Reproductive justice for incarcerated mothers and advocacy for their infants and young children.

The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well-being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research on the reproductive health of incarcerated women, (b) characteristics and experiences of pregnant incarcerated women, (c) outcomes of infants and young children with incarcerated parents, (d) implications of research findings for policy and practice, and (e) the need for increased research, public education, and advocacy. We strongly recommend that correctional policies and practices be updated to address the common misconceptions and biases as well as the unique vulnerabilities and health needs of incarcerated women and their young children.

Estados Unidos ha visto un crecimiento sin precedentes en el número de mujeres encarceladas, la mayoría de las cuales son madres con niños menores. Mayores preocupaciones de salud pública conciernen a la salud reproductiva de mujeres en prisiones y cárceles y el bienestar de sus infantes y niños pequeños. En el presente artículo, usamos un marco de trabajo de justicia reproductiva para examinar la intersección del encarcelamiento y la salud materno-infantil. Revisamos 1) la investigación actual sobre la salud reproductiva de mujeres encarceladas, 2) las características y experiencias de mujeres embarazadas encarceladas, 3) lo que resulta de infantes y niños pequeños con progenitores encarcelados, 4) las implicaciones de los resultados de la investigación en cuanto a políticas y prácticas, y 5) la necesidad de aumentar la investigación, la educación pública y la defensoría. Recomendamos fuertemente que se actualicen las políticas y prácticas correccionales para incluir los conceptos erróneos y prejuicios acerca de mujeres encarceladas y sus niños pequeños, así como también sus distintivas vulnerabilidades y necesidades de salud.

Les Etats-Unis d'Amérique ont été les témoins d'une augmentation sans précédent dans le nombre de femmes incarcérées, la plupart étant des mères avec des enfants mineurs. De grands problèmes de santé publique sont liés à la santé reproductive des femmes en prison et au bien-être de leurs nourrissons et de leurs jeunes enfants. Dans cet article nous utilisons une structure de justice reproductive afin d'examiner l'intersection de l'incarcération et de la santé maternelle et de l'enfant. Nous passons en revue: 1) les recherches actuelles sur la santé reproductive des femmes incarcérées, 2) les caractéristiques et les expériences de femmes incarcérées enceintes, 3) les résultats de nourrissons et de jeunes enfants avec des parents incarcérés, 4) les implications des résulats de recherche pour les lois et la pratique, et 5) le besoin de plus de recherches, plus d'éducation publique, plus de promotion et défense. Nous recommandons fortement que les lois correctionnelles et les pratiques correctionnelles soient mises à jour afin de traiter et de faire face aux conceptions erronées et à la partialité communes, ainsi qu'aux vulnérabilités uniques et aux besoins de santé des femmes incarcérées et de leurs jeunes enfants.

Collaboration Among DNP- and PhD-Prepared Nurses: Opportunity to Drive Positive Change.

Because of the rapidly changing environment of doctoral education, collaborative relationships between doctor of nursing practice and doctor of philosophy-prepared nurses continue to evolve. Although there are few currently reportable outcomes, examples are given of collaborative efforts highlighting scholarship, education, practice, and research. In accordance with the Institute Of Medicine recommendations and building upon work done by the American Association of Colleges of Nursing, this article describes opportunities for expanding collaboration among doctoral-prepared nurses. Collaboration facilitates a timely translation of research into practice, enhances educational opportunities, drives positive change, and improves health outcomes.

Continuities and changes in infant attachment patterns across two generations.

This study examined the intergenerational continuities and changes in infant attachment patterns within a higher-risk longitudinal sample of 55 female participants born into poverty. Infant attachment was assessed using the Strange Situation when participants were 12 and 18 months as well as several decades later with participants' children. Paralleling earlier findings from this sample on the stability of attachment patterns from infancy to young adulthood, results provided evidence for intergenerational continuities in attachment disorganization but not security. Children of adults with histories of infant attachment disorganization were at an increased risk of forming disorganized attachments. Although changes in infant attachment patterns across the two generations were not correlated with individuals' caregiving experiences or interpersonal stresses and supports during childhood and adolescence, higher quality social support during adulthood was associated with intergenerational changes from insecure to secure infant-caregiver attachment relationships.

Label-free microscopic assessment of glioblastoma biopsy specimens prior to biobanking [corrected].

Glioblastoma is the most common primary brain tumor with a median 12- to 15-month patient survival. Improving patient survival involves better understanding the biological mechanisms of glioblastoma tumorigenesis and seeking targeted molecular therapies. Central to furthering these advances is the collection and storage of surgical biopsies (biobanking) for research. This paper addresses an imaging modality, confocal reflectance microscopy (CRM), for safely screening glioblastoma biopsy samples prior to biobanking to increase the quality of tissue provided for research and clinical trials. These data indicate that CRM can immediately identify cellularity of tissue biopsies from animal models of glioblastoma. When screening fresh human biopsy samples, CRM can differentiate a cellular glioblastoma biopsy from a necrotic biopsy without altering DNA, RNA, or protein expression of sampled tissue. These data illustrate CRM's potential for rapidly and safely screening clinical biopsy samples prior to biobanking, which demonstrates its potential as an effective screening technique that can improve the quality of tissue biobanked for patients with glioblastoma.

The financial and clinical benefits of a hospital-based PhD nurse researcher.

Aligning quality outcomes with cost effectiveness is the cornerstone of the direction of health care in the United States. Implementing and supporting an evidence-based practice (EBP) environment requires resources. Because research is a foundational element of the EBP process, resources allocated for nursing research are essential. As part of operational costs, PhD nurse researchers can affirmatively impact an organization by improving quality of care and patient outcomes. Incorporation of a PhD nurse researcher can favorably alter the organization in a pay-for-performance environment.

Intergenerational relations of attachment: a research synthesis of urban/rural Mexican samples.

Intergenerational relations of attachment, including adult state of mind, adult care giving quality, and infant behavior, were examined in urban and rural samples. The sample included 66 dyads of contrasting populations, 35 middle-high urban Spanish speaking families and 31 rural Indian peasant families. Measures included the Adult Attachment Interview (George, Kaplan, & Main, 1985 /1996), home observations of mother-infant, and the Strange Situation attachment assessment (Ainsworth, Blehar, Waters, & Wall, 1978 ). Reliability among independent coders of Spanish AAI transcripts was established for the first time. Moreover, significant relations among the instruments were found, supporting the validity of the AAI to predict infant's attachment classifications and mothers sensitive care of their infants across cultures. Results further supported the cross-cultural robustness of core features of attachment theory and, to some extent, the pathway from adult state of mind through responsive care to attachment security.

Board leadership development: the key to effective nursing leadership in the 21st century.

This article discusses the need for board leadership development of nurses. The authors provide an overview of the Sigma Theta Tau International Board Leadership Development program based on the experiences of nine Fellows who completed the program. Elements necessary for a self-developed board leadership development program are presented. Rationale is discussed as to why the Sigma Theta Tau Board Leadership Development program and future similar programs need to include the critical success factors in the development of nurses as board members. The authors discuss the variety of professional and personal benefits of a program of this importance.

Impacting health through on-the-job counseling: role for professional nurses.

Employers have implemented a variety of workplace health promotion programs. An initiative in which experienced professional nurses were contracted to provide counseling sessions to employees at the workplace is described.

Point-of-care technology supports bedside documentation.

As the conversion to an electronic health record intensifies, the question of which data-entry device works best in what environment and situation is paramount. Specifically, what is the best mix of equipment to purchase and install on clinical units based on staff preferences and budget constraints? The authors discuss their evaluation of stationary personal computers, workshops on wheels, and handheld tablets related to timeliness of data entry and their use of focus groups to ascertain the pros/cons of data-entry devices and staff preferences. An assessment of the implications for costs related to the timeliness of data entry is also presented.

Cultural competence in the era of evidence-based practice.

Cultural competence has become an important concern for contemporary health care delivery, with ethical and legal implications. Numerous educational approaches have been developed to orient clinicians, and standards and position statements promoting cultural competence have been published by both the American Medical Association and the American Nurses Association. Although a number of health care regulatory agencies have developed standards or recommendations, clinical application to patient care has been challenging. These challenges include the abstract nature of the concept, essentializing culture to race or ethnicity, and the attempts to associate culture with health disparities. To make cultural competence relevant to clinical practice, we linked a cultural competency continuum that identifies the levels of cultural competency (cultural destructiveness, cultural incapacity, cultural blindness, cultural precompetence, and cultural proficiency) to well-established values in health care. This situates cultural competence and proficiency in alignment with patient-centered care. A model integrating the cultural competency continuum with the components of evidence-based care (i.e., best research practice, clinical expertise, and patient's values and circumstances) is presented.

A framework for cultural competence in advanced practice psychiatric and mental health education.

TOPIC: Cultural competence in psychiatric advanced practice education. PURPOSE: To present a framework for educators to use when addressing culturally competent advanced psychiatric nursing practice. SOURCES: NONPF competencies, published literature, and Web resources. CONCLUSIONS: Development of cultural competence is an important link to the reduction of mental health disparities. Situating the advanced nursing practice process within a negotiating space allows for incorporation of cultural information into patient care. The framework presented in this paper provides a theoretical and practical approach to orienting students to meeting the elements of cultural competence set out in the NONPF recommendations.

Developmental assessment of competence from early childhood to middle adolescence.

This study represents a developmentally informed, empirically validated examination of competence across multiple domains (Social, Cognitive, Emotional well-being), gender and age (early childhood, middle childhood, early adolescence, middle adolescence). Competence indicators were created and the structure of these domains was tested using multi-method, multi-informant data collected on 191 participants drawn from a prospective study of at-risk children. The results indicated that inter-individual differences in Cognitive and Social competence were stable across time, whereas inter-individual differences in Emotional well-being were stable only between early and middle adolescence. While the strength of stability of Cognitive competence was similar across different time points, the stability of Social competence declined after middle childhood, suggesting more inter-individual variability with regard to change. The findings also indicated that both the structure and the stability of competence are similar for boys and girls.

The Black-White perception gap and health disparities research.

Reducing and eliminating racial and ethnic health disparities has become a national research priority. This research agenda requires new research frameworks that encompass the social determinants of health and the translation pathways of these social contexts into physiological morbidity. Within these sociobiological research frameworks, identity and emotions are seen as crucial links in the causal pathways from stressors to biological responses. In this country, the lived social reality of African American individuals is experienced through the color of their skin. Their identity is bound with the racial inequities of our society. It has been suggested that the emotions of anger and frustration resulting from this institutionalized racial discrimination are an emotional causative pathway to the pathophysiology contributing to the health disparities experienced by African Americans. However, as much as we espouse the concept of cultural competency in health care, until recently, there has been very little honest dialogue about how race and racism influences health. This article will explore the Black-White cultural perception gap and attempt to provide insight on the relationship to African American health and implications for health disparities research.

Social capital, health, and health disparities.

PURPOSE: To synthesize the empirical evidence that links social capital to population health with the aim of identifying implications for health disparities research. METHODS: A literature search of PubMed and CINAHL databases from January 1990 to June 2002 was done using the search term "social capital." In addition, tables of contents of applicable journals from January 1997 to June 2002 were searched. Reference lists were examined for additional empirical and theoretical articles related to social capital and health. Eighty-four articles were retrieved for review and 19 articles met inclusion criteria. FINDINGS: Although most reseachers concluded that their findings supported an association between social capital and health, all research was descriptive, without conceptual development. This gap resulted in (a) lack of distinction of the concept as an attribute of a geographic space or as an individual attribute, (b) problematic use of operational variables, and (c) limited theoretical exploration of causal linkage. These deficits limit the usefulness of the concept for health disparities research. CONCLUSIONS: The lack of conceptual development diminishes the usefulness of social capital as a variable for public health research. However, the empirical evidence is sufficient to warrant further work to advance the concept in relation to population health and health disparities.