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Search Results: 1 - 10 of 3315 matches for " Michelle Tuten "
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HIV Sexual and Drug-Use Risk in Drug-Dependent Pregnant Patients in Comprehensive Drug Treatment
Hendrée E. Jones,Wendee M. Wechsberg,Kevin E. O'Grady,Michelle Tuten
International Journal of Family Medicine , 2011, DOI: 10.1155/2011/872638
Abstract: This secondary analysis study investigated HIV sexual and drug-use risk in drug-dependent pregnant patients over the first month postrandomization to reinforcement-based treatment (RBT) ( ) or usual care (UC) ( ). Analysis of primary outcomes had indicated that RBT participants spent significantly longer time in treatment and recovery housing than UC participants. The present study examined the ability of 9 risk markers—age, race, estimated gestational age at treatment entry, lifetime substance abuse treatment episodes, history of prostitution charges, history of serious depression, current heroin injection status, current housing status, and current partner substance use—to predict changes in HIV risks. Sexual risk declined for participant subgroups with prostitution-charge histories and unstable housing. Drug-use risk declined for heroin injectors and nondepressed participants. A relationship was found between number of lifetime drug treatment episodes and sexual and drug-use risk. The role of risk markers in the response of drug-dependent pregnant women to drug treatment require attention. 1. Introduction Substance-abusing women in their reproductive years have relatively high HIV seroprevalence rates [1]. Perinatal transmission of HIV accounts for 90% of pediatric HIV infection [2]. Thus, women with substance use disorders who are also pregnant are an important population to reach for both preventive interventions and treatment [3]. Drug abuse treatment itself has been shown to serve as a protective factor for HIV drug use risks and has been shown to prevent HIV in nonpregnant patients. These results come primarily through reduction of HIV drug-risk behavior [4, 5]. As yet these same results have not been reported in pregnant women. Moreover, to the best of our knowledge, the use of drug abuse treatment to reduce HIV sexual risk behaviors has been inconsistent in nonpregnant patients and has not been shown in pregnant women. Although comprehensive addiction treatment programs for substance-abusing pregnant women have been shown to result in improved maternal and neonatal outcomes compared to no treatment [6], considerably less attention has been focused on examining the impact that comprehensive drug abuse treatment provided during pregnancy may have on reducing HIV sexual and drug-risk behaviors. In fact, to our knowledge, no empirical study has examined the extent to which comprehensive treatment for drug dependence given to drug-dependent pregnant women can reduce either or both primary sources of HIV risk (that is, sexual and drug-risk
Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes
Lund IO,Fitzsimons H,Tuten M,Chisolm MS
Substance Abuse and Rehabilitation , 2012,
Abstract: Ingunn O Lund1, Heather Fitzsimons2, Michelle Tuten2, Margaret S Chisolm2, Kevin E O’Grady3, Hendrée E Jones2,41SERAF-Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway; 2Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; 3Department of Psychology, University of Maryland, College Park, MD; 4Substance Abuse Treatment Evaluations and Interventions Research Program, RTI International, Research Triangle Park, NC, USAAbstract: Pregnancy can motivate opioid-dependent women to seek substance abuse treatment. Research has demonstrated that although prenatal exposure to buprenorphine results in less severe neonatal abstinence syndrome (NAS) relative to prenatal methadone exposure, the maternal and other neonatal outcomes are similar for the two medications. Maternal and neonatal outcomes for opioid-dependent pregnant women receiving these medications have not been systematically compared with methadone-assisted withdrawal. The present study provides an initial assessment of the relative efficacy of both methadone and buprenorphine maintenance versus methadone-assisted withdrawal in terms of neonatal and maternal delivery outcomes. Data were derived from (1) the MOTHER (Maternal Opioid Treatment: Human Experimental Research) study at the Johns Hopkins University Bayview Medical Center (JHBMC), or (2) retrospective records review of women who underwent methadone-assisted withdrawal at the JHBMC during the time period in which participants were enrolled in the MOTHER study. Compared with the methadone maintenance group, the methadone-assisted withdrawal group had a significantly lower mean NAS peak score (Means = 13.7 vs 7.0; P = 0.002), required a significantly lower mean amount of morphine to treat NAS (Means = 82.8 vs 0.2; P < 0.001), had significantly fewer days medicated for NAS (Means = 31.5 vs 3.9; P < 0.001), and remained in the hospital for a significantly fewer number of days, on average (Means = 24.2 vs 7.0; P < 0.019). Compared with the buprenorphine maintenance group, the methadone-assisted withdrawal group required a significantly lower mean amount of morphine to treat NAS (Means = 8.2 vs 0.2; P < 0.001) and significantly fewer days medicated for NAS (Means = 12.0 vs 3.9; P = 0.008). Findings suggest that it is possible for some opioid-dependent pregnant women to succeed with methadone-assisted withdrawal. Future research needs to more fully evaluate the potential benefits and risks of methadone-assisted withdrawal for the maternal-fetal dyad.Keywords: pregnancy, methado
Health Promotion in Cardiac Rehabilitation Patients through the Use of a High-Intensity Interval Training Protocol  [PDF]
Michelle Tinkham
World Journal of Cardiovascular Diseases (WJCD) , 2014, DOI: 10.4236/wjcd.2014.410059
Abstract: According to the American Heart Association’s (AHA) recent statistical update, over 2150 Americans die each day from cardiovascular disease (CVD), which equals approximately 1 death every 40 seconds; many of which were under the age of 65 years old [1]. In 2009, 386,324 people, 1 in 6 Americans, died as a result of coronary artery disease (CAD) alone [1]. They also estimate 150,000 people have “silent” heart attacks each year [1]. Even though the number of cardiovascular disease deaths has declined in the last 10 years, they still accounted for 32.3% of American deaths [1]. As a result, the AHA updated their 2020 goals to improve the nation’s cardiovascular health by 20% [1]. One of these methods is through the use of cardiac rehabilitation. Cardiac rehabilitation (CR) is a health promotion strategy to help return cardiac patients to their previous level of functioning, increase health, decrease comorbidities and promote education and lifestyle change. For select patients, another alternative exercise plan may exist to gain even better results. High intensity interval training (HIIT) has shown positive training results for athletes and many studies show that it may also be an effective exercise modality for many cardiac patients instead of the traditional circuit training method. This article will review current literature on the effects of HIIT on CR patients as well as a sample HIIT protocol for instituting this treatment with appropriate patients.
Emotionally Competent Behaviors and Nurse Bullying: Is There a Direct Link?  [PDF]
Michelle Doas
Open Journal of Psychiatry (OJPsych) , 2015, DOI: 10.4236/ojpsych.2015.51008
Abstract: An abundance of literature spanning many years depicts the devastating effects of nurse bullying within the profession. The evidence suggests that bullying in general is a deliberate act aimed at another person. Conceptualizing nurse bullying appears to be a key ingredient in creating both awareness and preventative strategies. Emotional competence includes a set of behaviors which are unique to each individual. These behaviors according to Goldman (1995) include, but are not limited to emotional self-assessment, accurate self-assurance, self-confidence, emotional self-control, and empathy. The majority of researchers agree that emotionally competent behaviors are impacted by both positive and negative interactions and experiences. Thus, it is hypothesized that emotionally competent behaviors are continually cultivated throughout one’s life based upon lived experiences. This article assesses direct relationships between implementation of emotionally competent behaviors as a means of combatting nurse bullying within the profession. Creating awareness of these two areas can be initial steps in cultivating the needed tools and supportive interventions to assist nurses from novice to expert to professionally mentor and role model for generations to come.
Are We Losing the Art of Actively Listening to Our Patients? Connecting the Art of Active Listening with Emotionally Competent Behaviors  [PDF]
Michelle Doas
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.56060
Abstract: Active listening is an essential communication technique that requires the listener to focus and provide feedback on what is heard. The ability to listen actively demonstrates sincerity, and assumes that nothing is being shrugged or taken for granted. As a result, active listeners strive to improve professional and personal relationships, decrease misinterpretation of information, strengthen compliance, and foster understanding. Likewise, active listening can foster trust, mutual respect, and patient compliance. This paper will explore vital connections between active listening and displaying emotionally competent behaviors. Additionally, analysis of a case study as a means of strengthening these connections while improving patient outcomes will be assessed.
Teachers’ Perceptions about the Use of Play to Facilitate Development and Teach Prosocial Skills  [PDF]
Michelle Haney, Victor Bissonnette
Creative Education (CE) , 2011, DOI: 10.4236/ce.2011.21006
Abstract: The purpose of this study was to investigate teachers’ perceptions about the use of play to promote social, emotional, and cognitive skills to support planning for a school program aimed at increasing inclusive play for young children. This research was inspired by Vivian Gussin Paley’s book, You Can’t Say You Can’t Play (1992). Participants included undergraduate students and graduate education students in the Teacher Education Program at a small liberal arts college, as well as practicing elementary school teachers. The results indicated that graduate students and practicing teachers had a more accurate understanding about the developmental benefits of incorporating play into the classroom and a greater willingness to embrace the “you can’t say you can’t play” rule to promote inclusive play and acceptance. Implications for designing a preventative program for inclusive play in young children are discussed.
Survivors’ Perspectives of Organizational Downsizing on Knowledge Sharing in a Downsized Environment  [PDF]
Patricia Michelle Hall
Open Journal of Leadership (OJL) , 2012, DOI: 10.4236/ojl.2012.14004
Abstract: Organizational workforce reductions can negatively affect a company’s ability to preserve its knowledge base. The problem researched in this study was the perceived effect of downsizing on knowledge sharing among surviving employees. The purpose of this study was to determine the perceived effect of downsizing on knowledge sharing. Survivors’ knowledge sharing behavior was examined in relation to 1) survivor syndrome, 2) attitude towards knowledge sharing, and 3) perceived loss of knowledge power. A quantitative correlation research design was used to investigate the relationship between downsizing and knowledge sharing. A web-based survey was used to collect data. The convenience sample consisted of 37 management employees in the Texas region of a management consultant organization. Three sets of variables were examined: 1) survivor syndrome and actual knowledge sharing behavior, 2) survivors’ attitudes toward knowledge sharing and actual knowledge sharing behavior, and 3) perceived loss of knowledge power and actual knowledge sharing behavior. Findings from a Spearman rank order correlation revealed a statistically significant positive correlation between perceived loss of knowledge power and actual knowledge sharing behavior. Understanding survivors’ reactions can assist with planning for future reductions, and lead to the development of training programs to counter the challenges.
Developing nursing curriculum to facilitate the delivery of holistic care to the military veteran  [PDF]
Michelle Beckford, Corinne Ellis
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.35054
Abstract:

Daily media coverage tells the story of challenges facing returning members of the United States Military. High rates of suicide, more than twenty per day, horrific traumatic injuries necessitating challenging physical and emotional healing, and lingering post-traumatic stress disorders warranting the most advanced methods of treatment are reported daily. As America recoils from two prolonged oversea wars, the need for prepared healthcare providers is essential not only for the Veterans Administration (VA), but also for civilian based healthcare systems. The bulk of nursing education literature seems to evidence a void regarding this segment of the population. What seems like a prime education focus remains yet to be enacted in most nursing programs. The authors have responded to this challenge, by creating curricula developed to increase nursing student awareness of veterans’ unique needs, and to prepare undergraduate nursing students to provide quality care to veterans. Through the creation of a laboratory simulation scenario, students learned how to holistically view and respond to the needs of a veteran client. Debriefing allowed for reviewing the experience and discussing concerns. Outcomes measured via pre- and post- testing survey reflected the complexity of patient care needs. Students were asked to rate their ability to identify and prioritize appropriate nursing interventions. Anecdotal feedback was positive in that students consistently expressed a need to have additional simulation experiences.

A Qualitative Exploration of South African Women’s Psychological and Emotional Experiences of Infertility  [PDF]
Athena Pedro, Michelle Andipatin
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.45040
Abstract:

Despite the high prevalence of infertility in Africa, the study of reproductive health in Africa, has for the most part, not addressed the impact of involuntary childlessness on women. In contrast, the health priority has been on fertility regulation rather than on infertility. In Sub-Saharan Africa, at least 20% - 50% of couples of reproductive age experience a fertility problem and 30% are diagnosed with infertility. This study explored a sample of South Africa women’s psychological and emotional experiences of infertility or involuntary childlessness. Utilising a qualitative methodology, 21 married women who were diagnosed with infertility were recruited. Semi-structured, indepth individual interviews were conducted and the data were analysed using thematic analysis. The results of the study indicated that the women reported emotional turmoil characterised by emotions such as disappointment and shock, anger and frustration, a deep sense of sadness and then progressed to experience a sense of acknowledgement that a problem existed. Within each of these emotional phases the emotions of hope and optimism were present. The findings of this study suggest that severe psychological and emotional tug-of-war effects accompany infertility. Possible coping strategies for women struggling with infertility are discussed.

Canonical Form Associated with an r-Jacobi Algebra  [PDF]
Deva Michelle Bouaboté Ntoumba
Advances in Linear Algebra & Matrix Theory (ALAMT) , 2016, DOI: 10.4236/alamt.2016.61003
Abstract: In this paper, we denote by A a commutative and unitary algebra over a commutative field K of characteristic 0 and r an integer ≥1. We define the notion of r-Jacobi algebra A and we construct the canonical form associated with the r-Jacobi algebra A.
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