10 research outputs found
Nat Genet
Venous thromboembolism is a significant cause of mortality(1), yet its genetic determinants are incompletely defined. We performed a discovery genome-wide association study in the Million Veteran Program and UK Biobank, with testing of approximately 13 million DNA sequence variants for association with venous thromboembolism (26,066 cases and 624,053 controls) and meta-analyzed both studies, followed by independent replication with up to 17,672 venous thromboembolism cases and 167,295 controls. We identified 22 previously unknown loci, bringing the total number of venous thromboembolism-associated loci to 33, and subsequently fine-mapped these associations. We developed a genome-wide polygenic risk score for venous thromboembolism that identifies 5% of the population at an equivalent incident venous thromboembolism risk to carriers of the established factor V Leiden p.R506Q and prothrombin G20210A mutations. Our data provide mechanistic insights into the genetic epidemiology of venous thromboembolism and suggest a greater overlap among venous and arterial cardiovascular disease than previously thought
Motivation and technological readiness in the use of high-fidelity simulation: A descriptive comparative study of nurse educators
There are many driving forces to increase the use of high-fidelity simulation (HFS) in nursing education, as well as many factors that may influence the implementation of this teaching strategy. These include the motivation of nurse educators to use HFS, the technological readiness of nurse educators to use HFS and the changing demographics of the nurse educator workforce. The purpose of this study is to address the significant gaps in the literature in the nurse educators' perspective of the use of HFS, technological readiness and the motivational factors that may influence the incorporation of this technology into curricula. A national survey of nurse educators was completed with 662 participants; however, only 576 completed the entire survey. In addition to demographic information, participants were asked to complete the Revised Motivation at Work Survey (R-MAWS) and the Technological Readiness Index (TRI). Information was also obtained regarding the self-identified level of expertise in using HFS and the training to use this technology. Findings included perceptions of barriers and facilitators to the use of HFS, which corresponded closely with published literature. Self-identified novices had higher amotivation levels than those who did not use HFS, those identified as competent or expert. This finding supports the use of mentors to develop the skills of self-identified novices. Nurse educators are most highly motivated by the value they place on their work, as well as the intrinsic pleasure obtained from the work. Nurse educators have a high level of technological readiness; however neither technological readiness nor work motivation appear to play a large role in the use of HFS. Recommendations for further study include research to determine what other factors play a role in the use of HFS, studies to determine if the benefits of HFS are superior to other teaching strategies warranting the time and financial commitment. Validated evaluation tools must be developed particularly if HFS is used for high-stakes evaluation
Using A Structured Review Of The Literature To Identify Key Factors Associated With The Current Nursing Shortage
The current population of nurses is aging and rapidly approaching retirement, and graduation of new nurses is not expected to meet demand. Multiple reports have offered information regarding the pending shortage and made recommendations regarding interventions. It is important that suggested interventions be based upon current evidence. An integrated review of literature was undertaken, searching CINAHL, PubMed, Academic Search Premier, Medline, and PsychInfo. Studies were limited to those conducted in the United States and published in English between 2000 and 2007. Search terms were nursing shortage, job satisfaction in nursing, stress in nursing, nursing turnover, nursing image, nursing work environment, physical demands of nursing, and nursing faculty shortage. The identified reasons for nurses leaving hospital practice were management issues, job design, job stress, physical demands, and the failure to nurture new nurses. The education issues include a lack of qualified faculty and clinical sites to allow for more students to be accepted into the programs. These are issues that can be addressed; and changes, implemented. Steps must be taken immediately to resolve these issues in an effort to keep an adequate supply of nurses at the bedside. © 2010 Elsevier Inc
Mastering the Journey to Continuous Compliance
The accreditation process of a nursing program requires
self-assessment, peer evaluation, and identifying areas of improvement. In 2008, the
Commission on Collegiate Nursing Education (CCNE) began offering a 10-year accreditation
with a Continuous Improvement Progress Report (CIPR) at the fifth year. This article
focuses on an in-depth analysis of a system in which the school of nursing utilized an
ad hoc committee to complete the CIPR. Reports generated by the ad hoc committee
concluded that need for improvement was warranted related to policy review. An action
plan for continuous compliance generated implementation of policy software and the
creation of an academic support specialist position. An ad hoc committee completed the
CIPR rather than paying faculty overload hours; policy was an exemplar. Faculty
development, team performance, and accountability resulted in a plan for continual
compliance that can be adopted in other nursing schools to meet CCNE
accreditation
Motivation and technological readiness in the use of high-fidelity simulation: a descriptive comparative study of nurse educators
There are many driving forces to increase the use of high-fidelity simulation (HFS) in nursing education, as well as many factors that may influence the implementation of this teaching strategy. These include the motivation of nurse educators to use HFS, the technological readiness of nurse educators to use HFS and the changing demographics of the nurse educator workforce. The purpose of this study is to address the significant gaps in the literature in the nurse educators' perspective of the use of HFS, technological readiness and the motivational factors that may influence the incorporation of this technology into curricula. A national survey of nurse educators was completed with 662 participants; however, only 576 completed the entire survey. In addition to demographic information, participants were asked to complete the Revised Motivation at Work Survey (R-MAWS) and the Technological Readiness Index (TRI). Information was also obtained regarding the self-identified level of expertise in using HFS and the training to use this technology. Findings included perceptions of barriers and facilitators to the use of HFS, which corresponded closely with published literature. Self-identified novices had higher amotivation levels than those who did not use HFS, those identified as competent or expert. This finding supports the use of mentors to develop the skills of self-identified novices. Nurse educators are most highly motivated by the value they place on their work, as well as the intrinsic pleasure obtained from the work. Nurse educators have a high level of technological readiness; however neither technological readiness nor work motivation appear to play a large role in the use of HFS. Recommendations for further study include research to determine what other factors play a role in the use of HFS, studies to determine if the benefits of HFS are superior to other teaching strategies warranting the time and financial commitment. Validated evaluation tools must be developed particularly if HFS is used for high-stakes evaluation. (Published By University of Alabama Libraries
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Discovery of 318 new risk loci for type 2 diabetes and related vascular outcomes among 1.4 million participants in a multi-ancestry meta-analysis
We investigated type 2 diabetes (T2D) genetic susceptibility via multi-ancestry meta-analysis of 228,499 cases and 1,178,783 controls in the Million Veteran Program (MVP), DIAMANTE, Biobank Japan and other studies. We report 568 associations, including 286 autosomal, 7 X-chromosomal and 25 identified in ancestry-specific analyses that were previously unreported. Transcriptome-wide association analysis detected 3,568 T2D associations with genetically predicted gene expression in 687 novel genes; of these, 54 are known to interact with FDA-approved drugs. A polygenic risk score (PRS) was strongly associated with increased risk of T2D-related retinopathy and modestly associated with chronic kidney disease (CKD), peripheral artery disease (PAD) and neuropathy. We investigated the genetic etiology of T2D-related vascular outcomes in the MVP and observed statistical SNP-T2D interactions at 13 variants, including coronary heart disease (CHD), CKD, PAD and neuropathy. These findings may help to identify potential therapeutic targets for T2D and genomic pathways that link T2D to vascular outcomes
Genomic and transcriptomic association studies identify 16 novel susceptibility loci for venous thromboembolism
Venous thromboembolism (VTE) is a significant contributor to morbidity and mortality. To advance our understanding of the biology contributing to VTE, we conducted a genome-wide association study (GWAS) of VTE and a transcriptome-wide association study (TWAS) based on imputed gene expression from whole blood and liver. Wemeta-analyzedGWAS data from18 studies for 30 234 VTE cases and 172 122 controls and assessed the association between 12 923 718 genetic variants and VTE. We generated variant prediction scores of gene expression from whole blood and liver tissue and assessed them for association with VTE. Mendelian randomization analyses were conducted for traits genetically associated with novel VTE loci. We identified 34 independent genetic signals for VTE risk from GWAS meta-analysis, of which 14 are newly reported associations. This included 11 newly associated genetic loci (C1orf198, PLEK, OSMR-AS1, NUGGC/SCARA5, GRK5, MPHOSPH9, ARID4A, PLCG2, SMG6, EIF5A, and STX10) of which 6 replicated, and 3 new independent signals in 3 known genes. Further, TWAS identified 5 additional genetic loci with imputed gene expression levels differing between cases and controls in whole blood (SH2B3, SPSB1, RP11-747H7.3, RP4-737E23.2) and in liver (ERAP1). At some GWAS loci, we found suggestive evidence that the VTE association signal for novel and previously known regions colocalized with expression quantitative trait locus signals. Mendelian randomization analyses suggested that blood traits may contribute to the underlying risk of VTE. To conclude, we identified 16 novel susceptibility loci for VTE; for some loci, the association signals are likely mediated through gene expression of nearby genes.Clinical epidemiolog