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27 result(s) for "Azadeh Stark"
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A conceptual model of nurses’ workplace social capital: a theory synthesis
Background Research has confirmed the importance of workplace social capital in the nursing workforce. Integration of the empirical evidence about nurses’ workplace social capital into a scientific collection can provide a comprehensive presentation of this concept. This scientific collection can be a conduit for further research and advancement of nursing management and leadership. The purpose of this paper, therefore, is to discuss the process of developing a conceptual model of nurses’ workplace social capital, an effective and concise approach to illustrate a scientific phenomenon. Methods The model of nurses’ workplace social capital was developed following Walker and Avant’s strategy of theory synthesis. Empirical evidence relevant to nurses’ workplace social capital was synthesized by systematically examining the existing literature. PubMed, CINAHL, Web of Science and Google Scholar were searched periodically from October 2017 to July 2020. Results Our proposed conceptual model lays out the determinants and outcomes of nurses’ workplace social capital and specifies the relational statements among these concepts. Nurses’ workplace social capital is influenced by the organizational and individual determinants shaped by multiple layers of sub-concepts. The development and implementation of nurses’ workplace social capital has three themes of consequences: 1) nurses’ outcomes; 2) patients’ outcomes; and 3) organizational outcomes. All the concepts and statements have been organized and aligned with the principles of “inventory of determinants or results” and “theoretical blocks”. Conclusion Our theoretical synthesis offers a comprehensive picture of the current knowledge of nurses’ workplace social capital. Efforts should be dedicated to evaluating, revising, and revamping this newly developed model based on future empirical evidence. Our synthesized conceptual model is the segue to more comprehensive studies about nurses’ workplace social capital. Interventional programs for the development of social capital can be structured based on the identified determinants.
A qualitative study on the composition of international nursing students’ workplace social capital during clinical learning in China
Background Chinese academic diplomacy has opened international educational opportunities in different fields including nursing. Nursing students often experience tremendous challenges during their clinical learning; these challenges are elevated for international students due to limited familiarity with their new environment. Enhancing workplace social capital might be an effective approach to addressing these challenges. However, a comprehensive understanding of international nursing students’ workplace social capital remains unknown. This study aimed to describe the composition of workplace social capital as perceived by international nursing students during their clinical learning in China. Methods A qualitative descriptive design was applied. Participants were international students from 13 countries ( n  = 30), recruited from an international nursing program in China; all participants had completed 36 weeks of clinical learning in a Chinese teaching hospital. Data were collected through three rounds of focus group discussions and seven follow-up individual interviews between 2022 and 2024. Inductive qualitative content analysis was used for data analysis. Results Two themes were abstracted. The first theme addresses the structural configuration of workplace social capital. The two directions of relational network that contributed to the structural configuration are vertical (linking with mentors, nurse managers and physicians) and horizontal (bridging with Chinese-partners and bonding among international classmates). An obvious hierarchy exists in linking social capital. The second theme represents the cognitive elements in social capital including Trust, Empowerment, Equality and Social cohesion. Trust is the most well-recognized cognitive element. Empowerment and Equality are two distinct characteristics of international nursing students’ workplace social capital. Conclusions International nursing students’ workplace social capital is formed based on multi-directional professional interactions. Hierarchical differences in social capital should be reduced. Transcultural leadership and mentorship training to facilitate the advancement of workplace social capital in an international educational environment in China is encouraged. Our work is a prelude to understanding the concept of international nursing students’ workplace social capital and contributes to the development of intervention strategies for future investigations. Trial registration Our study does not report healthcare interventions on human participants. Trial registration is not necessary according to the International Committee of Medical Journal Editors (ICMJE)’s clinical trial registration policy.
Nurses’ Workplace Social Capital and Sustainable Development: An Integrative Review of Empirical Studies
Aim . The purpose of our review was to assess the role of nurses’ workplace social capital in meeting the Sustainable Development Goals (SDGs) of the United Nations (UN). Background . In 2015, the 2030 Agenda for Sustainable Development with 17 universal goals was adopted by members of the UN. Although nurses have been acknowledged as important contributors to sustainable development, they still have difficulties in connecting their work to the SDGs. Nurses’ workplace social capital is an important concept in nursing management due to its constructive consequences. However, the potential association between nurses’ workplace social capital and the SDGs has not been evaluated. Evaluation . We conducted an integrative review, following the methodology of Whittemore and Knafl. Seven databases, Medline, CINAHL, Web of Science, Cochrane Library, Embase, PsycINFO, and Scopus with no restriction on publication year, were searched in May 2023 to identify statistically significant empirical evidence. Only peer‐reviewed research papers published in English language journals were considered. We applied the Mixed Methods Appraisal Tool to evaluate the quality of the selected articles. We categorized outcomes of nurses’ workplace social capital into themes and connected them to the SDGs through repeated comparisons and discussions. Key Issues . Twenty‐nine of 2,188 retrieved articles were included in the final data analysis. Twenty‐three outcomes of nurses’ workplace social capital were identified, and three themes were abstracted. Nurses’ workplace social capital is positively associated with SDG 3 (good health and well‐being), SDG 8 (decent work and economic growth), and SDG 17 (partnerships for the goals). Conclusion . Findings of our integrative review shed light on the importance of nurses’ workplace social capital and the role of nurses in achieving the global movement for sustainable development. Implication for Nursing Management. Investment in nursing workforce and nurses’ workplace social capital can further strengthen the position of nurses to support and deliver the SDGs.
Mitochondrial autoimmunity and MNRR1 in breast carcinogenesis
Background Autoantibodies function as markers of tumorigenesis and have been proposed to enhance early detection of malignancies. We recently reported, using immunoscreening of a T7 complementary DNA (cDNA) library of breast cancer (BC) proteins with sera from patients with BC, the presence of autoantibodies targeting several mitochondrial DNA (mtDNA)-encoded subunits of the electron transport chain (ETC) in complexes I, IV, and V. Methods In this study, we have characterized the role of Mitochondrial-Nuclear Retrograde Regulator 1 (MNRR1, also known as CHCHD2), identified on immunoscreening, in breast carcinogenesis. We assessed the protein as well as transcript levels of MNRR1 in BC tissues and in derived cell lines representing tumors of graded aggressiveness. Mitochondrial function was also assayed and correlated with the levels of MNRR1. We studied the invasiveness of BC derived cells and the effect of MNRR1 levels on expression of genes associated with cell proliferation and migration such as Rictor and PGC-1α. Finally, we manipulated levels of MNRR1 to assess its effect on mitochondria and on some properties linked to a metastatic phenotype. Results We identified a nuclear DNA (nDNA)-encoded mitochondrial protein, MNRR1, that was significantly associated with the diagnosis of invasive ductal carcinoma (IDC) of the breast by autoantigen microarray analysis. In focusing on the mechanism of action of MNRR1 we found that its level was nearly twice as high in malignant versus benign breast tissue and up to 18 times as high in BC cell lines compared to MCF10A control cells, suggesting a relationship to aggressive potential. Furthermore, MNRR1 affected levels of multiple genes previously associated with cancer metastasis. Conclusions MNRR1 regulates multiple genes that function in cell migration and cancer metastasis and is higher in cell lines derived from aggressive tumors. Since MNRR1 was identified as an autoantigen in breast carcinogenesis, the present data support our proposal that both mitochondrial autoimmunity and MNRR1 activity in particular are involved in breast carcinogenesis. Virtually all other nuclear encoded genes identified on immunoscreening of invasive BC harbor an MNRR1 binding site in their promoters, thereby placing MNRR1 upstream and potentially making it a novel marker for BC metastasis.
Whole-Body Lifetime Occupational Lead Exposure and Risk of Parkinson's Disease
Background: Several epidemiologic studies have suggested an association between Parkinson's disease (PD) and exposure to heavy metals using subjective exposure measurements. Objectives: We investigated the association between objective chronic occupational lead exposure and the risk of PD. Methods: We enrolled 121 PD patients and 414 age-, sex-, and race-, frequency-matched controls in a case-control study. As an indicator of chronic Pb exposure, we measured concentrations of tibial and calcaneal bone Pb stores using$^{109}Cadmium$excited K-series X-ray fluorescence. As an indicator of recent exposure, we measured blood Pb concentration. We collected occupational data on participants from 18 years of age until the age at enrollment, and an industrial hygienist determined the duration and intensity of environmental Pb exposure. We employed physiologically based pharmacokinetic modeling to combine these data, and we estimated whole-body lifetime Pb exposures for each individual. Logistic regression analysis produced estimates of PD risk by quartile of lifetime Pb exposure. Results: Risk of PD was elevated by > 2-fold [odds ratio = 2.27 (95% confidence interval, 1.13-4.55); p = 0.021] for individuals in the highest quartile for lifetime lead exposure relative to the lowest quartile, adjusting for age, sex, race, smoking history, and coffee and alcohol consumption. The associated risk of PD for the second and third quartiles were elevated but not statistically significant at the α = 0.05 level. Conclusions: These results provide an objective measure of chronic Pb exposure and confirm our earlier findings that occupational exposure to Pb is a risk factor for PD.
Development and psychometric testing of quality nursing care scale in Mongolia
Background Quality Nursing Care (QNC) is fundamental to the profession of nursing practice. Perception of QNC differ across the globe because of differences in social norms, cultural values and political ambiance and economy. This study aimed to develop a QNC instrument congruent with the Mongolian (QNCS-M) healthcare system and cultural values and societal norms. Methods Exploratory sequential mixed-method design was implemented to develop and assess performance of QNCS-M. First, we focused on developing the components of QNCS-M and their operational definitions. Second, we dedicated to ascertaining psychometric performance of QNCS-M. The field testing consisted of assessing the construct validity and internal consistency reliability. Correlation between QNCS-M and the criterion tool, Quality of Nursing Care Questionnaire-Registered Nurse was evaluated. Results The initial version of QNCS-M contained 66 items of which 7 (I-CVI < .78) were deleted after item-content validity assessment. The total-item correlation analysis yielded to exclusion of another 3 items (<.3). Additional 12 items were excluded after inter-item correlation (<.3, >.7). Results from Spearman rank-order correlation analysis of the remaining 44 items indicated relationship between social desirability and 6 items ( r  = −.09 to r  = .11). These items were excluded to reduce the likelihood of potential information bias. A total of 38 items remained for exploratory factor analysis. Results from exploratory factor analysis yielded eigenvalues > 1.0 for the 9 domains. Three domains contained items fewer than 3. These domains and 2 items (factor loading <.4) were eliminated, yielding to 6 domains with 36-item. Results from internal consistency reliability yielded an overall Cronbach’s α = .92; the coefficient values for the 6 domains ranging between .72 and .85 and Pearson correlation for stability reliability yielded an acceptable ( r  = .82, P  < .001). Conclusion Improving the quality of healthcare services delivered by nurses is a priority for the Mongolian government. The development of QNCS-M is a major stride in addressing this concern. The final version of QNCS-M which contains 36 items, loaded into 6 domains, was morphed to the specifics of the Mongolian healthcare systems and cultural values and societal norms. QNCS-M demonstrates a high level of content and construct validity with acceptable reliability.
Molecular markers of risk of subsequent invasive breast cancer in women with ductal carcinoma in situ: protocol for a population-based cohort study
IntroductionDuctal carcinoma in situ (DCIS) of the breast is a non-obligate precursor of invasive breast cancer (IBC). Many DCIS patients are either undertreated or overtreated. The overarching goal of the study described here is to facilitate detection of patients with DCIS at risk of IBC development. Here, we propose to use risk factor data and formalin-fixed paraffin-embedded (FFPE) DCIS tissue from a large, ethnically diverse, population-based cohort of 8175 women with a first diagnosis of DCIS and followed for subsequent IBC to: identify/validate miRNA expression changes in DCIS tissue associated with risk of subsequent IBC; evaluate ipsilateral IBC risk in association with two previously identified marker sets (triple immunopositivity for p16, COX-2, Ki67; Oncotype DX Breast DCIS score); examine the association of risk factor data with IBC risk.Methods and analysisWe are conducting a series of case–control studies nested within the cohort. Cases are women with DCIS who developed subsequent IBC; controls (2/case) are matched to cases on calendar year of and age at DCIS diagnosis. We project 485 cases/970 controls in the aim focused on risk factors. We estimate obtaining FFPE tissue for 320 cases/640 controls for the aim focused on miRNAs; of these, 173 cases/346 controls will be included in the aim focused on p16, COX-2 and Ki67 immunopositivity, and of the latter, 156 case–control pairs will be included in the aim focused on the Oncotype DX Breast DCIS score®. Multivariate conditional logistic regression will be used for statistical analyses.Ethics and disseminationEthics approval was obtained from the Institutional Review Boards of Albert Einstein College of Medicine (IRB 2014-3611), Kaiser Permanente Colorado, Kaiser Permanente Hawaii, Henry Ford Health System, Mayo Clinic, Marshfield Clinic Research Institute and Hackensack Meridian Health, and from Lifespan Research Protection Office. The study results will be presented at meetings and published in peer-reviewed journals.
Racial Disparity in the Dose and Dose Intensity of Breast Cancer Adjuvant Chemotherapy
The purpose of this study was to investigate the impact of race and obesity on dose and dose intensity of adjuvant chemotherapy. We abstracted data on patient/tumor characteristics, treatment course, physicians' intention to give a first cycle dose reduction, and reasons for dose reductions/delays from oncology records of 489 women treated from 1985 to 1997 in 10 treatment sites in two geographical regions. Administered doses and dose intensity were compared to standard regimens. Multivariate regression models determined the impact of race and body mass index (BMI) on dose proportion (actual:expected doses) and relative dose intensity (RDI) controlling for patient characteristics, comorbidity, chemotherapy regimen, site, and year of treatment. Logistic regressions explored race and BMI versus use of first cycle dose reductions. African-Americans received lower chemotherapy dose proportion and RDI than whites (0.80 vs. 0.85, p = 0.03 and 0.76 vs. 0.80, p = 0.01). In multivariate analyses, dose proportion was 0.09 lower (p = 0.002), and RDI was 0.10 (p < 0.001) lower in non-overweight African-Americans than whites. Obesity was associated with lower dose proportion (p < 0.01) and RDI (p < 0.03). Race and BMI were independently associated with first cycle dose reductions. Non-overweight African-Americans (p < 0.05) and overweight and obese African-American and white women (p < 0.001) were more likely to have first cycle dose reductions than non-overweight whites. We identified systematic differences in the administration of chemotherapy given to African-Americans and to overweight and obese women. These differences may contribute to documented disparities in outcome.
The effect of outcome-based education on clinical performance and perception of pediatric care of the third-year nursing students in Mongolia
Mongolian government has set improvement of clinical proficiency of nursing students as one of its priorities. Nursing professionals have the sentinel role in providing healthcare services in rural areas. Outcome-based education (OBE) offers a promising pedagogical approach to actively mentally engage students to strengthen their clinical proficiencies. We implemented a pilot project with the objective of comparing students' clinical performance under OBE with our traditional didactic techniques. The researchers implemented a non-equivalent two-armed quasi-experimental post-test-only' design approach study. The intervention arm (n = 34) received OBE pediatric training, while the control arm (n = 32) received the traditional pedagogical pediatric nursing training. Each arm of the study completed 16 hours of theory, 32 hours of clinical skills practice and 32 hours of seminars in pediatric nursing care. Data were collected using a five-section instrument, Demographic, Competency Inventory, Nursing Students' Satisfaction, Course Experience, and Objective Structured Clinical Examination. Performance and knowledge proficiencies were evaluated by applying the two-sided independent T-test. The distributions of categorical variables were assessed by Fisher's exact test or chi-squared test of significance. The intervention arm had higher mean score value in the competency inventory ([Formula: see text] = 238.70, SD = ± 23.07) compared to the control arm ([Formula: see text] = 222.11, SD = ± 39.94) (P = 0.04); similarly, the mean value for nursing students' satisfaction was higher for the intervention arm ([Formula: see text] = 117.87, SD = ± 15.94) compared to the control group ([Formula: see text] = 109.76, SD = ± 16.94) (P = 0.049). Additionally, the difference in the mean value for course experience questionnaire between the intervention arm ([Formula: see text] = 125.33, SD = ± 19.30) and the control arm ([Formula: see text] = 110.41, SD = ± 11.28) was statistically significant (P = 0.0001). Finally, the intervention arm had a higher mean value ([Formula: see text] = 85.40, SD = ± 6.11) for objective structural clinical examination compared to the control arm ([Formula: see text] = 81.56, SD = ± 7.01) (P = 0.023). OBE pedagogical approach offers promising benefits to improving nursing students' clinical competencies; additionally, the OBE approach seems to increase students' satisfactions with their clinical curriculum.
Assessing Nurses’ Workplace Social Capital: A Study Protocol for Culturally Appropriate Instrument Development
Workplace social capital positively influences the quality but reduces the cost of healthcare services. Academic research suffers from limited and inadequate culturally sensitive nurses’ workplace social capital instruments. Here we report on the design and protocol of a culturally focused instrument development study in China. The overarching objective of our dual phase study is to develop and validate a questionnaire measuring nurses’ workplace social capital tailored toward Chinese cultural values and norms. In the first phase of INSTRUMENT DEVELOPMENT, the qualitative phase, we will conduct interviews with purposefully sampled nurses from five geographically diverse regions capturing 16 provinces in China to formulate the initial version of the Nurses’ Workplace Social Capital Questionnaire (NWSCQ). Data collection will be stopped at the saturation point and content analysis will be performed for interview data in parallel. The initial version of the NWSCQ will be evaluated and confirmed by two-rounds of expert consultation (target N = 20) and pre-tested among 70 nurses. During the second phase of INSTRUMENT VALIDATION or the quantitative phase, we will validate the psychometric properties of the NWSCQ. The validity and reliability of the questionnaire will be examined and validated through three cross-sectional surveys among nurses (target N = 1154) randomly selected from 12 tertiary hospitals. We have reported our study protocol with the intention of sharing our experience with researchers in other countries who are striving to advance the phenomenon of culturally sensitive and social normatively appropriate nurses’ workplace social capital. Findings from our study should advance the development of culturally appropriate and valid instrument of nurses’ workplace social capital, another important step toward recognition and incorporation of cultural diversity in the daily operation of healthcare industry.