Effect of Storytelling and Empathy Training to Support Affective Learning in Undergraduate Nursing Students.

BACKGROUND: Empathy is a desired characteristic in nurses, but its development is often overlooked in nursing simulation. PURPOSE: This study evaluated the effect of a storytelling and empathy training intervention to enhance empathy development in simulation-based learning. METHODS: A quasi-experimental control group design was used to evaluate differences in self-perceived and observed empathy in undergraduate nursing students (N = 71). Relationships between self-perceived and observed empathy were also assessed. RESULTS: Repeated-measures analysis of variance revealed a statistically significant increase in self-perceived empathy, and higher, but nonstatistically significant differences in observed empathy for subjects in the treatment condition. No relationship between self-perceived and observed empathy was observed. CONCLUSIONS: Storytelling and empathy training may augment simulation-based learning experiences to promote empathy development in undergraduate nursing students.

First Year Outcomes: Program Evaluation of a Statewide Nurse Residency Program.

In New Jersey, a statewide nurse residency program was implemented using an apprenticeship model. The pandemic created disruption to registered nurse residency programs. This included rapid restructuring of program delivery to online methods and a need to adapt curricula to reflect changing practice and guidelines. As a result of the pandemic, new graduates had educational gaps and nurse leaders experienced staffing shortages. First year program outcomes demonstrated a 90% retention of new graduates and financial benefits for organizations participating in the statewide nurse residency program.

Virtual Clinical Experiences in Nursing Education: Applying a Technology-Enhanced Storyboard Technique to Facilitate Contextual Learning in Remote Environments.

ABSTRACT: Many schools of nursing were not prepared to transition to remote instruction during the COVID-19 pandemic. Virtual and computer-based simulation can offer a substitution for in-person clinical learning. This article describes the use of storyboards, created by faculty, to provide context during remote clinical experiences. The theoretical basis for the design and implementation of the activity is discussed. Faculty observations of student behaviors (i.e., clinical decision-making, reflection on performance, and engagement) were consistent between computer-based and laboratory-based simulation settings.

Creating a Statewide Nurse Residency: Using an Apprenticeship Model.

The Institute of Medicine recommends residency programs be implemented for new graduates across all settings, yet hospitals have not consistently hardwired this into their organizations. The value proposition is in recruitment, retention, and the conservation of resources. New Jersey's experiences using the US Department of Labor apprenticeship model for nurse residency programs provides a strategy that can be implemented on a statewide basis.

The Diamond Project: A Quality Improvement Model for Adopting Shared Service Delivery in the Washington Vaccines for Children Program.

Context: Increasing federal requirements with no change in the Centers for Disease Control and Prevention budget creates an unsustainable delivery model between states and their local counterparts for programs like Vaccines for Children (VFC). Project: The Washington State Department of Health collaborated with the Washington Association of Local Public Health Officials to identify how best to improve the quality of the VFC program. Approach: Utilizing Quality improvement and Lean Six Sigma methods, the project team was able to adopt a new shared-service delivery model to improve the quality of the VFC program in Washington State. Discussion: Through utilization of quality improvement methods and Lean methodology Washington State Department of Health identified recommendations to adopt a shared-service delivery and implemented those changes.

Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial.

BACKGROUND AND OBJECTIVES: Physicians have a major influence on parental vaccine decisions. We tested a physician-targeted communication intervention designed to (1) reduce vaccine hesitancy in mothers of infants seen by trained physicians and (2) increase physician confidence in communicating about vaccines. METHODS: We conducted a community-based, clinic-level, 2-arm cluster randomized trial in Washington State. Intervention clinics received physician-targeted communications training. We enrolled mothers of healthy newborns from these clinics at the hospital of birth. Mothers and physicians were surveyed at baseline and 6 months. The primary outcome was maternal vaccine hesitancy measured by Parental Attitudes on Childhood Vaccines score; secondary outcome was physician self-efficacy in communicating with parents by using 3 vaccine communication domains. RESULTS: We enrolled 56 clinics and 347 mothers. We conducted intervention trainings at 30 clinics, reaching 67% of eligible physicians; 26 clinics were randomized to the control group. Maternal vaccine hesitancy at baseline and follow-up changed from 9.8% to 7.5% in the intervention group and 12.6% to 8.0% in the control group. At baseline, groups were similar on all variables except maternal race and ethnicity. The intervention had no detectable effect on maternal vaccine hesitancy (adjusted odds ratio 1.22, 95% confidence interval 0.47-2.68). At follow-up, physician self-efficacy in communicating with parents was not significantly different between intervention and control groups. CONCLUSIONS: This physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy. Research is needed to identify physician communication strategies effective at reducing parental vaccine hesitancy in the primary care setting.

The advertised diet: an examination of the extent and nature of food advertising on Australian television.

ISSUES ADDRESSED: The aim of the present study was to describe food advertising and expenditure on Australian television, and to conduct an audit to assess what proportion of food and beverage television advertisements was consistent with dietary recommendations. METHODS: Data were acquired from a national media monitoring company for advertisements broadcast in five major Australian cities from 1 September 2010 to 31 October 2010. Content analysis was undertaken on these advertisements and the advertised foods were assessed against the Australian Guide to Healthy Eating. The data also included advertising expenditures. RESULTS: Most advertised foods were non-core foods (63%), with few advertisements for fruits and vegetables (6%). Advertisements for non-core foods were significantly more frequent during prime time viewing periods (71% vs 60%; P<0.01). High levels of advertising for fast food (28%) and non-core beverages (24%) were recorded. CONCLUSIONS: The present study found that the foods advertised during the data-collection period were inconsistent with the recommended diet. There are clear areas for policy concern given that the majority of recorded advertisements were for foods classified as 'occasional foods', there were low levels of advertising for fruit and vegetables, and there were no social marketing messages to support healthy eating. SO WHAT? The findings of the study suggest that there is an urgent need for more comprehensive regulation of food advertising in Australia.

The effects of television and Internet food advertising on parents and children.

OBJECTIVE: The current study examined the impact of television and Internet food advertising on Australian parents and children. DESIGN: Parents and their children aged 8 to 14 years were exposed to a television advertisement, an Internet advertisement or a control picture for four commonly advertised energy-dense, nutrient-poor foods. SETTING: Online web panel survey, Australia. SUBJECTS: Parents (n 1302) and their children aged 8 to 14 years (n 1302). RESULTS: After a single exposure to each advertisement, parent respondents in the two exposure conditions evaluated the products more favourably, had a greater desire to consume the products and thought the product could be consumed more frequently than those in the control condition. Similar trends were observed among children, although the differences were statistically significant only for the frequency of food consumption in the Internet advertisement condition and the evaluation of one product. CONCLUSIONS: The results have implications for assumptions of adults' immunity to advertising. This is of particular importance in efforts to address child obesity and the reliance on parents to mediate the effects of food advertising.

Compliance with children's television food advertising regulations in Australia.

BACKGROUND: The objective of this study was to assess the effectiveness of the Australian co-regulatory system in limiting children's exposure to unhealthy television food advertising by measuring compliance with mandatory and voluntary regulations. An audit was conducted on food and beverage television advertisements broadcast in five major Australian cities during children's programming time from 1st September 2010 to 31st October 2010. The data were assessed against mandatory and voluntary advertising regulations, the information contained in an industry report of breaches, and the Australian Guide to Healthy Eating. RESULTS: During the two months of data collection there were a total of 951 breaches of the combined regulations. This included 619 breaches of the mandatory regulations (CTS) and 332 breaches of the voluntary regulations (RCMI and QSRI). Almost 83% of all food and beverages advertised during children's programming times were for foods classified as 'Extras' in the Australian Guide to Healthy Eating. There were also breaches in relation to the amount of advertising repetition and the use of promotional appeals such as premium offers, competitions, and endorsements by popular children's characters. The self-regulatory systems were found to have flaws in their reporting and there were errors in the Australian Food and Grocery Council's compliance report. CONCLUSIONS: This audit suggests that current advertising regulations are inadequate. Regulations need to be closely monitored and more tightly enforced to protect children from advertisements for unhealthy foods.

The extent and nature of alcohol advertising on Australian television.

INTRODUCTION AND AIMS: Current alcohol guidelines in Australia recommend minimising alcohol consumption, especially among minors. This study investigated (i) the extent to which children and the general population are exposed to television advertisements that endorse alcohol consumption and (ii) the themes used in these advertisements. DESIGN AND METHODS: A content analysis was conducted on alcohol advertisements aired over two months in major Australian cities. The advertisements were coded according to the products that were promoted, the themes that were employed, and the time of exposure. Advertising placement expenditure was also captured. RESULTS: In total, 2810 alcohol advertisements were aired, representing one in 10 beverage advertisements. Advertisement placement expenditure for alcohol products in the five cities over the two months was $15.8 million. Around half of all alcohol advertisements appeared during children's popular viewing times. The most common themes used were humour, friendship/mateship and value for money. DISCUSSION AND CONCLUSIONS: Children and adults are regularly exposed to advertisements that depict alcohol consumption as fun, social and inexpensive. Such messages may reinforce existing alcohol-related cultural norms that prevent many Australians from meeting current intake guidelines.

The use of negative themes in television food advertising.

The ability of food advertising to trigger food consumption and influence social norms relating to food consumption has resulted in increasing attention being given to the prevalence and nature of food advertising. The present study investigated the use of negative themes in food advertisements aired on Australian television to determine the prevalence of depictions of violence/aggression, mocking, nagging, boredom, loneliness, food craving, mood enhancement, and the emotional use of food across 61 days of programming time. The results suggest that advertisers are using negative themes to capture attention and invoke an emotional response in the target audience. Sixteen percent (14,611) of the 93,284 food advertisements contained negative themes, with mood enhancement and food craving being the most commonly depicted negative themes. Advertisements with negative themes were more likely to be for non-core foods and to be aired during children's popular viewing times than at other times. The potential for negative themes in food advertising to promote unhealthy food consumption behaviors among children is likely to be of concern to policy makers. Building on this exploratory study, further research is needed to investigate how nutrition-related decision making is affected by exposure to food advertisements employing negative emotional themes.

Addressing loneliness in later life.

OBJECTIVES: Social and solitary pastimes with the potential to ameliorate the experience of loneliness among older individuals were investigated for the purpose of informing future interventions designed to reduce the negative consequences of social isolation. METHOD: Nineteen individual interviews with Australians aged 65 years and older. RESULTS: Several pastimes were described by interviewees as instrumental in determining whether the increasing social isolation they experience in older age results in feelings of emotional isolation and thus of loneliness. CONCLUSION: The specific behaviours that were found to ameliorate loneliness included utilizing friends and family as an emotional resource, engaging in eating and drinking rituals as a means of maintaining social contacts, and spending time constructively by reading and gardening. Specific recommendations are provided for interventions designed to prevent and treat loneliness among older people.

Familial thoracic aortic aneurysms and dissections--incidence, modes of inheritance, and phenotypic patterns.

BACKGROUND: We examined the genetic nature and phenotypic features of thoracic aortic aneurysms (TAAs) and dissections in a large cohort of patients. METHODS: Interviews were conducted with 520 patients with TAAs and their pedigrees were compiled to identify family members with aneurysms. Study patients were divided into three groups: 101 non-Marfan patients, in 88 pedigrees, had a family pattern for TAA (familial group), 369 had no family pattern (sporadic group), and 50 had Marfan syndrome (MFS). We determined incidence of familial clustering, age at presentation, rate of aneurysm growth, incidence of hypertension, correlation of aneurysm sites among kindred, and pedigree inheritance patterns. RESULTS: An inherited pattern for TAA was present in 21.5% of non-MFS patients. The predominant inheritance pattern was autosomal dominant (76.9%), with varying degrees of penetrance and expressivity. The familial TAA group was significantly younger than the sporadic group (p < 0.0001), but not as young as the MFS group (p < 0.0001) (mean ages, 58.2 versus 65.7 versus 27.4 years). Among all 197 probands and kindred with aneurysm, 131 (66.5%) had TAA, 49 (24.9%) had abdominal aortic aneurysm (AAA), and 17 (8.6%) had cerebral or other aneurysms. Ascending aneurysm paired most commonly with ascending, and descending with abdominal. Abdominal aortic aneurysms (AAAs) and hypertension were more often associated with descending than with ascending TAAs (p < 0.001). Aortic growth rate was highest for the familial group (0.21 cm/y), intermediate for the sporadic group (0.16 cm/y), and lowest for the Marfan group (0.1 cm/y; p < 0.01). CONCLUSIONS: TAAs are frequently familial diseases. The predominant mode of inheritance is autosomal dominant. Familial TAAs have a relatively early age of onset. Aneurysms in relatives may be seen in the thoracic aorta, the abdominal aorta, or the cerebral circulation. Screening of first-order relatives of probands with TAA is essential. Familial TAAs tend to grow at a higher rate, exemplifying a more aggressive clinical entity.