Doctor of Nursing Practice-prepared academics: Promotion and tenure-eligible?

ABSTRACT: Since the Doctor of Nursing Practice (DNP) was implemented, there has been ongoing discussion about whether or not DNP-prepared faculty are eligible for promotion and tenure. This column updates that discussion through input from two DNP-prepared faculty key informants.

Genitourinary Syndrome of Menopause: Prevalence and Predictors.

The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection. Factors related to the prevalence of GSM included age and aging; reproductive aging stage; hormones, especially estrogen; and culture and language. We recommend further specification of diagnostic criteria for GSM; clarification of urinary symptoms in GSM; use of longitudinal study designs; validation of GSM-related measures; exploration of cultural equivalence of GSM measures; and assessing biases in completed research.

Climate change and the adverse impact on the health and well-being of women and girls from the Women's Health Expert Panel of the American Academy of Nursing.

Climate change has measurable adverse impact on the general and reproductive health of women and girls. Multinational government organizations, private foundations, and consumer groups identify anthropogenic disruptions in social and ecological environments as the primary threats to human health this century. Drought, micronutrient shortage, famine, mass migration, conflict over resources, and effects on mental health resulting from displacement and war are challenging effects to manage. The most severe effects will be felt by those with the least resources to prepare for and adapt to changes. Climate change is a phenomenon of interest to women's health professionals because women and girls are more vulnerable to the effects due to a combination of physiologic, biologic, cultural, and socioeconomic risk factors. Nurses, with our scientific foundation, human-centered approach, and position of trust in societies can be leaders in efforts at mitigation, adaptation, and building resilience in response to changes in our planetary health.

Overturning Roe v. Wade: consequences for midlife women's health and well-being.

In July 2022, the United States Supreme Court issued a decision in Dobbs v. Jackson Women's Health Organization that overturned Roe v. Wade, the Supreme Court decision that legalized access to abortion in the United States. The overturning of Roe v. Wade means women's ability to choose to have an abortion or continue a pregnancy is no longer protected by the constitution of the Unites States (Rohan, Editorial: Overturning Roe v. Wade: What are the implications for perinatal nurses?, 2021). Consequently, each state can now independently decide the legality of abortion. The purpose of this commentary is to discuss potential consequences of the overturning of Roe v. Wade for women's health, particularly midlife women's health, in the United States. The consequences discussed include unintended pregnancy, access to the full array of reproductive health services including abortion, impact on the reproductive health of poor women and women of color, and the impact on midlife women in their caregiving roles.

COVID-19 effects on women's home and work life, family violence and mental health from the Women's Health Expert Panel of the American Academy of Nursing.

BACKGROUND: The COVID-19 pandemic exaggerated women's roles in families as primary caretakers and overseers of family health. This is compounded by possible loss of work and resultant loss of health insurance. PURPOSE: We examine how pandemic-related factors have altered women's roles and created stressors challenging stress adaptation and typical coping strategies, including how registered nurses have faced unique challenges. FAMILY VIOLENCE AND PANDEMIC-RELATED MENTAL HEALTH CHALLENGES: Enforced stay-athome orders exaggerated by work-from-home has amplified family violence worldwide. Besides COVID-19 protective measures increasing greater contact with abusers, they limited women's access to help or support. Pandemic-related issues increased anxiety, anger, stress, agitation and withdrawal for women, children, and registered nurses. DISCUSSION: More evidence about pandemic-related impacts on women's home and work lives, especially the scope of stressors and emotional/mental health manifestations is urgently needed. Policies to support interventions to improve mental health resilience are paramount.

Women's sexual/reproductive health and access challenges amid COVID-19 pandemic.

Challenges to women's health in the context of COVID-19 is based on their unique experience shaped by sex/gender. This paper provides clinical practice-, research-, and policy-related commentary on key COVID-19 pandemic factors impinging on women's sexual/reproductive health (SRH) and care access, particularly in the context of pregnancy, childbirth, sexual/gender variations, and concurrent chronic conditions. Women tend to have less severe outcomes from COVID-19 than men but certain sub-groups are more vulnerable than others. Yet few United States studies have disaggregated the data accordingly. Forming a basis for well-informed policy generation, needed is more research specific to COVID-19 vulnerability/risk factors and outcomes for groups of women by age, race and socioeconomic and cultural determinants. Access to SRH-related clinical services has been diminished during the pandemic, making a priority for restoring/preserving inclusive SRH care for women, for example, family planning, healthy pregnancies, age-related disease screening and treatment, and health/wellness promotion. Important concerns include severity of the disease, morbidity in pregnant and postpartum women, increased risk to the fetus, virus transmission to fetus or newborn, and impact of lack care access. Uncertainty in current knowledge is heavily related to lack of sex specific data.

Business documents of the advanced practice registered nurse: Curriculum vitae, resume, and biosketches.

Advanced practice nurses (APNs) now have great opportunities to serve in leadership positions for organizations, institutions of higher education, community and public agencies, and more. The need exists for APNs to have a full set of professional business documents readily available. Such common documents would extend beyond the professional business card and professional photograph to include the curriculum vitae, the resume, and the National Institutes of Health Biographical Sketch (biosketch) and a professional biosketch. Advanced practice nurses should understand the differences between the documents as each document helps to share the professional identity.

The perils of not knowing the history of the nurse practitioner role.

Historians tell us there are perils to not knowing history and that studying history allows us to understand our past as well as our present. The how and why of our nurse practitioner (NP) role today lies in our history. The NP role was created in the 1960s by Dr. Loretta Ford and Dr. Henry Silver in Colorado out of need to increase patients' access to pediatric care. Today, Dr. Ford believes NPs providing high-quality primary care can solve what ails the country: access to care. To better understand how the NP role developed, what pushback was met from health care professionals and patients that hindered practice and how this was resolved, how NP practice has changed, and pearls of wisdom for contemporary NPs were questions asked of six pioneer NPs (female, n = 5; male, n = 1). Their collated responses illuminate myriad ways the role was established and how each one overcame restrictions and barriers to practice. These pioneer NP participants highlighted ways NP practice has changed since those early days. They imparted a variety of pearls of wisdom that can guide contemporary NPs to address scope of practice barriers and overcome patient's and other health professionals' objections to NP practice. Loretta Ford cautions us to remember the most important word in NP is "Nurse" and we need to be mindful of our professional roots. Many of these pioneer respondents noted the importance of collective voices when dealing with professional and practice issues; they urge all NPs to join and be active in professional organizations that are invested in promoting and protecting the NP role.

Redesigning Nursing Education to Build Healthier Communities: An Innovative Cross-Sector Collaboration.

Today's health care environment requires registered nurses to be prepared for an array of practice settings, providing care outside the hospital and directly in the community. There is increasing focus on wellness, prevention, access to care, and mental health services for an aging and more diverse population. To improve alignment of education with increasingly complex needs, donor-advised funding supported four prelicensure nursing schools to transform their curricula. Selected schools were guided through a curriculum redesign process emphasizing community and continuum of care. This innovation was consistent with meeting challenges to realize the Institute of Medicine's 2011 Future of Nursing recommendations.

Best practices in care for menopausal patients: 16 years after the Women's Health Initiative.

The Women's Health Initiative (WHI) was a large, randomized clinical trial funded by the National Institutes of Health to determine whether menopause hormone therapy (MHT) prevented heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women. Two WHI trials were stopped early, and the findings had a profound effect on the clinical practice guidelines related to postmenopausal health. This article provides an overview of the WHI MHT clinical trials and findings, discusses the early stoppage of the trials and subsequent implications, and details the current nomenclature and treatment options for women transitioning through menopause in light of the WHI. This study is based on a comprehensive literature review and an education activity developed by the American Association of Nurse Practitioners. To best serve patients and individualize therapy, clinicians must provide the best estimate of potential risks or benefits to the individual patient. It is important to balance evidence of symptom relief with long-term risks and benefits that fit the patient's characteristics of family and personal health history. Armed with evidence to support various hormonal and non-hormonal options, well-informed clinicians can counsel women about MHT and potentially avoid negative impact on quality of life.

Fostering promotion and protection of the professional nurse practitioner role: A call to action.

The professional obligations to protect and promote nursing professional roles stem from the American Nurses Association Code of Ethics. Nurturing new generations of NPs to assume leadership role is foundational to succession planning and is critical to assuring NPs' continued contributions to health care. Making professional role development a priority at various points in educational programs, modeling ways to contribute to the profession, and encouraging professional organization membership are a few of the suggestions presented for the academic environment. In clinical settings, NP meetings are opportunities to engage NPs in legislative and policy issues important to practice. Attaining employee benefits, such as conference attendance, can promote commitment; and precepting NP students forges professional bonds. Present and future generations of NPs must assume responsibility for protecting and promoting the role. Many threats to NPs' scope of practice and other professional conundrums are ongoing. Instilling the values of protecting and promoting the NP role in students and colleagues and then identifying leaders to direct these efforts are essential to succession planning.

Enhancing Social Interaction in Depression (SIDE study): protocol of a randomised controlled trial on the effects of a Cognitively Based Compassion Training (CBCT) for couples.

INTRODUCTION: Positive social interactions (PSIs) and stable relationships can exert substantial benefits on health. However, patients suffering from depression benefit less from these health-promoting effects. Moreover, relationship quality and even partners' health has been found to be negatively affected by depressive symptomatology, which may result in overall impairments in social functioning of a romantic couple. Psychobiological research indicates that these impairments may be accompanied by a maladaptive regulation of the patient's neuroendocrine response to external stressors. Concerning the improvement of social functioning, first studies showed promising results of "Cognitively Based Compassion Training (CBCT®)". However, randomised trials are still scarce. Previous programmes did not involve participation of the patient's romantic partner. Therefore, the present study aims to investigate whether a CBCT® programme adapted for couples (CBCT®-fC) can improve depressive symptoms, distress, social interaction skills and the neurobiological regulation of stress. METHODS AND ANALYSIS: Couples with the female partner suffering from depression will be invited to participate in a pre-to-post intervention assessment on two consecutive days, respectively, involving a standardised PSI task, eye-tracking, ECG recordings, saliva-sampling, blood-sampling and questionnaire data. After baseline assessment, participating couples will be randomised to either a 10 week CBCT®-fC or to a treatment as usual control condition. The primary endpoint is the reduction of depressive symptoms measured by the Hamilton Depression Rating Scale. Secondary outcomes encompass self-rated depression (Beck Depression Inventory), attention towards the partners face during PSI (eye tracking), stress-related biomarkers (cortisol, α-amylase, interleukin (IL)-1ß/IL-6, heart rate variability), methylation of oxytocin-receptor-genes and serotonin-transporter-genes and self-ratings of psychological constructs such as relationship quality and empathy. ETHICS AND DISSEMINATION: Ethical approval has been obtained by the Ethics Committee of the Medical Faculty Heidelberg. Results will be presented in international, peer-reviewed journals and on conferences in the field of clinical psychology and psychiatry. TRIAL REGISTRATION NUMBER: NCT03080025.

Successful design and delivery of a professional poster.

BACKGROUND AND PURPOSE: Poster presentations are increasingly popular for dissemination of scientific and clinical knowledge at professional meetings; however, this professional skill is generally absent from advanced practice registered nurse (APRN) curricula and acquisition of the skill must occur in other arenas. The purpose of this article is to promote professional development by educating APRNs, students, and faculty on the essentials of poster development and presentation. METHODS: To aid in poster presentation skill development, types of posters, advantages and disadvantages, content and design, and tips to enhance these presentations are discussed. What is known on these topics is summarized and emphasis on professional appearance and conduct is highlighted. CONCLUSIONS: Content and layout, use of color, imagery, and positive and negative space are crucial design elements. Poster presentation essentials include being prepared, professional appearance, and professional behavior. IMPLICATIONS FOR PRACTICE: Designing and presenting a professional poster is an essential skill for all APRNs as the ability to communicate knowledge is central to the role.

A mindful eating intervention: A theory-guided randomized anti-obesity feasibility study with adolescent Latino females.

UNLABELLED: While pediatric anti-obesity lifestyle interventions have received considerable attention, few show sustained impact on body mass index (BMI). Using the Information-Motivation-Behavioral Skills Theory as a framework, we examined the effects of a satiety-focused mindful eating intervention (MEI) on BMI, weight and mindful awareness. DESIGN AND SETTING: Utilizing a two-group, repeated measures design, 37 adolescent females with a BMI >90th percentile, recruited from a public high school in a Latino community in the Southwestern United States, were randomized 2:1, one third to the group receiving a 6-week MEI and two thirds to the comparison group (CG) receiving the usual care (nutrition and exercise information). INTERVENTION: During six weekly 90-min after school MEI group sessions, the behavioral skills of slow intentional eating were practiced with foci on satiety cues and triggers to overeat. OUTCOMES: Feasibility and acceptability were measured as participant retention (goal ≥55%) and evaluative comments from those in the MEI group, respectively. BMI and mindful awareness were measured on site at baseline, immediately post intervention, and at 4-week follow-up (week 10). RESULTS: Fifty-seven and 65% of those in the MEI and CG were retained throughout the study, respectively. MEI participants showed significantly lowered BMI compared with CG participants, whose weight increased (p<0.001). At six weeks, the MEI group BMI decreased by 1.1kg/m(2) (BMI continued to decline to 1.4kg/m(2) by week 10); while CG BMI increased by 0.7kg/m(2) (consistent with BMI >90th percentile standard growth projections). CONCLUSIONS: Initial and sustained decline of BMI in the MEI group supports further study of this theory-guided approach, and the value of practicing satiety-focused mindful eating behavioral skills to facilitate health behavior change.