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BackgroundFetal alcohol spectrum disorders (FASD) affect approximately 2% to 5% of the US population. However, most families are unable to access FASD-informed interventions. Barriers to care include the lack of a knowledgeable and skilled workforce and family-level barriers such as limited financial resources, inability to access childcare, and stigma. As a result, families often try peer-to-peer and self-help support strategies. However, they often take these strategies from disparate sources, which have quite variable intervention quality and empirical support. ObjectiveThis study aimed to initiate systematic development and evaluation of a mobile health intervention (app) for caregivers raising children with FASD. Focus groups were conducted to elicit participant perspectives on app design and functionalities to inform further app development. MethodsThe app, called FMF Connect, was derived from the scientifically validated Families Moving Forward (FMF) Program, a clinician-delivered behavioral consultation intervention. FMF Connect was intended for caregiver self-delivery and included five main components: (1) Learning Modules, (2) Family Forum, (3) Library, (4) Notebook, and (5) Dashboard. Focus group methods were used to solicit perspectives from diverse families during the early stages of app development. Questions were asked about interface design, relevance of components and content, and perceived barriers and facilitators of use. A total of 25 caregivers participated in 7 focus groups across 5 US cities. Data were analyzed thematically. ResultsFocus group participants were generally enthusiastic about the app interface design and components. Four global positive impression themes emerged, including (1) ease of access, (2) how the app guides and organizes information, (3) connection to other users and information, and (4) ability to share some content with others. Themes arose not only in discussions relating to positive app features but also when participants were asked about motivators for app use. Participants related how these positive global themes could address some system-level barriers, such as limited access to services, feeling isolated, and increased advocacy needs related to the societal lack of FASD knowledge. Participants identified many positive features about individual app components and functionalities. They also communicated potential barriers to use and raised important concerns and considerations relating to several app components. These included recognizability of the app based on the logo, and the balance of following the planned intervention sequence versus obtaining immediate answers. Also mentioned were privacy and dynamics within the Family Forum. ConclusionsFMF Connect is a promising novel intervention with potential to reach many families in need and reduce significant barriers to care, resulting in a broader public health impact. Study findings will guide further app development both in terms of content and technological advances to optimize intervention effects. FMF Connect app development provides useful directions for other apps aimed at changing parenting practices.

Field research can benefit medical students' learning through experiential engagement with research and personal exposure to foreign health systems. However, the off-campus nature of the activity raises challenges for teachers. This article presents a case study that illustrates the benefits and challenges of organising a field research project for intercalating undergraduate medical students in foreign, lower income countries. Data for the 2009/10 and 2010/11 academic years were collected from students, supervisors and project hosts. Findings show the tension involved as students navigate the research ethics standards of the sending institution and the foreign fieldwork location. The project hosts report mostly positive aspects of the field research. Robust procedures and support will help to ensure that students have a safe and healthy fieldwork experience. Field research is not a neutral activity, and the benefits for student learning need to be weighed against the challenges raised for module organisation, research ethics, relationships with project hosts and health and safety.

The (super 1)H NMR transverse relaxation and pulsed-gradient spin-echo self-diffusion measurements at 70-degree Celcius in poly(dimethylsiloxane) (PDMS) rubber before and after subsequent devulcanization by intense ultrasound. The effort serves the purpose of characterizing at a molecular level this novel method of rubber recycling.

One of the greatest challenges for any preceptor is the problem learner. For a community preceptor this can be doubly challenging, because the learner's issues will reflect on your practice [...]

Field research can benefit medical students’ learning through experiential engagement with research and personal exposure to foreign health systems. However, the off-campus nature of the activity raises challenges for teachers. This article presents a case study that illustrates the benefits and challenges of organising a field research project for intercalating undergraduate medical students in foreign, lower income countries. Data for the 2009/10 and 2010/11 academic years were collected from students, supervisors and project hosts. Findings show the tension involved as students navigate the research ethics standards of the sending institution and the foreign fieldwork location. The project hosts report mostly positive aspects of the field research. Robust procedures and support will help to ensure that students have a safe and healthy fieldwork experience. Field research is not a neutral activity, and the benefits for student learning need to be weighed against the challenges raised for module organisation, research ethics, relationships with project hosts and health and safety. [ABSTRACT FROM PUBLISHER]

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The article examines how advanced practice nurses (APN) in the U.S. can affect the treatment of addiction disorders in terms of policymaking by taking the roles of advocate, leader and lobbyist. Topics discussed include the background and significance of opiate addiction problems, the responsibilities of APN in addressing the problem, and the advocate role of APN in opiate addiction treatment.

Objective: To describe the characteristics of chronic noncancer pain (CNCP) patients taking oxycodone or its derivatives in a rural teaching practice., Design: Characteristics of CNCP patients taking oxycodone over a 5-year period (September 2003 to September 2008) were compared with those of patients not taking opioid medications using a retrospective chart audit., Setting: A rural teaching practice in southwestern Ontario., Participants: A total of 103 patients taking chronic oxycodone therapy for CNCP and a random sample of 104 patients not taking opioid medication., Main Outcome Measures: Number of visits, health problems, sex, and previous history of addiction and mental illness., Results: Patients with CNCP taking oxycodone had significantly more health problems (P < .001), including drug and tobacco addictions. They had more than 3 times as many clinic visits during the same period of time as patients not taking opioid medication (mean of 39.0 vs 12.8 visits, P < .001)., Conclusion: Patients with CNCP in this rural teaching practice had significantly more health issues (P < .001) and were more likely to have a history of addiction than other patients were. They created more work with significantly more visits over the same period compared with the comparison group.