Developing Competency-Based Nursing Treatment for Persons With Tobacco Use Disorder

Background: Tobacco continues to have a deleterious impact on health outcomes in the United States. Professional nurses at all levels of practice have an opportunity to be a part of the solution. The development of nurse-specific competencies for treating tobacco use disorder (TUD) disorder is long overdue. A task force of American Psychiatric Nurses Association (APNA) subject matter experts was assembled to engage in the process of reviewing the available peer-reviewed literature and additional evidence-based resources (e.g., professional organization position statement, toolkits, national survey results) to create the Nursing Competencies for Treating Tobacco Use Disorders. Objective: The aim of this article is ultimately to improve patient access to quality, evidence-based TUD nursing care by all nurses who are competent, full partners in TUD multidisciplinary care. Method: Search terms were defined and a scoping search and review of the TUD literature and resources was performed from November 2018 to November 2020. Results: Over 300 articles and evidence-based resources (e.g., professional organization position statements, toolkits, etc.) were discovered. Thirteen competencies were developed and were internally and externally reviewed prior to APNA Board of Director’s approval. Conclusion: TUD competencies have the potential to guide nursing education, practice, and research, allowing nurses to be full partners in the design, development, and implementation of effective TUD treatment.

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Secondary Prevention 1: Cancers and Principles of Screening

Mayo Clinic Preventive Medicine and Public Health Board Review ◽

10.1093/med/9780199743018.003.0010 ◽

2010 ◽

pp. 141-157

Author(s):

Martha P. Millman ◽

Paul J. Limburg

Keyword(s):

United States ◽

Cause Of Death ◽

Cancer Survival ◽

Task Force ◽

The United States ◽

Screening Tests ◽

Evidence Based ◽

Level Of Education ◽

Screening Strategies ◽

Evidence Based Guidelines

Screening tests are used to differentiate between persons with and without the condition of interest in a defined population. Screening strategies, or mass screening, is applied relatively indiscriminately to a population. Cancer is the second-leading overall cause of death in the United States; however, it is the leading cause of death for those under 85. Cancer risk is associated with environmental risk factors. Racial disparities in cancer incidence and death persist in the United States; level of education also appears to affect cancer survival. The United States Preventive Services Task Force has established evidence-based guidelines for screening, counseling, and chemoprevention.

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Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele: Executive Summary

Neurosurgery ◽

10.1093/neuros/nyz261 ◽

2019 ◽

Vol 85 (3) ◽

pp. 299-301 ◽

Cited By ~ 4

Author(s):

Catherine A Mazzola ◽

Nadege Assassi ◽

Lissa C Baird ◽

David F Bauer ◽

Alexandra D Beier ◽

...

Keyword(s):

Systematic Review ◽

Spina Bifida ◽

Task Force ◽

The United States ◽

Folic Acid Deficiency ◽

Evidence Based ◽

Executive Summary ◽

Full Text Review ◽

Level I ◽

The Impact

Abstract BACKGROUND The incidence of spina bifida (SB) in the developing world is higher than in the United States because of malnutrition and folic acid deficiency during pregnancy. Advances in technology have made prenatal repair of myelomeningocele (MM) possible. OBJECTIVE The objective of the guidelines are, (1) To create clinical recommendations for best practices, based on a systematic review and analysis of available literature, (2) to obtain multi-disciplinary endorsement of these guidelines from relevant organizations, and (3) to disseminate the educational content to physicians to improve the care of infants with MM. METHODS The Guidelines Task Force developed search terms and strategies used to search PubMed and Embase for literature published between 1966 and September 2016. Strict inclusion/exclusion criteria were used to screen abstracts and to develop a list of relevant articles for full-text review. RESULTS Guidelines authors aimed to systematically review the literature and make evidence based recommendations about the timing of closure after birth, hydrocephalus, the impact of prenatal closure, and the effect of prenatal closure on ambulation ability and tethered spinal cord. Evidence concerning persistent ventriculomegaly and cognitive impairment was also evaluated. Hundreds of abstracts were identified and reviewed for each of the 5 topics. A total of 14 studies met stringent inclusion criteria. CONCLUSION Based on a comprehensive systematic review, a total of 5 clinical practice recommendations were developed, with 1 Level I, 2 Level II and 2 Level III recommendations. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-1.

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Vitamin D Supplementation: A Potential Prevention Method against Contagious Viral Respiratory Illnesses

INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS ◽

10.47191/ijmra/v4-i10-25 ◽

2021 ◽

Vol 04 (10) ◽

Author(s):

Michael Ausi ◽

Keyword(s):

Vitamin D ◽

Immune Cells ◽

Task Force ◽

The United States ◽

Future Research ◽

Evidence Based ◽

T Helper ◽

Respiratory Illnesses ◽

Adaptive Immune Cells ◽

Viral Respiratory

This narrative review explores the protective value of Vitamin D (VD) and its metabolites, such as Vitamin D2 (VD2) and Vitamin D3 (VD3), and their preventive health potentials backed by evidence-based medicine against viral respiratory illnesses (VRI). With the recent events of late 2019, a severe acute respiratory illness began to sweep the globe. This SARS illness was of coronavirus-2 variant known as SARS-CoV-2 (COVID-19). With COVID-19 in mind, the purpose of this paper was to explore a preventative health model utilizing evidence-based medical research to safeguard against similar viral catastrophes. The knowledge gained is essential for the future education of the general population and necessary for a more preemptive and protective approach to VRIs. Google Scholar, PubMed, and DuckDuckgo were the most often utilized internet search engines and databases to collect sources. Twelve evidence-based medical articles were selected based on specific inclusionary and exclusionary criteria. More specifically, eleven systematic-review and meta-analyses (SRMA) and one Randomized Controlled Trial (RCT) were selected. The data extracted from the eleven articles were analyzed to understand the relationship between VD, VD3, and Viral Respiratory illnesses (VRIs). VD is known to have various protective actions on the immune system (IS). First, VD activates gene transcription upon innate immune cells to increase viral defensive proteins such as Defensins and Cathelicidins (Laaski, 2011; Liu, 2006; NIH, 2020). More importantly, VD down-regulates certain specific adaptive immune cells named T helper 2 (Th2). The Th2 cellular pathway indirectly downregulates T helper 1 (Th1), cell pro-inflammatory cytokine storms, thus assisting with viral clearance (Huang, Wang, Li et al., 2020). More EBM research displays an inverse relationship between VD status and VRI, like incidences, severity, and duration of VRIs (Abioye, Bromage & Fawz 2021). Recommendations for future research were presented to understand VD better and its possible use as a potential therapeutic or preventive medicine modality for the public. Proposals on health policy changes within health agencies like the United States Preventative Task Force (USPTF) were also provided. Changes included mandatory health VD screens tables and their metabolites for patients of different ages and breeds to achieve proper VRI protection to prevent future pandemics.

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Considering Systemic Barriers to Treating Tobacco Use in Clinical Settings in the United States

Nicotine & Tobacco Research ◽

10.1093/ntr/nty123 ◽

2018 ◽

Vol 21 (11) ◽

pp. 1453-1461 ◽

Cited By ~ 12

Author(s):

Alana M Rojewski ◽

Steffani R Bailey ◽

Steven L Bernstein ◽

Nina A Cooperman ◽

Ellen R Gritz ◽

...

Keyword(s):

United States ◽

Health Care ◽

Health Care System ◽

Tobacco Use ◽

The United States ◽

Evidence Based ◽

Comorbid Conditions ◽

Tobacco Treatment ◽

Care System ◽

Systemic Barriers

Abstract The Comorbidity Workgroup of the Tobacco Treatment Research Network, within the Society for Research on Nicotine and Tobacco, previously highlighted the need to provide tobacco treatment to patients diagnosed with comorbid physical and mental health conditions. Yet, systemic barriers in the United States health care system prevent many patients who present for medical treatment from getting the evidence-based tobacco treatment that they need. The identified barriers include insufficient training in the epidemiologic impact of tobacco use, related disorders, and pharmacological and behavioral treatment approaches; misunderstanding among clinicians about the effectiveness of tobacco treatment; lack of therapeutic support from clinical staff; insufficient use of health information technology to improve tobacco use identification and treatment; and limited time and reimbursement for clinicians to provide treatment. We highlight three vignettes demonstrating the complexities of practical barriers at the health care system level. We consider each of the barriers in turn and discuss evidence-based strategies that could be implemented in the clinical care of patients with comorbid conditions. In addition, in the absence of compelling data to guide implementation approaches, we offer suggestions for potential strategies and avenues for future research. Implications: Three vignettes highlighted in this article illustrate some systemic barriers to providing tobacco treatment for patients being treated for comorbid conditions. We explore the barriers to tobacco treatment and offer suggestions for changes in training, health care systems, clinical workflow, and payment systems that could enhance the reach and the quality of tobacco treatment within the US health care system.

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Monitoring the Tobacco Epidemic With National, Regional, and International Databases and Systematic Reviews: Evidence for Nursing Research and Clinical Decision Making

Annual Review of Nursing Research ◽

10.1891/0739-6686.27.91 ◽

2009 ◽

Vol 27 (1) ◽

pp. 91-114 ◽

Cited By ~ 2

Author(s):

Virginia Hill Rice

Keyword(s):

Tobacco Use ◽

Health Care Professionals ◽

Clinical Decision Making ◽

Nursing Intervention ◽

The United States ◽

Population Based ◽

Future Research ◽

Evidence Based ◽

Tobacco Epidemic ◽

Meta Analyses

Tobacco use (primarily cigarette smoking) continues to be the most preventable health risk in the United States and the second greatest health threat around the world. In 2020 the global burden is expected to exceed nine million deaths annually. Nursing, with the largest numbers of health care professionals has an opportunity to make a significant reduction in tobacco use through its research and client-focused care. This chapter addresses why and how monitoring the tobacco epidemic with population-based databases and meta-analyses is important for nurse researchers and for evidence-based nursing practice. Population-based surveys permit an examination of trends in tobacco use and the progress in tobacco control with some confidence across time, places (i.e., states, nations, communities, etc.), and large numbers of participants. Included in this review are a description of the numerous national and international databases and other resources that nurse researchers can use to build the science of tobacco use. Additionally, research reviews and meta-analyses are described as other vehicles for providing a basis for making evidence-based decisions about nursing intervention. Nurse scientists have an obligation to use and evaluate these diverse resources to determine the gaps in knowledge, provide a foundation for clinical practice, and identify the needs and directions for future research in the field.

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Commentary: Educational and Clinical Training Considerations for Addressing Tobacco-Related Cancer Health Disparities

Ethnicity & Disease ◽

10.18865/ed.28.3.187 ◽

2018 ◽

Vol 28 (3) ◽

pp. 187

Author(s):

Christine E. Sheffer ◽

Monica Webb Hooper ◽

Jamie S. Ostroff

Keyword(s):

United States ◽

Tobacco Use ◽

Health Care Providers ◽

Clinical Training ◽

The United States ◽

Evidence Based ◽

Prevalence Rates ◽

Care Providers ◽

Tobacco Treatment ◽

Underserved Groups

In the United States, tobacco use is a leading contributor to inequities in cancer health among individuals for many ethnic, racial, sexual minority, and other minority groups as well as individuals in lower socioeconomic groups and other underserved populations. Despite remarkable decreases in tobacco use prevalence rates in the United States over the past 50 years, the benefits of tobacco control efforts are not equitably distributed. Tobacco-related disparities include higher prevalence rates of smoking, lower rates of quitting, less robust responses to standard evidence-based treatments, substandard tobacco treatment delivery by health care providers, and an increased burden of tobacco-related cancers and other diseases.Among the multiple critical barriers to achieving progress in reducing tobacco treatment-related disparities, there are several educational barriers including a unidimensional or essentialist conceptualizations of the disparities; a tobacco treatment workforce unprepared to address the needs of tobacco users from underserved groups; and known research-to-practice gaps in understanding, assessing, and treating tobacco use among underserved groups.We propose the development of competency-based curricula that: 1) use intersectionality as an organizing framework for relevant knowledge; 2) teach interpersonal skills, such as expressing sociocultural respect, a lack of cultural superiority, and empathy as well as skills for developing other-oriented therapeutic relations; and 3) are grounded in the science of the evidence-based treatments for tobacco dependence. These curricula could be disseminated nationally in multiple venues and would represent significant progress toward addressing tobacco-related disparities.Ethn Dis. 2018;28(3):187- 192; doi:10.18865/ed.28.3.187.

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Viewpoint: Mismatch between the European and American guidelines on oral antiplatelet P2Y12 inhibitors after acute coronary syndromes

Thrombosis and Haemostasis ◽

10.1160/th13-02-0142 ◽

2013 ◽

Vol 110 (07) ◽

pp. 5-10 ◽

Cited By ~ 7

Author(s):

James DiNicolantonio ◽

Victor Serebruany

Keyword(s):

Acute Coronary Syndromes ◽

Task Force ◽

The United States ◽

The Other ◽

Evidence Based ◽

St Segment Elevation ◽

P2y12 Inhibitors ◽

The Us ◽

Coronary Syndromes ◽

Esc Guidelines

SummaryRecent European Society of Cardiology (ESC) Guidelines declare superiority of prasugrel and ticagrelor over clopidogrel in non-ST segment elevation myocardial infarction (NSTEMI) and STEMI patients with acute coronary syndromes (ACS). The recommendations for NSTEMI and especially STEMI are based on a subgroup analyses yielded from a single trial with either prasugrel (TRITON), or ticagrelor (PLATO). In contrast, the United States (US) Guidelines present a more balanced, conservative, and evidence-based outlook suggesting no proven extra benefit of one P2Y12 antagonist over the other(s). It was the purpose of this study to scrutinise the evidence leading to the current ESC ACS Guidelines on oral antiplatelet agents and compare them with US recommendations. Matching the evidence from TRITON and PLATO primary publications with the data reported in the Food and Drug Administration (FDA) official reviews in light of their impact on current regional ACS Guidelines on antiplatelet P2Y12 inhibitors. The available body of evidence on the efficacy and safety of the new oral P2Y12 inhibitors challenge the ESC Guidelines, and supports the US recommendations. Some of the pivotal data with regard to the newer P2Y12 inhibitors (prasugrel and ticagrelor) on event definition, adjudication, questionable efficacy, and serious safety concerns were ignored by the European Task Force Members, while the other “beneficial” findings were exaggerated to a disproportional extent. We conclude that current ESC Guidelines, with regard to their recommendation of superiority of prasugrel or ticagrelor over clopidogrel, in contrast to the US, are overoptimistic, and not evidence based. Low clinical utilisation of prasugrel and especially ticagrelor worldwide in general, and Europe in particular suggests mismatch of prescription habits with issued ESC recommendations.

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A 5-Factor Framework for Assessing Tobacco Use Disorder

Tobacco Use Insights ◽

10.1177/1179173x21998355 ◽

2021 ◽

Vol 14 ◽

pp. 1179173X2199835

Author(s):

Matthew Bucklin

Keyword(s):

Tobacco Use ◽

Visual Cues ◽

Treatment Options ◽

Smoking Behavior ◽

The United States ◽

Nicotine Addiction ◽

Social Reinforcement ◽

Emotional States ◽

Learning Mechanisms ◽

Tobacco Use Disorder

Cigarette use is the leading cause of preventable death in the United States. Despite the well documented dangers of smoking, nearly 20% of adults report regular use of tobacco. A majority desire to discontinue but the long-term cessation success rate remains near 4%. One challenge to reducing the prevalence of tobacco use is an incomplete understanding of the individual correlates that reinforce continued use. Evidence from research on nicotine and tobacco suggests that Tobacco Use Disorder is a complex, and multifactorial condition. Personality traits, comorbidities, habits and lifestyle, genetics, socioeconomic status, and mental and physical health all contribute to the risk for dependence and to the likelihood of quitting. This perspective review provides an overview of some common factors that contribute to liability risk for Tobacco Use Disorder and a framework for assessing individual tobacco users. The framework includes 5 areas that research suggests contribute to continued tobacco use: nicotine addiction, psychological influences, behavioral dependencies, neurobiological factors, and social reinforcement. Nicotine addiction includes drug-seeking behavior and the role of withdrawal avoidance. Psychological and emotional states contribute to a perceived reliance on tobacco. Behavioral dependence is reinforced by associative and non-associative learning mechanisms. Neurobiological factors include genetic variables, variations in neurotransmitters and receptors, pharmacogenetics, and interaction between psychiatric illnesses and nicotine use and dependence. Finally, social reinforcement of smoking behavior is explained by a network phenomenon and consistent visual cues to smoke. A comprehensive assessment of individual tobacco users will help better determine appropriate treatment options to achieve improved efficacy and outcomes.

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The Speech-Language Assessment of English Language Learning Students: A Non-Standardized Approach

Perspectives on School-Based Issues ◽

10.1044/sbi14.4.95 ◽

2013 ◽

Vol 14 (4) ◽

pp. 95-101 ◽

Cited By ~ 2

Author(s):

Robert Kraemer ◽

Allison Coltisor ◽

Meesha Kalra ◽

Megan Martinez ◽

Bailey Savage ◽

...

Keyword(s):

Language Learning ◽

Language Impairment ◽

Specific Language Impairment ◽

English Language ◽

Language Assessment ◽

The United States ◽

English Language Learning ◽

Assessment Practices ◽

Evidence Based ◽

English Speaking

English language learning (ELL) children suspected of having specific-language impairment (SLI) should be assessed using the same methods as monolingual English-speaking children born and raised in the United States. In an effort to reduce over- and under-identification of ELL children as SLI, speech-language pathologists (SLP) must employ nonbiased assessment practices. This article presents several evidence-based, nonstandarized assessment practices SLPs can implement in place of standardized tools. As the number of ELL children SLPs come in contact with increases, the need for well-trained and knowledgeable SLPs grows. The goal of the authors is to present several well-establish, evidence-based assessment methods for assessing ELL children suspected of SLI.

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