Interprofessional Education: A Summary of Reports and Barriers to Recommendations.

PURPOSE: Effective, quality care to achieve the newly developed sustainable development goals requires the development of collaborative teams and is predicated on implementing transformative interprofessional education and on team members who are equally empowered. This is a report on The Lancet commission on transformative education for health professionals and the National Academy of Medicine's dialogues on developing and implementing innovations to enhance collaborations and to facilitate the effectiveness of healthcare teams. METHODS: Using postcolonial feminist theory for critical analysis and integrations of findings from both reports, as well as for identification of barriers to achieving equity in team functioning. FINDINGS: The global Lancet commission and the National Academy of Medicine/Institute of Medicine forum developed frameworks that could be used to educate the next generation of professionals based on identifying the local needs of communities within a global context. Recommendations included breaking down silos that exists between schools and using an equity and justice framework in developing educational programs; utilizing contemporary innovations in teaching that correspond with innovations in healthcare systems; and insuring investments in time, energy, and resources in interprofessional education. However, without addressing the silos created through professional identities and power differentials, goals of interprofessional education and collaborative practice may not be achieved. CONCLUSIONS: While a great deal has been written about interprofessional education, it is imperative for faculty in the different professional schools and for members of healthcare teams to engage in dialogues that address the fundamental and most obstinate barriers to forming equitable teams, which is the consistent narrative of medical privilege and centrism. CLINICAL RELEVANCE: The dialogues about medical privilege and physician centrism in education and health care could drive the development of programmatic approaches to enhancing interprofessional education and teamwork based on justice and equity frameworks.

Improving women's cardiovascular health: a position statement from the International Council on Women's Health Issues.

Cardiovascular disease (CVD) is the number one killer of women worldwide, and it remains the primary cause of death and disability in both developed and developing countries. The International Council on Women's Health Issues is an international nonprofit association dedicated to the goals of promoting the health, health care, and the well-being of women. Based on the outcomes of a facilitated discussion at its 18th biannual meeting, delegates aim to raise awareness about the potent influence of gender-specific factors on the development, progression, and outcomes of CVD. Key recommendations for decreasing the burden of CVD are also discussed.

The health of women and girls determines the health and well-being of our modern world: A white paper from the International Council on Women's Health Issues.

The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally.

Nursing Theory in the Quest for the Sustainable Development Goals.

The 17 United Nations Sustainable Development Goals (SDG) are intended to promote a safe, healthy, and equitable world by the year 2030. Nurses are at the forefront of realizing the 2030 agenda through concerned citizenship and professional leadership. Nursing theory informs knowledge development and theory-guided practice essential for nurses working in all domains and in all nations. Although all extant nursing theories are relevant, a select few are discussed in detail to make explicit the links between theory and SDG realization. Middle-range theories are also valuable in helping to contextualize nursing practice through the lens of the SDGs. The SDGs address five themes - People, Planet, Peace, Prosperity, and Partnership - and theory remains vital to ensure nurses working in all settings are equipped to meet the needs of humanity and the world, now and in the future.

Women and Health: Women's Dual Roles as Both Recipients and Providers of Healthcare.

With the many economic, demographic, social and epidemiological global transitions, a Harvard-Penn-Lancet commission reviewed the current health status of women and its relationship to sustainability, and redefined the field as women and health. Four major recommendations were offered, insuring mechanisms to count women properly as providers and recipients of care, to value them by insuring protective policies, to treat and compensate them fairly and equitably, and to develop strategies to be accountable for sustaining and implementing the recommendations. However, without a life span approach to women, and their health, and without universal access to comprehensive health care, women's wellbeing and abilities to function up to their full capacities will be compromised. These recommendations have many implications for health care, education and practice.

The case against the DNP: history, timing, substance, and marginalization.

Doctor of Nursing Practice (DNP) or not? The answer is not! Within the historical context of our discipline, a doctorate degree should stand for advancing and translating knowledge. Clinical practice is the core of this knowledge. Separating the practice and research missions could undermine our ability to be equal partners in universities, as well as diminish our effectiveness in establishing the evidence for quality and safe health care.

Coping with grief after involuntary pregnancy loss: perspectives of African American women.

OBJECTIVE: To present the coping strategies used by African American women following their miscarriages, ectopic pregnancies, fetal deaths, and still-births, which the authors have termed involuntary pregnancy losses or IPLs. DESIGN: Semistructured audiotaped interviews; grounded theory methods used to collect and analyze the data. SETTING: Urban community-based sites in the Western United States. PARTICIPANTS: 20 African American adult women who reported a history of involuntary pregnancy loss within 3 years of interview. RESULTS: In this study, the women's responses to their IPL were grouped into four areas. They coped with personal reactions, reactions of others, memories of the baby, and subsequent pregnancies. CONCLUSION: The women in this study used inner resources to develop self-help strategies to cope with reactions following IPL. Nurses are challenged to harness the influence of family, friends, religion, and cultural traditions to assist women in processing the cognitive, emotional, and social traumas associated with IPL. Educating women to recognize grief responses after IPL and to manage these responses effectively may prevent adverse outcomes to their physical and mental health. A culturally sensitive framework of clinical assessment and intervention for African American women experiencing IPL has been developed.

Transforming vulnerability.

Asian American immigrant women engaged in filial caregiving are at special risk for health problems due to complex contextual factors related to immigration, cultural traditions, and role transition. This study examines the experience of two groups of immigrant Asian American women who are caring for older parents. A total of 41 women (22 Chinese American and 19 Filipino American) were interviewed in a study based on Strauss and Corbin's grounded theory methodology. The women were determined to be loyal to their traditional culture, which included strong filial values, while adapting to a new culture. Through the struggle of meeting role expectations and coping with paradox, the women mobilized personal and family resources to transform vulnerability into strength and well-being.

Caregiving between two cultures: an integrative experience.

In 1995, more than half of elderly immigrants to the United States were born in Asia or the Pacific region. The purpose of this study was to describe the process of caring for elderly parents by Asian American women. Forty-one women (22 Chinese American and 19 Filipino American) caring for elderly parents were interviewed in a study based on Strauss and Corbin's grounded theory methodology (1990). Although the women were moderately acculturated, indications of being in transition were evident. Analysis of interview data led to development of a substantive theory of caregiving between two cultures, reflecting the paradox of living and caregiving by two sets of standards and worldviews. The primary strategies used to manage the caregiving challenges were connecting and calibrating. Through personal growth and finding meaning, the caregivers integrated the caregiver role into their lives and became more connected with their families and within themselves.

Reflections on the doctorate of nursing practice.

A debate is currently raging in many academic nursing circles about a new degree, the Doctor of Nursing Practice (DNP). The degree is envisioned as the terminal degree in the discipline that focuses on clinical practice, and it is proposed to supplant the master's degree by 2015. There are a number of driving forces fueling the proposed change, including the hoped-for parity it will create with other health care disciplines and the potential for addressing the complexity of today's health care system. However, we believe that a substantive debate is required prior to a full-scale adoption of this new degree. In this article, we pose the potential unintended consequences of adopting a practice doctorate within our profession-the ones that might be negative for the nursing profession, for health care, and for society as a whole. We discuss these 3 dimensions and suggest that the DNP may erode the major progress nursing as a scientific discipline has made in universities over the past 3 decades. We suggest that the adoption of a DNP will threaten the generation of theory-based science in our discipline, either by decreasing the number of PhD-prepared nurses that will enter the field in the future or by lengthening the course of study to a PhD, thereby significantly shortening productive scientific careers. We question whether the creation of 2 doctoral tracks will further widen the chasm between nurse scientists and clinicians and result in many nurse clinicians feeling disenfranchised. We also pose questions about the impact of the DNP on health care and society. We are concerned that the number of nurses prepared at an advanced practice level will decrease and that the DNP will, thus, have negative impacts on quality, cost, and access to care. Finally, we question whether the DNP will create confusion among colleagues and consumers. We recommend that the adoption of the DNP only occur after thoughtful discussion both within and outside the profession.