Legislation affecting governmental assistance for children of parents with substance use: a policy analysis of social justice.

There is legislation that withdraws governmental assistance where parents are using drugs. Social justice is an important consideration in any policy that modifies governmental assistance that benefits vulnerable children. The purpose of this policy analysis is to analyze identified legislation that effect governmental assistance for children in response to parents' substance misuse. A selective review of data-driven studies examined findings describing actual or potential effects on children of legislation targeting parental substance misuse. Challenges in design, processes, and implementation contribute to poor child outcomes. Identifiable constructs of social justice were missing in the reviewed legislation. Social injustice is a potential outcome for children when legislative intent focuses solely on addressing parental drug behaviors. Legislative alternatives to withdrawing support can address substance abuse while maintaining health promotion for these vulnerable children.

Alcohol Misuse Among Nursing Students.

BACKGROUND: The self-reported prevalence of alcohol use among U.S. college students decreased from 90.5% in 1980 to 79.2% in 2012. National efforts exist to reduce alcohol misuse among college students in the United States, yet little research addresses substance abuse among nursing students and even less addresses alcohol misuse. Alcohol misuse in nursing students may result in patient harm. PURPOSE: This scoping study describes the state of the science of alcohol misuse among nursing students, guided by the research question: "What is the current state of alcohol misuse among U.S. nursing students?" METHODS: Evidence was drawn from several scholarly sources. Articles were included if they addressed U.S. nursing students; alcohol misuse; substance abuse or chemical impairment; prevalence rates; and/or characteristics including nursing student behaviors, attitudes, and beliefs. Using thematic analysis, common themes were extracted, followed by hand coding those themes and using NVivo qualitative software. RESULTS: Six studies met inclusion criteria. Three themes, eight subthemes, and several gaps in knowledge were identified. The themes include "high prevalence exists," "necessity of supportive environments," and "hopelessness without policies." Subthemes include "root cause," "vulnerable population," "scholarship and substance use," "education," "identification of risk factors," "prevention and deterrents," "safety," "ethical and legal issues," and "consequences." CONCLUSIONS: On the basis of this analysis, several research questions were developed to explore alcohol misuse in this population. Alcohol was the most often used substance. Nursing students were unaware of a safe level of consumption and the potential negative health-related and professional effects associated with alcohol misuse.

Nursing and genetic biobanks.

Biobanks function as vital components in genetic research, which often requires large disease-based or population-based biospecimens and clinical data to study complex or rare diseases. Genetic biobanks aim to provide resources for translational research focusing on rapidly moving scientific findings from the laboratory into health care practice. The nursing profession must evolve as genetic biobanking practices advance. Nursing involvement in genetic biobanking practices comes with a distinct set of educational, ethical, and practice competencies. In response to these growing competency standards, nursing science developed a conceptual framework and continues to study ethical considerations to guide genetic biobanking initiatives.

Thematic analysis of cardiac care patients' explanations for declining contribution to a genomic research-based biobank.

BACKGROUND: Health care delivery systems increasingly ask patients to contribute biological samples for future genomic-based health research during critical care admissions, as the result of genome-based research requirements of unprecedented large sample sizes. Few reports describe patients' perceptions and responses to actual biobanking approaches in clinical settings. A qualitative study was conducted to explore 568 cardiac care patients' explanations of why they declined to contribute their samples to a future genomic research biobank. OBJECTIVES: To (1) identify themes emerging from explanations for declining contribution to the research biobanking initiative and (2) determine how the content informs the stewardship conceptual framework that addresses evidence-based clinical ethics practices in genomic and genetic research biobanking. METHODS: This qualitative study used an analytic method that combines inductive and deductive approaches to identify themes in patients' explanations for declining to contribute to a research biobank initiative. The hybrid design has relevance to health services research that seeks to develop taxonomy, themes, and theory. RESULTS: Inductive approaches showed that themes of intrusion and autonomy dominated explanations. Deductive approaches affirmed previously proposed elements of a stewardship conceptual framework that addresses ethics in biobanking. CONCLUSION: Research in understanding patients' perceptions can guide nursing and biobank practices in developing best practices.

Genetics' influence on patient experiences with a rare chronic disorder: a photovoice study of living with alpha-1 antitrypsin deficiency.

Patients with rare chronic disorders and their caregivers increasingly form communities to support and exchange social experiences. Because up to 10% of the United States population is affected by one of 5000 to 6000 rare disorders, efforts to understand the individuals and affected communities are important. This study was conducted using community-based participatory research approaches within a community of patients and caregivers living with alpha-1 antitrypsin (AAT) deficiency. Patient populations at some risk for lung transplant include individuals who smoked cigarettes and patients who underwent liver transplant in infancy and later adulthood due to accumulation of misfolded AAT within hepatocytes.

The stewardship model: current viability for genetic biobank practice development.

The "stewardship model" of ethics relationships is a conceptual framework initially proposed by Jeffers in Advances in Nursing Science, 24(2), 2001. It conceptualized ethical responsibilities in the practice of systematic collection and storage of biospecimens in biobanks for future healthcare genetic research. Since the article's publication 8 years ago, genetic biobanks have grown in number around the world and discernible biobank relational conceptualizations were published. Nursing leadership adopted competency standards for all genetic nursing practices. The involvement of nurses has increased and is projected for further significant increase as biobank practices emerge from research into clinical care settings. This assessment of current viability of this previously established stewardship model offers fresh insights to existing and future nursing research and practice. The purpose of this article was to analyze the original stewardship model's components, the relational parties, and characteristics; by contrasting those with proposed conceptualizations and existing biobank practices developed subsequent to its publication. The model's current viability and theoretical development status are assessed for its ability to support a future nursing evidence base for best practices. Proposals for the model's expansion are suggested.