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PURPOSE: Nurse practitioners (NPs) are in a unique position to address the problem of opioid use disorders (OUDs) because they provide a large percentage of primary care services (Agency for Healthcare Research and Quality, 2014). This study aimed to increase doctoral NP students' beliefs/attitudes about their ability to care for and about individuals with OUDs through a multifaceted educational approach, guided by social cognitive theory. METHODS: Researchers used a quasi-experimental pre/post design. Five doctoral students attended lectures and 16 hours of direct clinical exposure to individuals with OUDs at a medication-assisted treatment center. The 22-item Drug and Drug Problems Perception Questionnaire examined students' attitudes toward individuals with OUDs before and after receiving this multifaceted education. Students completed reflective writings. Descriptive statistics and effect sizes were computed, and reflective writings were reviewed. RESULTS: Changes in Drug and Drug Problems Perception Questionnaire scores before and after intervention showed a fairly large effect size. This suggests that the intervention may have clinical significance for practice and is likely to attain statistical significance with a larger sample size. Greatest changes occurred in students' perceptions of role adequacy and self-esteem scores, indicative of higher self-efficacy. Measured score increases correspond to increases in confidence, knowledge, and skills to therapeutically engage with this population. CONCLUSION: Doctoral NP students had more positive attitudes and beliefs about individuals with OUDs after the multifaceted intervention. Enhancement of self-esteem and adequacy in the caregiver role for this population were promising signals that education can reduce stigma. Further study is warranted with a larger and more diverse sample.

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This longitudinal study describes the heart failure (HF) patient's perceived benefits and barriers to self-care during hospitalization, 1 week, and 1 month after hospitalization. Seventy-eight patients with acute HF completed the Health Belief Scales to determine the greatest benefits and barriers to self-care at each time point. Findings suggest that early benefits to performing self-care include reducing symptoms and improving quality of life. Later benefits focus more on promoting health. Barriers to self-care include forgetfulness and knowledge deficits about self-care behaviors. At 1 month, 15.1% to 48.5% patients reported that monitoring increases worry about HF. Home care clinicians can promote self-care through education and skills training.

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The present study was designed to assess the importance of binocular information (i.e. binocular disparity and angle of convergence) in the control of prehension. Previous studies which have addressed this question have typically used the same experimental manipulation: comparing prehensile movements executed either under binocular conditions to those executed when one eye was occluded (monocular). However this may not be the correct comparison as in addition to depriving the subject of binocular depth cues. it also deprives the subject of any visual information in one eye. Therefore we determined the prehensile performance when the subject viewed the target object and scene with either (i) two different views (binocular), (ii) two identical views (bi-ocular), or (iii) one view only (monocular). Overall, the qualitative and quantitative performance in the bi-ocular and monocular control conditions was very similar on all the main measures (and different from the performance in the binocular condition). We conclude that the deficits in performance observed found for 'monocular' reaches should be attributed to the lack of local depth information specified by the binocular cues. In addition we speculate that convergence angle and binocular disparity, although involved in both the pre-movement and movement-execution phases of the reach, the cues may be weighted differently in both phases of a prehension movement depending on the behavioural strategy involved.

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The present study examined the effects of a pre-movement delay on the kinematics of prehension in middle childhood. Twenty-five children between the ages of 5 and 11 years made visually open-loop reaches to two different sized objects at two different distances along the midline. Reaches took place either (i) immediately, or (ii) 2 s after the occlusion of the stimulus. In all age groups, reaches following the pre-movement delay were characterised by longer movement durations, lower peak velocities, larger peak grip apertures and longer time spent in the final slow phase of the movement. This pattern of results suggests that the representations that control the transport and grasp component are affected similarly by delay, and is consistent with the results previously reported for adults. Such representations therefore appear to develop before the age of 5.

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Binocular visual information may be involved in the selection of appropriate motor programs before a reach is executed or it may be involved during the movement-execution phase in order to monitor and guide the hand to the target object. Here we introduced binocular information after 0%, 25%, 50% or 75% of the movement-execution phase and determined its effects on the kinematic indices of prehensile movements made to objects of different sizes placed at different distances. Kinematic indices linked to the transport component, such as peak velocity and time-to-peak velocity, were unaffected by the presence of binocular cues whereas later occurring indices, such as peak grip aperture and time in the slow phase, were significantly affected. Although the magnitude of the peak grip was affected by the presence of binocular cues, the time at which it occurred did not change. This pattern of results suggest that the visuo-motor control of prehensile movements utilises both feedforward and feedback strategies and that binocular cues are particularly important for the fine manual adjustments typical of the latter.

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