An Open Letter from Past Presidents of the American Nurses Association.

Eight former ANA presidents urge nurses to consider nursing's values when they vote.

Factors Related to Medication Self-Management in African American Older Women.

Individuals with multiple chronic diseases are often prescribed medications for each condition and thus must manage a drug regimen. Medication self-management is challenging for most individuals with chronic diseases, but it can be especially difficult for African American older women. This study investigated how medical mistrust, caregiver role strain, and other relevant variables may be associated with medication self-management behaviors (MSMB) among African American older women, and whether goal congruence and self-efficacy mediated the relationship between the predictor variables and MSMB. A sample of 116 African American older (age >50 years) women from central Milwaukee participated in this correlational, cross-sectional study. Although goal congruence and self-efficacy were not found to act as mediators, the main finding was that goal congruence, self-efficacy, and age predicted 30% of the variance in MSMB. The results suggest that it is essential to strengthen individual self-efficacy, determine the goals that individuals have for their medication regimen, and develop support mechanisms to help patients attain these goals to better manage chronic disease. [Res Gerontol Nurs. 2019; 12(2):71-79.].

Cross-Plane Carrier Transport in Van der Waals Layered Materials.

The mechanisms of carrier transport in the cross-plane crystal orientation of transition metal dichalcogenides are examined. The study of in-plane electronic properties of these van der Waals compounds has been the main research focus in recent years. However, the distinctive physical anisotropies, short-channel physics, and tunability of cross layer interactions can make the study of their electronic properties along the out-of-plane crystal orientation valuable. Here, the out-of-plane carrier transport mechanisms in niobium diselenide and hafnium disulfide are explored as two broadly different representative materials. Temperature-dependent current-voltage measurements are preformed to examine the mechanisms involved. First principles simulations and a tunneling model are used to understand these results and quantify the barrier height and hopping distance properties. Using Raman spectroscopy, the thermal response of the chemical bonds is directly explored and the insight into the van der Waals gap properties is acquired. These results indicate that the distinct cross-plane carrier transport characteristics of the two materials are a result of material thermal properties and thermally mediated transport of carriers through the van der Waals gaps. Exploring the cross-plane electron transport, the exciting physics involved is unraveled and potential new avenues for the electronic applications of van der Waals layers are inspired.

Enabling Ultrasensitive Photo-detection Through Control of Interface Properties in Molybdenum Disulfide Atomic Layers.

The interfaces in devices made of two-dimensional materials such as MoS2 can effectively control their optoelectronic performance. However, the extent and nature of these deterministic interactions are not fully understood. Here, we investigate the role of substrate interfaces on the photodetector properties of MoS2 devices by studying its photocurrent properties on both SiO2 and self-assembled monolayer-modified substrates. Results indicate that while the photoresponsivity of the devices can be enhanced through control of device interfaces, response times are moderately compromised. We attribute this trade-off to the changes in the electrical contact resistance at the device metal-semiconductor interface. We demonstrate that the formation of charge carrier traps at the interface can dominate the device photoresponse properties. The capture and emission rates of deeply trapped charge carriers in the substrate-semiconductor-metal regions are strongly influenced by exposure to light and can dynamically dope the contact regions and thus perturb the photodetector properties. As a result, interface-modified photodetectors have significantly lower dark-currents and higher on-currents. Through appropriate interfacial design, a record high device responsivity of 4.5 × 103 A/W at 7 V is achieved, indicative of the large signal gain in the devices and exemplifying an important design strategy that enables highly responsive two-dimensional photodetectors.

Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies.

OBJECTIVE: To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). MATERIALS AND METHODS: The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a "user-centered design approach." A survey was completed to assess functionality and user satisfaction. RESULTS: IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. DISCUSSION: A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. CONCLUSION: IMATS satisfies the need for a system for monitoring and reporting health departments' countermeasure quantities so that decision makers are better informed. The "user-centered design approach" was successful, as evident by the many public health departments that adopted IMATS.

Graphene- and aptamer-based electrochemical biosensor.

This study investigated the effectiveness of a graphene- and aptamer-based field-effect-transistor-like (FET-like) sensor in detecting lead and potassium ions. The sensor consists of a graphene-covered Si/SiO2 wafer with thrombin binding aptamer (TBA) attached to the graphene layer and terminated by a methylene blue (MB) molecule. K(+) and Pb(2+) both bind to TBA and cause a conformational change, which results in MB moving closer to the graphene surface and donating an electron. Thus, the abundance of K(+) and Pb(2+) can be determined by monitoring the current across the source and drain channel. Device transfer curves were obtained with ambipolar field effect observed. Current readings were taken for K(+) concentrations of 100 µM to 50 mM and Pb(2+) concentrations of 10 µM to 10 mM. As expected, I d decreased as ion concentration increased. In addition, there was a negative shift in V Dirac in response to increased ion concentration.

Global nursing leadership: a practical guide.

Nursing leaders of today must be prepared for a nursing practice environment inclusive of local, national, and global work and issues. The educational preparation of nursing leaders should incorporate a fundamental curriculum that offers a broad preparation and basic leadership skills along with guidelines and experiences to support global outreach and collaboration with many cultures and health care environments. This article provides a practical guide on entry into Global Nursing Leadership for nursing leaders from the nurse executive including all levels of nursing management.

Characterization of public health alerts and their suitability for alerting in electronic health record systems.

Public health agencies including federal, state, and local governments routinely send out public health advisories and alerts via e-mail and text messages to health care providers to increase awareness of public health events and situations. Agencies must ensure that practitioners have timely and accessible information at the critical point-of-care. Electronic health record (EHR) systems have the potential to alert physicians of emerging health conditions deemed important for public health at the most critical time of need. To understand how public health agencies can leverage existing alerting mechanisms in EHR systems, it is important to understand characteristics of public health alerts to determine their suitability for alerting in EHR systems. Authors conducted a review and analysis of public health alerts for a 3-year period to identify critical data attributes necessary to support public health alerting in EHR systems. The alerts were restricted to those most relevant for clinical care. The results showed that there is an opportunity for disseminating actionable information to clinical practitioners at the point of care to guide care and reporting. Public health alerts in EHR systems can be useful in reporting, recommending specific tests, as well as suggesting secondary prevention.

Introduction: Building Global Alliances V: The Challenges of Migration For Health Professional Women.

The following four articles are based on presentations delivered at Building Global Alliances V: The Challenges of Migration for Health Professional Women, held in Philadelphia on December 7-8, 2008 and hosted by CGFNS International (formerly the Commission on Graduates of Foreign Nursing Schools).

An integrative review of global nursing workforce issues.

Migration has been a way of life since the beginning of time, with migrants seeking other lands for personal and professional betterment. Today, in an era of globalization, trade agreements and technological advances, an increase in migration is inevitable. All professions have been affected, but the migration of health professionals, particularly nurses, has been the most dramatic. However, the migration of nurses across national and international borders comes with many challenges: systematic tracking of migration flows, harmonization of standards, recognition of professional credentials, fair and equitable distribution of the global health care workforce, and the effect of migration on the health care infrastructure of both source and destination countries. The international migration of nurses to address shortages in developed countries has, in some instances, left source countries with insufficient resources to address their own health care needs. The increasing complexity of health care delivery, aging of the population and the nursing workforce, and the escalating global demand for nurses create on-going challenges for policy makers. Strategically addressing global nursing workforce issues is paramount to sustaining the health of nations.

An informatics solution for informing care delivery of immediate public health risks to their patients.

This paper describes a public health alerting approach that has the potential to improve patient care during a public health outbreak and reduce healthcare costs, streamline the process of public health alert management and dissemination, and heighten the crucial feedback loop between public health officials and clinicians. The approach ties public health alerts into the diagnostic process and allows clinicians to more easily determine when an observed medical condition may be related to a more widespread disease outbreak. A prototype Alert Knowledge Repository (AKR) service using this approach was demonstrated within the Health Information and Management Systems Society (HIMSS) and the Public Health Information Network (PHIN) interoperability showcases in April and September 2009, respectively.

Introduction: Building Global Alliances IV: Global Health Challenges in a World Divided by Health Inequities.

The five papers following this introduction are based on presentations delivered at Building Global Alliances IV, Global Health Challenges in a World Divided by Health Inequities , sponsored by CGFNS International on December 3-4, 2007, in Philadelphia. Building Global Alliances IV provided opportunities to generate greater understanding of the local, national, and global ramifications of health inequities; the United Nations Millennium Development Goals (MDGs); the effect of migration on the distribution of health professionals (particularly the issues posted by international nurse migration); and the impact of these issues on health care delivery systems.

An overview of papers presented at Building Global Alliances III: The Impact of Global Nurse Migration on Health Services Delivery.

Global nurse migration has become a major phenomenon, impacting health service delivery in both developed and developing countries. The phenomenon has created a global labor market for health professionals and fueled international recruitment. International migration and recruitment are viewed as solutions to staffing shortages for some countries and as exacerbating problems for others. As a result, migration and recruitment have become prominent features of the international health policy debate.

Developing a new resource on international nurse migration: the international centre on nurse migration.

A new collaborative project on nurse migration was recently launched by the International Council of Nurses and the Commission on Graduates of Foreign Nursing Schools. This collaboration, the International Centre on Nurse Migration, guided by the principles of ethical recruitment and equitable treatment of migrating nurses, focuses on promoting, collecting, creating, and disseminating data and information on nurse migration; acting as a resource center; tracking trends and patterns of global health care workforce migration; analyzing policy; generating policy options; advocating for sound policy concerning nurse migration; promoting, undertaking, and disseminating research; providing consultant and expert advice; and offering continuing education about migration.

Trends in international nurse migration.

Predicted shortages and recruitment targets for nurses in developed countries threaten to deplete nurse supply and undermine global health initiatives in developing countries. A twofold approach is required, involving greater diligence by developing countries in creating a largely sustainable domestic nurse workforce and their greater investment through international aid in building nursing education capacity in the less developed countries that supply them with nurses.