Low-Income Residents' Perceptions of Medication Availability.

Access to medications is a critical determinant of health which often mediates the effects of diseases and leads to healthier lifestyles. With limited access to pharmacies, neighborhoods become pharmacy deserts. The purpose of this study was to explore the medication needs and perceptions of low-income community residents. A purposive sample of 40 low-income community residents participated in focus groups. Content analysis revealed four themes: transitioning to the present, stereotyping, feelings of disconnectedness, and ideal pharmacy. These findings reiterate the difficulties of living in pharmacy deserts, and decrease the gaps of limited qualitative research in this area.

Inclusion and Belonging at the Bedside and Beyond.

Inclusive work environments lead to a sense of belonging and improve retention.

Evaluating and Addressing the Diversity, Equity, Inclusion, and Belonging Climate in a School of Nursing.

BACKGROUND: There is a critical need to prepare a diverse nursing workforce and address issues of structural racism and health inequities. PROBLEM: A shortage of underrepresented nurse faculty exacerbates the lack of diversity in nursing education. Microaggressions and discrimination experienced by underrepresented nursing students hinder their personal and professional growth. Evaluating diversity, equity, and inclusion (DEI) and belonging within a school of nursing is crucial for progress. APPROACH: An alumni survey and a faculty/staff survey were conducted to assess DEI perceptions, which informed the development of a strategic plan. Goals focused on monitoring the cultural climate, increasing diversity and inclusivity, and enhancing faculty competencies. Educational offerings and initiatives were implemented to support these goals. OUTCOMES: Ongoing evaluation is essential to sustain progress in this critical area. CONCLUSION: These efforts are necessary for sustainable progress and equitable care provision.

Advancing faculty diversity in nursing education: Strategies for success.

Despite the established value of diversity, equity, and inclusion as critical components to achieving academic excellence, building diversity within nursing education remains a challenge. Institutional gatekeeping, overt racism, and implicit biases are barriers that perpetuate a low percentage of nursing faculty of color. From pre-search strategic prioritization to submission of the search committee report, a multi-prong, just, transparent, systematic, and strategic approach to hiring is needed to advance opportunities for hiring a diverse faculty. This article provides nursing administration leaders, search committee members, and faculty engaged in hiring practices with a stepwise review of specific strategies. Evidence and tools to mitigate bias, attract excellent and diverse applicant pools, conduct fair evaluations, and support ongoing reflection and improvement of hiring practices are described. An overview of types of implicit bias in hiring practices, descriptive evaluation rubrics, and self-reflection questions are included.

Creating Collaborative Relationships With Historically Black Colleges and Universities: An Approach to Diversifying the Nursing Workforce.

BACKGROUND: The lack of a diverse nursing workforce and inclusive nursing student pipeline initiatives can impact existing health disparities in the United States. PROBLEM: Gaps in the representation of future Black nurses in schools of nursing provide missed opportunities for cultural congruence and awareness. APPROACH: Developing collaborative relationships with historically Black colleges and universities (HBCUs) for recruitment is a mutually beneficial strategy. Undergraduate interns from 3 HBCUs attended a 6-week summer nursing immersion program at a graduate school of nursing on the campus of a predominately White institution. The aim was to provide awareness of the nursing profession and mentorship for further exploration into the profession. CONCLUSIONS: The program managed by Black nurse faculty provides a recruitment strategy that serves as a framework to support the financial, emotional, and social needs of prospective Black nursing students.

Writing a Diversity and Inclusivity Statement: Guidelines for Nursing Programs and Faculty.

BACKGROUND: For decades, nursing programs have worked to address the need for a culturally diverse workforce and student body to better reflect the populations they serve. The development of a diversity and inclusivity statement is a first step in ameliorating this issue. PROBLEM: A clearly communicated diversity and inclusivity statement should demonstrate a nursing organization's commitment to the value of people from all backgrounds. It should include language that emphasizes the value of diverse cultures, experiences, thoughts, and contributions. APPROACH: Nursing faculty can benefit from an organized and literature-supported model for writing meaningful diversity and inclusivity statements. CONCLUSIONS: Such an approach will communicate a nursing program's commitment to diversity and inclusion in the organization's mission, policies, practices, relationships, and curricula. This article provides nursing faculty with evidence-supported guidelines for writing meaningful diversity, inclusion, and equity statements for their nursing programs.

A Summer Professional Immersion in Nursing Program for Underrepresented Minority Undergraduate Students.

BACKGROUND: By 2044, more than 50% of the U.S. population will consist of ethnic/racial minorities. To facilitate optimal health, the projected nursing workforce should mirror this statistic. This pilot study examined the effects of a Summer Professional Immersion in Nursing Program (SPIN) on confidence in career decision making of under-represented minority undergraduate students. The 4-week program exposed participants to various nursing experiences. METHOD: The Career Decision Self-Efficacy Scale was administered pre- and post-SPIN to measure level of confidence in career decision making. RESULTS: The sample included eight women, with an average age of 19.63 years (SD = 0.52). Comparative analysis was performed using a reliable change index. The pre- to post-SPIN change was 0.38, indicating a meaningful significant increase in confidence. CONCLUSION: SPIN is an example for nursing programs interested in attracting undergraduate underrepresented minority students. The program positively influenced self-efficacy toward career selection and may positively influence enrollment of underrepresented nurses in the future. [J Nurs Educ. 2020;59(11):631-636.].

God and genes in the caring professions: clinician and clergy perceptions of religion and genetics.

Little is known about how care providers' perceptions of religion and genetics affect interactions with patients/parishioners. This study investigates clinicians' and clergy's perceptions of and experiences with religion and genetics in their clinical and pastoral interactions. This is an exploratory qualitative study designed to elicit care providers' descriptions of experiences with religion and genetics in clinical or pastoral interactions. Thirteen focus groups were conducted with members of the caring professions: physicians, nurses, and genetics counselors (clinicians), ministers and chaplains (clergy). Preliminary analysis of qualitative data is presented here. Preliminary analysis highlights four positions in professional perceptions of the relationship between science and faith. Further, differences among professional perceptions appear to influence perceptions of needed or available resources for interactions with religion and genetics. Clinicians' and clergy's perceptions of how religion and genetics relate are not defined solely by professional affiliation. These non-role-defined perceptions may affect clinical and pastoral interactions, especially regarding resources for patients and parishioners.

A qualitative perspective of barriers to health-promoting behaviors of African Americans.

African American mortality and morbidity rates remain alarmingly high. Implementation of health promotion strategies can be effective in reducing these rates. Yet, African American health-promoting behaviors remain inadequate. Exploration of perceived barriers to implementing health-promoting behaviors from a qualitative perspective may lead to a better understanding of African American barriers to healthier lifestyles. The purpose of this study was to explore barriers to health promotion for African Americans from a qualitative perspective. Focus group interviews were held in two southeastern states. The results yielded three themes. These were cost, lack of discipline versus not having enough time, and a lack of motivation. When health care professionals develop treatment strategies for African Americans, these barriers should be considered to aid in the development of more efficacious plans of care.

Improving cancer pain management through patient and family education.

The purpose of this study was to determine if continued access to information following a baseline pain education program would increase knowledge and positive beliefs about cancer pain management, thus resulting in improved pain control during a 6-month follow-up period. Patients with cancer-related pain and their primary caregivers received a brief pain education program, and were then randomized into one of three information groups: a) usual care, b) pain hot line, and c) weekly provider-initiated follow-up calls for 1 month post-education. Sixty-four patients and their primary caregivers were recruited. Both patients and caregivers showed an improvement in knowledge and beliefs after the baseline pain education program. Continued access to pain information with either the pain hot line or provider-initiated weekly follow-up calls did not affect long-term outcomes of pain intensity, interference because of pain, adequacy of analgesics used, or pain relief. In addition, long-term outcomes did not differ between patients who had improvement and those who showed decline in knowledge and beliefs pre-post education. These findings suggest that a brief pain education program can improve knowledge and beliefs of both patient and primary caregiver. Continued access to pain related information using either a patient- or provider-initiated format did not affect long-term pain outcomes.

Racial identity from an African Amercian perspective.

Mortality and morbidity rates for African Americans remain high. Many of the contributing factors to these deaths may be associated with lifestyle. Research has shown that racial identity influences the lifestyles of African Americans. Racial identity includes the adoption of personal behaviors and identification with a group of people with similar characteristics. Clarifying the notion of racial identity may lead to a better understanding of how racial identity influences health behaviors. The purpose of this study was to explore racial identity from a qualitative perspective. A focus group of African Americans residing in a metropolitan (n = 12) city of the United States was used for data collection. Seventy-five percent of the sample were female (n = 16) with a mean age of 43 years (s.d. = 7.26) and a range of 36 to 54 years of age. After analyses of the data, three themes emerged. These themes were "Racial Identity When Growing Up," "Becoming Aware of Racial Differences," and "Present Racial Identity." Sub-themes of each were explored in detail.

Genomics, nutrition, obesity, and diabetes.

PURPOSE: To present evidence of genetic and environmental interactions as they relate to nutrition, diabetes, and obesity. METHODS: A review of seminal literature related to genetics, obesity, and diabetes. FINDINGS: Multifactorial interactions are important in the development of nutrition-related disorders, but the challenge remains to explain how these interactions are expressed. Treating subpopulations of people might be important and useful to some extent at present, but in the future treating people of given genetic predispositions and other personal and environmental factors will have greater effects on quality-of-life indicators and life expectancies. CONCLUSIONS: Individualization coupled with multifactorial interactions will lead to new and more effective preventive and treatment modalities of nutrition-related disorders. With obesity and diabetes, genomics will bridge the traditional use of diet, exercise, and weight reduction with other environmental factors, ultimately leading to healthier lives.

Gender differences in health-promoting lifestyles of African Americans.

Despite progress in meeting Healthy People 2010 goals, African American (AA) men and women have higher mortality and morbidity rates as compared with Caucasian Americans. These may be attributed to lifestyle behaviors; however, this is a complex, multifactorial problem. The purpose of this study was to examine gender differences among AA lifestyle behaviors. A descriptive comparative design was used. The sample consisted of 223 AAs residing in southeastern United States. The health-promoting lifestyle profile (HPLP) was used to measure health-promoting behaviors. Independent t-test analysis revealed no statistically significant gender differences for total HPLP scores, t(220) = -1.49, p = 0.14. When controlling for income, education, and marital status, no significant interactions were seen with gender on HPLP. Independent t-test analyses revealed statistically significant differences for interpersonal relationship support, t(221) = -1.97, p = 0.05, health responsibility, t(214) = -2.46, p = 0.02, and nutrition t(219) = -3.27, p < 0.01, with women scoring higher than men. Although gender differences in AAs are evident for specific health-promoting lifestyle behaviors, these differences become less dominant when education and marital status were used as covariates.

Genomics and cardiovascular disease.

PURPOSE: To describe genetic knowledge and discovery in the area of cardiovascular disease (CVD) and to discuss how these new advances will influence the clinical care of affected people. ORGANIZING FRAMEWORK: A selective review of the literature is presented on the disease mechanism of both the Mendelian and multifactorial genetic cardiovascular conditions. A case study approach is used to illustrate how the genetic paradigm affects the healthcare experience of a family affected with familial hypertrophic cardiomyopathy. FINDINGS: The current state of CVD treatment remains complex. An understanding of genomic concepts and a genome-based approach is necessary to determine: (a) the risk of CVD susceptibility beyond traditional risk factors; (b) early detection of illness; (c) response to treatment; and (d) molecular taxonomy of the disease. CONCLUSIONS: The results of genetic research, education, and teaching will lead to a new understanding of genes and pathways, resulting in powerful new therapeutic approaches to CVD. The challenge is to translate genetic discoveries into clinical practice that ultimately leads to preventing CVD and reducing mortality.

The relationships among racial identity, self-esteem, sociodemographics, and health-promoting lifestyles.

The purpose of this study was to explore the relationships between racial identity, self-esteem, sociodemographic factors, and health-promoting lifestyles in a sample of African Americans. African American mortality rates are disproportionately high. These rates are associated with health behaviors that are driven by many factors including lifestyle practices. Other factors may be self-esteem and racial identity. Research shows gender differences in health behaviors, but no studies have explored a racial identity and gender interaction. Exploring these relationships may lead to the improved health status of African Americans. A convenience sample of 224 was recruited consisting of 48% males (n = 108). The mean age was 37.2 years (SD = 12.6). Regression analyses demonstrated that the internalization racial identity stage (beta = .12; p < .001) and self-esteem (beta = .50; p < .001) contributed to the variance in health-promoting lifestyles. Self-esteem did not mediate the relationship between immersion and health-promoting lifestyle scores (beta = -.16; p = .03). The full model Beta values show that racial identity remains significant with sociodemographics and interactions controlled, but moderators do not. Racial identity, while not a strong predictor, has some impact on health-promoting lifestyles regardless of sociodemographics.

Pain-related distress and interference with daily life of ambulatory patients with cancer with pain.

PURPOSE/OBJECTIVES: To examine the unique and combined effects of pain intensity, pain-related distress, analgesic prescription, and negative mood on interference with daily life because of pain. DESIGN: Descriptive, cross-sectional. SETTING: Two cancer clinics in academic medical centers in the southeastern United States. SAMPLE: 64 ambulatory patients with cancer who had pain that required analgesics. METHOD: Participants completed a number of self-report instruments during a regularly scheduled clinic visit. Standard instruments were selected to measure the main research variables. MAIN RESEARCH VARIABLES: Worst pain intensity, pain-related distress, analgesic adequacy, negative mood, and interference with daily life. FINDINGS: Patients with higher levels of worst pain, pain-related distress, and negative mood and inadequately prescribed analgesics reported greater interference with daily life because of pain. Multiple regression analysis indicated that interference with daily life was explained by the combination of these four predictors. All variables except negative mood were significant predictors of interference. The unique variance explained by pain-related distress exceeded that explained by worst pain intensity or inadequately prescribed analgesics. CONCLUSIONS: Data suggest that pain-related distress may be an important factor when investigating interference with daily life caused by pain. In addition, pain-related distress may provide a target for future intervention studies aimed at improving the impact of cancer-related pain on daily life. IMPLICATIONS FOR NURSING: Assessment of pain-related distress may be important in planning interventions. Common nursing interventions may be employed to reduce pain intensity and pain-related distress, which may result in enhanced physical and emotional well-being.

Chromophore formation in resorcinarene solutions and the visual detection of mono- and oligosaccharides.

The colorimetric properties of resorcinarene solutions had not been investigated since Baeyer's initial synthesis. We recently reported that solutions containing resorcinarene macrocycles develop color upon heating or standing. In the presence of saccharides, these solutions exhibit significant color changes which are easily seen. We herein present strong evidence that the solution color is due to macrocycle ring opening and oxidation. The optical responses to saccharides are due to complexation of the sugar with the acyclic chromophores. We apply these mechanistic insights toward the challenging problem of the visual detection of neutral oligosaccharides by simple chromogens. In addition, we also report the first single-crystal X-ray crystal structure determination of a rarely observed "diamond" resorcinarene stereoisomer.