Accelerating design and transforming baccalaureate nursing education to foster a culture of health

Healthcare reform and changing population health demographics call for a radical transformation in healthcare delivery and the education of healthcare providers. Nurses comprise the largest proportion of healthcare providers making it necessary to ensure that they are prepared to address the challenges that arise from the evolving healthcare delivery system. A key message of the Institute of Medicine’s The Future of Nursing: Leading Change, Advancing Health, is that nurses must lead healthcare change. To accomplish this, nurses must recognize their role in educating the new nursing workforce about creating a culture of health. Specifically, nurse educators must act as stewards for promoting health and wellness, and reducing health disparities and inequities. They must also recognize their role in forming partnerships with community organizations to improve primary care and population health by addressing social determinants of health. The purpose of this paper is to describe the structure for developing an innovative baccalaureate nursing curriculum and lessons learned that can inform the efforts of others interested in accelerating design of new curriculum

The distribution of the time taken for an epidemic to spread between two communities

Assessing the risk of disease spread between communities is important in our highly connected modern world. However, the impact of disease- and population-specific factors on the time taken for an epidemic to spread between communities, as well as the impact of stochastic disease dynamics on this spreading time, are not well understood. In this study, we model the spread of an acute infection between two communities (‘patches’) using a susceptible-infectious-removed (SIR) metapopulation model. We develop approximations to efficiently evaluate the probability of a major outbreak in a second patch given disease introduction in a source patch, and the distribution of the time taken for this to occur. We use these approximations to assess how interventions, which either control disease spread within a patch or decrease the travel rate between patches, change the spreading probability and median spreading time. We find that decreasing the basic reproduction number in the source patch is the most effective way of both decreasing the spreading probability, and delaying epidemic spread to the second patch should this occur. Moreover, we show that the qualitative effects of interventions are the same regardless of the approximations used to evaluate the spreading time distribution, but for some regions in parameter space, quantitative findings depend upon the approximations used. Importantly, if we neglect the possibility that an intervention prevents a large outbreak in the source patch altogether, then intervention effectiveness is not estimated accurately.Ada W.C.Yan, Andrew J.Black, James M.McCaw, Nicolas Rebuli, Joshua V.Ross, Annalisa J.Swan, Roslyn I.Hickso

Accelerating Curriculum Design: A Love It, Don\u27t Leave It Approach to Creative Process and Idealized Design

Purpose and Background: The Institute of Medicine’s (IOM) report (2010) on the “Future of Nursing” emphasized the need for nurses to lead health care change. One of the key messages in this report is a call to action for nursing schools to re-envision nursing education that focuses on a population-based perspective and emerging roles for nurses across the care continuum. With an evolving focus on primary and community-based care rather than acute care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses now and in the future will need to be prepared with a breadth of knowledge, skills, and competencies. In response, the Jefferson College of Nursing (JCN) embarked on the ambitious task of designing a new 21st century baccalaureate nursing curriculum over a 13-month period. Nursing curriculum design varies widely and can span the course of two to five years. To reduce the lengthy process and ensure faculty commitment, JCN leadership selected a core team of nine faculty members to navigate the full faculty through the design of the curriculum. Each team member was assigned three teaching credits for curriculum development and design. Although a 13-month turnaround time for curriculum design is unprecedented, what is most unique about JCN’s initiative is that it began with a charge of developing an idealized curriculum from a blank slate. To ensure that the curriculum reflected multiple perspectives, the team recruited six stakeholders including a nurse practice partner, health care consumer, community leader, alumnus, current student, and adjunct clinical faculty. Poster presented at: NLN Education Summit, 2015:Bridging Practice and Education, Las Vegas, Nevada, September 30, 2015-October 2, 2015.https://jdc.jefferson.edu/nursingposters/1009/thumbnail.jp

Attitudes towards emotional expression mediate the relationship between childhood invalidation and adult eating concern

Previous research has suggested that invalidating childhood environments are positively related to the symptoms of eating disorders. However, it is unclear how childhood environments might impact upon the development of eating disorder symptoms. This study examined the relationship between parental invalidation and eating disorder-related attitudes in a nonclinical sample and tested the mediating effect of attitudes towards emotional expression. Two hundred women, with a mean age of 21 years, completed measures of invalidating childhood environments, attitudes towards emotional expression, and eating pathology. Eating concerns were positively associated with recollections of an invalidating parental environment. The belief that the expression of emotions is a sign of weakness fully mediated the relationship between childhood maternal invalidation and adult eating concern. Following replication and extension to a clinical sample, these results suggest that targeting the individual's attitude towards emotional expression might reduce eating attitudes among women who have experienced an invalidating childhood environment

Ways to teach modelling—a 50 year study

This article describes a sequence of design research projects, some exploratory others more formal, on the teaching of modelling and the analysis of modelling skills. The initial motivation was the author’s observation that the teaching of applied mathematics in UK high schools and universities involved no active modelling by students, but was entirely focused on their learning standards models of a restricted range of phenomena, largely from Newtonian mechanics. This did not develop the numeracy/mathematical literacy that was so clearly important for future citizens. Early explorations started with modelling workshops with high school teachers and mathematics undergraduates, observed and analysed—in some case using video. The theoretical basis of this work has been essentially heuristic, though the Shell Centre studies included, for example, a detailed analysis of formulation processes that has not, as so often, been directly replicated. Recent work has focused on developing a formative assessment approach to teaching modelling that has proved both successful and popular. Finally, the system-level challenges in trying to establish modelling as an integral part of mathematics curricula are briefly discussed

Mortality in Pharmacologically Treated Older Adults with Diabetes: The Cardiovascular Health Study, 1989–2001

BACKGROUND: Diabetes mellitus (DM) confers an increased risk of mortality in young and middle-aged individuals and in women. It is uncertain, however, whether excess DM mortality continues beyond age 75 years, is related to type of hypoglycemic therapy, and whether women continue to be disproportionately affected by DM into older age. METHODS AND FINDINGS: From the Cardiovascular Health Study, a prospective study of 5,888 adults, we examined 5,372 participants aged 65 y or above without DM (91.2%), 322 with DM treated with oral hypoglycemic agents (OHGAs) (5.5%), and 194 with DM treated with insulin (3.3%). Participants were followed (1989–2001) for total, cardiovascular disease (CVD), coronary heart disease (CHD), and non-CVD/noncancer mortality. Compared with non-DM participants, those treated with OHGAs or insulin had adjusted hazard ratios (HRs) for total mortality of 1.33 (95% confidence interval [CI], 1.10 to 1.62) and 2.04 (95% CI, 1.62 to 2.57); CVD mortality, 1.99 (95% CI, 1.54 to 2.57) and 2.16 (95% CI, 1.54 to 3.03); CHD mortality, 2.47 (95% CI, 1.89 to 3.24) and 2.75 (95% CI, 1.95 to 3.87); and infectious and renal mortality, 1.35 (95% CI, 0.70 to 2.59) and 6.55 (95% CI, 4.18 to 10.26), respectively. The interaction of age (65–74 y versus ≥75 y) with DM was not significant. Women treated with OHGAs had a similar HR for total mortality to men, but a higher HR when treated with insulin. CONCLUSIONS: DM mortality risk remains high among older adults in the current era of medical care. Mortality risk and type of mortality differ between OHGA and insulin treatment. Women treated with insulin therapy have an especially high mortality risk. Given the high absolute CVD mortality in older people, those with DM warrant aggressive CVD risk factor reduction

Assessment in the service of learning: challenges and opportunities or Plus ça Change, Plus c’est la même Chose

This paper begins with a brief overview of literature indicating that, although there have been significant advances in the field’s capacity to conduct both formative and summative assessments over the past decades, those advances have not been matched by comparable impact. The bulk of the paper is devoted to a series of examples from the Mathematics Assessment Project that illustrate issues of methods, and the unrealized potential for advances

Fighting Terrorism: Empirics on Policy Harmonisation

This paper models the feasibility of common policy initiatives against global terrorism, as well as timelines for their enforcement. The empirical evidence is based on 78 developing countries for the period 1984–2008. Domestic, transnational, unclear and total terrorism variables are used. Absolute (or unconditional) and conditional catch‐ups are estimated using Generalised Method of Moments. We establish consistently that, the rate of catch‐up is higher in domestic terrorism relative to transnational terrorism. The time to full catch‐up required for the implementation of common policies without distinction of nationality is found to be in a horizon of 13–20 years for domestic terrorism and 24–28 years for transnational terrorism. Hence, from a projection date of 2009, in spite of decreasing cross‐country differences in terrorists’ attacks, there is still a long way to go before feasible common policy initiatives can be fully implemented without distinction of nationality. The paper is original by its contribution to the empirics of conflict resolution through decreasing cross‐country differences in terrorism tendencies. Policy implications are discussed

The Intentional Use of Service Recovery Strategies to Influence Consumer Emotion, Cognition and Behaviour

Service recovery strategies have been identified as a critical factor in the success of. service organizations. This study develops a conceptual frame work to investigate how specific service recovery strategies influence the emotional, cognitive and negative behavioural responses of . consumers., as well as how emotion and cognition influence negative behavior. Understanding the impact of specific service recovery strategies will allow service providers' to more deliberately and intentionally engage in strategies that result in positive organizational outcomes. This study was conducted using a 2 x 2 between-subjects quasi-experimental design. The results suggest that service recovery has a significant impact on emotion, cognition and negative behavior. Similarly, satisfaction, negative emotion and positive emotion all influence negative behavior but distributive justice has no effect

Characterizing wave- and current- induced bottom shear stress : U.S. middle Atlantic continental shelf

This paper is not subject to U.S. copyright. The definitive version was published in Continental Shelf Research 52 (2013): 73-86, doi:10.1016/j.csr.2012.10.012.Waves and currents create bottom shear stress, a force at the seabed that influences sediment texture distribution, micro-topography, habitat, and anthropogenic use. This paper presents a methodology for assessing the magnitude, variability, and driving mechanisms of bottom stress and resultant sediment mobility on regional scales using numerical model output. The analysis was applied to the Middle Atlantic Bight (MAB), off the U.S. East Coast, and identified a tidally-dominated shallow region with relatively high stress southeast of Massachusetts over Nantucket Shoals, where sediment mobility thresholds are exceeded over 50% of the time; a coastal band extending offshore to about 30 m water depth dominated by waves, where mobility occurs more than 20% of the time; and a quiescent low stress region southeast of Long Island, approximately coincident with an area of fine-grained sediments called the “Mud Patch”. The regional high in stress and mobility over Nantucket Shoals supports the hypothesis that fine grain sediment winnowed away in this region maintains the Mud Patch to the southwest. The analysis identified waves as the driving mechanism for stress throughout most of the MAB, excluding Nantucket Shoals and sheltered coastal bays where tides dominate; however, the relative dominance of low-frequency events varied regionally, and increased southward toward Cape Hatteras. The correlation between wave stress and local wind stress was lowest in the central MAB, indicating a relatively high contribution of swell to bottom stress in this area, rather than locally generated waves. Accurate prediction of the wave energy spectrum was critical to produce good estimates of bottom shear stress, which was sensitive to energy in the long period waves.P.S. Dalyander was supported by the U.S. Geological Survey Mendenhall Research Fellowship Program