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Background: Homeless, runaway, and transgender youth are at high risk for commercial sexual exploitation in the United States. Research examining this phenomenon is growing but requires synthesis to facilitate its use by professionals who serve this population. The purpose of this review was to aggregate the qualitative evidence regarding commercially sexually exploited youth (CSEY) in the United States. Methods: The search included published and unpublished qualitative studies with current or former CSEY who reside in the United States. Results: There were 19 studies included in the review with a total of 795 participants. Eight themes were identified and grouped into three broader categories: experiences that preceded sex work entry, experiences that facilitated sex work continuation, and experiences that facilitated sex work exit. Conclusions: Understanding the barriers and facilitators of commercial sexual exploitation can inform the development of interventions that address the needs of CSEY and youth at risk for exploitation. The results of this review highlight the social and economic influences as well as the role of positive and negative reinforcements involved in sex work entry, its continuation, and exit. Needs for services, research, and advocacy are also discussed.

(1) Background: African American women breast cancer survivors face unique experiences that impact their quality of life as they transition beyond treatments. Experiences may be complicated by living at the intersection of systemically oppressed identities, including gender, race, social class, and cancer-related disability. Using the Black Feminist Thought (BFT) framework and the PEN-3 cultural model, this qualitative study sought to: (a) understand African American women breast cancer survivors’ lived experiences; (b) examine how the multiple intersecting factors of race, gender, social class/socioeconomic status, and cancer-related disability impact their quality of life; and (c) inform future health promotion programming that is culturally relevant to AAWBCS to improve their quality of life. (2) Methods: Seven focus groups were conducted with 30 African American breast cancer survivors in a Midwestern metropolitan region. Focus groups were audiotaped and transcribed verbatim. Framework analyses were conducted to identify themes with NVivo qualitative analysis software. (3) Results: Four themes emerged: (a) caregiving roles provide both support and challenges for survivors, (b) the “strong Black woman” is inherent in survivor experiences, (c) intersectionality impacts survivorship, and (d) African American women resist oppression through culturally specific supports and advocacy. (4) Conclusions: The intervention point of entry should be at the peer support group level and centered on family and provide community-based support and services. Future research should move upstream to address social determinants of health, including racism, sexism, and ableism; there is a critical need to discuss how structural racism affects health care and develop interventions to address racial discrimination and racial bias in health care.

Background: To address health inequities, the American Association of Colleges of Nursing, Institute of Medicine, and Association of American Medical Colleges recommend holistic admissions review (HAR) to increase health professional diversity. Method: This cross-sectional study collected admissions criteria from 1,547 nursing programs. Criteria were categorized according to the experiences, attributes, and academic metrics (EAM) model, and programs were dichotomized into those with holistic admissions criteria versus none. Results: Only 43% of nursing programs considered holistic admissions criteria. Regionally, rates varied from 35% in the South to 54% in the West. The rate of HAR integration exceeded 67% in only six states. Conclusion: Nursing programs have not widely integrated HAR despite evidence that academic metric use alone disadvantages qualified underrepresented students. HAR implementation can be facilitated by standardizing how HAR is operationalized and applying best evidence to rubric development that appropriately weighs admissions criteria based on the EAM model, and also training reviewers for unbiased candidate evaluation. [J Nurs Educ. 2022;61(7):361–366.]

Chronic hepatitis C affects millions of people worldwide and patients born between 1945 and 1965 are at elevated risk. Hepatitis C infection can lead to health complications including liver cirrhosis and hepatocellular carcinoma. Recent advancements in direct-acting antiviral treatments have placed the spotlight on primary care providers to identify undiagnosed patients with chronic hepatitis C for treatment and attaining a sustained-virologic response. Primary care providers do not routinely screen patients born between 1945 and 1965 for hepatitis C despite CDC recommendations. To evaluate the effectiveness of a hepatitis C screening protocol implemented in a primary care setting with no prior protocol. A multidisciplinary team was used to implement a hepatitis C screening protocol for patients born between 1945 and 1965 (birth cohort screening). A retrospective analysis was conducted to compare the rate of hepatitis C screening 2 years before and 2 years after the protocol was implemented. Frequency data were collected monthly and tracked in a run chart noting relevant events that affected screening. In the 2 years before the screening protocol began, 81 patients were screened (average = 3 per month); and in the 2 years after the intervention was implemented, a total of 637 patients were screened (average = 25 per month). The protocol was successful in increasing screening rates from 15 to 66% in the 2 years post-intervention. This quality improvement study demonstrated that targeting the birth cohort population was a successful method for increasing hepatitis C screening in a primary care clinic.

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

OBJECTIVEThe objective of this study is to assess benefits of the acuity-adaptable (AA) care model in rural hospitals. BACKGROUNDThe AA model aims to provide care in the same space from admission to discharge regardless of acuity. Evidence is lacking to support claims that AA care will improve patient safety, increase nurse productivity, and improve patient/staff satisfaction in rural hospitals. METHODSPatients admitted to a rural intensive care unit (ICU) were allocated to an AA group or an ICU group. Patients in the AA group remained in the ICU room through discharge. Patients in the ICU group transferred out of ICU when acuity permitted. Patient anxiety, depression, and perception of emotional care were measured. Staff responses were assessed qualitatively. RESULTSAcuity-adaptable patients reported significantly more anxiety and less perceived emotional care than ICU patients. Intensive care unit nurses resisted caring for less acute patients. CONCLUSIONDisadvantages may outweigh benefits of AA care delivery in the rural ICU.

Researchers have established an association between the stressors of providing informal care and physiological and psychological health risks (Applebaum & Breitbart, 2013; Au et al., 2010; Bainbridge, Krueger, Lohfeld, & Brazil, 2009; Gilliam & Steffen, 2006; Mausbach et al., 2012; Merluzzi, Philip, Vachon, & Heitzmann, 2011; Perez, Ussher, Butow, & Wain, 2011). Despite the recognized negative consequences of informal care, researchers have identified the existence of mediators which have the potential to buffer, manage, transform, or prevent the negative influence of stress (Bolden & Newsome-Wicks, 2008; Kreitler, Peleg, & Ehrenfeld, 2007; Merluzzi et al., 2011; Roscoe, Corsentino, Watkins, McCall, & Sanchez-Ramos, 2009). The purpose of the study was to determine the relationship between self-efficacy and stress in adult informal caregivers providing end of life care while controlling for caregivers' socioeconomic status. A cross-sectional, associational design which included 78 adult informal caregivers who were providing end-of-life care for an adult was conducted. Caregivers answered a demographic questionnaire and three survey instruments measuring caregiver self-efficacy, perceived stress, and perceived health. The Stress Process Model (Pearlin, Mullan, Semple, & Skaff, 1990) was used to guide this study. The study was approved by the University of Texas at Arlington Institutional Review Board. Study participants included a convenience sample of 78 cognitively intact, English speaking, adult informal caregivers who were providing end-of-life care for an adult in the North Central Texas Region. Caregivers were caring for individuals with a variety of illnesses, the most frequent of which was reported as cancer. A majority of the care recipients resided with the caregivers, and all of the sampled caregivers were receiving some level of caregiving support from an agency that provided end-of life supportive services. Caregiver self-efficacy had a significant, negative correlation with perceived stress (r = -.53; p < .01). Caregiver self-efficacy explained 28.3% of the variance in perceived stress. Because self-efficacy is a multi-dimensional construct, a multivariate regression was performed to explore the relationship between caregivers' confidence in managing medical information, caring for the care recipient, caring for oneself, and managing difficult interactions and emotions and perceived stress. Caregivers' confidence in caring for themselves had a significant negative relationship with perceived stress (r = - .63, p < .01). Caring for oneself predicted 38% of the variance in perceived stress. Caregivers with higher levels of confidence in managing demands of caregiving had lower levels of perceived stress. More specifically, caregivers' with higher levels of confidence in caring for themselves had lower levels of perceived stress. These findings highlight the importance of caregivers' self-care needs. Healthcare practitioners must recognize and intervene to support caregivers' self-care needs. Further research is needed to investigate caregivers' self-care needs as well as to investigate interventions which might enhance caregivers' self-care.