Empowering Nurses of Minority in the Face of Incivility and Bullying: Through the Lens of Phenomenology

Abstract Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design used a purposeful sample of minority registered nurses to explore how they experience these phenomena in the workplace. The participants were recruited through electronic communications with leaders of national healthcare and nursing organizations, minority nurses’ associations, and word of mouth via social media in the United States. The Workplace Incivility Survey was used to identify minority nurses who have experienced incivility. Then, semi-structured interviews were collected to investigate nurses’ experiences in depth. Colaizzi’s Descriptive Phenomenological Method guided the data analysis. The themes identified in the analysis indicated that nurses representing the minority population have a range of unique experiences related to incivility, bullying, and empowerment. These experiences are influenced by implicit bias, microaggression, and systemic racism. Minority nurses also offered several ideas for empowerment, such as resources, tools, education, instilling confidence and power, providing mentors, and autonomy provided to nurses individually and for the organization, provide more diverse people in management positions, managerial accountability, consequences for bad behavior, anonymity reporting, and unification throughout the organization. Findings point toward future research for interventions and education in health care systems and schools of nursing. Keywords: minority nurses, incivility, minorities in nursing, empowerment nursing, empowering nurses, minority nurses, bullying, phenomenology, and incivility

Using Google Location History data to quantify fine-scale human mobility

Abstract Background Human mobility is fundamental to understanding global issues in the health and social sciences such as disease spread and displacements from disasters and conflicts. Detailed mobility data across spatial and temporal scales are difficult to collect, however, with movements varying from short, repeated movements to work or school, to rare migratory movements across national borders. While typical sources of mobility data such as travel history surveys and GPS tracker data can inform different typologies of movement, almost no source of readily obtainable data can address all types of movement at once. Methods Here, we collect Google Location History (GLH) data and examine it as a novel source of information that could link fine scale mobility with rare, long distance and international trips, as it uniquely spans large temporal scales with high spatial granularity. These data are passively collected by Android smartphones, which reach increasingly broad audiences, becoming the most common operating system for accessing the Internet worldwide in 2017. We validate GLH data against GPS tracker data collected from Android users in the United Kingdom to assess the feasibility of using GLH data to inform human movement. Results We find that GLH data span very long temporal periods (over a year on average in our sample), are spatially equivalent to GPS tracker data within 100 m, and capture more international movement than survey data. We also find GLH data avoid compliance concerns seen with GPS trackers and bias in self-reported travel, as GLH is passively collected. We discuss some settings where GLH data could provide novel insights, including infrastructure planning, infectious disease control, and response to catastrophic events, and discuss advantages and disadvantages of using GLH data to inform human mobility patterns. Conclusions GLH data are a greatly underutilized and novel dataset for understanding human movement. While biases exist in populations with GLH data, Android phones are becoming the first and only device purchased to access the Internet and various web services in many middle and lower income settings, making these data increasingly appropriate for a wide range of scientific questions

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Additional file 3. Google Surveys and other Google Location History data (GLH) analysis

Using Google location history data to quantify fine-scale human mobility

Background: Human mobility is fundamental to understanding global issues in the health and social sciences such as disease spread and displacements from disasters and conflicts. Detailed mobility data across spatial and temporal scales are difficult to collect, however, with movements varying from short, repeated movements to work or school, to rare migratory movements across national borders. While typical sources of mobility data such as travel history surveys and GPS tracker data can inform different typologies of movement, almost no source of readily obtainable data can address all types of movement at once. Methods: Here, we collect Google Location History (GLH) data and examine it as a novel source of information that could link fine scale mobility with rare, long distance and international trips, as it uniquely spans large temporal scales with high spatial granularity. These data are passively collected by Android smartphones, which reach increasingly broad audiences, becoming the most common operating system for accessing the Internet worldwide in 2017. We validate GLH data against GPS tracker data collected from Android users in the United Kingdom to assess the feasibility of using GLH data to inform human movement. Results: We find that GLH data span very long temporal periods (over a year on average in our sample), are spatially equivalent to GPS tracker data within 100m, and capture more international movement than survey data. We also find GLH data avoid compliance concerns seen with GPS trackers and bias in self-reported travel, as GLH is passively collected. We discuss some settings where GLH data could provide novel insights, including infrastructure planning, infectious disease control, and response to catastrophic events, and discuss advantages and disadvantages of using GLH data to inform human mobility patterns. Conclusions: GLH data are a greatly underutilized and novel dataset for understanding human movement. While biases exist in populations with GLH data, Android phones are becoming the first and only device purchased to access the Internet and various web services in many middle and lower income settings, making these data increasingly appropriate for a wide range of scientific questions.</p

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Additional file 2. Literature review data

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Additional file 1. Study materials

Assessing the effect of global travel and contact reductions to mitigate the COVID-19 pandemic and resurgence

Travel and physical distancing interventions have been implemented across the World to mitigate the COVID-19 pandemic, but studies are needed to quantify the effectiveness of these measures across regions and time. Timely population mobility data were obtained to measure travel and contact reductions in 135 countries or territories. During the 10 weeks of March 22 - May 30, 2020, domestic travel in study regions has dramatically reduced to a median of 59% (interquartile range [IQR] 43% - 73%) of normal levels seen before the outbreak, with international travel down to 26% (IQR 12% - 35%). If these travel and physical distancing interventions had not been deployed across the World, the cumulative number of cases might have shown a 97-fold (IQR 79 - 116) increase, as of May 31, 2020. However, effectiveness differed by the duration and intensity of interventions and relaxation scenarios, with variations in case severity seen across populations, regions, and seasons.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was supported by the grants from the Bill &amp;amp; Melinda Gates Foundation (OPP1134076); the European Union Horizon 2020 (MOOD 874850). N.R. is supported by funding from the Bill &amp;amp; Melinda Gates Foundation (OPP1170969). O.P. is supported by the National Science Foundation (1816075). A.J.T. is supported by funding from the Bill &amp;amp; Melinda Gates Foundation (OPP1106427, OPP1032350, OPP1134076, OPP1094793), the Clinton Health Access Initiative, the UK Department for International Development (DFID) and the Wellcome Trust (106866/Z/15/Z, 204613/Z/16/Z). Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical clearance for collecting and using secondary population mobility data was granted by the institutional review board of the University of Southampton (No. 48002). All data were supplied and analyzed in an anonymous format, without access to personal identifying information.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesCode for the model simulations is available at the following GitHub repository: https://github.com/wpgp/BEARmod. The data on COVID-19 cases and interventions reported by country are available from the data sources listed in Supplementary Materials. The parameters and population data for running simulations and estimating the severity are listed in Supplementary Data S1 to S2. The population movement data obtained from Baidu are available at: https://qianxi.baidu.com/. The Google COVID-19 Aggregated Mobility Research Dataset used for this study is available with permission of Google, LLC

Assessing the effect of global travel and contact restrictions on mitigating the COVID-19 pandemic

Travel restrictions and physical distancing have been implemented across the world to mitigate the coronavirus disease 2019 (COVID-19) pandemic, but studies are needed to understand their effectiveness across regions and time. Based on the population mobility metrics derived from mobile phone geolocation data across 135 countries or territories during the first wave of the pandemic in 2020, we built a metapopulation epidemiological model to measure the effect of travel and contact restrictions on containing COVID-19 outbreaks across regions. We found that if these interventions had not been deployed, the cumulative number of cases could have shown a 97-fold (interquartile range 79–116) increase, as of May 31, 2020. However, their effectiveness depended upon the timing, duration, and intensity of the interventions, with variations in case severity seen across populations, regions, and seasons. Additionally, before effective vaccines are widely available and herd immunity is achieved, our results emphasize that a certain degree of physical distancing at the relaxation of the intervention stage will likely be needed to avoid rapid resurgences and subsequent lockdowns

Risk of SARS-CoV-2 Transmission among Air Passengers in China

BACKGROUND: Modern transportation plays a key role in the spread of SARS-CoV-2 and new variants. However, little is known about the exact transmission risk of the virus on airplanes.METHODS: Using the itinerary and epidemiological data of COVID-19 cases and close contacts on domestic airplanes departing from Wuhan city in China before the lockdown on January 23, 2020, we estimated the upper and lower bounds of overall transmission risk of COVID-19 among travellers.RESULTS: 175 index cases were identified among 5797 passengers on 177 airplanes. The upper and lower attack rates (ARs) of a seat were 0.60% (34/5622, 95%CI 0.43%-0.84%) and 0.33% (18/5400, 95%CI 0.21%-0.53%), respectively. In the upper- and lower-bound risk estimates, each index case infected 0.19 (SD 0.45) and 0.10 (SD 0.32) cases respectively. The seats immediately adjacent to the index cases had an AR of 9.2% (95%CI 5.7%-14.4%), with a relative risk 27.8 (95%CI 14.4-53.7) compared to other seats in the upper limit estimation. The middle seat had the highest AR (0.7%, 95%CI 0.4%-1.2%). The upper-bound AR increased from 0.7% (95%CI 0.5%-1.0%) to 1.2% (95%CI 0.4%-3.3%) when the co-travel time increased from 2.0 hours to 3.3 hours.CONCLUSIONS: The ARs among travellers varied by seat distance from the index case and joint travel time, but the variation was not significant between the types of aircraft. The overall risk of SARS-CoV-2 transmission during domestic travel on planes was relatively low. These findings can improve our understanding of COVID-19 spread during travel and inform response efforts in the pandemic.</p

Integrated vaccination and physical distancing interventions to prevent future COVID-19 waves in Chinese cities

The coronavirus disease 2019 (COVID-19) pandemic has posed substantial challenges to the formulation of preventive interventions, particularly since the effects of physical distancing measures and upcoming vaccines on reducing susceptible social contacts and eventually halting transmission remain unclear. Here, using anonymized mobile geolocation data in China, we devise a mobility-associated social contact index to quantify the impact of both physical distancing and vaccination measures in a unified way. Building on this index, our epidemiological model reveals that vaccination combined with physical distancing can contain resurgences without relying on stay-at-home restrictions, whereas a gradual vaccination process alone cannot achieve this. Further, for cities with medium population density, vaccination can reduce the duration of physical distancing by 36% to 78%, whereas for cities with high population density, infection numbers can be well-controlled through moderate physical distancing. These findings improve our understanding of the joint effects of vaccination and physical distancing with respect to a city's population density and social contact patterns.</p