Improving Retention Strategies for Experienced Nurses

Experienced nurses depart the workforce in significant numbers; therefore, it is critical to understand how those departures affect patient care and safety. The focus of this systematic review included appraisal of recent research to provide an understanding of strategies used in acute care settings to retain experienced nurses. Guided by Benner\u27s model of skill acquisition, the purpose of this systematic review was to identify factors that influence the decision of nurses with experience to leave or remain working in acute care work settings. The 19 articles selected for this review were limited to those pertaining to experienced registered nurses who have worked in the acute care setting for 2 years and longer. The review excluded articles pertaining to registered nurses with fewer than 2 years of experience, who were considered at the novice or proficient level of nursing. The results of this literature review showed that management conflicts, lack of support, work environments, work schedules, and disproportionate staffing levels were among the factors leading to morale distress and burnout in experienced nurses. These findings have the potential to contribute to positive social change by guiding administrative efforts to retain experienced nurses and improve mentoring of newer nurses and, ultimately, improve patient outcomes

Efficacy of Chlorhexidine Varnish for the Prevention of Adult Caries: A Randomized Trial

The Prevention of Adult Caries Study, an NIDCR-funded multicenter, double-blind, randomized clinical trial, enrolled 983 adults (aged 18-80 yrs) at high risk for developing caries (20 or more intact teeth and 2 or more lesions at screening) to test the efficacy of a chlorhexidine diacetate 10% weight per volume (w/v) dental coating (CHX). We excluded participants for whom the study treatment was contraindicated or whose health might affect outcomes or ability to complete the study. Participants were randomly assigned to receive either the CHX coating (n = 490) or a placebo control (n = 493). Coatings were applied weekly for 4 weeks and a fifth time 6 months later. The primary outcome (total net D1-2FS increment) was the sum of weighted counts of changes in tooth surface status over 13 months. We observed no significant difference between the two treatment arms in either the intention-to-treat or per-protocol analyses. Analysis of 3 protocol-specified secondary outcomes produced similar findings. This trial failed to find that 10% (w/v) chlorhexidine diacetate coating was superior to placebo coating for the prevention of new caries (Clinicaltrials.gov registration number NCT00357877)

Educating Black Males in Black-Lives-Matter Movement Space

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Quantifying the importance of inhaler attributes corresponding to items in the patient satisfaction and preference questionnaire in patients using Combivent Respimat

Abstract Background Physicians consider ease of use, satisfaction, and preferences when prescribing an inhaler device. These factors may impact appropriate usage and compliance. Methods The objectives were to quantify the relative importance of inhaler attributes in patients currently using Combivent Respimat by eliciting preferences for performance and convenience attributes assessed by items in the Patient Satisfaction and Preference Questionnaire (PASAPQ). Using a pharmacy database, 19,964 adults in the United States who filled ≥2 Combivent Respimat prescriptions were identified. Of those, 8150 patients were randomly selected to receive invitation letters. The online cross-sectional survey included the PASAPQ and best-worst scaling (BWS) questions. The PASAPQ measures satisfaction with medication attributes across two domains: performance and convenience. BWS questions asked participants to select the most and least important device attributes. A descriptive statistics analysis of the PASAPQ and a random-parameters logit model of BWS responses were conducted. Results The survey was completed by 503 participants. Most were female (57.3%), white (88.5%), and 51–70 years old (67.6%). Approximately 47% reported a chronic obstructive pulmonary disease diagnosis, 21.9% asthma, 8.2% other lung disease, and 23.1% more than one lung disease. PASAPQ scores indicated that the majority were satisfied or very satisfied; up to 20% reported being dissatisfied with Combivent Respimat. The three most important inhaler attributes were Feeling that your medicine gets into your lungs, Inhaler works reliably, and Inhaler makes inhaling your medicine easy. The most important attributes corresponded to six of seven items in the PASAPQ performance domain. Conclusions Most participants reported satisfaction with Combivent Respimat. Performance attributes were more important than convenience attributes

Composite Counterstories~Memoir~Oral Histories~Ethnography with Young Children

This is a continuation of dialogue on pushing methodological boundaries as we continue to research on the counternarratives of curriculum of schools, neighborhoods, and communities in the U. S. South. In this session, a group of researchers present their dissertation works-in-progress. These researchers use composite counterstories (Solórzano & Yosso, 2002; Yosso, 2006; also, He & Ross, 2012; He, Ross, & Seay, 2015), memoir (Barrington, 1997; Birkerts, 2008; Ledoux, 1993; Roorbach, 2008; Zinsser, 1995, 2004), oral histories (Brown, 1988; Leavy, 2011; Ritchie, 2003) and ethnography (Clifford, 1977, 1988, 1997; Clifford & Marcus, 1986/2010; Madison, 2020; Marcus, 1998; Spradley, 1979, 1980; Van Maanen, 1988, 1995; Wolcott, 1999/2008) with young children as forms of curriculum inquiry into a wide array of topics such as Black skin, darkened curriculum: the Black children’s experience of mainstream schooling in racialized systems in the U. S. South; a memoir: being mixed, Black and Filipino, and multiracial in the U. S. South Georgia middle school; oral histories of Willow Hill Elementary--a historically Black school in Georgia; hyphenated identity and negotiated intersectionality: a memoir of a firstgeneration Nigerian-American male teacher in an inner city Title I elementary school in Georgia; educating Black males in Black-lives-matter movement space; counterstories: Back male teachers in rural Georgia; hearing silent voices: counternarratives of African American students overrepresented in special education programs in urban schools in Georgia; developing the culturally responsive/relevant/sustaining third-grade social studies curriculum: an ethnographic inquiry; doing ethnographic research with young children through multicultural children literature. These researchers explore creative ways to push methodological boundaries, perform dissertation writing and liberate academic writing by diving into life, writing into contradictions, and living against oppressions in schools, families, and communities in the U. S. South. Theoretical traditions and modes of expression are particularly explored. Innovative writings engendered from the inquiries will be demonstrated. Potentials, challenges, and future directions of creative inquiries and representations will be discussed

The COOH-terminal domain of huntingtin interacts with RhoGEF kalirin and modulates cell survival

Human huntingtin (Htt) contains 3144 amino acids and has an expanded polyglutamine region near the NH2-terminus in patients with Huntington’s disease. While numerous binding partners have been identified to NH2-terminal Htt, fewer proteins are known to interact with C-terminal domains of Htt. Here we report that kalirin, a Rac1 activator, is a binding partner to C-terminal Htt. Kalirin and Htt co-precipitated from mouse brain endosomes and co-localized at puncta in NRK and immortalized striatal cells and primary cortical neurons. We mapped the interaction domains to kalirin674-1272 and Htt2568-3144 and determined that the interaction between kalirin and Htt was independent of HAP1, a known interactor for Htt and kalirin. Kalirin precipitated with mutant Htt was more abundant than with wild-type Htt and had a reduced capacity to activate Rac1 when mutant Htt was present. Expression of Htt2568-3144 caused cytotoxicity, partially rescued by co-expressing kalirin674-1272 but not other regions of kalirin. Our study suggests that the interaction of kalirin with the C-terminal region of Htt influences the function of kalirin and modulates the cytotoxicity induced by C-terminal Htt

PMB Panel : Pushing Methodological Boundaries - Liberating Dissertation Writing: Counternarratives of Curriculum in Schools, Neighborhoods, and Communities in the South

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