The Interdisciplinary Doula Project: Innovations in Nursing Clinical Education.

ABSTRACT: People giving birth report overwhelmingly positive experiences with nursing students acting as doulas. However, no programs report on improving diversity among students, pregnant people, and curricula. This article describes the Interdisciplinary Doula Project, a program to enhance diverse perspectives and clinical skills of university students. Nursing (n = 21, 77.8%) and other health students (n = 6, 22.2%) completed doula training, diversity seminars, and 36 hours of intrapartum care. Seven nursing students were hired to work on labor and delivery upon graduation. This innovative program may increase registered nurses trained to provide culturally congruent labor support for vulnerable pregnant populations.

Contributions of Multimethod Personality Assessment in Indirect Evaluation.

Indirect assessment is a useful tool in forensic evaluation, especially in cases of threat assessment. To this end, we illustrated the ability to conceptualize a complicated case (i.e., Theodore John Kaczynski) using an indirect approach, with a particular emphasis upon dimensional frameworks of personality. Raters who were unrelated to Mr. Kaczynski's case and with expertise in relevant domains were asked to study information available in the public domain about Mr. Kaczynski and provide ratings using several assessment instruments. Our aim was not to provide a professional clinical opinion, but rather engage in scholarly discourse about the utility of instruments. Mr. Kaczynski was rated to demonstrate characteristics associated with lone actor terrorists. He showed an elevation on a measure of psychosis, and raters conceptualized trauma as an important aspect of his functioning. He demonstrated impairments in detachment and psychoticism (Criterion B of the AMPD) and interpersonal functioning (Criterion A of the AMPD). Clinical conceptualizations for Mr. Kaczynski emphasized schizotypal and paranoid personality disorders. This analysis of an infamous case about which considerable data are publicly available demonstrates the ease with which indirect and multimethod assessment can be applied and integrated in forensic assessment, using modern conceptualizations of personality pathology.

Preliminary findings of problematic sexual behavior-cognitive-behavioral therapy for adolescents in an outpatient treatment setting.

BACKGROUND: The lack of empirical support for interventions commonly used to treat adolescents with problematic sexual behaviors (PSB) has led to restrictive policies and interventions largely based on perceptions of these youth as younger versions of adult sex offenders, without consideration for developmental and etiological differences between populations. OBJECTIVE: This study's aim is to evaluate a low-intensity outpatient treatment regarding the reduction of internalizing symptoms and externalizing behaviors to include, PSB. PARTICIPANTS & SETTING: The study examined outcomes for 31 adolescents who completed Problematic Sexual Behavior - Cognitive Behavioral Therapy for Adolescents (PSB-CBT-A) at a Children's Advocacy Center between 2013 and 2016. METHODS: Evaluation of PSB and other symptomology was conducted through pre- and post-treatment administration of standardized instruments. RESULTS: Adolescent PSB-CBT-A treatment completers demonstrated a trend towards statistical significance in reduction of PSB on the YSBPI from 5.33 (SD = 6.86) at pre-treatment to 0.17 (SD = 0.41) at completion. Additionally, significant reductions in caregiver-reported youth internalizing and externalizing problems were associated outcomes of completing PSB-CBT-A (t(13) = 5.00, p < .001 and t(13) = 2.34, p = .036, respectively). CONCLUSIONS: The promising results achieved in this study support further exploration of low-intensity outpatient treatment interventions for adolescents with PSB.

Child Pornography and Online Sexual Solicitation.

PURPOSE OF REVIEW: This review highlights recent literature regarding online sexual offending, including the prevalence, characteristics, a brief review of recent typology literature, victimization risk factors, risk factors of being a "crossover" offender, rates and risk factors for recidivism, and a discussion of prevention efforts. RECENT FINDINGS: Online sexual offenders are overwhelmingly White men with relationship problems who were rarely previously arrested for felonies. They score lower on measures of antisocial behavior, compared to offenders who commit contact sexual offenses against children. Individuals who commit pornography offenses are at lower risk to commit contact offenses and their risk factors include having sexual interest in children and antisocial attitudes. Online offenders are different from contact sexual offenders and from offenders who commit both types of offenses. Recidivism in online noncontact offenders is difficult to assess due to the lack of empirically supported tools and the inappropriateness of using popular actuarial tools that lack norms on these offenders, but a new measure (CPORT) is being studied for use with this population.

An economic model of the benefits of professional doula labor support in Wisconsin births.

INTRODUCTION: The purpose of this study is to estimate the immediate cost savings per delivery with in-hospital professional doula labor support in Wisconsin. This is the first study that calculates the estimated cost savings of professional doula labor support specific to Wisconsin. METHODS: This analysis used results presented in and derived from the Cochrane Review of continuous labor support to estimate procedure reduction and cost savings in Wisconsin using birth statistics from 2010. The delivery outcomes included were cesarean deliveries, instrumental deliveries, and regional analgesia use. To accurately reflect published studies on labor support, only low-risk deliveries were used for intervention reduction calculations. RESULTS: For 2010 data, estimated savings of 28,997,754.80 dollars could have been achieved if every low-risk birth were attended in-hospital by a professional doula. A professional doula providing only in-hospital labor support would yield an estimated cost savings of 424.14 dollars per delivery or 530.89 dollars per low-risk delivery. CONCLUSION: A system-based change in how laboring mothers are supported would be an innovative step that would put Wisconsin at the forefront of cost-effective health care, reducing interventions while improving outcomes. It is recommended that Wisconsin insurers consider reimbursing for professional doula labor support. It is also recommended that pilot programs be implemented in Wisconsin that can better assess the implementation of professional doula labor support services.