This chapter reviews prevention, including genetic counseling. It discusses genetic testing for diagnosis as opposed to screening and the treatment for genetic disease. Methods of prevention begin with education of the public and health care professionals and identification of those at risk. Genetic counseling is the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. The malignant cells often exhibit aneuploidy as well as translocations that are found only within the tumor cells. Genetic errors that arise from specific cell lines are somatic mutations. It is suggested that there is a thorough collection of family, genetic, and medical history for children entering the adoption process. Nurses may play a variety of roles in genetic counseling that reflect their preparation, area of practice, primary functions, and setting. The chapter explains the incidence of chromosome abnormalities.
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The initial recognition of the need for a genetics referral may arise when a nurse suspects a genetic contribution to disease because of personal or family medical history and/or findings from a physical assessment. Family history is a valuable and cost-effective tool that is often underutilized in clinical practice. Many common genetic conditions result from complex interactions between genetic and environmental factors. It is critical to collect information about potential environmental exposures to help inform a patient’s risk assessment. Health care professionals should become familiar about toxic environmental agents that are common in their specific geographic location. A growing number of Food and Drug Administration (FDA) approved drugs have labeling that includes pharmacogenomic information, which can be used to optimize drug dosage and prevent adverse and life-threatening drug reactions in a patient or family member.
Nurses working in the field of obstetrics must have a greater depth and breadth of genetic knowledge over any other subspecialty. In gestation, nurses should include education on the effects of teratogens, prenatal screening options, and prenatal diagnoses. After delivery, early recognition of genetic disorders is important for immediate initiation of potentially life-saving therapies. Preconception education is a critical component of health care for women of reproductive age. The Centers for Disease Control and Prevention (CDC) recommend that all women of childbearing age consume 0.4 mg of folic acid daily to prevent neural tube defects (NTDs). Counseling can still be useful in terms of optimum pregnancy management in a setting best able to cope with any anticipated problems. Complex and multifaceted maternal and fetal factors influence the consequences of drugs, radiation, and chemical and infectious agents to the developing fetus.
- Go to chapter: Social Work and the Law: An Overview of Ethics, Social Work, and Civil and Criminal Law
This chapter demonstrates how social work ethics apply to ethical and legal decision making in forensic social work practice. It discusses the context of social work practice in legal systems. The chapter also details the basic structures of the United States (U.S.) civil and criminal legal systems. It lays the foundation for the criminal and civil court processes in the United States and introduces basic terminology and a description of associated activities and progression through these systems. The chapter focuses on providing an introductory, and overarching, picture of both civil and criminal law in the U.S. and introduces the roles social workers play in these systems. It focuses on the ETHICA model of ethical decision making as a resource and tool that can be used to help forensic social workers process difficult and complex situations across multiple systems.
This chapter explains the theoretical basis for motivational interviewing (MI). It reviews the empirical evidence for the use of MI with diverse populations in forensic settings. MI involves attention to the language of change, and is designed to strengthen personal motivation and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. It is now internationally recognized as an evidence-based practice intervention for alcohol and drug problems. MI involves an underlying spirit made up of partnership, acceptance, compassion, and evocation. The chapter discusses four key processes involved in MI: engaging, focusing, evoking, and planning. It also describes five key communication microskills used throughout MI: asking open-ended questions, providing affirmations, offering summarizing statements, providing information and advice with permission, and reflective statements.
The learning landscape continues to evolve as new technological tools enable teachers to deliver robust learning experiences. It is important to help teachers, administrators, and students know where to begin so that the transition to virtual learning is smooth, without educational loss. This chapter consists of two sections: current trends and issues in technology integration and technological pedagogical content knowledge. The first section briefly reviews the trends in instructional or educational technologies that are causing administrators, teachers, and students to reflect on and modify their thinking about learning and educational content delivery. The second section explores constructivism, the scientific underpinnings of nursing informatics, and ethics. Nurse educators must also address the ethical challenges brought about by this evolving learning landscape. After reading this chapter, one can understand current trends and issues, as well as the influence of nursing informatics and ways to approach new ethical dilemmas.
Healthcare is in a state of rapid change. Although practice environments have become more complex, educational delivery methods have remained stagnant. Innovative technologies provide opportunities to enhance nursing student learning and help nursing programs become more responsive to changes in the practice environment; however, obstacles may hinder successful implementation. With the increasing complexity of today’s health care environment, innovations in nursing curricula are necessary. This chapter explores some of the general challenges associated with the integration of innovative educational technologies, as well as some challenges unique to virtual simulation. It helps the reader to analyze the challenges of integrating educational technologies into nursing education associated with faculty, administrators, and students. It also helps the reader to examine practical and philosophical barriers related to technology integration and explores challenges unique to the adoption of virtual simulation.
Simulation has many advantages for nursing education, some of which include creating safe learning environments for students and reinforcing information learned in the classroom; it also has the advantage of being available in inclement weather as well as 24 hours a day for student access. Simulation in nursing is one of many methods used for teaching students. Teaching and learning in a virtual learning environment has many advantages for administrators, faculty, and students. One of the advantages includes the use of other disciplines to help create or participate in a virtual world learning experience. The virtual learning environment can be created to look similar to real communities, disaster areas, or homes, with avatars populating that environment. The advantage to using virtual reality, rather than a real-life experience, is that in real life, students could be immersed in an environment that could cause them harm.
To think today that health issues in one country are confined to that country indicates a lack of understanding of disease transmission, cultural practices, and migration patterns at the least. This chapter presents health problem or issues and policies that impact populations around the globe. To highlight the worldwide impact, the content is framed within the seven continents. The health issues are not exclusive but selected to reflect the extent of political or governmental impact. It briefly describes government structures, and presents an overview of the policy-making process of Africa, Antarctica, Asia, Australia, Europe, Italy, North America, and South America. The policy process will vary among countries depending on the type of government. Some issues may reflect cultural practices that may not be amenable to government intervention. The reader should determine the extent to which citizens, especially nurses, can be involved in the policy process as advocates and change agents.
This chapter opens with the challenge Nightingale and her close colleagues faced in establishing nursing as a profession when the ethical standards of the existing (secular) nurses were (generally) so low. The ethical issues she had to deal with in her own school, soon after it opened, are discussed three thorny problems with appointments. Anyone reading Nightingale’s writing on nursing will be struck by how often and how forcefully she insisted on high ethical standards. The reason for the emphasis on ethical standards is obvious enough in the task Nightingale faced in raising the new profession from its disreputable past. The International Council on Nursing (ICN) established its Code of Ethics in 1953, again based on Nightingale principles. It identified four responsibilities: to promote health, to prevent illness, to restore health, and to alleviate suffering. The code asks nurses not only to act ethically themselves, but to challenge unethical practices.
- Go to article: Sexual Teen Dating Violence Victimization: Associations With Sexual Risk Behaviors Among U.S. High School Students
Sexual Teen Dating Violence Victimization: Associations With Sexual Risk Behaviors Among U.S. High School Students
Adolescent dating violence may lead to adverse health behaviors. We examined associations between sexual teen dating violence victimization (TDVV) and sexual risk behaviors among U.S. high school students using 2013 and 2015 National Youth Risk Behavior Survey data (combined n = 29,346). Sex-stratified logistic regression models were used to estimate these associations among students who had dated or gone out with someone during the past 12 months (n = 20,093). Among these students, 10.5% experienced sexual TDVV. Sexual TDVV was positively associated with sexual intercourse before age 13, four or more lifetime sexual partners, current sexual activity, alcohol or drug use before last sexual intercourse, and no pregnancy prevention during last sexual intercourse. Given significant findings among both sexes, it is valuable for dating violence prevention efforts to target both female and male students.Source:
This chapter explores how three successful nursing leaders, using different leadership approaches, demonstrate traditional leadership attributes such as strategic vision; risk-taking and creativity; interpersonal and communication effectiveness; and inspiring and leading change. It discusses the opportunities and implications for nursing leaders and those external to the profession to develop collaborative and transformative partnerships to advance quality health care. Pragmatic leaders demonstrate leadership excellence by effectively translating their nursing care assessment skills into the ability to approach organizational problem solving and decision making in a systematic, logical manner. In contrast to the present-needs focus of pragmatic leaders, charismatic leaders are vision-based leaders who predicate their leadership agenda on attaining future goals. Each of the three nursing leaders profiled understands the importance of being politically astute and effectively leveraging power and influence to make value-added contributions. To varying degrees, the various constituents of the nursing leaders profiled view them as socialized leaders.
This chapter shows the importance, for older persons, of support groups. In spite of the changes that have occurred in the American family, and all the negative things that fill the popular press concerning family relationships, the family is still the backbone of support for most older people. To some extent, the type of family support older people obtain depends on whether they are living in the community or in an institutional setting such as a group home, retirement village, or nursing facility. Whether a person is married, has great impact on that person’s support within a family setting including emotional, financial, and physical support, particularly in times of illness or infirmity. The success of a second marriage depends to a considerable extent on the reaction of the adult children of the elderly couple. Older grandparents, no matter how motivated, can find caring for grandchildren to be very tiring.
Delirium, also known as acute confusional state, organic brain syndrome, brain failure, and encephalopathy, is a common occurrence among medical and surgical patients and causes extensive morbidity and mortality. This chapter provides an updated review of delirium, including pathophysiological correlates, clinical features, diagnostic considerations, and contemporary treatment options. The defining features of delirium include an acute change in mental status characterized by altered consciousness, cognition, and fluctuations. The chapter explores the risk factors for delirium. These can be divided into two categories: predisposing factors and precipitating factors. Imbalances in the synthesis, release, and degradation in gamma-aminobutyric acid (GABA), glutamate, acetylcholine, and the monoamines have also been hypothesized to have roles in delirium. GABA is the primary inhibitory neurotransmitter in the central nervous system (CNS) and medications such as benzodiazepines and propofol have known actions at GABA receptors and have been associated with delirium.
This chapter shows how the United States and the world are experiencing an aging evolution we are growing older. America is going through a revolution. As a whole, Americans are becoming older, and there are many more older people among people than ever before in our history. Obviously all cohorts of the population youth, young adults, middle-aged, young-old, oldest-old are heterogeneous. When some people think about the elderly as a whole, they picture frail, weak, dependent persons, some in nursing homes and many confined to their homes. The chapter demonstrates the differences the various age categories have in relation to selected chronic health conditions that cause limitations of activity. Widowhood is much more common for elderly American women than for older men. The aging of Baby Boomers will solidify the shift America is experiencing with the aging of its population. Centenarians make up a small percentage of the total U.S. population.
The author, Martin Alpert, presents a method by which individual nurses can be independent, improve patient care, have fun, and earn more money. He proposes that the nursing profession become the leader in a shift to sustainable, least invasive therapies and evaluations (LITE). LITE represents a major profit opportunity for nurses. Many of these new therapies require medical professionals, but not necessarily doctors. They can be administered by dedicated and trained nurses. The impact of LITE on the global society of nursing leading this area of medicine could be transformational for nursing, medicine, and society. Nursing could lead in diagnosis and treatment under the LITE paradigm. Acupuncture is becoming part of conventional therapy. It can be a part of nursing practice. Recently, the World Health Organization estimated that 80” of people worldwide rely on herbal medicines for some part of their primary health care.
Mindfulness provides a framework for monitoring the emotions and examining the thoughts as one move through their professional lives. However, for mindfulness to become a way of life, deliberate and consistent practice is required. For many people, that practice is fostered through meditation. Meditation is a cognitive practice where the goal is to focus the mind and foster the capacity to remain centered in the present moment, here and now, rather than be ruminating about the past or worrying about the future. Some practice walking meditation as methods that help to keep attention focused on the present moment and on the immediate sensations within the body. Through meditation, people can easily shift into calm centeredness, a state of balanced equilibrium that allows them to achieve a tranquil state, able to strategically think through the steps of mindful patient care. This chapter shows several techniques that enhance mindfulness and mindful practice.
As a clinical pharmacist, Al Patterson has shared-many experiences with nurses; he reflects on the key dimensions of nursing leadership and describes the similarities between the professions of pharmacy and nursing. He believes that nursing leaders recognize the societal responsibility inherent in their role, and the professional responsibility to provide the most meaningful care to each patient and to structure the environment to ensure safety and quality. There are several things that stand out to me as examples of the transformational nature of nursing leadership: patient advocacy, professional development, and most important, the focus on quality and safety. Initially many department leaders volunteered staff for quality advisor (QA) training, and over 160 teams were formed to address a wide array of problems. Central to the concepts of shared leadership/shared governance is the recognition that the profession must continually improve itself.
Primary progressive aphasia (PPA) is the term applied to a clinical syndrome characterized by insidious progressive language impairment that is initially unaccompanied by other cognitive deficits. This chapter describes several variants of PPA and more than one etiology. It explains three main variants of PPA, namely, semantic Variant of PPA (svPPA), nonfluent/agrammatic variant of PPA (nfvPPA) and logopenic variant of PPA (lvPPA), and also describes criteria for their diagnoses. The defining symptom of PPA is the presence of a language impairment for at least 2 years in the absence of any other significant cognitive problem. Assessment of other cognitive domains is challenging because many tests of memory, attention, executive functioning, and visual-spatial skills rely on language processes in some manner. There are no drug therapies proven to arrest progression of signs and symptoms of PPA due to frontotemporal lobar dementia (FTLD) or Alzheimer’s disease (AD) pathologies.
In order to function effectively, clinicians need to have both confidence in their professional judgment and belief in their clinical competence. The overconfident clinician who ignores opposing evidence or overlooks additional information runs considerable risk of not only making mistakes but alienating patients and families. Hubris is a major source of mistakes within health care. It is this hubris that also accounts for much of the downstream impact of medical mistakes. Patient-provider relationships are especially harmed when clinician hubris inevitably proves unwarranted, the diagnostic conclusions are erroneous, and/or mistakes occur. Mindfulness allows for self-correction, a recalibrating of one’s compassion capacity and an energy re-orientation away from ineffective self-enhancement and a refocus on patient treatment. However, when mistakes do happen, apologies are necessary. Apologies are best when they are sincere and delivered with humility and understanding.
Dementia is an umbrella term for conditions such as Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), vascular dementia (VaD), and frontotemporal dementia (FTD). Under that umbrella, FTD, also known as frontotemporal lobar degeneration (FTLD), can be further categorized to define a group of neurodegenerative disorders resulting from a progressive deterioration of the cells in the anterior temporal and/or frontal lobes of the brain. More specifically, ventromedial-frontopolar cortex is identified with metabolic impairment in FTD. This chapter elaborates on the history, epidemiology, pathophysiology, clinical features, treatment, and outcomes of FTD. The history and background section of each of the FTD categories highlights the evolution of the disease conceptualization. The FTD subtypes are conceptualized in three categories: neurobehavioral variant, motor variant, and language variant. The chapter illustrates the features of all three categories of FTD.
Humans thrive on relationships. Positive interactions are the essence of one’s happiness. Connecting to others, in a positive way, is affirming. There is no more important time for people to feel connected to and supported by others as when they face a serious illness or trauma. When entering the health care system, patients move through seemingly countless encounters with a variety of personnel. Interactions that strain patient-provider relationships are costly for the patient than for the caregiver. Patients who are perceived to be difficult are at greater risk for experiencing nontherapeutic encounters. In order to provide patient-centered care, clinicians need guidelines for how they can consistently assume the kind of demeanor that makes such care part of a conscious choice, a way of being in the health care world. The power of positive regard, conveyed to patients through even the shortest of encounters, can be life changing and life saving.
The author, Arthur G. Cosby speaks about his mother, Lillie Mae Mclntire Cosby; a nurse who led him to understand what constitutes leadership, his responsibilities to others, and the role of women in the modern world. In his mother’s mind, discipline was a critical aspect of good health care. As head nurse, she supervised large number of junior nurses, aids and orderlies, many of whom had limited formal health care training. It was very important to him that he had a mother who could do so many things and do them well. Not only was she a mother and nurturer, she was also a woman who was the breadwinner, who could successfully carry out most any job even the most difficult. Over the course of her career, she actively carried out the health care responsibilities of head nurse, hospital administrator, emergency room nurse, obstetrics nurse, public health nurse and nurse practitioner.
The concept of Mild cognitive impairment (MCI) makes a lot of sense in that individuals are typically not “normal” one day and “demented” the next. In theory, especially for progressive neurodegenerative conditions, such as Alzheimer’s disease (AD), frontotemporal dementia (FTD), the development of dementia may take months or years. The clinical syndrome of MCI due to AD can be identified via a neuropsychological evaluation or less-sensitive cognitive screening measures. Much of what we are learning about MCI, and therefore refining its diagnostic criteria, is coming from two large-scale studies of cognition and aging: Alzheimer’s Disease Neuroimaging Initiative (ADNI) and Australian Imaging, Biomarkers and Lifestyle (AIBL). According to the most recent research diagnostic criteria for MCI due to AD, evidence of beta-amyloid deposition, neuronal injury, and/or other biochemical changes needs to be seen to increase confidence of the etiology of MCI. Cholinesterase inhibitors remain the primary pharmacological treatment for AD.
This book offers leadership lessons for aspiring nurse leaders from luminaries in business, medicine, philanthropy, government, academia, research, and health care. It offers practical advice, lessons learned, and testimonials as to how nurses can prepare themselves for leadership, which in turn, will help them to provide exceptional patient care. As per the report of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), the heightened roles of the professional nurse allow nurses of all practices to more fully develop their leadership skills. Nurse leaders are moving the interprofessional collaboration agenda forward by serving in key leadership positions. A nurse leader who led public research in the Kent State University and Bowling Green State University challenged the common perception that successful leaders are born, complete with the requisite temperament and talents. Nurses who play leadership roles can fill in research on health care policy formulation and implementation that will change the course of health care payment, delivery, and quality. The book discusses nurse research leadership from an economist’s perspective, hiring leaders to understand leadership, and nursing leadership lessons from an association executive’s perspective, from a physician’s chief executive officer’s perspective, from a nursing friend’s perspective and from a collaborative team’s perspective. The book also highlights nursing leadership’s contributions to safety and quality, how leadership can usher in health reforms and achieve better health for all people, and advancing the cause of transformational nurse leadership.
This chapter suggests that the dysexecutive syndrome associated with vascular dementia (VaD) is caused by impairment in separate but related cognitive concepts; that is, pathological inertia, mental bradyphrenia, disengagement, and temporal reordering. During the late 19th and early 20th centuries, cerebrovascular dementia was a well-established clinical syndrome. Multi-infarct dementia (MID) generally became associated with all types of vascular syndromes. Recent research suggests the presence of considerable overlap between the neuropathology underlying Alzheimer’s disease (AD) and VaD. Patients diagnosed with VaD tend to produce hyperkinetic/interminable perseverations, suggesting an inability to appropriately terminate a motor response. Other aspects of the dysexecutive syndrome associated with VaD revolve around constructs related to interference inhibition, flexibility of response selection, and sustained attention. From the view point of diagnosis, the neuropathology of VaD often differentially impacts the frontal lobes, whereas the neuropathology associated with AD revolves more around circumscribed temporal lobe involvement.
Karen Gross shares eight lessons learned about leadership that occurred not from leading per se but from the process of hiring an academic nursing leader. The search now successfully concluded gave her an opportunity to reflect on what type of health care leader they were seeking at Southern Vermont College (SVC). Although not a health care professional, she spent more than 15 months thinking about leadership in the context of nursing. The whole search process from creating the job description to identifying a quality candidates’ pool to interviewing and ultimately selecting a divisional chair to helping the successful candidate see the fit with the institution allowed her to consider what qualities are critical to nursing leadership within the academy. In an interesting way, the search for a leader in nursing enabled her to think more effectively about leadership, and in the world of unintended consequences, made her a better leader.
Dementia pugilistica (DP) is a form of chronic traumatic encephalopathy (CTE) that involves gross impairment of cognitive and motor functioning due to repetitive blows to the head from boxing. Rapidly increasing in popularity among fight fans and fighters is mixed martial arts (MMA). In the area of sport-related concussion, there are two other frequently used terms that are necessary to distinguish from DP and CTE: postconcussion syndrome (PCS) and second impact syndrome (SIS). The classical clinical signs and symptoms of DP include combinations of dysarthria, incoordination, gait disturbance, pyramidal and extrapyramidal dysfunction, and cognitive impairment. Some media reports about concussion and the potential link between repetitive concussions and long-term problems include eye-catching and emotionally provocative titles. This chapter has provided an overview of the many complex issues surrounding the effects of repeat concussive trauma, particularly in sports.
Nurse leaders should be poised for change. One of the common themes across entries was that nurses are central to the changes occurring in health care and that they should seize the opportunities to be in charge of the redesign of the U.S. health care system. There was another strong theme that permeated the entries: that of the knowledge necessary for nurse leaders in health care delivery. To assume leadership roles in a new delivery system, nurse leaders are advised to understand policy and finance and the roles of all team members. Furthermore, leadership must be about the organizational goals, not one’s individual goals. Self-knowledge is essential, including the understanding of how you are reflected in the eyes of others. A high level of self-confidence is essential for leadership. Other important developmental needs for nurse leaders include quantitative skills and technological expertise, including electronic and digital forms of communication.
Interprofessional education (IPE) and collaborative practice are increasingly called upon to improve these domains such as patient care, community health, health care delivery systems respective and overlapping spheres of activity with the larger goal of improving the overall health care system. Nurse leaders are moving the interprofessional collaboration agenda forward by serving in key leadership positions nationally and on local campuses. Nurse leaders, through a combination of their training, professional experiences, and personal preferences, have unique knowledge and skills for which they are enthusiastic champions. Effective leaders apply principles of good communication in their work with individuals and groups. Nurse leaders possess valuable professional knowledge and skills, and when coupled with individual talents and strengths, they offer important assets to the success of a collaborative effort. Nurse leaders should recognize how they can best capitalize on their leadership abilities and confidently apply them.
This chapter talks about mentor intelligence as a source of excellence. In order to perform successfully in a complex profession like nursing, there are beginning threshold requirements such as intellectual intelligence (IQ) and specialized knowledge and skills. Further, it is thought that working at a high level of excellence in one’s field requires emotional intelligence. However, the lack of Mentor Intelligence presents major impediments in developing one’s full potential to the highest level. The chapter provides ten tips for raising nurse’s mentor intelligence. The tips include such as cultivating the three ingredients of Mentor Intelligence, practicing nursing profession in a culture of mentorship and collegiality, sharpening nurse’s communication skills and their message, networking, becoming a mentor-leader, and being a “forever” student of mentoring, and developing the art of mentoring others. Three ingredients of Mentor Intelligence include mentoring mentality; mentoring lens; and mentoring momentum.
The Transmissible spongiform encephalopathies (TSEs) form a group of illnesses, characterized by a pathological form of the native prion protein, which results in a rapidly progressive neurodegenerative illness. They also are responsible for Gerstmann-Strâussler-Scheinker (GSS) syndrome and fatal familial insomnia (FFI), and they have been produced experimentally in several other animals. Creutzfeldt-Jakob disease (CJD) is the most common TSE in humans. Human prion diseases have three etiologies: (a) sporadic, (b) genetic, and (c) acquired. Human prion diseases are important to understand because of their underlying pathophysiology, public health implications, and clinical features that often result in misdiagnosis. This chapter reviews the historical discovery of prion diseases and the formulation of the prion hypothesis. It explores prion hypothesis and the neuropathogenesis of prion diseases. The chapter ends with a description of the diagnosis, prognosis, and experimental treatment of human prion diseases.
The increasingly more complex, diverse, and interdisciplinary facets of the health care system prompted the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) to join together and assess the current state of health care, thus issuing a “call to action” by the nursing profession. This monumental report challenges nurses to practice to the full extent of their training, transform health care and improve research and information systems. The heightened roles of the professional nurse allow nurses of all practices to more fully develop their leadership skills. The author’s, Greer Glazer, personal and professional life changed when she was notified by the RWJENF Program that she was a finalist for their leadership program. Doctor of Nursing Practice (DNP) programs are designed to prepare nurses for the highest level of leadership in practice that is innovative, evidence based, and reflects application of research.
Dementia with Lewy bodies (DLB) is a clinical syndrome characterized by progressive dementia, cognitive fluctuations, visual hallucinations (VH), and parkinsonism. In 1961, Okazaki, Lipkin, and Aronson reported two patients with dementia and parkinsonism with cortical neuronal inclusions similar to the brain-stem Lewy bodies (LB) seen in Parkinson’s disease (PD). LBs are intra-cytoplasmic neuronal inclusions containing α-synuclein and ubiquitin. There are other associated pathological features in DLB such as spongiform change neuronal loss, and Alzheimer’s disease (AD) pathology includes amyloid plaques and neurofibrillary tangles (NFTs). DLB and other entities such as PD and multiple system atrophy (MSA) have been grouped under the term synucleinopathies due to the existence of α-synuclein inclusions in the brain. The central feature required for a diagnosis of DLB is the presence of dementia: a progressive cognitive decline of sufficient magnitude to interfere with normal social or occupational function.
Steven A. Wartman, the author, provides key advice for potential and aspiring nurse leaders. He advises to let go of the guild mentality, particularly important for nurses who aspire to leadership positions that transcend nursing. Nurse’s perspectives are invaluable in bridging the gap between the technical experience of health care and its meaning in the lives of patients and their families. Nurse leaders are advised to become transformational rather than transactional leaders, and to move beyond the rewards and punishments inherent in transactional leadership styles. Transformational leadership is especially challenging, given the traditional hierarchies in the medical fields and academia. To provide the most effective and “transformational” leadership, potential nurse leaders should focus their efforts on four areas: eliminate the “guild mentality”; change restrictive policies and regulations that weaken the role of nursing; seek to become a “transformational” leader; and learn to take the ego out of the job.
This chapter describes an overview of the procedures that a neuropsychologist may apply to a range of similar referrals in the area of civil capacities. It explores the presentation of a framework developed by the American Bar Association/American Psychological Association (ABA/APA) working group on capacity issues and provides more specific guidance regarding assessment tools. Decision making is a complex cognitive process that involves multiple brain regions and brain systems. Injuries to the prefrontal cortex are common in dementia and are often linked to changes in decision-making abilities. Key differences between clinical assessments and those for capacity evaluations include knowledge of relevant legal and ethical issues, a functional assessment, and an ability to present neuropsychological data to lay readers. Research on medical consent capacity and financial capacity highlight the importance of the assessment of calculation, executive function, and verbal memory as part of any test battery.
This chapter discusses the historical background of the mentor connection and mentoring relationships in nursing, different types of support relationships and mentors. It also discusses why and when nurse need mentors and early career challenges and mentoring. The mentor connection is a developmental, empowering, nurturing relationship extending over time, in which mutual sharing, learning, and growth occur in an atmosphere of respect, collegiality, and affirmation. Clearly, mentor connections and networks were integral to the developmental experience of successful career-oriented men. Mentoring is a vital component of professional nursing and that mentors are essential for nurses’ ongoing development and leadership achievement. In organizations, mentoring relationships serve as an antidote to disrespectful attitudes and behaviors among nurses and physicians and other health care providers. Mentors mentoring activities can be broken down into two categories: career functions and psychosocial functions.
Chronic alcohol use has been related to various linked disorders when used in excess, particularly when this excessive use becomes chronic. It is important for clinicians to clarify the amount and type of alcohol being consumed and the frequency of this consumption when considering its potential role in any neuropsychological profile. The most commonly reported terms found in the literature include alcohol-induced persisting dementia (APA), alcohol-related dementia, and Korsakoff’s syndrome (KS). This chapter provides some synthesis of this literature to offer some clarity on cognitive dysfunction as it relates to alcohol and the manifestation of dementia as a result of chronic use, including discussion of the classic KS and related presentations. Alcohol dependency is commonly associated with a number of neurological impairments including deficits in abstract problem solving, visuospatial and verbal learning, memory function, perceptual-motor skills, and even motor function.
Kate Judge’s first glimpse of nursing leadership in action came the day she arrived at the University of Pennsylvania School of Nursing for an in-person interview to lead Penn Nursing’s development and alumni relations program. During her 8 years at Penn Nursing, she collaborated with a number of faculty members who were gifted in attracting philanthropy. Leadership in philanthropy combines a deep personal moral purpose and the perfect balance between impatience for immediate impact and a desire to achieve long-term outcomes. To be a nurse leader in philanthropy, one must expose oneself to other values, interests, and priorities. Nursing can assume a larger role in tomorrow’s health care delivery if it commands a larger portion of U.S. and global philanthropy. Finally, to be leaders in philanthropy, nurses need to educate themselves about the larger world and the values and issues that resonate with donors.
This chapter presents what it means to be a professional nurse, the difference between a career and an occupation, the seasons and stages of a nursing career, and the value of collegiality in a nursing career. Professional nurses are expected to expand their knowledge and expertise throughout the different stages of their careers in order to provide safe comprehensive health services to the public in accordance with contemporary best practices. The chapter highlights the key elements of professional nursing as described in Nursing’s Social Policy Statement, Code of Ethics for Nurses, Nursing: Scope & Standards of Practice, and a State Nurse Practice Act. All life and career developmental models acknowledge the central importance of support persons in the life and career journey of every human being. Professional nurses demonstrate collegiality with each other by respecting, mentoring, and advocating for nursing students and nursing colleagues.
Barry H. Smith’s opening is significant: that nursing care is at the core of humanity. He recounts his own experiences with nurses, when as a surgical resident he learned the value of team work, and developed a respect for the nurses who were so tuned in to the needs of the patients and families. Smith asserts that nurses must be the central point of any health care system, and yet many factors have converged to keep nurses in a subservient role within health care. Today, there are Nurses Aides, Licensed Practical Nurses, Registered Nurses, Nurse Practitioners, and those with doctorates in nursing, with an increasing premium being placed on advanced nursing clinical practice, as well as research. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
Disgust may seem like an odd topic to highlight in a book dedicated to enhancing patient-provider relationships, but it bears special consideration given that it is rarely openly discussed even though it is a common phenomenon. In the course of the authors’ work, clinicians are exposed to patients’ most basic human products: urine, feces, pus, blood, and vomit, to name a few. The authors encounter smells, see anatomical parts, hear bodily sounds, and touch things that people outside of health care can only imagine. Some of these things are very difficult to experience, and yet doing so is not only part of the job, but doing so graciously, with acceptance and sensitivity, is a gesture of compassion. Being in a state of mind to make that compassion happen is aided by mindfulness. This chapter provides an example of a forty five year-old woman with end-stage pancreatic cancer.
Listening is an obvious and often overlooked aspect of high-quality patient care. Given the environment in which modern health care is provided, the ability to stop, shift, and turn one’s full attention to a patient and family, to their thoughts, feelings, and needs, means having to temporarily “turn off and tune out” all manner of distractions. Being able to focus is a core aspect of mindfulness. To engage in quality listening is a commitment, made over and over again, in the service of effective patient care. Vulnerable patients who express doubt about the suitability of their treatment or question the clinician’s opinion run considerable risk of being marginalized or treated with dismissive indifference. When a patient challenges a provider’s perspective, conclusion, or diagnosis, the clinician needs to honor that challenge; have the emotional maturity and humility to use the patient’s concerns as data.
This chapter explores the importance of risk prevention in mentor relationships, about potential roadblocks for mentors and protégés, and how to manage change in the mentoring experience. Good risk prevention includes agreeing with nurse’s mentors on basic expectations about their goals and outcomes, frequency of contact, roles their mentor can play, expected performance of both partners, and how to address problems if they arise. Studies have reported various types of mentoring relationship problems such as unrealistic expectations, personal and professional mismatches, power and control issues, excessive competitiveness, “cloning”, communication, and dependence. Abuses of power in the mentor relationship occur when there are instances of manipulation, exploitation and excessive demands of loyalty and conformity by the mentor. Frequent, open, and honest communication is the foundation of healthy mentor relationships. The power and magic of mentor relationships are reflected in the achievements, joyful sharing, and professional and life connections between mentoring partners.
This chapter presents how to create a Personal Mentor Action Plan, types of mentors and where to find them, selection process of the mentor and the protégé, and how to inventory individuals and groups as potential mentors. The elements of this Action Plan are vision and goals, mentoring strategies, implementation activities, and mentoring outcomes. Potential mentors can be found at nurse’s workplace, conferences, classrooms, clinical units, meetings, and conventions. Two main types of mentor relationships will boost nurse’s career development: relationships that are “chosen” by the mentor and protégé, and relationships in which mentors and protégés are “matched” or assigned in a formalized program. “Assigned” mentors are found in on-the-job mentor programs, professional associations, specialty nursing organizations, and community volunteer programs. Currently, professional nursing and student associations are very proactive in offering formal mentor programs that address their members’ needs in various ways.
Frontotemporal dementia (FTD) is the third leading cause of dementia in large pathological series but tends to have an earlier age of onset than Alzheimer’s disease (AD) and Lewy body dementia, the most frequent and second most frequent forms of dementia. Semantic dementia (SD) includes impairment in the understanding of the meanings of words and difficulty in identifying objects. Semantic primary progressive aphasia, also known as SD, includes difficulties with naming and single-word comprehension although grammar and fluency are often spared. SD is a disorder that involves loss of semantic memory, anomia, receptive aphasia, and an actual loss of word meaning. The chapter presents some assessment tools that are those conducted by a psychologist or a neuropsychologist. Such an evaluation should include a clinical interview and neuropsychological examination. SD has been associated with ubiquitin-positive, TAR-DNA-binding protein-43 (TDP-43)-positive, tau-negative inclusions.
The range of emotions experienced by clinicians spans the spectrum of human emotions in general, but certain emotions are particularly challenging for those working in health care settings. Anxiety can be an almost constant companion for the first year or two of practice, until time and experience help them begin to feel more comfortable in their roles. Through consistently witnessing the suffering of others, clinicians can easily absorb their patients’ sadness, frustration, and even despair. Horror, grief, shock, and outrage are normal responses that many clinicians experience when faced with patients whose suffering comes as the result of violent or traumatic events. Tired and fatigued, some clinicians hope to call upon the psychiatry service to contend with the patients who dramatically display suffering. This can occur in situations where the patient’s emotions are quite understandable, and are no reflection of psychopathology. Mindfulness provides a framework for mentally processing distress-provoking situations.
This chapter discusses how to find and keep mentors, compatibilities that contribute to the mentoring “match”, ground rules for productive mentoring, and transitions in the mentor-protégé relationship. Nurses find that they benefit from both expert and peer mentors, particularly at transitional points throughout their career. Openness and a curiosity to learn are crucial qualities in a mentor relationship. In the early stages of the relationship, the mentoring partners should discuss and mutually agree on: goals and expectations, time management, work approaches and boundaries, and feedback opportunities. From the beginning of the mentor relationship through each evolving phase, it is essential to engage in ongoing review and evaluation of the protégé’s changing needs, career goals, personal expectations, and key outcomes. Review and evaluation help both mentor and protégé to gain insight and confidence to move forward with new challenges and new goals. Reciprocal rewards are always part of mentoring outcomes.
Alzheimer’s disease (AD) and related cortical dementias are a major health problem. Patients with AD and related dementia have more hospital stays, have more skilled nursing home stays, and utilize more home health care visits compared to older adults without dementia. This chapter discusses the role of family caregivers and how they interact with in-home assistance, day care, assisted living, and nursing homes in the care of an individual with dementia. It also discuss important transitions in the trajectory of dementia care, including diagnosis, treatment decision making, home and day care issues, long-term care placement, and death. It highlights the importance of caregiver assessment, education, and intervention as part of the care process. Dementia caregivers are at risk of a variety of negative mental health consequences. Another important moderating variable for dementia caregiver distress is self-efficacy.
Vascular dementia (VaD) is an umbrella term representing a clinical grouping with inherent heterogeneity in its clinical manifestations reflecting a variability in its underlying etiology. This chapter discusses specific presentations that can fall under the VaD heading. It includes discussion of multi-infarct dementia (MID) and dementia associated with lacunar states (LSs), as well as Binswanger’s disease (BD), which remains embroiled in controversy. The chapter discusses cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and moyomoya disease due to their clinical overlap. The etiology of MID is in many ways the same as the etiology of cerebrovascular disease (CVD) in general and even late-life dementia. The term MID itself is used to describe a disorder characterized by a stepwise deterioration of cognitive functioning associated with strokes or accumulated transient ischemic attacks (TIAs).
The care management nurse faces a different task than the nurse in the inpatient or outpatient setting. The focus for the latter is typically narrow: care for the patient during the acute treatment, then releases the patient to home, a nursing facility, a step-down unit, and so on. This chapter discusses the Triple Aim of care, health, and cost, which serves as a framework to discuss other key dimensions of leadership in managed care. A nurse leader’s basic skill set is similar to that of a nurse leader in any role. Innovative organizations are realizing that successful clinical management can be a huge competitive advantage for both employers and health plans. This sector of the medical industry is poised for explosive growth as population health management takes center stage in the era of health reform.
Louise Woerner, the author has often been called a friend of nursing. From her perspective, she is an admirer of nursing and nurses. In fact, she is virtually in awe of nurses. She became part of the health care system through a turn in her business concept based on the regulatory environment in New York, and through that, an admirer of nurses. Over the course of her career, she has come to know there are many different types of nurse leaders. Leadership has to incorporate some exibility based on the situation and the goal. Home Care Rochester (HCR) began a successful “Roadway to Independence” program that took the home health aide employees from “bussers” to car owners, which enabled more care to be delivered in the hard- to-reach suburbs, and offered a new opportunity for both the patients and employees. Home care is a nursing-driven business with quiet leaders.
Nurse mentors can inspire and “champion” other nurses, as well as model and imprint the highest standards of excellence. This book provides insight for protégés and mentors on using mentoring to build new generations of successful nurses. It covers a quick history of why mentoring is important, and how a protégé can identify and mentor. It also contains the necessary tools to help novice nurses benefit from mentor support through difficult and sometimes frightening and confusing times. The first two chapters discuss what it means to be a professional nurse, the difference between a career and an occupation, and present the historical background of the mentor connection and mentoring relationships in nursing, different types of support relationships and mentors. Mentor intelligence has three characteristics or competencies namely mentoring mentality, mentoring lens and mentoring momentum. Chapter four explains how to create a Personal Mentor Action Plan, types of mentors and where to find them, selection process of the mentor and the protégé, and how to inventory individuals and groups as potential mentors. After dealing with the factors leading to success and failure and cultivating a nurse’s potential, the book describes the need of networking as an essential marketing tool. The book concludes by presenting tips to increase mentor intelligence after talking about healthy mentor-protégé relationship and mentor leadership.
This chapter presents about success and factors leading to success, cultivating nurse’s potential and talent through Mentor Intelligence, how to be a “perfect” protégé, the difference between mentoring and “tormenting” behaviors, and about mentoring cultures: “places of realized potential”. Becoming a successful nurse, athlete, lawyer, musician, chef, or entrepreneur- the success factors are the same: a hodgepodge of individual, collective, and environmental forces. Like success, talent develops as a combination of many personal, interpersonal, and external factors. Nurses can raise their Mentor Intelligence by activating their mentoring mentality, mentoring lens, and mentoring momentum. Nurses work in highly bureaucratic systems in which they may feel disrespected, unsupported, and powerless- leading to angry and oppressive behaviors toward colleagues. The Joint Commission states that “intimidating and disruptive behaviors” can foster medical errors, contribute to poor patient satisfaction and preventable adverse outcomes, increase the cost of care, and cause employees to leave the organization.
This chapter provides the basics of networks and networking, how and where to make connections, and the successful networker’s important skills and tools. A network is a web of interpersonal and technological connections and relationships. In the nursing profession there are numerous specialty associations that are highly organized to help their members connect face-to-face with each other. These networking connections serve many purposes: learning about new trends, engaging in policy and political action, and mentoring each other. Tapping into online networks, such as forums, discussion boards, listserve groups, and blogging sites, has become essential for expanding personal and professional contacts. Online social and professional engagement has created effective networking opportunities. Global sharing and electronic mentoring are now possible with professional colleagues around the world. Nurses have a strong networking advantage for sharing and making connections. Networking tools include an up-to-date resume, business cards, address books, and electronic networking sites.
Jerry Cromwell has a rich history of both preparing nurse leaders in research and collaborating with nurse researchers. On the basis of his extensive experience, he offers cogent advice on leadership roles that nurses can fill in research on health care policy formulation and implementation that will change the course of health care payment, delivery, and quality throughout the United States. Cromwell believes that nurse researchers can provide leadership through the development of skills in management, program development, research, and teaching. To illustrate the characteristics of nurse research leaders, Cromwell describes one such leader with whom he has worked for more than two decades. He details her skills in project leadership, her technical research skills, and her management skills. Cromwell also identifies other nurse researchers who are leading policy development at the government levels, including those at some of the top federal agencies.
- Go to chapter: Family Televisiting: An Innovative Psychologist-Directed Program to Increase Resilience and Reduce Trauma Among Children With Incarcerated Parents
Family Televisiting: An Innovative Psychologist-Directed Program to Increase Resilience and Reduce Trauma Among Children With Incarcerated Parents
This chapter identifies how psychological frameworks can be integrated into a cohesive, multigenerational intervention to connect children with their incarcerated parents. It describes scenarios through which televisiting develops resiliency in children. The chapter delineates how geographic, financial, temporal, and intergenerational barriers can be reduced or removed via televisiting. It describes supportive televisiting services as an innovative, psychologist-directed, multidisciplinary program that connects children and teenagers with their incarcerated parents via secure, live, interactive video teleconferencing. The chapter also discusses the seven main pillars that make up the theoretical foundation of the televisiting program: child-focused; the attachment theory; trauma-informed care; resilience and strengths-based perspective; mental health challenges; the developmental, life-span, and intergenerational approach; and yellow flag not red flag policy.
- Go to chapter: Restorative Justice and Community Well-Being: Visualizing Theories, Practices, and Research—Part 1
This chapter introduces the theoretical basis for restorative justice (RJ). It assesses the empirical evidence for RJ programs, and explores the challenges and opportunities associated with applying core competencies. The chapter describes competencies of specific interest which include: engaging diversity and difference in practice, and engaging with individuals, families, groups, organizations, and communities. It also discusses skills essential to the success of RJ which include supporting processes that value the experiences of people associated with a crime or harm. The chapter suggests the importance of practical and context-specific knowledge and skills relevant when individuals, families, groups, organizations, and communities find themselves in conflict and require support. Programs that rely upon restorative principles have been used at a variety of points in the criminal justice process. The chapter discusses a practice, a family group conference, which was first developed in New Zealand involving social workers considerably.
This chapter presents the Mentor Readiness Assessment, how to determine a good “mentor match”, the Mentor Intelligence framework, and assessment of nurse’s Mentor Intelligence. Nurses who want to be mentored should take a critical look at the impressions they make on people who could be potential mentors. Mentoring is a personal relationship and requires relationship skills and time. It is a complex relationship involving both personal and professional aspects. Recording perspectives in a journal can be a springboard for gaining self-knowledge and confidence in nursing practice. Mentor intelligence has three characteristics or competencies namely mentoring mentality, mentoring lens and mentoring momentum. Mentor intelligence can make significant contributions to empowerment and leadership in the nursing profession, in addition to the individual benefits that one and other nurses will find. Every student and every nurse should develop mentor intelligence for talent development and career achievement.
This chapter talks about becoming a mentor-leader: Beliefs and behaviors, mentoring across cultures and generations, and mentor as Pygmalion: Believing in potential and expecting success. Nurses can learn leadership by observing good leaders, mentors, and role models; studying leadership theories and research; testing leadership behaviors through work and professional association activities; and using reflective learning to develop and fine-tune nurse’s behaviors. Mentor-leaders are present in every cultural and ethnic group and in every generation. Global, cross-cultural, and cross-generational mentoring occur when nurses are open and receptive to learning from each other and are willing to share their unique perspectives and skills. The nursing profession has an impressive track record of global collaboration and mentorship. Through mentor bonds that break down global and cultural boundaries, nurses have unprecedented opportunities for driving change in health and nursing around the world.
This chapter discusses the concepts, underlying principles, benefits, and challenges of using “whole-family” approaches in social work. It articulates the theory and skills associated with family engagement as part of a human rights and social justice framework for social work practice in forensic settings. The chapter describes the ethical imperatives and evidence base supporting the use of family group decision making (FGDM) in regulatory settings. It engages whole families as partners in the use of FGDM in child protection and youth justice. The chapter also describes the theory, empirical support, and skills in use of FGDM, or family group conferencing (FGC). It concluded with an example of how alert forensic social workers must be to the potential for their best intentions to collide with the tenants of responsive practice and a quote from a child protection social worker who worked closely with the author on a pilot project using FGC.
This chapter presents ways in which forensic social workers respond flexibly, collaboratively, and effectively to situations of domestic violence. It describes ways to engage men who abuse in becoming better fathers and partners. The chapter examines how social workers can foster culturally respectful partnerships with and around families that safeguard all family members. Few services are available for men who abuse to learn how to become responsible parents, and evaluations of these programs are even more limited. Two exceptions are a Canadian program called Caring Dads and a North Carolina program called Strong Fathers. These responsible fatherhood programs seek to raise the men’s awareness of the deleterious impact of children’s exposure to domestic violence and to enhance the men’s skills in communicating and parenting.
- Go to chapter: Thinking Outside the Box: Tackling Health Inequities Through Forensic Social Work Practice
This chapter emphasizes the importance of improving health literacy. It describes the incorporation of cultural competence standards in forensic social work practice perspectives. The chapter also explains how to promote engagement of informal support networks in promoting health and well-being among diverse groups. Disadvantaged racial and ethnic minorities in the United States have long been overrepresented in the criminal justice systems. The elimination of health care disparities and ensuring the health care delivery system is responsive to minority groups is a social justice issue. The roles and function of forensic social workers that provide services to persons with these cultural norms can be expanded using a broader ecological framework and the applied social care model to develop intervention strategies and care plans with incarceration persons. Identifying and incorporating culturally appropriate practice approaches are challenging, yet necessary undertakings for forensic social workers.
This chapter highlights the critical importance of nurse collaboration in international settings, particularly with nursing organizations across borders. Such collaboration is essential in partnership formation and builds on the concept of bridging cultures and mutual respect of both nurses and host partners. In many cases, such collaboration builds capacity for nurse partner organizations. The chapter defines different types of organizations relevant to global health and addresses the importance of nursing organizations to the advancement of the profession. It also provides the mandate to collaborate globally with nurses and nursing organizations. The chapter provides some examples of organizations in the United States to offer a comparison for emerging organizations in distant global settings. It presents a case study on collaboration With Rwanda after the 1994 civil war. The chapter also presents a case study on promoting the profession of nursing through collaboration with nursing organizations in Romania.
- Go to chapter: Intersectoral Collaboration: Mental Health, Substance Abuse, and Homelessness Among Vulnerable Populations
Intersectoral Collaboration: Mental Health, Substance Abuse, and Homelessness Among Vulnerable Populations
Substance abuse is a significant problem among persons who are homeless. This chapter explores the application of addiction recovery management (ARM) principles for developing practice skills in the recovery process among vulnerable populations. It examines demographic and social action factors that may impede or foster successful completion of this long-term recovery for persons who are experiencing home insecurity. The chapter offers insight for forensic social workers about how to engage diversity and differences in practice, as well as advance human rights and social, economic, and environmental justice. Analytic concepts in forensic social work can enhance the capacity of educators to prepare practitioners to be effective in closing the gap that exists for racial disparities in treatment approaches and programs. Critical race theory can be used to develop guiding principles for competency-based education and outcomes that address the gaps in existing systems of care.
This chapter describes how forensic social workers can develop their expert witness testimony skills. It explains how to advocate on behalf of vulnerable racial and ethnic populations generally underrepresented in American legal system, to increase advocacy from a human rights perspective. The chapter explores how to use expert testimony to highlight a range of social justice issues including human trafficking, death, and persecution. It introduces forensic social workers to integrating narrative methods with evidence-based trends that can best support any legal claim for hardship. Expert witness testimony comprises core mitigation components: client interviews; collateral interviewing; obtaining institutional records; identifying core themes of hardship that have directly impacted the individual or family; identifying intergenerational patterns of illness and/or systemic traumas that impact family; identifying environmental and country conditions; writing a report; and preparing for direct testimony and cross-examination.
This chapter aims to disseminate theoretical and practical knowledge of practice using an empowerment and feminist perspective specifically when working with marginalized and oppressed forensic populations and in forensic settings. Forensic social work focuses on both victims and offenders, and strives to integrate the skills and knowledge of empowerment and feminist theory and practice with principles of social justice and human rights. The chapter discusses empowerment and feminist theories and their relevance to practice with forensic populations. It highlights a case example of group work with women, who were sexually abused, that was first presented in the 1990s and told from a strengths-based approach, but could very much be considered both a feminist and empowerment process of working. The chapter also highlights applying an empowerment approach to working with female and male prisoners in London.
- Go to chapter: Life Course Systems Power Analysis: Understanding Health and Justice Disparities for Forensic Assessment and Intervention
Life Course Systems Power Analysis: Understanding Health and Justice Disparities for Forensic Assessment and Intervention
This chapter describes the life course pathways of cumulative health and justice disparities experienced by historical and emerging diverse groups, which is often found among forensic populations. It helps readers articulate a life course systems power analysis strategy for use with forensic populations and in forensic settings. The chapter demonstrates how a data-driven and evidence-based assessment and intervention plan can be used to address clinical and legal issues using case examples of an aging prison population. It uses older people in prison to illustrate the complex life course of health and social structural barriers and needs of incarcerated people who have histories of victimization and criminal convictions. Information about trauma and justice, especially related to the trauma of incarceration, which in itself is often a form of abuse, especially when frail elders are involved and they are at increased risk for victimization, medical neglect, and “resource” exploitation is presented.
This chapter defines restorative justice and discusses the various forms that this approach to wrongdoing and offending may take. It reveals the relevance of restorative interventions to social work practice. The chapter recognizes pioneers in the field of restorative justice with special emphasis on social work theorists. It describes the various forms of restorative justice from micro level victim-offender conferencing to community-level healing circles to macro level reparative justice. The chapter argues for greater social work involvement in shaping policies that include restorative justice options in situations of wrongdoing and social work involvement in facilitating victim–offender and anti bullying conferencing. The chapter also describes aspects of restorative justice that address competencies related to advocacy for human rights and issues of spirituality.
This chapter illustrates how factors outside of families affect lives of people within families. It examines the potential impact that two major issues—work-family conflict and mass incarceration—can have on the lives of family members. The chapter describes ways in which laws governing systems external to families, particularly work and criminal justice, can disrupt families in ways that may lead them to use social workers. It aims at providing necessary understanding of how social workers can help support such families, keeping in mind that family needs often develop from the social and economic context in which each family is situated. The chapter discusses the relevant ethical, legal, and policy issues facing work-family conflict and mass incarceration. It encourages social workers to look beyond the individual—to the systems in which individuals are situated, to better understand the behaviors, decisions, and mental health of individual clients.
- Go to chapter: The Criminal Justice System: A History of Mass Incarceration With Implications for Forensic Social Work
The Criminal Justice System: A History of Mass Incarceration With Implications for Forensic Social Work
This chapter aims to provide social workers with a historical and contemporary understanding of mass incarceration in the United States. The goal is to facilitate informed forensic social work practice and advocacy with individuals, families, and communities impacted by this destructive phenomenon. The chapter examines the prevalence of jails and prisons, as well as an overview of the people who inhabit them. It discusses the core roles and functions of forensic social work. Restorative justice is often hailed as a prevention, and/or intervention, in justice settings. High levels of suspensions have seen schools become feeders not for college, but for the juvenile, and adult criminal justice systems. This phenomenon has been titled the school to prison pipeline; its impact can be felt predominantly among poor students of color. Research has demonstrated the effectiveness of restorative justice in both juvenile justice and school settings.
This chapter discusses in detail the scope of the problem of child maltreatment, and current evidence-based assessment and interventions in the child welfare system. It covers the history of child protection legislation, and describes the foster care crisis in the United States, including the foster care to prison pipeline, the impact of parental incarceration, and current policies such as reforms in the juvenile jurisdiction system. Additionally, trauma-informed care and the juvenile jurisdiction system is examined in light of recent trends to more closely align systems of care with neuroscience research and best practices for serving children and adolescents. The chapter reviews the relevant theoretical and practical approaches, including the application of neuroscience research, trauma-informed care, father engagement, and addressing secondary trauma among child welfare professionals. It also presents a case study and challenges of working with incarcerated fathers who may have children in the child welfare system.
This chapter provides an orientation to the critical issues, history, trends, policies, programs, and intervention strategies of the juvenile justice system. It reviews the types, functions, and legal responsibilities of the various juvenile justice agencies and institutions. The chapter describes the case flow within the juvenile justice system. It also discusses systems of care in juvenile justice, and specialized assessment and treatment issues with adolescents, including sexually abusive youth. It explores the foundation and groundwork for the study of juvenile delinquency and juvenile justice system while delineating the legal definitions of juvenile status offenses and juvenile delinquency, examining the nine steps in the juvenile justice case-flow process. The chapter also gives attention to systems of care, the link between trauma and delinquency, as well as the assessment and treatment considerations for forensic social workers when addressing the specialized needs of juveniles in the justice system.
Forensic Social Work, 2nd Edition:Psychosocial and Legal Issues Across Diverse Populations and Settings
The growing public awareness of bias and discrimination and the disproportionate involvement of minority populations, especially based on race, class, and gender, have affected the social work profession with a call to fulfill its long-forgotten mission to respond and advocate for justice reform and health and public safety. Forensic social workers practice far and wide where issues of justice and fairness are found. This book emphasizes on the diversity of populations and settings, social workers would best serve their clients adding a forensic or legal lens to their practice. It targets the important and emerging practice specialization of forensic social work, a practice specialization that speaks to the heart, head, and hands (i.e., knowledge, values, and skills) of social work using a human rights and social justice approach integrated with a forensic lens. The book defines forensic social work to include not only a narrow group of people who are victims or convicted of crimes and subsequently involved in the juvenile justice and criminal justice settings, but broadly all the individuals and families involved with family and social services, education, child welfare, mental health, and behavioral health or other programs, in which they are affected by human rights and social justice issues, or federal and state laws and policies. Practitioners who read this book will learn and apply a human rights legal framework and social justice and empowerment theories to guide multilevel prevention, psychosocial assessments, and interventions with historically underserved individuals, families, and communities, especially using the life course systems power analysis strategy and family televisiting. The book fills a critical gap in the knowledge, values, and skills for human rights and social justice–focused social work education and training.
This chapter describes a forensic practice framework using a human rights and social justice systems approach. It articulates the definition and theme-based strategies that distinguish forensic social work from social work practice as usual. The chapter then proposes an integrated theoretical perspective that the authors refer to as a human rights and social justice systems (HR-SJS) approach. This approach helps to visualize forensic social work practice in any practice setting. The chapter also reviews the history of forensic social work using the United States as the case example to illustrate how a two-pronged approached to practice was integrated throughout this specialized arena of practice. A review of forensic social work history shows that well over 100 years ago, social workers understood that government, as author and institutor of policy, can and should be an arena for reform.
This book presents a framework for nursing to build and, ultimately, sustain partnerships. Exemplar case studies written by nurses working in global health follow each chapter to illustrate specific elements of a strong partnership. The guiding principle for the book is that partnerships are paramount in creating sustainable outcomes. Varying degrees of partnership integration can include coordination, cooperation, and close collaboration. No matter their degree of partnership, nurses are ethically and morally obliged to be concerned with the world’s suffering. The book begins with a chapter which discusses types of existing partnerships and how nurses make the selection of an appropriate program to begin a partnership. Chapter 2 addresses how cultural perspectives, personal attributes, expectations, and knowledge of host country influence a volunteer nurse’s experience. In the third chapter, nursing roles in host country are addressed, community assessment as essential knowledge is highlighted. The importance of nursing licensure, mutual respect, and partnership is also dealt with. Chapter 4 presents examples of nurses’ experience with volunteers or partners, differences in the scope of practice between nursing partners, and the role of the nurse and nursing profession in host countries. This is followed by chapter which emphasizes the importance of resources, whether human, material, or financial, which are essential in developing a partnership. Two other chapters discuss important aspects of collaborative nursing research in international settings and explore the elements of sustainability to address the leadership required to maintain the partnership.
This chapter promotes understanding of the intersection of social work case level practice skills and social welfare programs and policy. It describes the social work advocacy process, and explores how social and political values impact accessibility to social welfare programs. It assists social workers in developing competence in policy practice and in case and policy advocacy. The chapter also helps social workers recognize when social welfare and economic policies are not fairly distributed, and to become skilled in taking action at the micro-, mezzo, and/or macro level. It discusses the interaction of direct practice with case advocacy to underscore the critical need to understand and interpret policy to achieve social justice. The chapter further highlights the importance of social workers engaging in case and policy advocacy to achieve a socially just outcome for any individual or group, especially those impacted by involvement in the criminal justice system.
This chapter enhances the understanding of the multifaceted challenges that individuals, especially older adults, seeking housing with a criminal background face. It reviews the ways in which individuals, especially older adults, can be vulnerable in terms of safety and security in their housing settings. Older adults may be particularly concerned about security and safety at home because their homes have been shown to be places where they can be victimized, either by telephone scams, door-to-door solicitation, bullying in age-congregate settings, and witnessing other crimes occurring in their residences. The chapter discusses ways in which forensic practitioners can support vulnerable populations, including older adults. It also discusses the complexities of affordable and safe housing using case examples and descriptions focusing on the older adult population. The chapter provides further recommendations on other areas of assessment and intervention that forensic social workers can conduct.
This chapter explains the paths and obstacles that immigrants face when they navigate the justice system in an attempt to stay in the United States. It provides an overview of what happens to an immigrant who seeks to enter the country “legally”, as well as the challenges for an immigrant who enters the country without authorization. The chapter also discusses paths to authorized immigration, including application for resident visas using the family- or merit-based immigration systems. It provides an insight into why 11.9 million immigrants have entered the United States without authorization rather than attempt legal means to immigrate. The chapter primarily focuses on those who either crossed the border without authorization or who remained here despite the expiration of their visas. It further explores how social workers can support immigrants who are involved in the immigration justice system.
This chapter focuses on partnerships between low- and middle-income countries (LMICs) and higher income countries (HICs). It presents information about three types of international partnerships. The first type is partnerships that focus on academic education, prelicensure as well as advanced degree programs. The second type is partnerships that focus on advances in professional nursing, which provide professional development for nurse leaders and clinicians in specific settings and capacity-building measures for the profession in the host country. The third type is partnerships that provide direct clinical care or improve a specific aspect of health care in a developing country. The chapter addresses the host partner factors and presents a case study that reports on the educational partnership between the Alice Ramez Chagoury School of Nursing (ARCSON), the Lebanese American University (LAU), and the University of New Mexico College of Nursing (UNMCON).
This chapter examines the significance for vulnerable groups of social welfare policies and advocacy to meet basic human needs. It identifies key policies and programs established to meet needs of income, food, and shelter. The chapter encourages students to begin using research and statistical data to assess needs and adequacy of programs. It also identifies social work’s role and skills in addressing needs of vulnerable groups. The chapter focuses on the key role of social work professionals in establishing, maintaining, and improving programs needed to ensure a basic level of income for families with children (i.e., income security), access to adequate nutrition (i.e., food security), and access to adequate shelter (i.e., housing security). It also discusses the challenges faced by social workers who serve populations with the basic human needs, including offenders and victims of crime.
This chapter deals with interviewing techniques that have been empirically found to elicit the most detailed and accurate information when conducting a forensic interview. It describes three evidence-based best practices for forensic interviewing. The chapter also delineates the ways in which interviewer beliefs and expectations can bias the interview. It describes forensic interview as the first step in the investigation, when an allegation of child sexual abuse is referred to Child Protective Services. Although there are a number of forensic interviewing models, all consist of sequential phases or stages and include the following: rapport building, substantive phase, and closure. Forensic interviews should be video- or audio-recorded, so that a clear record of the interview is preserved. The chapter also discusses some of the main points in the NICHD protocol and the Michigan protocol for best practices.
- Go to chapter: Substance Use and Co-Occurring Psychiatric Disorders Treatment: Systems and Issues for Those in Jail, Prison, and on Parole
Substance Use and Co-Occurring Psychiatric Disorders Treatment: Systems and Issues for Those in Jail, Prison, and on Parole
This chapter describes how mental health and substance use interact with criminal justice involvement. It examines the common assessment and intervention strategies for co morbid mental health and substance abuse in forensic population and settings. The chapter gives a brief review of how substance use disorders co-occur with psychiatric disorders. The chapter describes prevalence of co-occurring disorders such as anxiety/depression, bipolar disorders, psychotic disorders, personality disorders, and posttraumatic stress disorder in general. It then discusses prevalence of psychiatric disorders in the prison/jail systems. The chapter also describes medication-assisted therapies for opioid use disorders and, treatment and aftercare services. It explores two of the most common types of treatments for those in the CJS, cognitive behavioral therapy (CBT) and 12-Step groups. The chapter further reviews two CBT programs, aggression replacement training and strategies for self-improvement and change.
This chapter discusses the need for universal standards for education and practice across countries for health professionals including nursing. It then explains the practice and licensure of foreign-born nurses migrating to low- and middle-income countries (LMICs). The chapter discusses the ethics of nursing practice with short-term international programs in LMICs including international study tours, clinical placements, voluntary missions, and service learning programs. An effective professional nursing practice in a host country also requires ethically based community involvement and collaboration. This partnership incorporates participatory decision making and engagement that can lead to transformative international service learning for the nurses and students. The chapter also presents a case study that describes the movement from participating in a volunteer mission program for health professionals serving a population in the rural areas along the Dominican- Haitian border to the development of a short-term, international service learning program for nursing students in Dominican Republic (DR).
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Human Rights Issues and Research With Prisoners and Other Vulnerable Populations: Where Does Evidence-Based Practice Go From Here?
This chapter discusses the history of forensic research atrocities. It promotes the use of National Association of Social Workers (NASW) Code of Ethics as a foundation for forensic research. The NASW Code of Ethics purports that social workers should promote and facilitate evaluation and research to contribute to the development of knowledge. This underscores both an ethical and a human rights obligation for the need for more prevention and intervention studies with incarcerated individuals. The chapter describes national and international responses to historic forensic research, and aims to build awareness of the need for new research to serve forensic populations and to increase familiarity with forensic research methodologies. The National Commission for the Protection of Human Subjects identifies three categories of research in prison settings: convenience research, prison-oriented research, and treatment-oriented research.
This chapter illustrates how capacity building can be used within the context of global health and nursling’s potential and vital role in addressing health problems, issues, and concerns across national boundaries. It reviews a current definition of capacity building and describes how capacity building relates to global health. The chapter proposes an updated definition of capacity building that better fits the new context of global health and explores capacity building for nursing research. It explores dimensions of the collaborative relationship: counterparts and facilitation. The chapter then presents a case study that provides a description of the collaborative journey from 2005 to 2013 and the process of helping Russian nurses learn about nursing research and aiding the Russian Nurses’ Association (RNA) in creating opportunities for these nurses to use research in understanding and improving their practice.
Host country ownership of partnership projects is dependent on the complex forces of politics and economy and the motivation of governments and individuals who implement health policy. Partnership leading to ownership is a definitive outcome of sustainability. The nurse, as a member of the team, must also maintain awareness of his or her individual contribution to the transfer of ownership. Partnerships can continue long after specific project goals are achieved with full ownership of the project assumed by the partner, agency, or government. The ongoing efforts of multilateral and bilateral agencies working with national governments, nongovernmental agencies (NGOs), and private partnerships to manage the HIV/AIDS epidemic illustrates a more current example of both success and failure in the process of local ownership. This chapter presents two case studies to offer a detailed look into ownership within an academic institution in Vietnam and a children’s hospital in Cambodia.
This chapter articulates a basic understanding of human rights and how they relate to social work. It describes some of the changes that are needed in social work practice in the United States in order to adhere to human rights principles. The chapter then addresses the implication of human rights for social workers. It offers some background on the concept of human rights, with emphasis on the relationship between human rights and social work and human rights and the law. The chapter further discussed the implication of human rights for social work education and social work practice, with a focus on building community. It discusses obstacles to social work practice from a human rights perspective, and concludes with a discussion on how social work needs to change to have consistency between discourse and action.
This chapter focuses on the role that Adult Protective Services (APS) and related service systems play in protecting vulnerable older adults and adults with disabilities from abuse, neglect, and exploitation. It articulates policy issues connected to elder justice. The chapter also explores human rights issues related to elder abuse, aging, and disabilities, particularly how to balance rights to self-determination and safety when working with abused, neglected, and exploited older adults. APS operate within a continuum of services that challenge social workers in their efforts to respond effectively to elder abuse. In addition to knowledge of aging, disabilities, the dynamics of family violence and care giving, and community resources and skills in capacity assessment, working in multidisciplinary teams, advocacy, and systems navigation, social workers need commitment to values of self-determination and empowerment to guide their work in this system.
This chapter describes the importance and need for interdisciplinary collaboration in forensic settings. It discusses how the evidence-based principles of risk, need, and responsivity (RNR) model can guide interdisciplinary collaboration with justice-involved individuals. The chapter highlights a treatment program for high-risk justice-involved males demonstrating interdisciplinary collaboration and specifically the role of the forensic social worker. Interdisciplinary collaboration is an essential core skill in evidence-based forensic social work practice. Interdisciplinary collaboration can be multidimensional, interactional, and developmental, and the following strategies have been identified as most important in achieving a best practice: preplanning, commitment, communication, strong leadership, understanding the cultures of collaborating agencies, and structural supports and adequate resources for collaboration.
This chapter provides an alternative view of traditional leadership, describing assumptions of leadership in global health and how these assumptions, along with leadership skills, can be adapted fluidly among members of global health projects in order to maintain partnerships. Global health nursing leadership occurs within organizations and the highest levels of government, but the concept of leadership in global health nursing extends to nurses working within nongovernmental organizations or serving as volunteers on health care teams. Critical team leadership roles include the following: convener, visionary, strategist, and team builder. Leadership roles will continue to emerge throughout the partnership as the need arises, and partners will assume leadership roles according to their personal and professional skills as well as experience. The chapter then provides two case studies that demonstrate the challenges involved in maintaining partnerships between academic institutions in different countries.
This chapter helps forensic social workers (FSWs) understand how to incorporate research into their practices. It clarifies the terms associated with evidence-based practice (EBP), and demonstrates three different approaches that FSWs can use in their practice settings. The chapter focuses on clinical interventions within forensic settings. It provides a brief summary and overview of some of the intervention models used in forensic settings with established empirical support, along with a discussion of their strengths and limitations. The chapter highlights commonly used forensic intervention models such as risk-needs-responsivity models, motivational interviewing, trauma-informed care, trauma-focused cognitive behavioral therapy, schema-focused therapy, and dialectical behavioral therapy. It concludes with a case example to illustrate how to use EBP in order to ensure that FSWs are providing interventions that are the best combination of art and science.
This chapter aims to enhance understanding of the justice-involved veteran population including the extent of involvement, risk, and protective factors associated with offending, and the impact of criminal justice involvement on the veteran and the veteran’s family system. It discusses the targeted programs and services for justice-involved veterans, how social workers assist this population, and the specific skill set required for effective intervention. The chapter also deals with health and mental health of incarcerated veterans, causes and consequences of arrest among veterans, and the use of trauma-informed care models and other interventions designed to address trauma that are critical for addressing the complex needs of justice-involved veterans. It further discusses jail-diversion programs, and jail and prison-based programs and services.
- Go to chapter: Forensic Research and Evaluation: Program and Policy Interventions That Promote Human Rights and Social Justice
Forensic Research and Evaluation: Program and Policy Interventions That Promote Human Rights and Social Justice
This chapter describes how forensic social workers can use the knowledge and skills of intervention development to design or evaluate existing interventions with forensic populations or settings, and about funding for their cause. It articulates the language of program and proposal development to prepare forensic social workers to be the creators of programs needed for forensic populations. The chapter enables preparing forensic social workers to possess basic competencies for understanding the language and practice of program development and evaluation of forensic social work interventions. The chapter provides an overview of the different parts of the logic model and how it can be linked to program development and evaluation. It provides questions related to the common types of evaluation, which include a needs assessment and process, outcome, or efficiency evaluations. The chapter also reviews forensic intervention development using a human rights and social justice systems approach.
Working with justice-involved youth and employment-related services requires a wide range of social work and systems knowledge, skills, and expertise. This chapter enhances understanding of the role employment services play in forensic social work with youth. It presents relevant findings from recent research on employment services for justice-involved youth and their effects on recidivism. The chapter discusses the targeted programs and services for justice-involved youth, providing case examples and discussion of how social workers assist this population, and the skills required for effective intervention. It also provides a basic understanding for how employment services fit within the system. The chapter aims to connect research with real-life examples. It outlines two of the ways inequality and oppression impact juvenile justice and employment. The chapter also discusses two evidence-based employment intervention strategies that are available to justice-involved youth in New York.
This chapter discusses the complexity of the role of the school social worker. It describes how to respond collaboratively and effectively to the variety of issues presented within public schools. The chapter provides a brief history of social work services in schools. It addresses recent demographics and trends and the scope of the problems in this specialty area. Specific legal and ethical issues of concern in the practice of school social work, and issues of assessment, prevention, and intervention are also discussed. The chapter describes the types of services provided through social work in schools, ranging from traditional child study team work to reentry services for students returning from correctional and/or treatment facilities. The chapter further examines the origin and development of school social work services in the United States.
Nursing has a long heritage of seeking to improve health and prevent illness through collaboration and partnership. Nurses have always worked to improve health and achieve equity in health. This chapter discusses the initiation of a partnership and explains how nursing and personal roles are established. It also explores important components of seeking a partnership, approaching potential partners with whom you have never worked, and dealing with unrealistic expectations while in a host country. The American Association of Colleges of Nursing compiled a summary of literature on successful partnerships in nursing that is congruent with the Leffers and Mitchell partnership model. Central to these partnerships are: Mutual trust and respect, Communication, Shared vision, and Commitment. There is tremendous opportunity for international student partnerships that challenge students to extend themselves beyond providing basic clinical procedures, moving them away from “us and them” to true partnerships.
This chapter explores the expanding role of intercultural communication and how the differences in cultures potentially impact provider–patient communication. One of the important realizations about health care is that patients and families are not part of the same culture as health care providers. Patients and families are part of the larger American culture, but not the health care culture. All of these intercultural differences create communication problems for providers and patients and many of them are not even directly related to the illness/injury/health concerns that the provider–patient are addressing. However, the intra– and intercultural differences can impact both patients and providers. Health care providers’ roles require them to change their identities related to leadership, paternalistic, or even authoritarian communication behaviors depending on the context and the communication requirements. The chapter explores social and cultural identity issues by examining verbal and nonverbal communication using an intercultural lens.
This chapter presents an interaction between the provider and the patient. The patient’s demeanor, tattoos, and piercings had impacted the interaction. The patient’s request for pain medicine changed the provider’s perception of the patient’s complaints. Preconceptions and stereotypes about drug seekers and drug-seeking behaviors affect interpersonal communication and interpersonal relationship development in settings like the emergency department (ED). Verbally aggressive behaviors had impacted the exchange of information. The provider’s willingness to acknowledge the patient’s pain and discuss his or her plans to medicate affects the interaction. Health care providers need to work diligently to keep stereotypes from influencing their perceptions, while at the same time using all the data they can gather to enhance their assessments and decision making. Patients in pain want pain relief, but with drug-seeking patients, especially in urgent care and ED, it can be difficult to assess who needs pain medicine and who does not.