Iowa Board of Nursing Annual Report, July 1, 2008-June 30, 2009

The annual report of the Iowa Board of Nursing includes information on legislation, administrative rules, nursing education, nursing practice, continuing education, licensing, enforcement, administration, financial report, statistics and general nursing demographics.

Literature review on advance care planning of nursing home residents

Aim: Conduct a search and analytic review of literature regarding attributes of Advance Care Planning (ACP) and Advance Directive in order to identify the experiences and the best care strategies for older adults resident in nursing homes or long term institutions. Methodology: An extensive electronic search was undertaken in the following databases: Pubmed (via Ovid search), Cumulative Index of Nursing and Allied Health (CINAHL, via EBHOST), psychINFO and Cochrane. After analyzing and eliminating duplicates and professional's point of view (19), 144 titles were considered relevant: 28 opinion papers, 94 descriptive/qualitative studies or predictive studies, 17 experimental and five systematic reviews. Most of them were produced in North America and only 10 were in French. Results: With regard to European experiences, studies are scarce and further research could benefit from North American evidence. Contrary to Europe, nurses in North America play a major role in the process of care planning. The major findings were related to the poor efficacy of the completion of Advance Directives, even in presence of a substantial variety of implementation strategies. The evidence supports interventions that conceptualize ACP as a process, with an emphasis on the ascertainment of patients' values and beliefs and the necessity to include the family or loved ones from the beginning of the process in order to favor the expression and sharing of one's life perspectives and priorities in care. The most relevant findings were associated with the conceptualization of the ACP as a change in health behaviors which needs an involvement in different stages to overcome a variety of barriers. Conclusion: Rigorous research in ACP for the older adults in Swiss nursing homes that promote respect and dignity in this frail population is needed. How to best achieve patients and families goals should be the focus of nursing intervention and research in this domain.

Psychophysiological activation during preparation, performance, and recovery in high- and low-anxious music students

The present study provides a comprehensive view of (a) the time dynamics of the psychophysiological responding in performing music students (n = 66) before, during, and after a private and a public performance and (b) the moderating effect of music performance anxiety (MPA). Heart rate (HR), minute ventilation (VE), and all affective and somatic self-report variables increased in the public session compared to the private session. Furthermore, the activation of all variables was stronger during the performances than before or after. Differences between phases were larger in the public than in the private session for HR, VE, total breath duration, anxiety, and trembling. Furthermore, while higher MPA scores were associated with higher scores and with larger changes between sessions and phases for self-reports, this association was less coherent for physiological variables. Finally, self-reported intra-individual performance improvements or deteriorations were not associated with MPA. This study makes a novel contribution by showing how the presence of an audience influences low- and high-anxious musicians' psychophysiological responding before, during and after performing. Overall, the findings are more consistent with models of anxiety that emphasize the importance of cognitive rather than physiological factors in MPA.

Iowa Board of Nursing Annual Report FY 10 (7/1/09 - 6/30/20)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Placement of Students Ages 3-21 with Disabilities Under the Individuals with Disabilities Education Act (IDEA): A Policy Discussion, May 2010

The provision of free appropriate public education (FAPE), an Individualized Education Program (IEP), and the least restrictive environment (LRE) have been important cornerstones of educating students with disabilities since the enactment of the Education of All Handicapped Children Act (EAHCA), Public Law 94-142, in 1975, and its subsequent reauthorizations, the Individuals with Disabilities Education Act (IDEA) in 1990, 1997, and 2004. It is impossible to consider any one of these cornerstones without the others, when determining an appropriate educational placement for a student with a disability. The Iowa Department of Education has identified several practice issues regarding the interplay between FAPE, LRE, and the IEP in placement decisions for students with disabilities. To that end, this document will provide guidance for administrators of local education agencies (LEAs) and area education agencies (AEAs), as well as IEP teams (or other placement teams) within Iowa LEAs and AEAs when making placement decisions for eligible children with disabilities. This guidance will specifically discuss ten LRE and FAPE placement/program policy questions that have been identified by the Iowa Department of Education as needing attention. The policy discussions are consistent with the legal provisions of the 2004 reauthorization of IDEA (IDEA 2004) and its 2006 final federal implementing regulations issued by the U.S. Department of Education, Office of Special Education Programs (OSEP). This document is also consistent with the Iowa Administrative Rules of Special Education (2007) [hereinafter “Iowa Rules”]. In addition, the term local education agency (LEA) is used interchangeably for school district throughout this document. Prior to the discussion of specific policy questions, a federal and state legal framework for providing FAPE for students with disabilities within the LRE is briefly outlined. Pertinent FAPE and LRE court decisions that impact Iowa LEAs and AEAs are also included within Section II.

Vision suisse romande de la pratique infirmière avancée [Advanced nursing practice: vision in Switzerland].

To meet the challenges related to the development of health problems taking into account the development of knowledge, several innovations in care are being implemented. Among these, advanced nursing roles and increased interprofessional collaboration are considered as important features in Switzerland. Although the international literature provides benchmarks for advanced roles, it was considered essential to contextualize these in order to promote their application value in Switzerland. Thus, from 79 statements drawn from the literature, 172 participants involved in a two-sequential phases study only kept 29 statements because they considered they were relevant, important and applicable in daily practice. However, it is important to point out that statements which have not been selected at this stage to describe advanced practice cannot be considered irrelevant permanently. Indeed, given the emergence of advanced practice in western Switzerland, it is possible that a statement judged not so relevant at this moment of the development of advanced practice, will be considered as such later on. The master's program in nursing embedded at the University of Lausanne and the University of Applied Sciences Western Switzerland was also examined in the light of these statements. It was concluded that all the objectives of the program are aligned with the competencies statements that were kept.

Rising to Greatness An Imperative for Improving Iowa’s Schools, 2011

In the early 1990s, the Cold War ended, Back to the Future III was in theaters, and Iowa led the nation in reading and mathematics. Times have changed. A decade into the 21st century, Iowa has conceded its place at the top. During the past 20 years, achievement trends illustrate Iowa’s slide from a national leader in PK-12 education to a national average―sometimes below average―performer as other states (and nations) have accelerated past the state. Iowa students’ futures are at risk. Collectively, Iowa students are not hitting the mark in mathematics and reading competency. Sure, Iowa has its share of super-achievers. But the mass of Iowa students—not just underprivileged or minority students, but many of the majority white, relatively affluent students as well—are falling short of what is needed to attain quality jobs, growing incomes, and secure livelihoods in today’s globally competitive world. The world has moved beyond the industrial age and information age and is now in the innovation age. Students must be armed not only with knowledge, but also with skills and insights needed to critically analyze and innovate. The pressing problems and grand opportunities the world faces require that many more people contribute as innovators and problem solvers, not order takers and implementers. Innovators will prosper. Order takers will stagnate. The days of an abundance of low-skill jobs have come to an end.

Iowa Board of Nursing Annual Report FY 10 (7/1/09 - 6/30/10)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Iowa Board of Nursing Annual Report FY 11 (7/1/10 - 6/30/11)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Polypharmacy as predictor of drug cost, length of hospital stay and mortality rate in nursing homes : a retrospective analysis of pharmacy medication records

Background and objectives: Polypharmacy (PP) is a typical con-sequence of multiple chronic conditions in elderly patients. PP is commonly defined as the use of multiple concurrent drug therapies although a standard definition is not used. The aims of this study were to assess the PP rate among nursing home (NH) residents using the data of the pharmacy medication records and to investigate the threshold level of PP as predictor of drug cost, length of hospital stay and mortality rate

Decrease in hemoglobin levels following surgery influences the outcome in head and neck cancer patients treated with accelerated postoperative radiotherapy.

AIM: To assess the influence of hemoglobin (Hb) levels in locally advanced head and neck cancer (LAHNC) patients treated with surgery and postoperative radiotherapy (PORT). MATERIAL AND METHODS: Pre- and postoperative Hb levels were collected in 79 patients treated with surgery followed by accelerated PORT for LAHNC. Median follow-up was 52 months (range 12-95 months). RESULTS AND DISCUSSION: Four-year overall survival (OS) rate was 51%. Neither pre- nor postoperative Hb level (<120 or 130 g/l in women or men, respectively) influenced the outcome. However, when Hb decrease between pre- and postoperative Hb values was taken into account, 4-year OS was significantly higher in patients with Hb difference less than 38 g/l (quartile value) compared with those with Hb decrease 38 g/l or more (61% versus 16%, P = 0.008). CONCLUSION: Decrease in Hb level by more than 38 g/l after surgery secondary to blood loss influences the outcome when postoperative RT is indicated.

A quasi-randomized group trial of a brief alcohol intervention on risky single occasion drinking among secondary school students.

OBJECTIVES: To show the effectiveness of a brief group alcohol intervention. Aims of the intervention were to reduce the frequency of heavy drinking occasions, maximum number of drinks on an occasion and overall weekly consumption. METHODS: A cluster quasi-randomized control trial (intervention n = 338; control n = 330) among 16- to 18-year-old secondary school students in the Swiss Canton of Zürich. Groups homogeneous for heavy drinking occasions (5+/4+ drinks for men/women) consisted of those having medium risk (3-4) or high risk (5+) occasions in the past 30 days. Groups of 8-10 individuals received two 45-min sessions based on motivational interviewing techniques. RESULTS: Borderline significant beneficial effects (p < 0.10) on heavy drinking occasions and alcohol volume were found 6 months later for the medium-risk group only, but not for the high-risk group. None of the effects remained significant after Bonferroni corrections. CONCLUSIONS: Group intervention was ineffective for all at-risk users. The heaviest drinkers may need more intensive treatment. Alternative explanations were iatrogenic effects among the heaviest drinkers, assessment reactivity, or reduction of social desirability bias at follow-up through peer feedback.