Johns Hopkins University School of Medicine posts displayed by tag

Rebecca Wiseman

Nursing’s Wiseman Leads Work Group in Revising State Nursing Articulation Plan

Rebecca Wiseman, PhD ’93, RN, associate professor and chair of the School of Nursing at the Universities at Shady Grove, served as project coordinator for the recently revised Maryland Nursing Articulation Plan. The original Maryland Nursing Articulation Plan, which dates back to 1985, set the stage for several other articulation plans in the state of Maryland.

“The articulation model serves as a road map for colleges and universities as they plan and provide academic progression models for registered nurses. It allows us to adequately address the barriers encountered by registered nurses as they continue their education, which is crucial as we strive to adhere to the Institute of Medicine’s (IOM) Future of Nursing recommended goal of 80 percent of registered nurses prepared at the Bachelor of Science level by 2020,” Wiseman said. “The revision to the Maryland articulation plan reflects the current practices in transfer of credits, prerequisite requirements, and dual-admission/dual-enrollment programs.”

Maryland is one of four states predicted to experience a shortage of 10,000 registered nurses or more by 2025. Through the Maryland Action Coalition (MDAC), formed in 2011 in response to the IOM report, the state has been promoting seamless academic progression to baccalaureate programs as a solution and top priority. In response, the dual-admission articulation model was created, allowing students to apply and be admitted to a Bachelor of Science (BSN) program while in an Associate Degree in Nursing program at a community college. These new approaches and commitments to academic progression models needed to be reflected in the articulation plan to assure consistency across colleges and universities.

In 2015, Wiseman solicited the Maryland Council of Deans and Directors of Nursing Programs (MCDDNP), currently chaired by Nina Trocky, DNP, RN, NE-BC, CNE, assistant professor and associate dean for the baccalaureate program at the UM School of Nursing (UMSON), to form a work group to review the articulation plan. Wiseman led the six-member group in discussing and revising the plan.

“Dr. Wiseman was instrumental in coordinating the Maryland Council of Deans and Directors of Nursing Programs to develop an articulation document that more accurately supports nursing education and, specifically, the attainment of the BSN,” Trocky said. “MCDDNP is committed to developing a competent nursing workforce who provides high-quality care to the citizens of Maryland. This revision minimizes barriers to academic progression, thereby supporting this goal.”

The work group presented a final draft of the revised articulation agreement to the MCDDNP in December 2016, and after review, a subgroup submitted recommendations to MCDDNP in February 2017. In May 2017, MCDDNP members voted on the revision, resulting in 100 percent acceptance. The Maryland Higher Education Commission endorsed the articulation agreement in November.

“Drs. Wiseman and Trocky are to be commended for their forward thinking and tireless efforts in actualizing the 2017 Maryland Nursing Education Articulation Agreement for the Maryland Higher Education Commission. MDAC has focused on ensuring that the state has a well-educated nursing workforce,” said MDAC co-lead Patricia Travis, PhD ’99, MS ’76, BSN ’69, RN, CCRP, senior associate director, clinical research, Johns Hopkins University School of Medicine. “Although the newly released HRSA report for 2014-30 projects that Maryland is no longer in danger of experiencing a shortage of registered nurses, the future is still uncertain. Promoting seamless academic progression is one strategy to meet Maryland’s upcoming nursing demands.”

The effort to revise the Maryland Nursing Articulation Plan was funded through grants from the Robert Wood Johnson Foundation and AARP’s Future of Nursing: Campaign for Action State Implementation Plan IV and the Maryland Higher Education Commission’s Nurse Support Program II.

Kevin Nash Bulletin Board, Education, People, UMB News, University Life, USGAJanuary 16, 20180 comments
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Study Finds Link Between Antidepressants and Type 2 Diabetes in Youths

A team of researchers from the University of Maryland School of Pharmacy and the University of Maryland School of Medicine found that current (prolonged) use of serotonin reuptake inhibitors — a major class of antidepressant medications — in children and adolescents was associated with a nearly twofold increased risk of developing Type 2 diabetes when compared to youths who formerly used (but eventually discontinued) those medications. Published in JAMA Pediatrics, this is the first population-based study that comprehensively examines pediatric patients’ risk of developing Type 2 diabetes after beginning treatment with an antidepressant.

“Antidepressants are one of the most commonly used psychotropic medication classes among youth in the United States, with serotonin reuptake inhibitors representing a majority of total antidepressant use in this population,” says Mehmet Burcu, PhD, a May 2017 graduate of the doctoral program housed within the Department of Pharmaceutical Health Services Research (PHSR) at the School of Pharmacy, who led the study for his dissertation. “These findings provide new information on the risk of a rare but serious adverse outcome that is often difficult to assess in clinical trials due to limited sample size and inadequate follow-up.”

According to Burcu and his team, there has been a marked increase in the percentage of children and adolescents in the United States who use antidepressants over the past two decades — from 1.5 percent in 1996-1998 to 2.6 percent in 2010-2012. This increase has been largely driven by a rise in the number of antidepressants prescribed by pediatricians and other primary care providers. Although a number of studies have demonstrated a link between antidepressant use and risk for Type 2 diabetes in adults, evidence of a similar risk among children and adolescents remains limited.

For their study, Burcu and his team analyzed Medicaid administrative claim files for nearly 120,000 children and adolescents between the ages 5 of and 20 from California, Florida, Illinois, and New Jersey, who initiated treatment with an antidepressant between Jan. 1, 2005, and Dec. 31, 2009, for conditions such as depressive disorder, attention-deficit/hyperactivity disorder, and anxiety disorders. Medications that patients were prescribed included serotonin reuptake inhibitors, tricyclic or other cyclic antidepressants, and other antidepressants.

The team applied rigorous design and statistical approaches to compare incident cases of diabetes in current antidepressant users to former users, rather than non-users (children and adolescents who were never prescribed an antidepressant). “This approach represented a methodological strength of our study, as the comparison of current users to non-users could potentially lead to biased estimates due to several factors, such as confounding by indication and medical care utilization intensity bias,” Burcu says.

In its analysis, the team uncovered 233 incident cases of Type 2 diabetes, of which 156 occurred during current use and 77 occurred during former use of antidepressants, demonstrating that current use of antidepressants in children and adolescents was associated with a twofold increased risk of developing Type 2 diabetes.

In addition, within current users, the team assessed the risk of incident diabetes according to duration of use, cumulative dose, and average daily dose. This secondary analysis showed that the risk for children and adolescents who were prescribed serotonin reuptake inhibitors further intensified with an increasing duration of use (long-term use), cumulative dose, and average daily dose.

“The increased risk of Type 2 diabetes following prolonged use of serotonin reuptake inhibitor antidepressants in youth is clearly supported by these findings, with the data showing a greater effect on those youths who were prescribed the medications over longer durations and at higher doses,” says Daniel J. Safer, MD, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and adjunct professor at the University of Maryland School of Medicine, who has practiced for more than 40 years in the field of child psychiatry and is a co-author of the study. “We know that long-term use of these antidepressants is not without risk, and further research on outcomes, especially for current, long-term users, is warranted to assure a favorable benefit-risk balance for patients.”

“I am proud of Dr. Burcu’s ability to use the most sophisticated methods available to address the question of whether antidepressant use in children elevates their risk for developing Type 2 diabetes,” adds Julie Zito, BSPharm, PhD, professor in PHSR, who served as Burcu’s advisor and is a co-author on the study. “The nested cohort approach that he employed offers a fair comparison of those children who are currently using an antidepressant versus those children who previously used an antidepressant. It helps reduces bias in the research, which is often a challenge with safety studies such as this.”

Burcu and his colleagues hope their study paves the way for further research on the biological mechanisms underlying the relationship between antidepressant use and increased risk for Type 2 diabetes in children and adolescents, noting that their results can be used to spur policy development to improve patient monitoring and ensure these medications are used safely and effectively.

Malissa Carroll Research, UMB NewsOctober 23, 20170 comments
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Migraine Headache

Do You Suffer From Migraine Headaches?

To participate, you must:

  • Be 18-65 years old
  • Have had migraines for at least 1 year
  • Experience 4 to 14 headaches per month
  • Not be using opioid (“narcotic”) pain medication

To see if you are eligible, you must complete:

    • Two screening visits that include:
      1. Evaluation and questionnaires
      2. Sensory testing procedures
    • One or more MRIs of your brain
      1. Daily migraine diaries completed online
  • If you are eligible, the study involves:
    1. Assignment to one of two stress management groups
    2. Both groups use non-drug techniques and one group includes mindfulness meditation
    3. Each group includes 12-13 sessions that will occur over a 4 month period

All examinations, parking, and tests are provided at no cost. Compensation up to $900, for completing ALL study visits.

If interested, please call us at (410) 550-9056.

Protocol No.:NA_00091884 / HP-00053524

David A. Seminowicz, PhD
Principal Investigator, University of Maryland School of Dentistry

Jennifer Haythornwaite, PhD
Principal Investigator, Johns Hopkins University School of Medicine

Mariya Prokhorenko ResearchJune 6, 20160 comments
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