The Impact of Mentorship on Nurses’ Level of Self-Efficacy and Motivation to Pursue Board Leadership Positions

Background: Nurses comprise the largest component of the healthcare workforce and possess a unique understanding of healthcare operations and patient care. On average, the proportion of nurses serving on hospital boards range from 2 to 6%, with the proportion of physicians averaging 20%. Over the last decade, much attention has been placed on emphasizing the importance of a nurse’s presence on boards. Despite these initiatives, nurses continue to display an overall hesitancy towards board service. Objectives: The aim of this project was to implement an evidence-based mentorship program to address barriers to board leadership and increase overall self-efficacy and motivation to pursue these positions. Methods: Eleven nurse leader mentees and eleven mentors participated in a voluntary mentorship program that addressed barriers to board leadership and gave guidance to seeking out board positions. Mentees completed the Sundean Healthcare Index for Preparedness in Board Competency (SHIP-BC) survey pre and post participation to measure changes in self-efficacy. Mentors and mentees also completed additional surveys to measure overall satisfaction with the program. Results: There were increases in the mentees average score on the SHIP-BC survey after program completion with a statistically significant difference in personal – interpersonal skills, as exhibited by a two-sided exact p-value of 0.027. Both groups expressed satisfaction in the program, expressing the value of formal mentorship and increased comfort level surrounding pursuing board leadership positions. Conclusions: Nurses possess a unique understanding of the healthcare sphere that make them valuable resources for board positions. Through these roles, nurses would have increased opportunities to advocate for patients and influence healthcare transformation. Utilization of an evidence-based mentorship model can assist in increasing nurses’ understanding of the importance of board leadership and overall feelings of self-efficacy

Associations between Nurse Experience, Clinical Specialty Setting, and Level of Nursing Education with Adherence to Clinical Practice Guidelines for Inpatient Influenza and Pneumococcal Vaccination Administration

Background: This research project examines associations between years of nursing practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. Previous research demonstrates novice nurses are at higher risk for errors of omission and face challenges with critical thinking. Objectives: 1) Identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration and 2) to identify associations among independent variables including levels of education, and specialty setting. Methods: A retrospective chart review was conducted to identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. Aggregate data were obtained from the quality improvement coordinator of a 37 bed inpatient community hospital. A chi-squared analysis was used to identify the relationship between variables. Results: There were sixty-three Registered Nurses in this study with a compliance rate of 81.64%. We accepted the three null hypotheses. Nurse experience X 2 (1, N=50) =0.836, p=0.361, specialty setting X 2 (1, N=50) =0.836, p=0.361, level of education (ADN=35.30%, BSN and above = 44.40% X 2 (1, N=44) =0.863, p=0.36. Proficient/Expert=47.10%), specialty setting (Med-Surg= 39.40%, ICU=52.90%), level of education (ADN=35.30%, \u3eBSN = 44.40%). Conclusion: This project will serve as a basis for future quality improvement projects to improve compliance with vaccination administration. A significant finding was compliance among these groups being \u3c 50% (compliance was defined at \u3e90%). Overall compliance with nurse experience 45.20% (Novice = 42.90%, Competent =45.50%, No statistically significant associations were found between compliance based on nurse experience, clinical specialty setting, and education level

Grifonin-1: A Small HIV-1 Entry Inhibitor Derived from the Algal Lectin, Griffithsin

Background: Griffithsin, a 121-residue protein isolated from a red algal Griffithsia sp., binds high mannose N-linked glycans of virus surface glycoproteins with extremely high affinity, a property that allows it to prevent the entry of primary isolates and laboratory strains of T- and M-tropic HIV-1. We used the sequence of a portion of griffithsin's sequence as a design template to create smaller peptides with antiviral and carbohydrate-binding properties. Methodology/Results: The new peptides derived from a trio of homologous β-sheet repeats that comprise the motifs responsible for its biological activity. Our most active antiviral peptide, grifonin-1 (GRFN-1), had an EC50 of 190.8±11.0 nM in in vitro TZM-bl assays and an EC50 of 546.6±66.1 nM in p24gag antigen release assays. GRFN-1 showed considerable structural plasticity, assuming different conformations in solvents that differed in polarity and hydrophobicity. Higher concentrations of GRFN-1 formed oligomers, based on intermolecular β-sheet interactions. Like its parent protein, GRFN-1 bound viral glycoproteins gp41 and gp120 via the N-linked glycans on their surface. Conclusion: Its substantial antiviral activity and low toxicity in vitro suggest that GRFN-1 and/or its derivatives may have therapeutic potential as topical and/or systemic agents directed against HIV-1

Examining mindfulness-based stress reduction: Perceptions from minority older adults residing in a low-income housing facility

<p>Abstract</p> <p>Background</p> <p>Mindfulness-based stress reduction (MBSR) programs are becoming increasingly common, but have not been studied in low income minority older populations. We sought to understand which parts of MBSR were most important to practicing MBSR members of this population, and to understand whether they apply their training to daily challenges.</p> <p>Methods</p> <p>We conducted three focus groups with 13 current members of an MBSR program. Participants were African American women over the age of 60 in a low-income housing residence. We tape recorded each session and subsequently used inductive content analysis to identify primary themes.</p> <p>Results and discussion</p> <p>Analysis of the focus group responses revealed three primary themes stress management, applying mindfulness, and the social support of the group meditation. The stressors they cited using MBSR with included growing older with physical pain, medical tests, financial strain, and having grandchildren with significant mental, physical, financial or legal hardships. We found that participants particularly used their MBSR training for coping with medical procedures, and managing both depression and anger.</p> <p>Conclusion</p> <p>A reflective stationary intervention delivered in-residence could be an ideal mechanism to decrease stress in low-income older adult's lives and improve their health.</p

The Teaching Leader Series: Interprofessional Faculty Development Update

Seminar (24 PowerPoint slides) Purpose: The mission of the Teaching Leader Series is to strengthen teaching, learning and assessment skills by providing opportunities and support for faculty to achieve educational excellence, promote interdisciplinary collaboration and encourage instructional innovation. Background: The Series is based on the assumption that an inclusive strategy would help ensure sustainability and that unique learning experiences occur when two or more professions together learned with, from, and about each other’s teaching practice. Since the Series began in 2008 over 20 different topics have been presented including Adult Learning, Curriculum Development, Narrative Medicine, and Teaching with Simulation and Standardized Patients. Description of Intervention or Program: We recognize individuals who have made the Series a part of their educational process and their development as teaching leaders with a pin. In order to receive a pin, participants must attend at least 6 workshops, prepare a report describing how they have applied information from the workshop and must agree to participate in a best practice focus group. Our goal is to have these individuals team teach a workshop with a current presenter who serves as their mentor. Results: The Series demographics are 50% nurses, 25% physicians, and 25% other educators. At the conclusion of each workshop, participants are asked to complete a self-retrospective evaluation. During AY 2011 92% of participants agreed that they would be able to apply what they learned to their job. Pin recipients (physician, pharmacists, nurse) have presented Teaching at the Bedside and Small Group Teaching with a PhD medical educator mentor. Relevance to interprofessional education or practice: Healthcare is practiced in teams and the Series models the importance and effectiveness of interprofessional learning and teaching. Not only are the participants from different disciplines, we also pair presenters from different disciplines. Learning Objectives: Upon completion of this session the participants will be able to Identify the effectiveness of providing interprofessional faculty development. Identify how interprofessional faculty development facilitates collaboration of clinical educators across traditional boundaries. Identify strategies used to integrate interprofessional education into faculty development

Radio emission from Supernova Remnants

The explosion of a supernova releases almost instantaneously about 10^51 ergs of mechanic energy, changing irreversibly the physical and chemical properties of large regions in the galaxies. The stellar ejecta, the nebula resulting from the powerful shock waves, and sometimes a compact stellar remnant, constitute a supernova remnant (SNR). They can radiate their energy across the whole electromagnetic spectrum, but the great majority are radio sources. Almost 70 years after the first detection of radio emission coming from a SNR, great progress has been achieved in the comprehension of their physical characteristics and evolution. We review the present knowledge of different aspects of radio remnants, focusing on sources of the Milky Way and the Magellanic Clouds, where the SNRs can be spatially resolved. We present a brief overview of theoretical background, analyze morphology and polarization properties, and review and critical discuss different methods applied to determine the radio spectrum and distances. The consequences of the interaction between the SNR shocks and the surrounding medium are examined, including the question of whether SNRs can trigger the formation of new stars. Cases of multispectral comparison are presented. A section is devoted to reviewing recent results of radio SNRs in the Magellanic Clouds, with particular emphasis on the radio properties of SN 1987A, an ideal laboratory to investigate dynamical evolution of an SNR in near real time. The review concludes with a summary of issues on radio SNRs that deserve further study, and analyzing the prospects for future research with the latest generation radio telescopes.Comment: Revised version. 48 pages, 15 figure

Integrating Patient Reported Outcomes with Clinical Cancer Registry Data: A Feasibility Study of the Electronic Patient-Reported Outcomes from Cancer Survivors (ePOCS) system.

Background: Routine measurement of Patient Reported Outcomes (PROs) linked with clinical data across the patient pathway is increasingly important for informing future care planning. The innovative electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system was developed to integrate PROs, collected online at specified post-diagnostic time-points, with clinical and treatment data in cancer registries. Objective: This study tested the technical and clinical feasibility of ePOCS by running the system with a sample of potentially curable breast, colorectal, and prostate cancer patients in their first 15 months post diagnosis. Methods: Patients completed questionnaires comprising multiple Patient Reported Outcome Measures (PROMs) via ePOCS within 6 months (T1), and at 9 (T2) and 15 (T3) months, post diagnosis. Feasibility outcomes included system informatics performance, patient recruitment, retention, representativeness and questionnaire completion (response rate), patient feedback, and administration burden involved in running the system. Results: ePOCS ran efficiently with few technical problems. Patient participation was 55.21% (636/1152) overall, although varied by approach mode, and was considerably higher among patients approached face-to-face (61.4%, 490/798) than by telephone (48.8%, 21/43) or letter (41.0%, 125/305). Older and less affluent patients were less likely to join (both P<.001). Most non-consenters (71.1%, 234/329) cited information technology reasons (ie, difficulty using a computer). Questionnaires were fully or partially completed by 85.1% (541/636) of invited participants at T1 (80 questions total), 70.0% (442/631) at T2 (102-108 questions), and 66.3% (414/624) at T3 (148-154 questions), and fully completed at all three time-points by 57.6% (344/597) of participants. Reminders (mainly via email) effectively prompted responses. The PROs were successfully linked with cancer registry data for 100% of patients (N=636). Participant feedback was encouraging and positive, with most patients reporting that they found ePOCS easy to use and that, if asked, they would continue using the system long-term (86.2%, 361/419). ePOCS was not administratively burdensome to run day-to-day, and patient-initiated inquiries averaged just 11 inquiries per month. Conclusions: The informatics underlying the ePOCS system demonstrated successful proof-of-concept – the system successfully linked PROs with registry data for 100% of the patients. The majority of patients were keen to engage. Participation rates are likely to improve as the Internet becomes more universally adopted. ePOCS can help overcome the challenges of routinely collecting PROs and linking with clinical data, which is integral for treatment and supportive care planning and for targeting service provision

A Network of Conserved Damage Survival Pathways Revealed by a Genomic RNAi Screen

Damage initiates a pleiotropic cellular response aimed at cellular survival when appropriate. To identify genes required for damage survival, we used a cell-based RNAi screen against the Drosophila genome and the alkylating agent methyl methanesulphonate (MMS). Similar studies performed in other model organisms report that damage response may involve pleiotropic cellular processes other than the central DNA repair components, yet an intuitive systems level view of the cellular components required for damage survival, their interrelationship, and contextual importance has been lacking. Further, by comparing data from different model organisms, identification of conserved and presumably core survival components should be forthcoming. We identified 307 genes, representing 13 signaling, metabolic, or enzymatic pathways, affecting cellular survival of MMS–induced damage. As expected, the majority of these pathways are involved in DNA repair; however, several pathways with more diverse biological functions were also identified, including the TOR pathway, transcription, translation, proteasome, glutathione synthesis, ATP synthesis, and Notch signaling, and these were equally important in damage survival. Comparison with genomic screen data from Saccharomyces cerevisiae revealed no overlap enrichment of individual genes between the species, but a conservation of the pathways. To demonstrate the functional conservation of pathways, five were tested in Drosophila and mouse cells, with each pathway responding to alkylation damage in both species. Using the protein interactome, a significant level of connectivity was observed between Drosophila MMS survival proteins, suggesting a higher order relationship. This connectivity was dramatically improved by incorporating the components of the 13 identified pathways within the network. Grouping proteins into “pathway nodes” qualitatively improved the interactome organization, revealing a highly organized “MMS survival network.” We conclude that identification of pathways can facilitate comparative biology analysis when direct gene/orthologue comparisons fail. A biologically intuitive, highly interconnected MMS survival network was revealed after we incorporated pathway data in our interactome analysis

Environment And Genetics in Lung cancer Etiology (EAGLE) study: An integrative population-based case-control study of lung cancer

Background: Lung cancer is the leading cause of cancer mortality worldwide. Tobacco smoking is its primary cause, and yet the precise molecular alterations induced by smoking in lung tissue that lead to lung cancer and impact survival have remained obscure. A new framework of research is needed to address the challenges offered by this complex disease. Methods/Design: We designed a large population-based case-control study that combines a traditional molecular epidemiology design with a more integrative approach to investigate the dynamic process that begins with smoking initiation, proceeds through dependency/smoking persistence, continues with lung cancer development and ends with progression to disseminated disease or response to therapy and survival. The study allows the integration of data from multiple sources in the same subjects (risk factors, germline variation, genomic alterations in tumors, and clinical endpoints) to tackle the disease etiology from different angles. Before beginning the study, we conducted a phone survey and pilot investigations to identify the best approach to ensure an acceptable participation in the study from cases and controls. Between 2002 and 2005, we enrolled 2101 incident primary lung cancer cases and 2120 population controls, with 86.6% and 72.4% participation rate, respectively, from a catchment area including 216 municipalities in the Lombardy region of Italy. Lung cancer cases were enrolled in 13 hospitals and population controls were randomly sampled from the area to match the cases by age, gender and residence. Detailed epidemiological information and biospecimens were collected from each participant, and clinical data and tissue specimens from the cases. Collection of follow-up data on treatment and survival is ongoing. Discussion: EAGLE is a new population-based case-control study that explores the full spectrum of lung cancer etiology, from smoking addiction to lung cancer outcome, through examination of epidemiological, molecular, and clinical data. We have provided a detailed description of the study design, field activities, management, and opportunities for research following this integrative approach, which allows a sharper and more comprehensive vision of the complex nature of this disease. The study is poised to accelerate the emergence of new preventive and therapeutic strategies with potentially enormous impact on public health

Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: The electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system

<p>Abstract</p> <p>Background</p> <p>Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs) is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service.</p> <p>Methods/Design</p> <p>Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups), within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore if and how they relate to disease, treatment and/or individual differences characteristics.</p> <p>Discussion</p> <p>There is currently no system in the UK for collecting PROMs online and linking these with patients' clinical data in cancer registries. If feasible, ePOCS has potential to provide an affordable UK-scalable technical platform to facilitate and support longitudinal cohort research, and improve understanding of cancer survivors' experiences. Comprehensive understanding of survivorship difficulties is vital to inform the development and provision of supportive services and interventions.</p