Managing Obesity in Primary Care

Excess body weight has been shown to negatively impact morbidity and mortality in both developed and underdeveloped countries. Over two-thirds of U.S. adults are considered overweight or obese. Obesity and overweight present a pressing practice problem in primary care because many of these patients suffer from long-term consequences. Thus, the practice-focused question that guided this project was: Whether a clinical practice guideline (CPG) would be accepted for implementation in a primary care setting. The purpose of the Doctor of Nursing Practice (DNP) project was to develop a CPG for use in primary care and present the CPG to a panel of four expert nurse practitioners (NPs) in primary care practice. The project was based on the Johns Hopkins Evidence-Based Practice model and was supported by a comprehensive review of the literature. All four participants strongly agreed with each of the 23 Agree II survey items, resulting in a score of 100% across all six domains. Answering the question about their planned use of the CPG, all four NPs stated that they would use the CPG in their practice. NP1 and NP2 had already implemented the CPG for use in their practices. This DNP project supports positive social change by improving the primary care provider PCPs’ knowledge and participation in obesity and overweight care management in primary care. Patients needing to lose weight to maintain optimal health status are the primary beneficiaries because the CPG fosters weight reduction

High School Principals’ Perspectives of Job Stressors that Influence Job Satisfaction

The role of the school principal has become increasingly stressful and the problem is that school principals in a large school district in Maryland experience multiple job stressors that are contributing to low job satisfaction. The purpose of this basic qualitative study was to explore high school principals’ perspectives of stressors that affect their job satisfaction as well as what support systems they believe are necessary to increase their job satisfaction. An additional purpose was to identify methods that could be used to reduce such stress. Herzberg’s theory of motivation, which outlines how job factors motivate workgroups, was used to guide this research. Data were collected from eight high school principals in a large school district in Maryland who have one or more years of experience as a school principal in the district. A generic data analysis was conducted based on Creswell’s six steps of the generic analysis process to identify four themes associated with the participants’ experiences associated with stress and the school principal role: stress is derived from expectations, need for coping and well-being, satisfaction amidst challenges, and desire for institutional educational change. Recommendations for future research include extending the scope of participants, incorporating mixed methods of research, and collecting more specific data related to stressors via survey. As a result of this research, district leaders may have the data necessary to further support school administrators in their efforts to meet district level expectations, thereby improving their overall job satisfaction. Increasing the level of job satisfaction will hopefully improve morale, thereby causing positive social change for educational leaders.

Analysis of Sri Lanka’s Ethnic Inequality Through the Lens of Polarities of Democracy

Sri Lanka, despite gaining independence in 1948, has been plagued by ethnic separatism, negatively impacting 29.9% of its ethnic minorities and causing violence and civil unrest throughout the nation. This has hindered the nation’s sustained growth and development. This study addresses Sri Lanka’s ethnic separatism by examining three stages of its history through the lens of the polarities of democracy model. The research question for the study is “How has the balance of polarities of democracy contributed or detracted from Sri Lanka’s pre-colonial, colonial, and post-colonial governance in terms of sustaining ethnic harmony?” The study took the form of a qualitative historical-comparative case study to examine Sri Lankan history in three periods: pre-colonial (5 BCE–1505), colonial (1506–1948), and post-colonial (1949-Present). Data were collected through documentative sources and analyzed through qualitative document analysis and frequency tables. The results of the study confirm that pre-colonial Sri Lankan governance, which leveraged the overarching values of the polarities of democracy model, thrived in sustaining ethnic harmony. However, neglecting to leverage these polarities during the colonial and post-colonial periods led to a cycle of failed governance from 1948–2022, resulting in Sri Lanka becoming a failed state in 2023. This study fills gaps in existing literature on Sri Lanka’s ethnic crisis by building a polarities of democracy model specific to Sri Lanka’s crisis. This information can encourage positive social change, allowing future leaders to balance the polarity pairs, recover the state, and sustain its growth

Private Sector Staff’s Lived Experiences With Gamified Onboarding Programs

Although gamification is an emerging area of study, it is still a relatively new concept in workplaces. The purpose of this qualitative study was to explore the lack of existing literature on the topic of an interpretative, phenomenological analysis approach of private sector staff when gamification is utilized in onboarding processes. Data were collected via 12 individual semistructured interviews of full- or part-time employees at a partner organization in the information technology sector in India. Self-determination theory was used as the conceptual framework of this study. The research questions explored the lived experiences of staff with gamified onboarding programs and how those lived experiences informed their levels of organizational commitment and job satisfaction. Data from this study were analyzed using a seven-step iterative coding approach. The findings of this study indicated that although the concepts of gamification were new to almost all the participants of this study, the participants had a positive experience with the employer’s gamified onboarding program. The gamified onboarding program was motivating to the employees, and this organization provides an engaging, positive culture that results in high levels of organizational commitment and job satisfaction among employees. Future research could explore whether the delivery method of gamified onboarding programs impact levels of engagement and how different cultures may interact with gamified onboarding programs. Results of this study may influence positive social change by informing organizations that integrating a gamified approach in their onboarding programs fosters employee enjoyment at work, and this enjoyment may improve employee engagement throughout private, nonprofit and government organizations alike

The Relationship Between Nurse Staffing Ratio of Hospitals and Patient Satisfaction in Emergency Units

This completed quantitative research study explores the intricate relationship between nurse staffing ratios in emergency units and patient satisfaction, grounded in Donabedian\u27s conceptual model. The primary objective was to examine the correlation between nursing staff?to-patient ratios and patient satisfaction, utilizing the Davis Consumer Emergency Care Satisfaction Scale. Employing a correlational analysis research design, the study utilized descriptive and inferential statistics, including analysis of covariance (ANCOVA), to control for factors such as nursing hours per patient day, nursing staff mix, and education/experience levels. The study\u27s significance lies in informing healthcare managers about the pivotal role of nurse staffing in enhancing healthcare services for patients, nurses, and the community. Addressing gaps in current literature, the research provides a comprehensive understanding of factors contributing to staff shortages and their impact on patient satisfaction. The target population comprised nurses in Alabama hospitals, selected based on official datasets from Medicare.gov. The findings offer valuable insights for policy discussions and decision-making related to nurse-to-patient ratios, particularly in emergency units. As the healthcare landscape evolves, the study underscores the importance of addressing staffing challenges, especially in emergency units where patient needs are urgent and unpredictable. The COVID-19 pandemic further highlights the critical role of staffing as demand overwhelms the supply of healthy nurses. This research significantly contributes to the healthcare quality improvement discourse by unraveling the complex relationship between nurse staffing ratios and patient satisfaction. The findings provide practical guidance for policymakers, administrators, and healthcare leaders in optimizing nurse staffing levels for improved patient outcomes and experiences. The study emphasizes the ongoing importance of addressing staffing challenges, particularly in the dynamic environment of emergency units

Effects of a Mentorship Program on High Need College Students: Reflections from Mentors and Mentees

On average, the college graduation rates for minority and/or high-need students are generally low. To address this situation, a Mid-Atlantic Consortium recently secured a grant to improve 4-year graduation rates of high-need students (i.e., new first-time students and transfer students who qualify as low-income students, first-generation college students, adult students, and/or students of color) by 20% over each selected college’s baseline. The purpose of this qualitative case study was to explore the experiences of students and faculty mentors toward accomplishing this goal. Data were transcribed, coded, and analyzed thematically. Some of the effects identified in this study included enhanced academic and career planning, strengthening relationships between mentors–mentees through enhanced communication and trust building, enhanced research skills, development of mentorship skills, development of intellectual curiosity, and improved academic outcomes. We discuss implications for practice, policy, and further research

Knowledge, Attitudes, and Hesitancy to COVID-19 Vaccination Uptake in Nigeria

Vaccine hesitancy is a major global health problem despite their being historically effective at preventing infectious diseases such as tetanus, diphtheria, polio, rabies, pertussis, measles, and yellow fever. It has significantly hampered herd immunity, with a rate of 67% for COVID-19 globally. Vaccine hesitancy is common in underdeveloped nations like Nigeria. Misinformation and rumors may be the foundation of the lower vaccination rates in impacted African nations, particularly Nigeria. Thus, the Nigerian population has primarily remained unvaccinated or hesitant about COVID-19 vaccination uptake. This qualitative study explored the knowledge and attitudes towards hesitancy regarding COVID-19 vaccination uptake in Nigeria. The health belief model guided the study. Purposive and snowballing sampling strategies were used to select 18 participants ages 18 to 60 years who were unvaccinated from across Nigeria. NVivo qualitative data analysis software was used to analyze the data collected. The study findings suggest that the participants\u27 attitude towards hesitancy to COVID-19 vaccination uptake remains unchanged, indicating persistent low uptake of COVID-19 vaccine among the population. Implications for positive social change include encouraging collaboration between policy actors in health management. Working with stakeholders and the community, this health team can create social awareness through trusted social media networks and health centers and have transparent scientific data readily available to the community for verification to rekindle trust in vaccine programs in Nigeria

Organic Food Supply Chain Efficiency Strategies to Reduce Costs for Local Food Businesses

The price of organic foods makes consumers unable to reduce risks of specific health issues, including pesticide-related diseases and allergies. Supply chain managers are concerned that the financial barrier to accessing organic foods can exacerbate nutritional inequalities, particularly affecting communities facing food insecurity. Grounded in the resource dependency theory, the purpose of this qualitative pragmatic inquiry was to explore the processes supply chain leaders at four organizations use to supply organic foods to local grocery stores in South Carolina. The data collected from four semistructured interviews were thematically analyzed, resulting in six primary themes: organic certification, food appearance, expensive freight costs, speed of food distribution, labor, and relationships with farmers. A primary recommendation for organic food suppliers is to develop relationships with transit organizations and be creative in the strategies used to transport produce. The implications for positive social change include the potential to reduce organic food production costs to make organic produce less expensive and more attainable to all consumers