Background: Cognitive behavioral therapy (CBT) is an effective treatment modality for adolescents suffering from depression. Yet, it is often under-utilized among family nurse practitioners (FNPs) in the primary care setting. Known barriers exist within the realm of providers' lack of use of CBT in the primary setting, however, there is little research specifically on FNPs usage of the modality. Purpose: This paper seeks to understand FNPs' use of CBT in the primary care setting to treat adolescents with depression. Method and Sampling: A qualitative design was used to understand FNPs' use of CBT for adolescents suffering from depression. A faculty member and I recruited FNP participants through email. Ten FNPs currently working in the primary care setting with experience ranging from one to ten years participated in the study. Two focus group interviews were conducted in order to have a deeper understanding of the use of CBT in practice to treat adolescent depression. The interviews were audio taped and analyzed to reveal emerging themes. Results: After analyzing the audio recordings two common themes emerged: Unpreparedness and role conflict. Subthemes emerged within the area of unpreparedness that included knowledge regarding screening for depression in the adolescent population, utilization of clinical practice guidelines, available community resources and referrals, and the application of CBT in the treatment of adolescent depression. The theme of role conflict was associated with time constraints within the allotted time frame per patient and the conflict of providing mental health services when feeling as though their primary training is that of a family practice provider. Conclusion: The findings showed that the lack of use of CBT is multifactorial with knowledge being the greatest inhibiting factor. CBT is a recommended, first-line treatment option within the clinical practice guidelines for the treatment of adolescent depression. However, FNPs are not currently utilizing CBT in their practice to treat adolescent depression. There is much to be learned about adolescent depression in its entirety prior to incorporating CBT into practice.

Submitted by Edisangela Bastos (edisangela@ufpa.br) on 2013-12-02T21:43:46Z No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Tese_InfluenciaFacilitacaoNeuromuscular.pdf: 11873339 bytes, checksum: 43e00811e580d1936c7ef19ca961a6e5 (MD5) / Approved for entry into archive by Ana Rosa Silva(arosa@ufpa.br) on 2013-12-10T16:54:54Z (GMT) No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Tese_InfluenciaFacilitacaoNeuromuscular.pdf: 11873339 bytes, checksum: 43e00811e580d1936c7ef19ca961a6e5 (MD5) / Made available in DSpace on 2013-12-10T16:54:54Z (GMT). No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Tese_InfluenciaFacilitacaoNeuromuscular.pdf: 11873339 bytes, checksum: 43e00811e580d1936c7ef19ca961a6e5 (MD5) Previous issue date: 2013 / A Facilitação Neuromuscular Proprioceptiva – FNP – é uma técnica que cada vez mais vem sendo utilizada no treinamento muscular de pessoas saudáveis e atletas. Pesquisas vêm mostrando que exercícios de resistência, dentre eles a FNP, são capazes de converter o tipo das fibras musculares treinadas. Esta pesquisa teve como objetivo verificar a eficiência da FNP no acréscimo de força muscular e verificar por métodos não invasivos se haveria indicativo de conversão de tipo de fibra muscular após o treinamento. Um grupo amostral de 22 jovens, universitárias do sexo feminino com idade entre 18 e 25 anos e fisicamente ativas, foi dividido em: grupo controle (GC n=10) e grupo experimental (GE n=12). Foram inicialmente mensurados: I - força da Contração Voluntária Máxima - CVM do músculo quadríceps por dinamometria analógica e root mean square - RMS e II - área de ativação muscular por eletromiografia de superfície (EMG) de todos os sujeitos. Após a primeira coleta de dados o GE realizou treinamento baseado na FNP no membro inferior dominante por 15 sessões em 5 semanas. Ao final, nova mensuração foi feita em todos. Quanto à força muscular, houve acréscimo em ambos os grupos, significativa no GC (p<0,01) e no GE (p<0,05); para RMS e tempo de CVM, houve aumento não significativo no GE, mas a interação Vxt aumentou significativamente para este grupo. Os resultados corroboram a literatura ao mostrar que músculos com predomínio de fibras resistentes (fibras I/ II A) possuem maior tempo de contração com mais ativação elétrica e de que a FNP é capaz fibras tipo II B para II A. Concluiu-se que para a amostra estudada o treinamento foi eficiente no acréscimo de força muscular e os dados EMG apresentados mostram fortes evidências da conversão das fibras do músculo treinado. / The PNF - Proprioceptive Neuromuscular Facilitation - is a technique that is increasingly being used in muscle training of healthy people and athletes. Studies have shown that resistance exercise, including PNF, are able to convert the trained muscle fiber type. This research aimed to verify the effectiveness of PNF in increased muscle strength and check for non-invasive methods would be indicative of conversion of muscle fiber type after training. A sample group of 22 young, female university students aged between 18 and 25 years, physically active, was divided into a control group (CG n = 10) and experimental group (EG n = 12). It was collected first the Maximum Volunteer Contraction MVC of Quadriceps muscle for analogic dynamometry and root mean square - RMS by surface electromyography (EMG) of all subjects. After the first data collecting GE conducted FNP based training in the dominant lower limb to 15 sessions in 5 weeks. Before the training sessions, new MVC and RMS data were collected of all samples. Regarding muscular strength, there was an increase in both groups, significant in CG (p< 0.01) and GE (p <0.05) for RMS and MVC time, there wasn´t significant increase in GE, but the interaction Vxt was significantly increased for this group. The results corroborate the literature by showing that muscles with a predominance of resistant fibers (fiber I / IIA) have greater contraction time with more electrical activation and that the FNP is able to type IIB fibers II A. In conclusion the training sample was efficient to increase muscle strength and EMG data presented show strong evidence of the conversion of muscle fibers trained.

The Doctor of Nursing Practice (DNP) Family Nurse Practitioner (FNP) curriculum was developed to incorporate learning outcomes and experiential opportunities for students to attain the core FNP knowledge for doctoral education. Historically, challenges related to developing clinical skills in blended/online programs has been problematic. The appeal of online FNP education has challenged educators to develop new ways to provide students opportunities to experience hands-on clinical skills within the subspecialties of the DNP, FNP role. With limited clinical sites, and now with more clinical access constraints imposed by the COVID-19 pandemic, it is imperative that new models of instruction provide students opportunities for skills training. The purpose of this project is to describe use of scaffolding methodology to design student skills learning activities using synchronous online and on-ground sessions during DNP intensives. Student and faculty input identified the types of practice skills and procedures needing improvement, such as suturing, electrocardiogram, etc. An intensive task force was organized to evaluate curricular elements; content was then mapped to analyze gaps. The first step included aligning advanced practice nursing skills sessions in each intensive with the related clinical courses offered within that semester. Then, students were organized into a skills rotation plan based on their date of admission and place within their program of study. Modifications required by COVID-19 on-ground restrictions necessitated re-thinking intensive skills sessions. Student satisfaction scores significantly improved after the intensive sessions were restructured. Faculty continue to seek feedback from the students to provide beneficial practice opportunities during the DNP intensives.

ITC/USA 2005 Conference Proceedings / The Forty-First Annual International Telemetering Conference and Technical Exhibition / October 24-27, 2005 / Riviera Hotel & Convention Center, Las Vegas, Nevada / This paper describes the Flexible Telemetry Transceiver (FNT)-a modular, scalable, standards-based, software configurable, microwave wireless telemetry network transceiver. The FNT enables flexible, high-rate, long-range, duplex, network services across multipoint to multipoint wireless channel.