The NPWH Board of Directors is pleased and proud to announce its selection of Heather L. Maurer as the organization’s new CEO. She will assume her leadership role on April 13.
Many people prefer to simply swallow their medication as it’s quick and easy. But is the oral route the best way to replace hormones?
Dear NPWH Members,
On behalf of the NPWH Board of Directors and Staff, we want to express our sincerest compassion, appreciation, and support to all of our members during this challenging time. As a professional organization serving nurse practitioners, we are honored to represent our members on the front lines of the COVID-19 pandemic, caring for women and their families, and we earnestly thank you. It is the heroic work of nurse practitioners and healthcare workers around the globe that will see us through this storm together.
Why has a 30-year-old woman never been able to enjoy pain-free sex?
ACOG, CDC Recommend Separating Mothers With Confirmed Or Suspected COVID-19 From Newborns For Up To A Week Or More
USA Today (3/26, Rodriguez) reports “pregnant women who become infected with the new coronavirus or are exposed to the illness it causes face more distressing news: possible separation from their newborn for up to a week or more.” The article says that the American College of Obstetricians and Gynecologists and the CDC both recommend that course of action “to stop the potential spread of the virus from mother to child.” According to the new guidelines, “facilities should consider temporarily separating the mother who has confirmed COVID-19 or is a PUI (person under investigation) from her baby until the mother’s transmission-based precautions are discontinued.”
We are excited to continue our NPWH Member Spotlight feature, where we highlight different members and their journey to becoming an NP. Our latest Member Spotlight is Kim Choma, DNP, WHNP-BC. Click here to read her story. If you would like to nominate a member or yourself to be highlighted, please email firstname.lastname@example.org.
Nurses, nurse practitioners, and nurse midwives on the front lines of COVID-19: How do we protect the nursing workforce?
Today, we cannot escape the turmoil of living every moment of every day immersed within the chaos of the novel COVID-19 pandemic. Registered nurses (RNs), nurse practitioners (NPs), and nurse-midwives (MWs) are on the front lines of these unprecedented times and are concerned for their patients and the unknown potential adverse effects of COVID-19, the effects on their personal and family’s health and well-being, and the communicability within the neighborhoods in which they live and work.
Study Reveals Correlation Between Endometriosis And IBS Among Adolescents And Women With And Without Endometriosis
Healio (3/21, Jaramillo) reported researchers “revealed a correlation between endometriosis and irritable bowel syndrome [IBS] among adolescents and women with and without endometriosis.” The study found that “more adolescent patients with endometriosis had comorbid IBS (54 of 224 patients) vs. those without endometriosis (7 of 99 patients).” The study also found that “patients with endometriosis had a 5.26-fold higher risk for IBS.”
The findings were published online in Clinical Gastroenterology and Hepatology.
TODAY (3/16, Pawlowski) reports researchers in China “followed four pregnant women” with coronavirus in Wuhan “who gave birth to full-term infants,” and found that “none of the three infants whose parents gave consent for them to be checked for the illness tested positive for the virus.” The findings published in Frontiers in Pediatrics are consistent with previous research that indicated the virus is not transmitted from mothers to their babies. The article says that the American College of Obstetricians and Gynecologistscurrently has “no recommendations about how COVID-19 should be evaluated or managed specifically in pregnant women.” However, on Friday, ACOG issued a practice advisory that “said even though pregnant women don’t seem to be at increased risk for COVID-19, they should still be considered an at-risk population given that other respiratory infections like the flu can pose a danger to them.” Dr. Iffath Hoskins, chairwoman for ACOG in New York, said, “The patients are clearly very concerned – every mother is concerned for her fetus.”
Editor’s Note 3/11: The following is an an announcement from the Centers of Disease Control and Prevention about an update to its upcoming webinar on care for pregnant women during the COVID-19 outbreak.
As I mentioned in my introductory article, I was a pharmacist who loved compounding before I retired and began writing more seriously. And, as I compounded products for women that were unavailable in Canada, I became increasingly interested in women’s health issues. But, before I describe what I learned while using compounding to solve women’s health problems, I wanted to explain just what compounding is and how patients and practitioners can benefit from this specialized skill of pharmacists.
NPWH highlights member, Carolyn Sutton, WHNP-BC.
NPWH is monitoring CDC recommendations regarding coronavirus disease 2019 (COVID-19) prevention and control. We especially encourage nurse practitioners and other healthcare providers who provide care for pregnant and postpartum women to regularly check the CDC website for updates.
The CDC’s Interim guidance is available for: Inpatient obstetric healthcare –https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html
CDC’s Guidance on Breastfeeding – https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-guidance-breastfeeding.html
CDC’s Infection prevention and control in healthcare settings –
Answers to frequently asked questions about COVID-19 and pregnancy are also available on the CDC website – https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-faq.html
The World Health Organization said early studies suggest pregnant women may not be at a higher risk than the general population of severe symptoms from COVID-19, which is caused by the novel coronavirus. An analysis of data for 147 women found 8% had severe disease and 1% were in critical condition, with no evidence of transmission from mother to child. Full Story: The New York Times (tiered subscription model).
NPWH highlights member, Sarah Freeman, FNP. Sarah is a previous Chair of the NPWH Board of Directors.
The U.S. Food and Drug Administration (FDA) recently approved marketing for the very first genetic test to help diagnose Fragile X Syndrome (FXS).
In this spotlight, we get to know Heather Quaile, DNP, WHNP-BC, SANE. Heather is on the Program Committee for our 22nd Annual Premier Women’s Healthcare Conference and currently in training to be a sexuality counselor.
Connectedness: Women and their Daughters Heart Health
Since 1963, February has been celebrated as American Heart Month. In 2004, the American Heart Association expanded this initiative with their Go Red for Women campaign to raise awareness of the importance of heart health for women. Heart disease is the leading cause of death for women in the United States with a statistical report of approximately 1 in every 5 female deaths in 2017 attributed to heart disease.
A study recently published in the Journal of Adolescent Health examined the prevalence of mental illness in young mothers (younger than 21). The researchers surveyed 450 women living in Ontario, Canada.
In this spotlight, we get to know Linda Dominguez, CNP. Linda has been a nurse for more than 50 years and is former Chair of the NPWH Board of Directors.
In this spotlight, we get to know Cookie Bible, WHNP-BC. Cookie has been a member of NPWH since its first year and is a former Board member. She currently serves on the Policy Committee. She is also former President of the Board of Nursing for the State of Nevada. She is pictured here with her rescue dog, Zephyr.
Study shows reduced risk of cardiovascular disease during times of bereavement with daily aspirin intake
A study published in the American Heart Journal explored the effects of aspirin and low dose metoprolol intake during early bereavement periods.
In this spotlight, we get to know Laurie Hudec, WHNP-BC.
A recent study published in the Holistic Nursing Practice journal highlights the positive effects of yoga, tai chi, and other “movement-based mind-body interventions” for nurses and nurse practitioners who suffer from chronic back pain.
This month we get to know Caroline Cianfrocco, WHNP-BC.
A recent study published in the Medical Journal of Australia examined the “proportion of cancer diagnoses in Australia that might reasonably be attributed to overdiagnosis.”
A recent study published in the Hepatology journal of the American Association for the Study of Liver Diseases investigates if indole, a microbiota metabolite may help alleviate inflammation and diet-induced non-alcoholic fatty liver disease (NAFLD)
The World Health Organization (WHO) recently announced that the rate of coronavirus transmission outside of China may soon be increasing.
Did you know that the Women’s Preventive Services Initiative (WPSI) has a mobile-friendly interactive Well-Woman Chart?
A new program for helping families affected by postpartum depression is set to hit New York City in 2024. The program is The New Family Home Visits initiative, and will first begin in Brooklyn before expanding throughout the rest of the city.
The ECRI Institute recently launched its Coronavirus Outbreak Preparedness Center for healthcare providers and hospitals to learn how to protect themselves and their patients.
My name is Jeannie Collins Beaudin, and I’m a retired Canadian pharmacist and former owner of a specialty compounding pharmacy. Compounding, by the way, is essentially making medicines from scratch. While all pharmacists do some compounding, I went further with a dedicated lab space and two full-time compounding technicians. The best part of my job was helping my patients. Nothing made my day better than having a client come back and tell me my advice or my specialized compounded medicine had solved their problem!
In a recent study, the World Health Organization (WHO) describes a study which aims to eliminate cervical cancer “as a public health problem.”
The National Association of Nurse Practitioners in Women’s Health (NPWH) advocates for a nonjudgmental and evidence-based approach to screening and counseling women concerning marijuana use during pregnancy and lactation. NPWH supports strategies to educate the public about safety concerns and to reduce marijuana use during pregnancy and lactation. Legislation, policies, and clinical processes should ensure that women who use marijuana have access to nonjudgmental, nonpunitive, patient-centered healthcare throughout pregnancy, birth, and postpartum period. NPWH supports ongoing research on the effects of marijuana use on fetal and neonatal outcomes, long-term effects on neurodevelopment, and safety of use during breastfeeding.
In this article, the author discusses how the PALM-COEIN classification system helps clinicians group various causes of abnormal uterine bleeding into structural and nonstructural etiologies, allowing assessment and management to be more specifically employed by nurse practitioners to offer women the most effective treatments.
A new report indicates that there could be over 75,000 reports of coronavirus infections in Wuhan, China, and almost 10,000 cases across the entire nation of China.
It is my pleasure to announce the launch of the National Association of Nurse Practitioners in Women’s Health (NPWH) new and innovative online website for women: H.E.R. [Health. Education. Resources.] Hub at www.myherhub.com. H.E.R. Hub captures the unique perspective and expert advice of women’s health nurse practitioners (WHNPs) and offers it to women in a convenient, one-stop, digital portal. By focusing on both preventive well-woman care and the treatment of women’s health conditions, H.E.R. Hub is a valuable new online resource for patients and clinicians alike.
A study recently published in the Journal of the American Medial Association aimed to examine if a treatment combination of vitamin C, hydrocortisone, and thiamine would lead to a “rapid resolution of septic shock” compared to using only hydrocortisone.
A recent study published in Health Affairs highlights how much the out-of-pocket (OOP) expenses for maternity care have increased over time.
In late December 2019, the U.S. Food and Drug Administration (FDA) announced the approval of Merck’s Ervebo, the first FDA-approved vaccine to prevent Ebola virus disease.
Based on new findings from a 2020 American Cancer Society report, mortality rates from cancer have declined by 29% between 1991 to 2017 in the US. Additionally, between 2016 to 2017, there was a 2.2% drop, which is the largest drop within a single year that was ever recorded.
On the heels of today’s earlier post regarding the increase mortality rates in Wuhan, China from the coronavirus, The New York Times (NYT) just released an article detailing news that the first U.S. patient with coronavirus has been identified.
In the past 24 hours, news coverage of the coronavirus in Wuhan, China has become more and more rampant. I first heard of the outbreak from my husband last night before bed, and was surprised how I missed the news before our conversation, especially after seeing the onslaught of news from a quick Google search this morning.
MK Hedrick is a former colleague of mine who works in healthcare market research. When we worked together, we were tasked with trying to understand the ins and outs of different online disease communities for our clients.
The U.S. Food and Drug Administration (FDA) recently announced the approval of Blueprint Medicines Corporation’s avapritinib (Ayvakit) for the treatment of adult patients with metastatic gastrointestinal stromal tumor (GIST) with the “platelet-derived growth factor receptor alpha (PDGFRA) exon 18 mutation.”
The Parkinson’s Foundation recently announced the launch of its new Parkinson’s Nurse Fellowship program in the U.S.
The U.S. Food and Drug Administration (FDA) recently issued a warning letter to Alkermes, Inc. due to misbranding on the drug Vivitrol, which is used to prevent opioid dependence relapse. The letter was issued because promotional materials didn’t including warnings about risks associated with the treatment, specifically a lack of language about the “vulnerability to opioid overdose.”
In early January 2020, the Canadian Medical Association Journal published a commentary from Drs. Jasleen Grewal and Lawrence Loh regarding potential concerns around the use of cannabis edibles.
A new study recently published in the Journal of the American Medical Association reveals that there is no statistical significance between a women’s use of talcum powder and developing ovarian cancer.
The Community Preventative Services Task Force (CPSTF) recently released new recommendations around the management of school-based asthma. These management strategies aim to reduce the amount of hospitalizations and emergency room visits from children and adolescents suffering from the condition.
The U.S. Food and Drug Administration (FDA) recently granted accelerated approval for Sarepta Therapeutics’ golodirsen (Vyondys 53), an injection for patients with Duchenne muscular dystrophy (DMD) with a mutation in the dystrophin gene “that is amenable to exon 53 skipping.”
The results of the Annual Gallup poll were released on January 6, 2020 which, for the 18th consecutive year, revealed that nurses were ranked as the #1 most honest and ethical profession.
A study published in Applied Nursing Science details how acupressure may help nurses who experience chronic back pain.
Women typically visit an ob/gyn practice, family practice, or internal medicine practice for routine, annual well-woman visits (WWVs). The focus of this visit may vary within these different settings.1 This can result in missing important components in the history, physical examination, and screening tests that constitute a comprehensive preventive health assessment along with appropriate health promotion education and counseling.
New data from the Association of American Medical Colleges (AAMC) reveal that for the first time, women now make up the majority of first-year medical students in the United States.
Approximately 46 million individuals—about 15% of the population of the United States—reside in rural areas of the country.1 A slightly larger proportion, 22.8%, of US women aged 18 years or older call rural America home.2 For all rural residents, top priorities set forth by Healthy People 2020 include increasing access to primary care services, emergency department (ED) services, and insurance coverage.3 Rural women, when compared with their urban counterparts, experience more disparities in terms of primary care and reproductive healthcare.1 Although the need for specialists in women’s healthcare is particularly evident in rural areas, few such healthcare providers (HCPs) cover these areas.3 Nurse practitioners (NPs), including women’s health nurse practitioners (WHNPs), can help reduce health disparities, improve access to care, and promote favorable health outcomes for female rural residents.
The U.S. Food and Drug Administration (FDA) recently granted accelerated approval to Global Blood Therapeutics’ voxelotor (Oxbryta), a treatment for adults and pediatric patients (12 years and older) with sickle cell disease (SCD).
The Women’s Healthcare team is excited to announce several changes to our site, all of which are intended to enhance your experience.
It’s the holiday season and for many people alcohol is a part of celebrating at family, friend, and co-worker get togethers. But what if a woman is pregnant or may be pregnant? Here are some tips to help her plan for an alcohol-free holiday season – Alcohol Free Holidays for Baby and Me.
You can find more information on fetal alcohol spectrum disorders (FASD) and preventing alcohol-exposed pregnancies at www.cdc.gov/FASDtraining and the NPWH webinar series Optimizing Preconception Health: Preventing Unexpected Teratogen Exposure in Reproductive Age Women.
Approximately 1 in 10 women has distressing low sex drive, otherwise known as hypoactive sexual desire disorder (HSDD). How do healthcare providers determine whether a given patient has HSDD? And how should they treat it? The authors address these challenges in this article.
Editor’s Note: 2019 conference presentations coming soon!
This issue of Women’s Healthcare: A Clinical Journal for NPs features the podium presentation abstracts that were introduced at the 21st annual NPWH conference in San Antonio in October 2018. Abstracts of the first- and second-place poster award winners and the first- and second-place student poster award winners appeared in the September 2019 issue of the journal.
My heartiest congratulations to all! Each year the NPWH conference is enriched by these podium presentations. Please take time to review the abstracts that provide state-of-the-science information about women’s health, and please consider submitting your work for 2020.
–Lorraine Byrnes, PhD, FNP-BC, PMHNP-BC, CNM (ret.), FAANP
2018 NPWH Research Committee Chair
A new study from Obstetrics & Gynecology indicates that women with low-risk pregnancies, who delivered in a hospital setting with a midwife, may need fewer interventions and cesarean sections (C-sections) than women who saw obstetricians. However, these results may reveal more questions than answers.
2018 NPWH Women’s Health Nurse Practitioner Workforce Demographics and Compensation Survey: Highlights Report
The National Association of Nurse Practitioners in Women’s Health (NPWH), in collaboration with the National Certification Corporation (NCC), completed its Women’s Health Nurse Practitioner (WHNP) Workforce Demographics and Compensation Survey in fall 2018. Major objectives of the survey were (1) to obtain detailed demographic information to understand who today’s WHNPs are, where they work, what they do, and which populations they serve, (2) to identify trends in employment compensation specific to WHNPs, (3) to ascertain associations among WHNP education, experience, practice characteristics, and compensation, (4) to identify associations among experience, practice characteristics, and employment/role satisfaction, and (5) to explore trends and attitudes regarding the preceptor role.
This week is a special week for Women’s Healthcare and we’re excited to highlight the importance of all nurse practitioners (NPs) during National Nurse Practitioner’s Week.
According to findings from a new study, longer duration of endogenous estrogen exposure (EEE)may positively affect cognitive status in late life.
A recent study examined the use of complementary and alternative medicine (CAM) to help women as they transition into menopause. These CAM therapies included nutrition-based options, physical treatments, psychological therapies, herbal medicines, and folk medicines.
Greetings to all our readers from the Policy Chair and Treasurer-Elect of the NPWH Board of Directors. Before you read my first Policy & practice points column, in which I aim to provide insight into policies affecting women who serve in the military from the perspective of a woman serving in the military, I want to introduce myself. I am a women’s health nurse practitioner (WHNP) and a Lieutenant Colonel in the United States Air Force (USAF). I have 13 years’ experience serving in the military as a WHNP. I have served in multiple locations, including highly operational positions where I have supported military women worldwide. I now serve in the largest research organization in the USAF, where I am developing solutions to better incorporate women into the armed services.
This issue of Women’s Healthcare: A Clinical Journal for NPs features poster abstracts presented at the 21st annual NPWH conference in San Antonio in October 2018. These abstracts include those of the first- and second-place poster award winners and the first- and second-place student poster award winners. Abstracts of the podium presenters will appear in the December 2019 issue of the journal. My heartiest congratulations to all! Each year the NPWH conference is enriched by these poster sessions. Please take time to review the abstracts that provide state-of-the-science information about women’s health, and please consider submitting your work for 2020!
Opioid use disorder (OUD) has become such a prominent topic in today’s society that it’s hard to go one day without hearing news about new death statistics or pending litigation issues, but one aspect of this ever-growing tragedy that may be overlooked is how OUD affects women specifically.
The Journal of the American Academy of Child & Adolescent Psychiatry released a study in March 2019 that showcases steps parents can take, in addition to standard therapy, to help lower or prevent anxiety in their children.
The expanding role of the nurse practitioner (NP) into subspecialty settings such as reproductive endocrinology and infertility (REI) necessitates acquiring new technical skills that are particular to the subspecialty in question. NPs who enter the field of REI care for many women who need to undergo hysterosalpingography (HSG), a procedure in which radiopaque dye is instilled into the uterus and fallopian tubes to evaluate tubal patency. Because 30%-40% of female infertility is attributable to a tubal factor,1 this procedure is commonly performed. A major downside of the procedure is that it can engender a considerable amount of anxiety and pain,1-5 a concern to NPs providing patient-centered care.
The National Association of Nurse Practitioners in Women’s Health (NPWH) supports collaborative action to establish brain health as a crucial aspect of women’s healthcare. A comprehensive approach includes promoting brain health, detecting cognitive impairment (CI) to facilitate accurate diagnosis and early intervention, and identifying and addressing the needs of individuals who are caregivers for loved ones with CI.
NPWH believes a need exists for extensive research to better understand modifiable factors that influence brain health, improve one’s ability to make an early diagnosis of CI, establish effective therapies to prevent and treat CI, and support families and caregivers of individuals with CI. NPWH endorses federal and state policies that devote resources to finance the needed research and that ensur e access to needed diagnostic, care, and treatment resources for individuals with CI, caregivers, families, and healthcare providers.
Cognitive function refers to memory, speech, language, judgment, reasoning, and planning and thinking abilities.1 Brain health is a term commonly used to describe healthy cognitive function.2,3 Changes in these functions may indicate CI. These changes may range in their level of severity, may be progressive, and may have treatable causes.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition’s (DSM-5’s) diagnostic categories of minor and major neurocognitive disorders (NCDs) reflect the range in CI severity. Minor NCD is a condition in which the individual has mild but measurable changes in cognitive function that are noticeable to the person affected and to family members and friends but do not affect the individual’s ability to carry out activities of daily living (ADLs).1 Minor NCD may be progressive. Approximately 15%-20% of persons aged 65 years or older have minor NCD.4 Major NCD is impairment characterized by decline in at least two cognitive domains (e.g., memory, attention, language, visuospatial function, executive function) severe enough to affect a person’s ability to perform ADLs; the individual also may exhibit behavioral and psychological symptoms.1 Dementia is a commonly used term for major NCD.
Alzheimer’s disease (AD), a progressive degenerative brain disease, is the most common cause of dementia.1 Most statistics on dementia reflect data related to AD. As of 2018, about 5.7 million adults in the United States have AD, with 5.5 million of them being aged 65 years or older. As the size and proportion of this older U.S. population grows, it is projected that 7.1 million persons aged 65 or older will have dementia, primarily AD, by 2025.1 The annual number of new cases of AD and other dementias will likely double by 2050 unless research discovers the key to prevention.1
These statistics do not reflect pre-clinical AD. Current thinking is that Alzheimer’s-related brain changes may begin 20 or more years before symptoms occur.1 No proven strategies are available to prevent AD. However, recognized risk factors for cognitive decline and AD, some modifiable, do exist.5,6 Increasing evidence suggests that lifestyle interventions may have a long-term impact on preserving brain health. The Alzheimer’s Association published a report in 2015 summarizing existing evidence related to risk factors and risk reduction (Box 1).5
All nurse practitioners (NPs) who care for midlife and older adults play a critical role in early recognition of CI. Early signs and symptoms include problems with memory or language, noted deficits in personal or instrumental ADLs, and concerns reported by the individual or a family member or caregiver.7-9 Assessment to detect CI is a required component of the annual wellness visit established in 2011 for Medicare recipients under the Patient Protection and Affordable Care Act.7
The Alzheimer’s Association has published guidance on detection of CI during the annual wellness visit. This guidance includes an algorithm for health risk assessment, patient observation, unstructured questioning, and structured assessment.7 Use of a structured cognitive assessment instrument can improve detection of CI in primary care settings by identifying individuals who may need further evaluation. Validated brief cognitive assessment tools that can be administered in 5 minutes or less in the primary care setting are available. Individuals whose assessment findings indicate possible CI should be evaluated further or referred to a specialist.7 Several initiatives have provided lists of these assessment tools, as well as recommendations and strategies NPs can use to address brain health and CI (Box 2).10-12
Early detection of CI and diagnosis of dementia are integral to individual and family counseling, advance care planning, and consideration of supportive therapies.13-15 The years from diagnosis to end-of-life may be fraught with poor health and disability, resulting in loss of independence and, over time, a substantially lowered quality of life. When interprofessional team members work together with the individual, family members, and caregivers, the changes that occur throughout the course of the disease process can be anticipated and the best care provided.
The impact of this disease on quality of life extends to the more than 16 million adults in the U.S. who provide unpaid care for loved ones with dementia.1 Approximately two-thirds of these informal caregivers—that is, 10.7 million of them—are women, and more than one-third of these women are the daughters of the individuals with dementia.1 The average age of caregivers is 49 years, although about one-third of them are aged 65 years or older.1,16 One-fourth of caregivers belong to a sandwich generation—that is, they are caring not only for an aging parent but also for children younger than age 18.1
Caregiving tasks include helping with instrumental ADLs (e.g., shopping, providing transportation, managing finances) and personal ADLs (e.g., bathing, dressing, feeding). In addition, caregivers may coordinate healthcare and support services. As dementia progresses, caregivers often must manage behavioral symptoms of the disease (e.g., aggressive behavior, wandering).1 Such tasks can take an emotional and physical toll on caregivers, as well as affect their financial status if they must modify or terminate paid employment and pay for healthcare services for themselves and their care recipient.1,16 In many cases, their own needs go unrecognized and unattended.15
A call to action has arisen to transform policies and practices affecting the role of informal caregivers as a major source of care for a growing population of older adults with dementia. A strategic national-level action plan will be required to address the needs of these caregivers. Policies to create evidence-based training for informal caregivers specific to the care of individuals with dementia, provide support such as expanded family leave and job protection for working caregivers, and fund evidence-based caregiver services are critical. Policies must recognize the needs and values of a diverse population of caregivers and the individuals under their care.15,17,18 Box 3 lists resources devoted to caring for caregivers themselves.
Implications for women’s healthcare and NP practice
Nurse practitioners who provide healthcare to women of all ages have the opportunity to address brain health during annual well-woman visits and/or during other visits if concern about patients’ cognitive function arises. In addition, NPs are likely to see, on a regular basis, a large portion of the roughly 10.7 million informal caregivers who are female. NPs are in an excellent position to identify women who are in the caregiver role and address their physical and mental health needs, including their brain health needs.
Nurse practitioners who provide healthcare for mid-life and older women, as well as women of any age who may be caregivers for loved ones with dementia, should:
- raise the topic of brain health as part of women’s health during routine healthcare visits;
- address risk factors for cognitive decline that may be reduced with lifestyle changes (e.g., improved nutrition, regular physical activity, cognitive training, smoking cessation);
- include a question about memory or cognition on health risk questionnaires;
- observe for signs and symptoms of CI;
- use an evidence-based protocol for screening and diagnostic evaluation of patients’ brain health and referral for further evaluation if indicated;
- include a question about any caregiving responsibilities in health assessment;
- offer additional screening for caregivers to assess preparedness for caregiving and caregiver strain;19,20
- develop health system partnerships to connect individuals with dementia and their caregivers with community agencies to identify needs and access help;
- collaborate with affected individuals, caregivers, and an interprofessional team to facilitate decision making and planning (e.g., living arrangements, advance care planning, end-of-life care) that addresses changing needs over time and across care settings; and advocate for policies at local, state, and national levels that address the needs and values of individual with dementia and their caregivers.
NPWH will provide leadership to ensure that:
- continuing education programs and other evidence-based resources are available for NPs to learn and update knowledge regarding brain health, dementia, and caregiver needs;
- ongoing collaborative engagement occurs with a variety of stakeholders to address brain health and caregiving issues as important components of an older women’s health agenda;
- research moves forward in all aspects of brain health to prevent dementia, treat existing CI, help those with CI maintain function and quality of life, and support caregivers; and
- policies strongly support individuals and families in coping with the physical, emotional, and financial burden of dementia.
- Alzheimer’s Association. 2018 Alzheimer’s Disease Facts and Figures. alz.org/alzheimers-dementia/facts-figures
- Alzheimer’s Association. Brain Health. 2018. alz.org/help-support/brain_health
- National Institute on Aging. What is Brain Health? 2018. brainhealth.nia.nih.gov/
- Roberts R, Knopman DS. Classification and epidemiology of MCI. Clin Geriatr Med. 2013;29(4):753-772.
- Baumgart M, Snyder HM, Carrillo MC, et al. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement. 2015;11(6):718-726.
- Moga D, Roberts M, Jicha G. Dementia for the primary care provider. Prim Care Clin Office Pract. 2017;44(3):439-456.
- Cordell CB, Borson S, Boustani M, et al. Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting. Alzheimers Dement. 2013;9(2):141-150.
- Falk N, Cole A, Meredith TJ. Evaluation of suspected dementia. Am Fam Physician. 2018;97(6):398-405.
- Scott J, Mayo A. Instruments for detection and screening of cognitive impairment for older adults in primary care settings: a review. Geriatr Nurs. 2018;39(3):323-329.
- Alzheimer’s Association. Cognitive Assessment Toolkit. 2013. alz.org/professionals/healthcare-professionals/cognitive-assessment
In September 2017, the FDA approved secnidazole for the treatment of bacterial vaginosis. Although new to the United States, secnidazole is a well-established anti-infective agent utilized worldwide for the treatment of various bacterial and parasitic infections. Published studies on secnidazole date back to the late 1960s, yet many U.S. healthcare providers remain unaware of the existence of this medication. This column details the history of secnidazole.
The iGeneration (iGen) comprises individuals who are adolescents and young adults right now. This generation is the first to have been familiar with the Internet since childhood and to use technology readily, even automatically. How the use of technology, including social media, is affecting their formative years and beyond is uncharted territory. The author reviews characteristics of iGens, reports what is known about their attitudes regarding healthcare, discusses the increased rate of certain mental illnesses among iGen members, and provides suggestions for healthcare providers in terms of how to better care for this population.