side effects, including drug-induced movement disorders (DIMDs). Nurse practitioners (NPs) in non-psychiatric-mental health specialties are increasingly managing psychotropic medication regimes. There is a void in peer-reviewed literature capturing the scope of NPs managing APMs, such as whether they received training to prescribe and manage risks of APM, and if so, what type (e.g., continuing education, attending conferences, consulting), and their confidence assessing and managing DIMDs. PURPOSE: To describe the scope of NP management, knowledge, and confidence related to APMs and associated risks of DIMDs. METHODOLOGY: Nonexperimental, descriptive, cross-sectional survey. Participants ( n = 400) recruited through a professional association membership portal. RESULTS: Nearly two-thirds of participants reported managing APMs (64%) and receiving training to prescribe and manage risks of APMs (63%). More than half (54%) reported they received training to do so in their NP education program. Thirty-five percent of participants indicated they were either completely (6%) or fairly (29%) confident, whereas most (65%) endorsed being somewhat (26%), slightly (20%), or not (19%) confident in assessing and managing DIMDs. CONCLUSIONS/IMPLICATIONS: Opportunities exist to broaden NP education in managing APMs and associated risks of DIMDs.

Corneal endothelial cell density in patients receiving chemotherapy.

PURPOSE: This study aimed to determine if the corneal endothelium was affected by chemotherapy. METHODS: Chemotherapy patients were recruited to undergo specular microscopy before treatment and again at 1- and 2-year follow-up visits. One eye per patient, per follow-up, was selected for comparison to baseline. RESULTS: Forty-six volunteers completed baseline and at least one follow-up assessment. From 51 eyes, there was no significant change in endothelial cell density for 41 eyes assessed at one year (MD = 0.73%, 95% CI -1.33 to 2.78%) and 18 eyes at two years (MD = 0.31%, 95% CI -3.53 to 4.15%). CONCLUSION: Although other studies have shown that chemotherapy can adversely affect the corneal epithelium, this study showed no measurable change in endothelial cell density.

Antidepressant adherence in United States active duty Army Soldiers: A small descriptive study.

While much is known about depression and antidepressant adherence associations with illness perceptions, medication beliefs, social support, and stigma in the general population, there is a dearth of knowledge among United States active duty Army Soldiers. The study objective was to explore antidepressant adherence and correlations between antidepressant adherence and illness perceptions, medication beliefs, social support, stigma and select demographic variables among Army Soldiers with depression. Results indicated age and gender were significantly correlated with and predictive of adherence. Low adherence was found. Findings suggest Soldiers who are younger and those who are female are more likely to report higher levels of adherence.

Recognition Without Words: Using Taste to Explore Survival Processing.

Many educational demonstrations of memory and recall employ word lists and number strings; items that lend themselves to semantic organization and "chunking." By applying taste recall to the adaptive memory paradigm, which evaluates memory from a survival-based evolutionary perspective, we have developed a simple, inexpensive exercise that defies mnemonic strategies. Most adaptive memory studies have evaluated recall of words encountered while imagining survival and non-survival scenarios. Here, we've left the lexical domain and hypothesized that taste memory, as measured by recognition, would be best when acquisition occurs under imagined threat of personal harm, namely poisoning. We tested participants individually while they evaluated eight teas in one of three conditions: in one, they evaluated the toxicity of the tea (survival condition), in a second, they considered the marketability of the tea and, in the third, they evaluated the bitterness of the tea. After a filler task, a surprise recognition task required the participants to taste and identify the eight original teas from a group of 16 that included eight novel teas. The survival condition led to better recognition than the bitterness condition but, surprisingly, it did not yield better recognition than the marketing condition. A second experiment employed a streamlined design more appropriate for classroom settings and failed to support the hypothesis that planning enhanced recognition in survival scenarios. This simple technique has, at least, revealed a robust levels-of-processing effect for taste recognition and invites students to consider the adaptive advantages of all forms of memory.

Edwin G. Boring: The Historian's Path in the Pages of The American Journal of Psychology.

Although he is best known for his classic textbook, A History of Experimental Psychology, Edwin Garrigues Boring published dozens of articles in The American Journal of Psychology and used its various formats to guide the discipline in the early 20th century. This report reviews a small sample of his publications, including obituaries, notes, and experimental articles, and presents them in historical and biographical context. A central objective is to show how Boring shared the values of his structuralist training with the emerging American schools and how time allowed him to reconsider his approach to history and the legacy of his iconic mentor, Edward Bradford Titchener.

An Instructor's Guide to (Some of) the Most Amazing Papers in Neuroscience.

Although textbooks are still assigned in many undergraduate science courses, it is now not uncommon, even in some of the earliest courses in the curriculum, to supplement texts with primary source readings from the scientific literature. Not only does reading these articles help students develop an understanding of specific course content, it also helps foster an ability to engage with the discipline the way its practitioners do. One challenge with this approach, however, is that it can be difficult for instructors to select appropriate readings on topics outside of their areas of expertise as would be required in a survey course, for example. Here we present a subset of the papers that were offered in response to a request for the "most amazing papers in neuroscience" that appeared on the listserv of the Faculty for Undergraduate Neuroscience (FUN). Each contributor was subsequently asked to describe briefly the content of their recommended papers, their pedagogical value, and the audiences for which these papers are best suited. Our goal is to provide readers with sufficient information to decide whether such articles might be useful in their own classes. It is not our intention that any article within this collection will provide the final word on an area of investigation, nor that this collection will provide the final word for the discipline as a whole. Rather, this article is a collection of papers that have proven themselves valuable in the hands of these particular educators. Indeed, it is our hope that this collection represents the inaugural offering of what will become a regular feature in this journal, so that we can continue to benefit from the diverse expertise of the FUN community.

Donor risk factors for graft failure in the cornea donor study.

PURPOSE: The purpose of this study was to assess the relationship between donor factors and 5-year corneal graft survival in the Cornea Donor Study. METHODS: Donor corneas met criteria established by the Eye Bank Association of America, had an endothelial cell density of 2300 to 3300/mm, and were determined to be of good to excellent quality by the eye banks. Donor corneas were assigned using a random approach and surgeons were masked to information about the donor cornea including donor age. Surgery and postoperative care were performed according to the surgeons' usual routines and subjects were followed for 5 years. Donor and donor cornea factors were evaluated for their association with graft failure, which was defined as a regraft or a cloudy cornea that was sufficiently opaque to compromise vision for a minimum of 3 consecutive months. RESULTS: Graft failure was not significantly associated with the type of tissue retrieval (enucleation versus in situ), processing factors, timing of use of the cornea, or characteristics of the donor or the donor cornea. Adjusting for donor age did not affect the results. CONCLUSION: Donor and donor cornea characteristics do not impact graft survival rates for corneas comparable in quality to those used in this study.

Responses of the teleostean nucleus isthmi to looming objects and other moving stimuli.

Visually evoked extracellular neural activity was recorded from the nucleus isthmi (NI) of goldfish and bluegill sunfish. When moving anywhere within the right eye's visual field, three-dimensional checkered balls or patterns on a computer screen evoked bursts of spikes in the left NI. Object motion parallel to the longitudinal body axis gave responses that habituated markedly upon repetition, but movement into recently unstimulated regions of the visual field gave vigorous responses. Thus, while NI's response is not visuotopic, its habituation is. An object approaching the animal's body generated a rising spike density, whereas object recession generated only a transient burst. During the approach of a checkered stimulus ball, average NI spike density rose linearly as the ball-to-eye distance decreased and at a rate proportional to the ball's speed (2.5-30 cm/s). Increasing ball size (2.2-9.2 cm) did not affect the rate of activity rise at a given speed, but did increase overall activity levels. NI also responded reliably to expanding textures of fixed overall size. The results suggest that NI signals changes in motion of objects relative to the fish, and estimates the proximity of approaching objects.

Omega 3 oils and pregnancy.

Women can safely commence omega 3 intake in early pregnancy to allow the full benefits to be incorporated into the body. Pregnant women should consider the intake of omega 3 oils and evening primrose oil throughout pregnancy in order possibly to prevent preterm delivery, promote an easier birth, assist the baby's brain and eye health and preprogram the baby's cell membranes for optimum lifelong wellness. Benefits to the mother may include prevention of postnatal depression and the comfort of knowing that she is giving her baby a healthy start in life.

Functional relationship between nucleus isthmi and tectum in teleosts: synchrony but no topography.

Neural activity in the optic tectum was compared with activity in the nucleus isthmi (NI) of both goldfish and sunfish with the aim of understanding how the two brain structures interact to process visual information. The two species yielded very similar results. Superficial tectum responds reliably to visual stimulation with topographically organized receptive fields; deep tectum and NI respond to stimulation throughout the field of the contralateral eye and habituate rapidly. Bursts of large-amplitude spiking in NI occur spontaneously and in response to contralateral visual stimulation. These NI bursts correlate with activity bursts across the tectal lobe on the same side, especially in the deeper layers. NI bursts may also synchronize with spiking activity in deep tectum. Trains of small-amplitude spikes in NI can be elicited by both ipsilateral and contralateral stimulation, but are not reflected in tectal activity. Simultaneous recordings from two sites in one NI were almost identical, suggesting that NI operates as a functional unit, broadcasting the same message across the ipsilateral tectal lobe.