Scholarly Work - Nursing
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Item Editorial: Building the clinical research workforce: challenges, capacities and competencies(Frontiers Media SA, 2024-07) Jones, Carolynn T.; Johnson, Elizabeth; Bierer, Barbara E.; Snyder, Denise C.; Smith, Hazel Ann; Akuffo, Emma; Sonstein, StephenIn this editorial, we summarize the identified headwinds evident in the clinical research professional workforce, ranging from capacity constraints to aligning competencies with the complexity of modern clinical research. This editorial is part of the Research Topic: “Building the Clinical Research Workforce: Challenges, Capacities and Competencies”. To move beyond common challenges, we outline opportunities for innovation in medical and pharmacological advancements from this Research Topic.Item A global pilot comparative, cross-sectional study of clinical research nurses/research midwives: Definition, knowledge base, and communication skills related to the conduct of decentralized clinical trials(Cambridge University Press, 2024-01) Johnson, Elizabeth A.; Hill, Gordon; Smith, Hazel Ann; Marsh, Lisa; Beer, KellyBackground: A gap in the literature exists pertaining to a global research nurse/research midwife resources and communication skill set necessary to engage with participants of diverse populations and geographic regions in the community or home-based conduct of decentralized clinical trials. Aims: An embedded mixed methods study was conducted to examine research nurse/research midwife knowledge base, experiences, and communication skill sets pertaining to decentralized trials across global regions engaged in remote research: the USA, Republic of Ireland, United Kingdom, and Australia. Methods: An online survey was deployed across international research nurse/research midwife stakeholder groups, collecting demographics, decentralized trial experience, barriers and facilitators to optimal trial conduct, and the self-perceived communication competence (SPCC) and interpersonal communication competence (IPCC) instruments. Results: 86 research nurses and research midwives completed the survey across all countries: The SPCC and IPCC results indicated increased clinical research experience significantly correlated with increased SPCC score (p < 0.05). Qualitative content analysis revealed five themes: (1) Implications for Role, (2) Safety and Wellbeing, (3) Training and Education, (4) Implications for Participants, and (5) Barriers and Facilitators. Conclusions: Common trends and observations across the global sample can inform decentralized trial resource allocation and policy pertaining to the research nurse/research midwife workforce. This study demonstrates shared cultural norms of research nursing and midwifery across varied regional clinical trial ecosystems.Item “Because We Are Afraid”: voices of the undocumented in a new immigrant destination in the United States(Springer Science and Business Media LLC, 2024-04) Metcalf, Madeline; Comey, Danika; Hines, Deborah; Chavez-Reyes, Genesis; Moyce, SallyThe purpose of this study is to explore immigrants’ perceptions of their daily lives in a state with anti-immigrant policies in the United States. Using snowball sampling, researchers recruited a sample of 30 Latino immigrants in southwest Montana. The research team conducted semi-structured interviews in Spanish and analyzed the data using thematic analysis. We identified four themes: difficulty accessing healthcare, frustration over the inability to obtain driver’s licenses, challenges related to employment, and desire to make a life in Montana. Fear permeated all topics. Lack of documentation presents complex economic, health, and social challenges that prevent immigrants from fully integrating into their communities. These are exacerbated in states that employ anti-immigrant policies. As Western states continue to experience growth in immigrant populations, it is critical to develop policies to support integration and equitable access to health and social services.Item Development of the Blackfeet Community Hospice Project: Pilot Workshop(SAGE Publications, 2022-08) Colclogh, Yoshiko; Brown, Gary M.Taboo perception on talking about death and dying among American Indians/Alaska Natives is prevalent. This suppressive value makes hospice introduction difficult, leading hospice disparity. Working together by using a community-based participatory research approach over a decade, we conducted a 6-hour workshop including information sharing and group activities. The purpose of the study was to investigate the community readiness for end-of-life knowledge by conducting a public workshop. We used pre- and post-workshop surveys with Likert-type responses to five questions to assess the effect of workshop in end-of-life knowledge. Thirty individuals participated the workshop; 80% of them reported their knowledge increase on at least one question. While the survey had concerns, positive participant responses indicated readiness and appropriateness to use workshops to increase end-of-life knowledge.Item Nursing and midwifery research priorities for Kenya: Results from a national Delphi survey(Wiley, 2023-10) Albanus, Albanus; Wager, Miriam; Nzengya, Daniel; Edwards, Joan; Secor‐Turner, MollyBackground. The International Council of Nurses and the World Health Organization have prioritized evidence-based nursing and midwifery practice derived from nurse-led research. However, in a low-resource country like Kenya, there is a need to identify research priorities to optimize utilization of limited existing research infrastructure and funding. Kenya lacks a nursing and midwifery research strategy to guide research prioritization. Introduction. The goal of this study was to identify and describe nursing and midwifery research priorities for Kenya. Methods. A cross-sectional Delphi survey using two iterative rounds of electronic data collection was used to reach a consensus about priorities for nursing and midwifery research in Kenya. NVivo-12 was used to analyze the qualitative data to identify categories, sub-themes, and themes; descriptive statistics were used to analyze quantitative data. Results. Participants included 159 nurse managers, administrators, and educators representing regional, county, and national referral, private, and faith-based hospitals, nurse training schools, research institutions, and nursing organizations in Kenya. Staffing challenges, motivation, remuneration, and funding for higher education were ranked as the top critically important issues using a cutoff point of ≥ 70% agreement. Conclusion. There is a need for the development of a National Framework for Nursing and Midwifery Research Priorities in Kenya to guide research that builds excellence in meeting nursing and midwifery human resource concerns and ultimately improves patient care practices and outcomes. Implications for nursing and nursing policy. The objective of Kenya's health goals delineated within three key national health documents cannot be attained without adequate numbers of nursing and midwifery professionals and policies that address nursing and midwifery staffing challenges, remuneration for employment, and improved funding for higher education.Item Hematoloechus sp. attachment shifts endothelium in vivo from pro- to anti-inflammatory profile in Rana pipiens: evidence from systemic and capillary physiology(American Physiological Society, 2023-08) Williams, Donna A.; Flood, Mary H.This prospective, descriptive study focused on lung flukes (Hematoloechus sp., H) and their impact on systemic and individual capillary variables measured in pithed Rana pipiens, a long-standing model for studies of capillary physiology. Three groups were identified based on Hematoloechus attachment: no Hematoloechus (No H), Hematoloechus not attached (H Not Att), and Hematoloechus attached (H Att). Among 38 descriptive, cardiovascular, and immunological variables, 18 changed significantly with H. Symptoms of H included weight loss, elevated immune cells, heart rate variability, faster coagulation, lower hematocrit, and fluid accumulation. Important capillary function discoveries included median baselines for hydraulic conductivity (Lp) of 7.0 (No H), 12.4 (H Not Att), and 4.2 (H Att) × 10−7 cm·s−1·cmH2O−1 (P < 0.0001) plus seasonal adaptation of sigma delta pi [σ(πc–πi), P = 0.03]. Pro- and anti-inflammatory phases were revealed for Lp and plasma nitrite/nitrate concentration ([NOx]) in both H Not Att and H Att, whereas capillary wall tensile strength increased in the H Att. H attachment was advantageous for the host due to lower edema and for the parasite via a sustained food source illustrating an excellent example of natural symbiosis. However, H attachment also resulted in host weight loss: in time, a conundrum for the highly dependent parasite. The study increases overall knowledge of Rana pipiens by revealing intriguing effects of H and previously unknown, naturally occurring seasonal changes in many variables. The data improve Rana pipiens as a general scientific and capillary physiology model. Diseases of inflammation and stroke are among the clinical applications.Item Using the social ecological model to identify challenges facing Latino immigrants(Wiley, 2023-05) Moyce, Sally; Comey, Danika; Anderson, Jacey; Creitz, Adam; Hines, Deborah; Metcalf, MadelineBackground. New Latino immigrant populations face challenges and barriers when arriving in new immigrant destinations. Objective. To better understand the challenges faced by Latino immigrants in a new immigrant destination by using the Social Ecological Model. Design. This study solicited the perceptions of key informants and Latino immigrant participants through qualitative data collection methods to understand how to address and decrease barriers to healthcare services and community resources. Sample. Researchers conducted semi-structured interviews with two groups of respondents: 13 key informants and 30 Latino immigrants. Measurements. Data were analyzed using thematic analysis and categorized based on the Social Ecological Model. Results. Themes identified at the individual and interpersonal levels of the Social Ecological Model include fear of deportation and stress. Themes at the community level include cultural differences, discrimination, and a lack of exposure of the majority community to Latino immigrants. At the system level, researchers identified language barriers, the cost of healthcare, and housing. At the policy level, researchers identified legal status and occupational exploitation as challenges for this community. Conclusion. Understanding the challenges faced by Latino immigrants requires multi-level interventions to address barriers that prevent new immigrants from accessing community resources.Item Nurses’ and midwives’ participation and utilization of health-related research in Kenya: Implications for evidence-based practice(Elsevier BV, 2023-04) Nzengya, Daniel M.; Mutisya, Albanus K.; Wagoro, Miriam C.A.; Secor-Turner, Molly; Edwards, JoanObjective. To assess the level of participation of nurses and midwives in health-related research, determine the status of utilization of research to inform nursing and midwifery practice in Kenya, and explore perspectives of nurses and midwives about strategies to empower nurses/midwives to engage in health research in Kenya. Methods. Data were extracted from online survey responses of 156 nurse and midwife educators, practitioners, and managers/administrators. SPSS version 26 was used to analyze quantitative data; qualitative data were analyzed using Excel to organize data into categories. Results. Over one-third of participants reported ever publishing research (37.2%, 58/156). Participants reported using knowledge gained in nursing school to guide practice most frequently (n = 148). Utilization of research findings to guide practice was reported by 80.3% (110/137) of participants. Strategies to enhance participation in the research included research training, research forums, policy reforms, and emphasis on research in curricula. Conclusions. There is need to intensify and prioritize proposed strategies to empower nurses/midwives to engage in health research.Item Marriage, Children, and Sex-Based Differences in Physician Hours and Income(American Medical Association, 2023-03) Skinner, Lucy; Yates, Max; Auerbach, David I.; Buerhaus, Peter I.; Staiger, Douglas O.Importance. A better understanding of the association between family structure and sex gaps in physician earnings and hours worked over the life cycle is needed to advance policies addressing persistent sex disparities. Objective. To investigate differences in earnings and hours worked for male and female physicians at various ages and family status. Design, Setting, and Participants. This retrospective, cross-sectional study used data on physicians aged 25 to 64 years responding to the American Community Survey between 2005 and 2019. Exposures. Earned income and work hours. Main Outcomes and Measures. Outcomes included annual earned income, usual hours worked per week, and earnings per hour worked. Gaps in earnings and hours by sex were calculated by family status and physician age and, in some analyses, adjusted for demographic characteristics and year of survey. Data analyses were conducted between 2019 and 2022.Results. The sample included 95 435 physicians (35.8% female, 64.2% male, 19.8% Asian, 4.8% Black, 5.9% Hispanic, 67.3% White, and 2.2% other race or ethnicity) with a mean (SD) age of 44.4 (10.4) years. Relative to male physicians, female physicians were more likely to be single (18.8% vs 11.2%) and less likely to have children (53.3% vs 58.2%). Male-female earnings gaps grew with age and, when accumulated from age 25 to 64 years, were approximately $1.6 million for single physicians, $2.5 million for married physicians without children, and $3.1 million for physicians with children. Gaps in earnings per hour did not vary by family structure, with male physicians earning between 21.4% and 23.9% more per hour than female physicians. The male-female gap in hours worked was 0.6% for single physicians, 7.0% for married physicians without children, and 17.5% for physicians with children. Conclusions and Relevance. In this cross-sectional study of US physicians, marriage and children were associated with a greater earnings penalty for female physicians, primarily due to fewer hours worked relative to men. Addressing the barriers that lead to women working fewer hours could contribute to a reduction in the male-female earnings gap while helping to expand the effective physician workforce.Item Improving Early Childhood Caries for American Indian 3- to 5-Year-Old Children Through Interprofessional Outreach: 2018–2022(American Public Health Association, 2023-02) Larsson, Laura S.; Hodgson, ChristineWe sought to determine the effectiveness of an interprofessional health team in improving access to oral health care among American Indian children enrolled in Head Start. Our team provided preventive treatments and case management during 11 visits from 2018 to 2022. Case management reduced the time between referral and dental treatment from a median of 166 days to 58.3 days over four years. An interprofessional team is an effective way to improve access to oral health care among rural American Indian Head Start children. (Am J Public Health. Published online ahead of print February 2, 2023:e1–e4. https://doi.org/10.2105/AJPH.2022.307205 )