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This article explores the importance of addressing the drug overdose epidemic through policy interventions. It identifies three main strategies: overdose education and naloxone distribution, harm reduction, and peer support programs. The focus is on harm reduction, specifically removing barriers to syringe service programs. The article includes an interview with Madeleine Lepore, a psychiatric nurse practitioner who is passionate about harm reduction and has been volunteering in a syringe service program. The author also discusses their own research on harm reduction policies, with a focus on syringe decriminalization and the need for syringe service programs in rural communities in Pennsylvania. They emphasize the effectiveness and cost-effectiveness of harm reduction, while acknowledging the existing stigma. The article highlights progress made in Pennsylvania, such as the decriminalization of fentanyl test strips and proposed bills for syringe service programs. It emphasizes the importance of harm reduction in addressing the opioid epidemic and intimate partner violence, and discusses the author's role in nursing education and teaching students about addiction nursing and harm reduction. [Extracted from the article]

Bullying among children and adolescents is recognized as a significant global public health problem, as it has serious health consequences. Schools are important sites in which to address violence prevention, specifically bullying prevention, and to promote positive youth development. The Ottawa Charter for Health Promotion outlines five action points (building healthy public policy, creating supportive environments, strengthening community actions, developing personal skills, and reorienting health services) that should be considered when creating a positive school climate focused on health promotion. Using the position statements of school nurses and school psychologists, we outline their complementary roles in bullying prevention and intervention. In addition, because the global and national school health models call for building partnerships and enhancing communication among professionals within the schools and with the community to achieve health goals, we discuss how these two professional groups can work collaboratively to address bullying as a school health issue.

Surrogate decision-makers make critical decisions for loved ones at the end of life, and some experience lasting negative psychological outcomes. Understanding whom they rely on for support and the types of support they value may inform nursing care and that of other health team members who work with surrogates. The purpose of the study was to explore decision support and other types of support provided to surrogate decision-makers at the end of life of their loved one and perceived usefulness of the support. This secondary analysis of data from a mixed-methods study involved the examination of the transcripts of qualitative interviews with 13 surrogate decision-makers in the United States, conducted between 2010 and 2014. A constant comparative method was used to identify common themes surrounding surrogate decision support at the end of life. Surrogates valued advance directives and conversations with their loved one about treatment preferences. Surrogates described involving many different types of people in decision-making and other types of support. Finally, surrogates appreciated being reassured that they were doing a good job in making decisions and seemed to seek out this type of affirmation from various sources including the health care team, family, and friends. Nurses are well-positioned to provide this affirmation because of the time that they spend caring for the patient and family. Future research should further explore the concept of affirmation of surrogates in their role as a means of support as they make decisions for a loved one. [ABSTRACT FROM AUTHOR]

The current emphasis on best practices for school-based health and mental health programs brings with it the demand for evaluation efforts in schools. This article describes the challenges of launching a successful school program and evaluation, with lessons learned from three projects that focus on intimate partner violence. The authors discuss issues related to constraints on the research design in schools, the recruitment of schools and participants within schools, program and evaluation implementation issues, the iterative implementation-evaluation cycle, and the dissemination of programs and study findings. The authors emphasize the need for flexibility and cultural awareness during all stages of the process.

This article reports qualitative findings of seven focus groups that illuminate the phenomenon of dating and dating violence from the perspective of the young adolescent. This study was part of a larger intervention project, "An Arts-Based Initiative for the Prevention of Violence Against Women and Girls," a collaboration of the Centers for Disease Control and Prevention and Johns Hopkins University, School of Nursing. Concepts of interest included: dating norms, ecological factors, elements of healthy and unhealthy relationships, and prevention strategies. Four themes emerged: respect versus disrespect, influence of friends, cost and benefit of sexual activity and violence as an acceptable response. The implications of this data highlight the need for school personnel to increase their awareness and understanding of the challenges middle school youth face. Dating violence prevention programs should be designed accordingly.

Abstract: Tuberculosis (TB) is endemic and epidemic throughout the world. More people will die of TB this year then in any previous year in modern history. However, in the United [...]

Background: Despite calls from professional organizations to prepare a nursing workforce with the requisite skills to address social determinants of health (SDOH), there is little guidance for nurse educators about how to actively promote student learning of these complex issues. Method: We applied a critical service-learning (CSL) pedagogy to enhance graduate public health nursing curriculum and support learner skill building in approaches to combat health disparities by addressing the underlying social conditions. Results: Course content and critical reflection activities were built incrementally across four courses and semesters to introduce and apply antioppressive frameworks, encourage students to examine their personal identities of privilege and oppression, and examine historical context and systems of power in public health settings. Conclusion: CSL supports student development of structural competence and their understanding of approaches that can dismantle inequitable systems by addressing SDOH that contribute to health disparities. CSL supports student development of structural competence and their understanding of approaches that can dismantle inequitable systems by addressing SDOH that contribute to health disparities. [[J Nurs Educ. 2021;60(1):38–43.] [ABSTRACT FROM AUTHOR]

Asthma morbidity and mortality are disproportionately higher among African American children. Medication adherence is essential for reducing adverse asthma outcomes in this population. Depressive symptoms, prevalent among mothers of children with asthma, have been linked to medication nonadherence. This longitudinal, multilevel analysis used data from a randomized clinical trial evaluating the efficacy of an environmental control educational intervention to evaluate the relationship between caregiver depressive symptoms (Center for Epidemiologic Studies Depression Scale) and caregiver-reported medication adherence (Medication Adherence Report Scale) in urban African American children with uncontrolled asthma (N = 208) at baseline, in six months, and in 12 months. Nearly a third (31.7%) of caregivers (97% female) had clinically significant depressive symptoms at baseline. A random intercept model showed that the within-caregiver effect of depression predicted lower medication adherence (β = –.079, p =.002) as did time (β = –.413, p <.001); the between-caregiver effect of depression did not (β = –.007, p =.77). Changes in a caregiver's baseline level of depressive symptoms appear to have a stronger influence on medication adherence than mean level of depressive symptoms. Policy, practice, and further research should address maternal mental health as a key element in the life course of African American children with asthma. [ABSTRACT FROM AUTHOR]

An interview with Shannon Opie, the Chief Executive Officer of the Florida Intervention Project for Nurses (IPN), is presented. Topics include ensure public health and safety by providing support, education, and monitoring to nurses in the state of Florida; and Impairment can involve substance use disorders, psychiatric illness, or impairing physical conditions affecting the safety of the public.

Objective: Urban children with asthma experience high rates of second hand smoke (SHS) exposure. The objective was to examine whether SHS exposure is associated with symptom frequency in children with poorly controlled asthma. Methods: Children were enrolled in a RCT to test the efficacy of an environmental control behavioral intervention versus an attention control group and followed over 12 months. SHS exposure assessed using salivary cotinine measurement. Frequency of child asthma symptoms, healthcare utilization, household smoking and caregiver daily life stress were obtained via caregiver report. Time of enrollment was recorded to assess seasonal factors. Symptom days and nights were the primary outcomes. Multivariable models and odds ratios examined factors that best predicted increased frequency of daytime/nighttime symptoms. Results: Children (n = 222) with a mean age of 6.3 (SD 2.7) years, were primarily male (65%), African American (94%), Medicaid insured (94%), and had poorly controlled asthma (54%). The final multivariable model indicated symptoms in the fall (OR 2.78; 95% CI 1.16, 6.52) and increased caregiver daily life stress (OR 1.13, 95% CI 1.02, 1.25) were significantly associated with increased symptom days when controlling for cotinine level, intervention status, child age and home and car smoking restrictions. Conclusions: There was no impact of SHS exposure on increased symptom frequency. High caregiver daily life stress and symptoms in fall season may place children with asthma at risk for increased day/nighttime symptoms. Close monitoring of symptoms and medication use during the fall season and intervening on caregiver life stress may decrease asthma morbidity in children with poorly controlled asthma. [ABSTRACT FROM AUTHOR]