Earlier this month, Brittany Abeln became the first University of Arizona College of Nursing student to be selected as a Jonas Scholar. Established in 2006 to advance all aspects of the nursing profession, Jonas Nursing and Veterans Healthcare supports doctoral students who will conduct critical research, educate the next generation of nurse leaders and transform clinical care. The scholarship offers financial assistance, leadership development and networking support. Abeln, a fourth year dual degree PhD/DNP Psychiatric Mental Health Nurse Practitioner (PMHNP) student, joins a cohort comprised of 200 scholars from across the U.S., focused on some of our most challenging healthcare needs. Abeln will receive a $10,000 award, matched by $10,000 from the College of Nursing, to support her studies between 2018 and 2020.

“I'm honored to have been chosen and very excited to represent the UA College of Nursing as the Jonas Scholar for the next two years." ~ Brittany Abeln

“We’re proud of Brittany’s achievement,” says UA College of Nursing Clinical Associate Professor, Rene Love, PhD, DNP, PMHNP-BC, FNAP, FAANP. “She has a special interest in exploring mental health inequalities that exist in the LGBTQ population, specifically the mental health inequalities that exist for transgender youth. She is highly motivated and has already presented at two conferences and co-published a manuscript as the primary author since starting the PhD/DNP dual degree program.”

“The Jonas Scholar award is highly competitive,” says Lois Loescher, PhD, RN, FAAN, Professor and Director of the UA College of Nursing PhD program. “Selection is based on the expertise of faculty and the strength of the doctoral programs, as well as individual student achievements. We are excited about this opportunity for the College of Nursing and for Brittany.”

Take a few minutes to learn more about Brittany and her studies at the UA College if Nursing:

What does it mean to you to be selected as a Jonas Scholar?

I’m honored to have been chosen and very excited to represent the UA College of Nursing as the Jonas Scholar for the next two years. The financial support for me, as a dual PhD/DNP student, is huge.

 Work you’ve done in the Psych Mental Health Program?

My research focus and interest is on LGBT mental health inequalities overall, but I’m specifically interested in examining anxiety and depression as well as protective factors in transgender youth. Over the past three years as a student, I’ve attended and presented posters at two Western Institute of Nursing (WIN) conferences as well as the International Society of Psychiatric-Mental Health Nurses (ISPN) conference. I’ve also worked with Dr. Love on a manuscript that will be published in September on Munchausen Syndrome and Munchausen Syndrome by Proxy.

As part of the next generation of nurse leaders, what will your contribution be?

I see my impact really being in contributing to nursing research. I plan to specifically focus on LGBT mental health, because research is lacking in that area. I want to help shine a light on the mental health inequalities that face this community to help find better interventions and lead to better outcomes for that population.

Why did you choose the UA College of Nursing?

When I graduated with my BSN in December of 2014, I had no doubt in my mind that the UA was where I would continue my graduate education in nursing. The faculty was absolutely incredible to work with as an undergrad, and now as a graduate student I’ve had so many amazing mentors help me along the way. They’ve been completely invaluable to my experience. Specifically, I’d like to thank Dr. Audrey Russell-Kibble, who was my honors thesis mentor back as an undergrad, for really pushing me to graduate school. I also want to thank Dr. Rene Love and Kate Sheppard for advising me and Dr. Lois Loescher for her help with the application for the Jonas scholarship.

What motivated you to pursue a career in nursing?

I wanted a career where I could interact with people and make a difference in their lives. I feel so lucky to have found nursing, because I consider this career to be one of the loves of my life. I’m kind of a geek for research, so I knew I wanted to work in academia.

What features of your current program mean the most to you?

With the exception of clinicals, my program is completely online, but I’ve still been able to make connections with other students and have really gotten to know my faculty and learn from them. I really enjoy the College’s emphasis on evidence-based practice, and within that there’s this great focus on research that I really love.

With the help of her $20,000 portion of a $3 million gift to the Center for University Education Scholarships (CUES), University of Arizona College of Nursing professor Cheryl Lacasse, PhD, RN, AOCNS, plans to build an innovative online, virtual health care system. It will include sections like administration, integrative health, discovery and evidence-based care, acute care, and palliative care, among others. This simulated learning environment will assist graduate-level nursing students to learn leadership skills through carefully constructed assignments for specific core courses in the Clinical Systems Leadership Masters of Nursing program.

Dr. Lacasse’s bold envisioning of online learning had modest roots. “It started out as an idea developed by a colleague and myself as a ‘real world’ example of a health care system to facilitate learning in a senior-level BSN nursing leadership class focused on quality and safety,” she says. Now, thanks to her participation in the inaugural CUES Distinguished Fellows cohort, she’s taking her idea to the next level.

This year, six faculty members received a $20,000 CUES grant for between one and three years to work on a project in their discipline that explores new ways to approach teaching and learning.  “I’m honored to be part of the first group of the CUES Fellowship,” says Dr. Lacasse. “Collectively, we’re going to have a big impact on the scholarship of teaching at the University of Arizona. They’re looking at our group to pave the way for future CUES fellows and be role models for excellence in teaching scholarship across the University.” The virtual health care system is still in the planning stage, but Dr. Lacasse aims to have a prototype and begin pilot testing by the second year of the project.

Tell us about your project.

The initial inspiration for the project was transformed into a multi-dimensional system for many courses in the RN-MSN program. The project will be built in a virtual space so that students in health care professions can engage in active learning about the dimensions of leadership in health care. This project assists students to experience a community-based health care system of the future using principles of simulation, gaming theory, and augmented reality.  The ultimate focus is on interprofessional education and providing a platform for students to develop their leadership skills as they work together to solve systems-related health care challenges and ultimately their capacity to have a positive effect on the evolution of health care.

How is it multi-dimensional?

The virtual health care system will include many critical dimensions for learning about leading in a complex system. Some dimensions will include critical information for learning and others will engage students in online experiential learning. It will be built to provide a platform for faculty to create assignments that incorporate critical information from a complex health system and inspire students to expand their thinking about specific aspects of systems leadership. Ultimately, my vision is that all professions involved in health care – pharmacy, public health, medicine, business and health law -- can use this platform for intra and interdisciplinary education.

How is your system different from other models that are available?

Currently, the virtual health care systems in education that are available focus on clinical care delivery. Most of them are focused on interacting with patients and families with chronic conditions and difficult social conditions from the viewpoint of a clinician entering their profession. This project provides an opportunity for graduate students to explore their influence on high quality care through the lens of leadership within a complex health care system.

What are your hopes for the prototype?

I’m working with a faculty leadership team, online educators, and experts in instructional design and creation of virtual environments. Initially, the prototype will be developed, tested, and piloted at the College of Nursing. Faculty will be consultants for structuring the prototype, and key individuals from colleges with health care tracks will also be invited to share their ideas. Health care is very dynamic and the challenge for this project is to develop an enduring platform for relevant, engaging education for future leaders in health care. In the future, this platform can be used by faculty teaching health care-related leadership courses across disciplines.  

What is the importance of this kind of technology in education and health care?

It is important that online students are intimately engaged with the use of educational technology to enhance the learning experience. Often, this means that students have a more personalized interaction with learning media. The key is to create media that facilitates meaningful learning that can be translated from the virtual learning environment to the real world in health care leadership. It’s also important for individuals to be able to enjoy their learning and to have an active learning experience. The virtual world ensures that diverse students can come together and have similar kinds of experiences, whether it be on a discussion board or in real time or perhaps using some of our other technologies to do video conferencing or asynchronous audio/video discussion to be able to talk about their experience in the simulation area.

Example of a simulation?

One media piece involves using an innovation lab to create an experimental healing environment. Students would have the ability to design a hospital room, or a space in a person’s home, or perhaps in long-term care as an optimal healing environment. They would be able to then place the furniture, paint the room, allow for direct or indirect sunlight, decorate with artwork, etc. Currently, the Healing Environments course in the RN-MSN program uses a similar learning activity with only one basic environment. There are several patient case scenarios, including a child, a middle-aged individual, and an older individual with various chronic conditions. And they all have different kinds of chronic conditions. Students chose to create their environment based on one of three specific health care cases. In this activity, students are encouraged to imagine what a person-centered healing environment might look like and how they can facilitate healing by leading small but important changes in the physical health care environment.

Why is this project unique/innovative/different?

The uniqueness of the project comes from the environment that will be built that’s focused on leadership development for online students experienced in the health professions. Opportunities for learning essential leadership skills in health care by interacting with a simulated, online health care system assists in translating knowledge into the workplace.

Continuing a tradition that began last year, the CVS Health Foundation recently awarded $5,000 in scholarship funds to support five Family Nurse Practitioner (FNP) students in the University of Arizona College of Nursing’s Doctor of Nursing Practice program. The scholars were selected based on their interest in family or retail healthcare practice, their stellar academic standing, their bilingual skills and their desire to spend a portion of their time with organizations that support underserved populations.

“The CVS Health Foundation focus on supporting Family Nurse Practitioner students aligns wonderfully with the academic mission of our Doctor of Nursing Practice program,” said Clinical Associate Professor and Director of Practice Innovations, Allen Prettyman, PhD, FNP-BC, FAANP. “The support from the CVS Health Foundation allows student awardees to academically shine a little brighter while providing volunteer healthcare for underserved communities now and in the future.”

Take a moment to meet this year’s CVS scholarship awardees and hear what this funding means to them:

Daniel O. Maduma: “I used to be a veterinarian, and I really wanted to get back to working with people – specifically families. That’s why I chose to pursue an FNP. While I work in a major hospital, it’s not a natural environment, so it was important to me to be somewhere that’s natural where I can interact with people living their lives. In the future, I plan to provide primary care to families in Tucson. I also want to be involved in teaching future nursing students.”

Megan Maley: “I decided to pursue an FNP because I wanted to be able to give more to patients that my current RN role does not allow. With an FNP, I can help each step of the way from diagnosing to formulating a treatment plan. Receiving the CVS scholarship means I can focus more on my studies to be more prepared for caring for patients on my own after graduation. The work I will be doing through my preceptorship involves caring for patients throughout their lifetime. I will begin working in a rural pediatric clinic this summer which I am looking forward to.”

Stephanie Marks: “I chose to pursue an FNP because I am passionate about providing quality, holistic care to persons of all ages. I feel strongly that mental, social and spiritual wellbeing are just as important as physical health. As an FNP, I am afforded the special opportunity of empowering my patients through education, medical care, and support over the course of their lifetime.  Receiving the CVS Scholarship means that I am able to dedicate more time to my studies and clinical experiences, consequently optimizing my patients’ health through innovation, collaboration, caring, integrity and accountability: values that reflect CVS Caremark’s mission. This scholarship means that the work I am doing, and plan on doing after graduation, is important to my community.”

Nila Safaeian: “The idea of being able to provide care across the lifespan appealed to me. FNPs have the unique opportunity to not only care for the health and well-being of the individual, but also for the family as a unit. Whether it be for our pediatric or geriatric patients, we have the ability to educate and empower them to take charge of their health through health maintenance and disease prevention measures. I also enjoy being able to see a variety of conditions in practice, from acute to chronic illnesses. You never know what you’re going to get, but that’s what makes it interesting. I am truly honored and grateful to receive this award. The CVS Scholarship will greatly assist me in reaching my goal of graduating in December and being one step closer to working as an FNP.”

John Sparks: In my prior career I worked in corporations for a large company. As I got older I wanted to have an impact on people around me in a more positive way, so I chose to enter the medical field so I could help people. It fits my personality a little better and I enjoy interacting with people and helping them to solve problems and 2 meet their needs, and do so by helping themselves, too, in the process. Financially, it makes a big impact. I’m an older learner, and I have 4 children and I’m married, so assistance helps me and my family meet my goals to become a DNP and also maintain financial solvency during that time.”

“The CVS Health Foundation focus on supporting Family Nurse Practitioner students aligns wonderfully with the academic mission of our Doctor of Nursing Practice program." ~ Dr. Allen Prettyman

At the UA College of Nursing, students pursuing the Family Nurse Practitioner (FNP) specialty receive a broad foundation of educational preparation in advanced nursing practice with families across the lifespan. Through a variety of service and learning opportunities, all nursing students apply the knowledge and skills they’ve gained in the classroom to real-life health challenges in our communities. Proximity to the Mexican border and tribal communities offers opportunities to serve and learn about issues in health and culture. Clinical sites available in the community and surrounding rural areas include nurse-managed clinics, health maintenance organizations, Indian Health Service sites, community health centers, physician-nurse practitioner practices, mental health centers, health departments, long-term care settings, retirement centers, schools and acute care settings. Last year we were delighted to receive CVS Health Foundation Scholarship funds for two of our FNP students. These two students, both of whom are bilingual, have excelled in their academic trajectories and plan to practice in primary care.

People with a high dependence on alcohol at risk of developing serious – and sometimes fatal – complications from respiratory inflammation soon may have a naturopathic supplement that would mitigate their risk factors.

Alcohol abuse is a significant contributor to the development of acute respiratory distress syndrome, which kills 114,000 Americans annually.

Alcohol abuse depletes intracellular glutathione, or GHS, a critical antioxidant in the lung. Research has shown that when GSH combines with oxygen, it impairs protein function and can result in fatal respiratory failure.

Curcumin, a compound found in turmeric, has proven effective as a nonpharmacological treatment for a variety of inflammatory diseases, and an increase of GSH synthesis.

Looking to evaluate curcumin’s effectiveness in facilitating the normal production of GSH, University of Arizona College of Nursing Assistant Professor Charles Downs, PhD, ACNP-BC, FAAN, has received a five-year $1.6M RO1 grant from the National Institutes of Health.

Using a carefully designed murine model in his study, “Using Proteomics to Develop Personalized Health Strategies to Prevent Lung Injury in Model Systems,” Dr. Downs hopes to demonstrate that curcumin reverses impaired protein function to restore lung fluid balance.

Acute respiratory distress syndrome occurs in response to inflammatory stresses such as pneumonia and is characterized by profound inflammation and a build-up of excess fluid in the lungs that culminates in respiratory failure. Although researchers are aware of the physiological disorders associated with the syndrome, current therapies are supportive rather than curative, Dr. Downs said.

“This project is part of a long-term effort that will elucidate the molecular underpinnings of acute lung injury but also will test the ability of a water-soluble formulation of curcumin to prevent and/or treat acute lung injury,” said Dr. Downs. “We hope this study will move the science forward and ultimately lead to the development of potential therapeutics.”

The results could have other wide-reaching benefits.

“We hope this study will move the science forward and ultimately lead to the development of potential therapeutics." ~ Charles Downs

“Understanding the cellular and molecular determinants of lung injury is critical for the development of effective targeted interventions,” said Usha Menon, PhD, RN, UA College of Nursing associate dean of research and global initiatives. “Dr. Downs’ current study is a major and important step toward his long-term goal to develop precision-health strategies to reduce the risk for lung injury and to improve outcomes for those affected.”

"It is fitting that the UA College of Nursing is pursuing this project. As one of the top 15 percent graduate nursing programs in the nation, with a strong emphasis on integrative health across research, clinical and teaching projects, this is an area in which we can have great impact," said UA President Robert C. Robbins, MD. "Integrative health care presents a dynamic frontier as we seek to broaden our treatment resources to include more than just traditional pharmacological options. Dr. Downs' research contributes to the University of Arizona’s goal of leading the world in novel approaches to healthcare research and teaching."

Dr. Downs’ multi-disciplinary team includes co-investigators Joe G.N. “Skip” Garcia, MD; UA College of Medicine; Janet Funk, MD, UA Cancer Center; Dean Billheimer, PhD, UA Mel and  Enid Zuckerman College of Public Health; George Tsaprailis, PhD; UA College of Pharmacy; Monica Jablonski, PhD; University of Tennessee Department of Ophthalmology.

Cancer survivors who suffer negative effects after treatment soon may have access to interventions with the potential to vastly improve their quality of life.

University of Arizona College of Nursing Professor Terry A. Badger, PhD, RN, PMHCNS-BC, FAAN, has received a $2.5 million grant from the National Cancer Institute to help improve symptoms for cancer survivors after their treatment.

Dr. Badger will employ the interventions and determine their effectiveness among ethnically diverse cancer survivors who have gone through medical treatment. One intervention will be made available in Spanish for the first time, Dr. Badger said.

Nearly 15.5 million American cancer survivors have experienced symptoms from cancer treatment that negatively impact their quality of life, according to the American Cancer Society. Although numerous symptom-management interventions have been tested during cancer treatment, few have addressed the continuing fatigue, pain, depression, anxiety, insomnia and other symptoms that continue after treatment has ended.

Dr. Badger, who also is a UA professor of psychiatry, will use two post-treatment innovations in her study. The first is a printed Symptom Management and Survivorship Handbook featuring evidence-based, self-care strategies for symptoms. The second is a more intensive intervention that combines the handbook with a telephone interpersonal counseling intervention for managing depressive symptoms.

Dr. Badger's interest in improving quality of life for cancer survivors began 18 years ago when she first conceived the idea of delivering interventions over the telephone. Many of Dr. Badger's previous studies focused on helping survivors during medical treatment. But in her latest work she examines the effectiveness of interventions post-treatment.

"One unique element of this study is that we are taking survivors after they have completed their chemotherapy, which is a time when they are transitioning back to their primary care provider. But they have a lot of unmet needs and lingering symptoms," she said.

“The Symptom Management and Survivorship Handbook is the first handbook of its kind to be made available for our Spanish-speaking cancer survivors." ~ Dr. Terry A. Badger

Dr. Badger will examine the effectiveness of the two interventions for managing symptoms in an ethnically diverse – about 30 percent Hispanic – sample of cancer survivors of solid tumors at the end of chemotherapy. Though the telephone intervention may not be "high-tech," its accessibility has proven to be a boon to cancer survivors. An important part of Dr. Badger's work is removing barriers between patients and their care.

"All my work is developed to remove barriers so that survivors can get the supportive care they need in a cost-conservative, timely and convenient way," she said. "The Symptom Management and Survivorship Handbook is the first handbook of its kind to be made available for our Spanish-speaking cancer survivors. In fact, both interventions are delivered in either English or Spanish, depending on the survivor's preference."

In development for almost a year, the handbook is heavily illustrated and easy to navigate. It was translated by a certified interpreter and revised after a focus group was held with Spanish speakers.

"We have made incredible advances in treating cancer, and we are now at a point where many people survive a cancer diagnosis,” said UA President Robert C. Robbins, MD. “However, many people still suffer from the very treatments that saved their life. The work that Dr. Badger is doing to help them as they move from being cancer patients to cancer survivors is addressing an important and unmet need. I am pleased to see that these interventions will be available in English as well as Spanish, which will help ensure that a greater number of people benefit from them."

Dr. Badger's team includes Chris Segrin, PhD, UA College of Social and Behavioral Sciences; Tracy E. Crane, PhD, UA College of Nursing; Pavani Chalasani, MD, MPH; UA Cancer Center; and Alla Sikorskii, PhD, Michigan State University Department of Psychiatry. The study began March 1 and has begun enrolling survivors.

"Thanks to this research, in the future we will be able to offer the right intervention, in the right dose, at the right time to our cancer survivors so that post-treatment symptoms can be reduced and healing hastened with these supportive interventions," Dr. Badger said.

Lois Loescher, PhD, RN, FAAN, professor at the University of Arizona College of Nursing, the Mel and Enid Zuckerman College of Public Health and the Skin Cancer Institute at the UA Cancer Center is acutely aware of the vital importance of sun safety. A zealous advocate for the cause, she was drawn to sun safety research because she was fascinated by how such a serious cancer - that can be challenging to treat - is so easy to prevent. Skin cancer, the most common cancer in the US, is increasing in incidence and can be fatal.

“Respect your skin,” she says. “The skin is your largest organ, your body’s first line of defense, and is your body’s ‘roadmap’.  I started regular application of sunscreen when I was 30, but I had already damaged my skin so much before then. If I’d started 20 years earlier my wrinkles and skin spots would be much fewer today. That’s a message that we need to emphasize with today’s youth.”

With the sunniest part of the year upon us, Loescher has some tips for skin cancer prevention.

1. Fair Skin = Extra Precaution. Everybody is at risk, but the fairer the skin, the bigger the risk. If you have a skin type that burns easily – fair skin, blue eyes, blonde/red hair—you have to be extra careful. But remember, even if you have very dark skin, you can still be at risk.
2. Sun Damage Adds Up Quickly. Sun damage is cumulative and sun safety needs to start very early in life. Make sure babies and children are protected.
3. Re-Apply All Day. Block the sun. Cover up. Wear a hat, preferably wide-brimmed. Wear sunglasses.  Apply and re-apply sunscreen to sun-exposed areas even after you’ve taken those precautions.
4. The Equation for Your Protection. Know how to interpret sun protection factor on sunscreen: Multiply the time it takes your skin to burn by the SPF on your sunscreen (e.g. if your skin burns in 5 minutes and you apply SPF 30 sunscreen, you will have 150 minutes of protection).
5. Shade Can Be Your First Defense. Avoid being outside or seek shade from 10AM – 4PM, when the sun’s rays are at their most damaging.
6. Avoid the Booth. Avoid tanning booths and artificial tanning. Studies show these significantly increase chances of skin cancer.
7. Get Naked… And Look at your Skin. Observe your skin. Know your moles and skin spots. If you can’t see parts of your skin have somebody else take a look. Check for any changes in spots such as size, shape, color, texture and sensation.
8. Follow through and See a Dermatologist. See a dermatologist if you find a mole or skin spot that is changing or new. A change in a mole could be change in size, shape, color, texture, sensation. 

Questions or concerns about the dangers posed by the summer sun? Find additional information at the Skin Cancer Institute at the UA Cancer Center.

Dr. Loescher’s passion is the study of skin cancer risk reduction and preventive behaviors. She has received funding for her research from the NIH, the State of Arizona, private foundations, and through collaborations with universities in Queensland Australia. As part of her joint appointment in the College of Public Health, she has developed and evaluated skin cancer prevention hybrid training for health sciences students. As a longstanding member of the UA Cancer Center, she has several years of experience developing and evaluating public and professional outreach education sun safety programs.

“Arizona has vast areas where people have limited to no access to care,” she said. “They either have to travel or they don't get services. My thought behind applying for this grant was, ‘Can we promote and help these students so they will see the value in working with patients in integrated settings in rural and medically underserved areas?’ And beyond that, ‘Can we encourage them to stay and help these patients in Arizona once they’ve graduated from the program?’”

“As Arizona’s flagship university, it is vitally important that the University of Arizona helps address the needs of our state. This includes providing quality mental health care for everybody who lives here, especially those in communities where access to care is limited,” said UA President Robert C. Robbins, MD. “I’m glad to see that the College of Nursing is helping to meet this need while also strengthening training for nurse practitioners, who hopfully will choose to serve these areas once they begin their careers.”

The project is a bold step forward for nurses in the psychiatric mental health nurse practitioners field, Dr. Love said.

“A big part of this project is about learning to work with other health-care professionals. Can we collaborate to give the best possible care to people who otherwise might not receive care?" ~ Dr. Rene Love

“It’s very different from the way I learned to practice originally,” said Dr. Love, whose clinical expertise is as a psychiatric mental health nurse practitioner. “Traditionally, a real stigma surrounded mental health. Psych providers were housed away from everyone else because no one wanted it known they (patients) were seeking mental health services.”

The funds from the grant will continue to break down those barriers: An important focus of Dr. Love’s project is to foster interprofessional collaborative care at rural facilities to which students are assigned.

“A big part of this project is about learning to work with other health-care professionals,” she said. “Can we collaborate to give the best possible care to people who otherwise might not receive that care?”

Another unique element of the study involves the length of training students will receive at the sites, which include facilities in northern Arizona and outside Tucson, as well as in New Mexico and Oregon. Training will happen at one site for at least six months to support understanding of interprofessional care in rural and medically underserved locations. Typically, students participating in clinical practice move to several sites in different geographic locations and might spend no more than one semester at a single location.

“Students really will be immersed in a community of practice that will give them knowledge they might not gain at other places,” Dr. Love says.

In addition, the collaborative aspect of the study will be stressed: Students will be encouraged to attend staff meetings with other health-care professionals to help foster a team perspective. Their training also will involve working on assessments, diagnosis and treatment, giving students a thorough exposure to the challenges and rewards of working in underserved communities. Dr. Love hopes they will be inspired by their experiences and choose to seek work in those same communities following graduation.

Nine inaugural students are set for placement in the program in 2018. One of those students, Catherine Clare Dockery-Jackson, is in the final year of the specialty program and has high hopes for her time in the newly created program.

“It will allow me to experience an integrative care practice that addresses the patient more completely,” she says. “For me, nursing has always been a holistic discipline, so I’m looking forward to seeing how the clinical site will address a patient’s mental and physical needs.”