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Cultural Norms Of Clinical Simulation In Undergraduate Nursing Education, Susan G. Mcniesh

Susan McNiesh

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a …

Anger Problems And Posttraumatic Stress Disorder In Male And Female National Guard And Reserve Service Members, Miranda E. Worthen, Sujit D. Rathod, Gregory Cohen, Laura Sampson, Robert Ursano, Robert Gifford, Carol Fullerton, Sandro Galea, Jennifer Ahern

Miranda E. Worthen

Anger is a common problem among veterans and has been associated with posttraumatic stress disorder (PTSD). This study aimed to improve understanding of how anger and PTSD co-occur by examining gender differences and differences by whether the triggering traumatic event is deployment-related vs. civilian-related in current service members. A representative cohort of Reserve and National Guard service personnel (n = 1293) were interviewed to assess for deployment- or civilian-related traumas, PTSD, and anger. The prevalence of self-reported anger problems was estimated among male (n = 1036) and female (n = 257) service members. Log Poisson regression models with robust standard …

Facilitating War-Affected Young Mothers’ Reintegration: Lessons From A Participatory Action Research Study In Liberia, Sierra Leone, And Uganda., Miranda E. Worthen, G. Onyango, A. Veale, M. Wessells, S. Mckay

Miranda E. Worthen

Young women and girls formerly associated with armed forces and armed groups face multiple challenges. Many become pregnant or have children while they are associated and face stigma and marginalization upon reintegration into civilian communities. This article describes a multi-year participatory action research study that took place in twenty communities in Liberia, Sierra Leone, and northern Uganda from 2006 – 2009 and included more than 650 young mother participants. We find that this community-based approach to reintegration improved the wellbeing of young mother participants and their children. We discuss the challenges and limitations of conducting participatory action research with war-affected …

Exploring Barriers To Organ Donation In The African American Communities Of California, D. R. Law, Susan Mcniesh

Susan McNiesh

There are a disproportionate number of African-Americans on transplant waiting lists across the country. The outcomes of a transplant are greatly improved when the donor and the recipient are from the same ethnic group. Sadly, the demand for cadaver organs in the African-American community exceeds the supply. Researchers in the past have sought to identify barriers to organ and tissue donation. To date, the studies have been conducted in the eastern and southern regions of the United States. This study examines whether the previously identified barriers are applicable in the African-American communities of California. A revised version of the Bone …

Iraq And Afghanistan Veterans’ Experiences Living With Their Parents After Separation From The Military, Miranda E. Worthen, M Moos, R Ahem

Miranda E. Worthen

When military service members separate from the military, many return to their families of origin, living with their parents for a period of several weeks to years. While research with veterans and their spouses has documented the particular strain of this reintegration period on veterans and their partners, little research to date has examined veterans’ experiences living with their parents. The present study sought to fill this research gap by investigating veterans’ experiences living with their parents using qualitative, in-depth interviews with Iraq and Afghanistan veterans in California. Overall, veterans appreciated the instrumental and emotional support their parents provided when …

Reintegration Of Young Mothers: Young Mothers Seeking Reintegration After Periods Of Time Spent Living With Fighting Forces And Armed Groups Face Exclusion And Stigma Rather Than The Support They And Their Children Badly Need., Miranda E. Worthen, Susan Mckay, Angela Veale, Mike Wessells

Miranda E. Worthen

No abstract provided.

The Lived Experience Of Students In An Accelerated Nursing Program: Intersecting Factors That Influence Experiential Learning, Susan Mcniesh

Susan McNiesh

The goal of this interpretive research study was to articulate the lived experience of students in an accelerated master’s of nursing entry program learning the practice of nursing within a clinical setting. Specific questions included: How did previous life experiences, education, and career choices influence the experience of second-degree students? What were the potential effects on learning of condensing and accelerating the curriculum as is requisite in second-degree programs? Data from small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Akin to the experience of tourists or new immigrants, students were confronted with new physical demands, …

The Composite First Person Narrative: Texture, Structure, And Meaning In Writing Phenomenological Descriptions, M. S. Wertz, M. Nosek, Susan Mcniesh, E. Marlow

Susan McNiesh

This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method’s applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting …

Changes In Temperature Of Heel Skin Under Pressure In Hip Surgery Patients, Vivian K. Wong, N. A. Stotts, H. W. Hopf, G. A. Dowling, E. S. Froelicher

Vivian K. Wong

OBJECTIVE: The aim of the study was to examine the effect of external pressure of the bed surface on heel skin temperature in adults in the first 3 days after hip surgery.

DESIGN: A quasi-experimental study in a prospective, within-subjects, repeated-measures design.

SETTING: This study was performed at 2 acute-care hospitals.

PARTICIPANTS: Eighteen subjects (9 men and 9 women) with a mean age of 58.3 (±16.1) years were recruited after hip surgery at the 2 hospitals.

METHODS: Temperature sensors were placed on the plantar surface of each foot, close to the heels. Measures were taken when the heels were (1) …

Skin Blood Flow Response To 2-Hour Repositioning In The Long-Term Care Residents: A Pilot Study, Vivian K. Wong

Vivian K. Wong

PURPOSE: The purpose of this noninvasive pilot study was to examine the changes in transcutaneous oxygen (tcO2), skin temperature, and hyperemic response in the heels, sacrum, and trochanters in a 2-hour loading-unloading condition in nursing home residents who are positioned in supine and lateral positions.

DESIGN: A 1-group, prospective, repeated-measures design was used.

SUBJECTS AND SETTING: Nine subjects (5 males, 4 females) with a mean age of 85.3 ± 10.86 years (mean ± SD) who required help in turning and positioning at a skilled nursing facility participated in the study.

METHODS: Oxygen and temperature sensors were placed on the heels, …

Integrating A Professional Apprenticeship Model With Clinical Simulation For Psychiatric Nursing Students, M. C. Crider, Susan Mcniesh

Susan McNiesh

In this article, we present a theory-based application of clinical simulation in psychiatric-mental health nursing education. As described by Benner, Sutphen, Leonard, and Day, a three-pronged apprenticeship that integrates intellectual, practical, and ethical aspects of the professional role is critical in the development of practical reasoning in nursing education and training. Clinical encounters are often fraught with ambiguity and uncertainty. Therefore, educating for a practice discipline requires experiential and situated learning. Using the three-pronged experiential model in simulated psychiatric-mental health nursing practice supports the development of critical nursing skills, ethics, and theoretical concepts. A clinical scenario is presented that demonstrates …

Learning Formative Skills Of Nursing Practice In An Accelerated Program, Susan Mcniesh, P. Benner, C. Chesla

Susan McNiesh

The purpose of this qualitative research study was to describe how students in an accelerated master’s degree entry program experientially learned the practice of nursing. One research question examined in this study was: What formative experiences did students identify as helping them develop and differentiate their clinical practice? Data from clinical observations and a combination of small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Students identified formative skills learned through the independent care of a patient as pivotal in their identity and agency development. By experiencing the responsibility and action from within the body and …

The Relations Between Traumatic Exposures, Post-Traumatic Stress Disorder And Anger In Male And Female Veterans, Miranda E. Worthen

Miranda E. Worthen

Military personnel who have served in Operation Iraqi Freedom and Operation Enduring Freedom have experienced high rates of combat exposure, which is associated with posttraumatic stress disorder. Less is known about the relations between military sexual trauma (sexual harassment, assault, and rape while serving in the military) and posttraumatic stress disorder. Little is known about anger problems in this Operation Enduring Freedom/Operation Iraqi Freedom veteran population, which research from prior conflicts suggests may be a consequence of both traumas and posttraumatic stress disorder. Anger is an emotional state closely related to aggression, hostility, and violence. Veterans who have difficulty controlling …

Sex Trafficking Or Sex Work: Conceptions Of Trafficking Among Anti-Trafficking Organizations In Nepal, Miranda E. Worthen

Miranda E. Worthen

Trafficking for sexual purposes is widely recognized as a violation of human rights. Trafficking of women and girls within Nepal and from Nepal to India’s red light districts is thought to be extremely common. There is sharp debate within the anti-trafficking community, both within Nepal and globally, about why trafficking occurs and how to prevent it. I argue that this disagreement is rooted in two distinct underlying frameworks employed by anti-trafficking advocates to understand trafficking, which I identify as the “Prostitution Framework” and the “Labour Exploitation Framework”. This article introduces these frameworks and investigates where the anti-trafficking community in Nepal …

Gender-Based Insecurity And Opportunities For Peace: Supporting The Reintegration Of Young War-Affected Mothers, Miranda E. Worthen, S Mckay, A Veale, M Wessells

Miranda E. Worthen

No abstract provided.

Building Meaningful Participation In (Re)Integration Among War-Affected Young Mothers In Liberia, Sierra Leone And Northern Uganda, S Mckay, A Veale, Miranda E. Worthen, M Wessells

Miranda E. Worthen

No abstract provided.

‘I Stand Like A Woman’: Empowerment And Human Rights In The Context Of Community-Based Reintegration Of Girl Mothers Formerly Associated With Fighting Forces And Armed Groups, Miranda E. Worthen, A Veale, S Mckay, M Wessells

Miranda E. Worthen

This article describes a multi-year participatory action research (PAR) study with young women and girls who were formerly associated with armed groups in Sierra Leone, Liberia, and northern Uganda and had children of their own during the conflict and with young mothers considered by their community to be especially vulnerable. Following a review of the literature on empowerment and human rights, the authors use examples from the PAR study to explore how empowerment and human rights relate in the context of reintegration of the most vulnerable members of society. In this context, the realization of rights and empowerment are inextricably …

The Development Of A Universal Tangible Symbol System, Ellen Trief, Susan M. Bruce, Paul W. Cascella, Sarah Ivy

Paul Cascella

Tangible symbols are objects or partial objects with qualities, such as shape, texture, and consistency, that can be used to represent a person, place, object, activity, or concept. They can be handled and share a perceptual relationship with what they represent, known as the referent. This article presents a study on the development of a universal tangible symbol system. The purpose of this study was to identify a set of standardized tangible symbols from which educational teams could select the most appropriate symbols for the children they serve.

Ratings Of Communication Competence By Siblings Of Persons With Down Syndrome, Sarah E. Smith, Paul Cascella

Paul Cascella

This study surveyed 25 siblings of persons with Down Syndrome to gain an ecological perspective of important communication competence indicators. Siblings favorably described persons with Down Syndrome as "effective" and "good" communicators who "communicate to potential." Siblings regarded social communication skills as especially important, i.e., being able to communicate without fear, ebing able to express wants, needs, opinions, and feelings, being able to ask questions, and alerting partners to communication breakdowns. Siblings also regarded language comprehension as an important skill. Favorable descriptive labels were often applied to adult-aged persons with mild ID and normal hearing. Clinical implications are discussed focused …

How Heel Oxygenation Changes Under Pressure, Vivian K. Wong, N. A. Stotts, H. W. Hopf, E. S. Froelicher, G. A. Dowling

Vivian K. Wong

The mechanism of heel pressure ulcers after hip surgery is not entirely understood. The purpose of this one-group, prospective, repeated-measures design study was to examine how the external pressure of the bed surface affects heel skin oxygen tension in adults on the first 3 days after hip surgery. Transcutaneous oxygen sensors were placed on the plantar surface of each foot, close to the heels. Measures were taken on room air and with an oxygen challenge with the heels (1) suspended above the bed surface (preload), (2) on the bed surface for 15 minutes (loading), and (3) again suspended above the …

Physiology And Prevention Of Heel Ulcers: The State Of Science, Vivian K. Wong, N. A. Stotts

Vivian K. Wong

The prevalence of heel ulcers across settings is high and is increasing. Prevention of ulcers requires knowledge of their etiology and the scientific basis for preventive care. The interaction between external pressure and the heel vasculature is central to the prevention of heel ulcers. This article focuses on the prevention of heel pressure ulcers. The physiology of heel tissue perfusion, the effect of external pressure on heel perfusion, as well as what is known about strategies to reduce external pressure and approaches to improve heel skin blood flow will be discussed. It is only through understanding of the physiology of …

Student Evaluations Of Teaching Effectiveness: The Interpretation Of Observational Data And The Principle Of Faute De Mieux, B. Burt Gerstman

B. Burt Gerstman

Student opinion surveys are important but widely misunderstood tools for evaluating teaching effectiveness. In this brief review, an analogy is drawn between the use and interpretation of observational data for public health and biomedical research and the use of student opinion data in evaluating teach ing effectiveness. Sources of systematic error in the form of selection bias, information bias, and confounding are defined and illustrated. Original data concerning intermittent "quid pro quo" confounding (i.e., the effect of expected grades on student evaluations of teaching) are presented. Finally, the principle of faute de mieux ("lack of anything better") and the interpretation …

Sources Of Nosocomial Infections In Immunocompromised Patients (Letter), B. Burt Gerstman

B. Burt Gerstman

No abstract provided.