Ann L. O'Sullivan

The family as a protective asset in adolescent development.

Adolescents are considered at high risk for engaging in such negative health behaviors as drug and alcohol use, unprotected sexual intercourse, and violence. Conventional wisdom has long upheld the belief that the peer group exerts the strongest influence on adolescent behavior. However, recent research has shown that in fact the family remains a strong factor in moderating teen risk behavior. Holistic nursing acknowledges the crucial relationship between environment and health; the environment is composed of everything that surrounds the individual, which by definition includes the family. The purpose of this article is to examine the evidence supporting the concept of the family as a protective external asset in adolescent development, to explore the way the family helps defend young people from risk, and to review briefly the implications for nursing research, practice, advocacy, and education.

Developing a Blueprint for Cultural Competence Education at Penn

This article describes the structure, process, and outcomes of developing a blueprint for integration of cultural competence education into the curriculum at the University of Pennsylvania, School of Nursing. The overarching framework of Kotter (1995) on leading change and organizational transformation was used as a guide for evaluation of faculty efforts. Within the setting of a research-intensive university, the process consisted of implementing a series of action steps which included appointment of a Director of Diversity Affairs, selection of a Master Teachers Taskforce on Cultural Diversity as catalysts for change; conduction of intensive faculty development programs, dissemination of information about cultural competence education, and use of innovative teaching approaches and student participation in curriculum activities. In addition, a Blueprint for Integration of Cultural Competence in the Curriculum (BICCC) was developed and used as the instrument for faculty surveys for 2 consecutive academic years. Faculty survey findings showed a substantial increase in the number of courses integrating cultural competence content in the programs of study. Successful outcomes of the Penn initiative were due to administrative and faculty support, utilization of a Director of Diversity Affairs, innovative work of the Master Teachers Taskforce on Cultural Diversity, faculty development initiatives, and development of the BICCC as a guiding framework for identifying areas of needed curricular change.

Pediatric sun exposure.

The risk of malignant melanoma may double if severe sunburns are experienced during childhood. Because children are exposed to sunlight for the longest period of time before age 21, regular use of sunscreen can reduce a childs lifetime risk of developing skin cancer. Therefore, preventive education is vital for parents of infants, preschool and school-age children, and adolescents. By assessing a childs risk factors, health care providers, teachers, and child-care professionals can incorporate preventive sun-safety education into their practice. This effort needs to occur at the community, state, and national level for widespread preventive sun safety and protection. In collaboration with the Healthy People 2000 project and in compliance with the United States Preventive Service recommendations, health care providers can help reduce the incidence of skin cancers in the American population.

Prompting Healthy Behavior via Text Messaging in Adolescents and Young Adults

Unhealthy and risky behaviors among adolescents and young adults, such as poor nutrition, lack of physical activity, smoking, and sexual practices, can lead to long-term negative health outcomes. Individuals with chronic diseases in these age groups are also more prone to nonadherence in the management of their diseases. Positively influencing the voluntary aspect of unhealthy behaviors in adolescents and young adults is an important public health topic. Recent research on cell phone text messaging has emerged as a potentially efficient, real-time intervention portal to prompt healthy behaviors in these populations. The purpose of this article is to review the current state of research evaluating the effectiveness of text messaging as a health intervention for adolescents and young adults.

Raising Awareness of Pressure Ulcer Prevention and Treatment

PURPOSE To provide the practitioner with updated information about pressure ulcers and their management. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in better understanding the scientific principles governing pressure ulcer development and treatment. OBJECTIVES After reading this article and taking this test, the participant should be able to: Discuss the etiology and assessment of pressure ulcers. Describe treatment options for pressure ulcers.

Hand-to-hand combat: Preventing MRSA infection.

PURPOSE To provide practitioners with a general overview of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) and their diagnoses and treatment. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in preventing, diagnosing, and treating MRSA infection. OBJECTIVES After reading this article and taking the test, the participant should be able to: 1. Discuss the microbiology, demographics, and epidemiology of CA-MRSA and HA-MRSA. 2. Explain the diagnosis, treatment, and preventative care associated with MRSA infections.

A Policy Analysis of Legally Required Supervision of Nurse Practitioners and Other Health Professionals

The use of legally required supervision occurs across health professionals who provide similar services. Legally required supervision has the potential to disrupt the production of high-quality, cost-efficient, accessible health services across disciplines. This paper examines the effects of nurse practitioner collaborative practice agreements and similar models of health professional regulation, defined as legally required supervision, on the cost and delivery of health services. A policy analysis examines empirical, policy, and law literature between two health professionals providing a similar service. Analysis includes literature on dental hygienists, dentists, certified registered nurse anesthetists, midwives, nurse practitioners, physicians, and pharmacists. A framework for legally required supervision across health professionals is presented. Antecedents of legally required supervision include occupational licensure, reimbursement policy, and institutional policy. Legally required supervision inhibits provider entry to practice and the production of health services by supervised providers. The cost of care increases under legally required supervision. Costs are measured by wages for providers and the price of services for patients. This paper and proposed framework summarize the antecedents and consequences of legally required supervision. Discipline-specific antecedents and provider characteristics must be considered when calculating the full effect of legally required supervision on the delivery and cost of health services.