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The primary roles of nurse scientists in conducting health policy research are to increase knowledge in the discipline and provide evidence for informing and advancing health policies with the goal of improving the health outcomes of society. Health policy research informs, characterizes, explains, or tests hypotheses by employing a variety of research designs. Health policy research focuses on improving the access to care, the quality and cost of care, and the efficiency with which care is delivered. In this article, we explain how nurses might envision their research in a policy process framework, describe research designs that nurse researchers might use to inform and advance health policies, and provide examples of research conducted by nurse researchers to explicate key concepts in the policy process framework. Health policies are well informed and advanced when nurse researchers have a good understanding of the political process. The policy process framework provides a context for improving the focus and design of research and better explicating the connection between research evidence and policy. Nurses should focus their research on addressing problems of importance that are on the healthcare agenda, work with interdisciplinary teams of researchers, synthesize, and widely disseminate results.

It is vital for the healthcare system that nurses of children and young people have the ability and courage to lead. These qualities can affect all elements of healthcare, from direct care through service commissioning ( Royal College of Nursing 2014 ) to staff satisfaction and retention ( Kerfoot 2000 , Corning 2002 , Heller et al 2004 ).

The EU have set standards in relation to cultural competence, and findings from previously funded EU commission projects have illuminated an extensively developed body of knowledge in this area in relation to healthcare. Evidence from contemporary literature shows that education interventions have a positive impact on the cultural competence of health care professionals. Nonetheless, short accessible resources that can be used flexibly to support teaching and learning around cultural competence are not available across many European countries. The aim of the TransCoCon (2017-2020) project has been to develop innovative accessible multi-media learning resources to enable undergraduate nursing students and registered nurses in five countries to develop their cultural self-efficacy and cultural competence for nursing. The purpose of this paper is to describe and discuss this European ERASMUS + funded strategic partnership project (TransCoCon 2017-2020) and the creation of its underpinning theoretical and organising framework. The rationale for this guiding framework will be discussed within the context of supporting literature. info:eu-repo/semantics/publishedVersion

Background: Current treatment for locally advanced rectal cancer (LARC) includes multimodality therapy in the neoadjuvant and adjuvant settings. Response to neoadjuvant therapy (NT) is prognostic of long-term outcomes. While long-course chemoradiation (CRT) had been the traditional NT regimen, novel regimens adding systemic therapy and/or eliminating radiation have been introduced. We examined if circulating tumor cells provide prognostic information independent of the specific treatment regimen utilized. Specifically, we aimed to define the significance of CTC-defined minimal residual disease (MRD) in LARC. Methods: A prospective longitudinal protocol enrolled LARC patients (N=100; clinical stage II=4; stage III=96) undergoing NT. Peripheral blood was collected at baseline (t1, treatment-naive), after NT (t2, intraoperatively before tumor manipulation), after resection (t3, 2-8 weeks postoperatively), and after completion of adjuvant therapy (t4, 2-12 weeks after completion). CTC was enumerated by the CellSearch® platform within 72 hours of collection. Patients were followed for disease-free survival (DFS). Results: At t1, CTCs were detected in 28/90 (31.1%) patients with available samples with a median CTC count of 1.5 [IQR: 1.0, 2.75]. NT consisted of long-course pelvic CRT (65%), extended NT with systemic chemotherapy and long- or short-course pelvic CRT (22%), and a radiation-sparing regimen with systemic chemotherapy only (13%). At t2, CTCs were detected in 34/75 (45.3%) patients with a median CTC count of 1 [IQR: 1, 1]. Type of NAT did not correlate with CTC positivity (p=0.637). Ten (9.4%) patients declined surgery, while cPR occurred in 12/93 (12.9%) surgical patients. Postoperatively (t3), CTC was detected in 12/47 (25.5%) patients, with a median count of 1.5 (IQR: 1.0-3.0). After completing adjuvant chemotherapy (t4), only 3/29 (10.3%) patients had detectable CTC. With a median follow-up of 47.50 months from diagnosis for the entire cohort, CTC positivity at t4 significantly stratified DFS (p=0.035). Conclusions: One third of locally advanced RC patients harbored detectable CTCs at baseline. CTC detection after completion of curative-intent multimodality therapy (i.e., MRD) correlated with long-term DFS. Citation Format: Lucas Lee, Carol Hall, Antony Lucci, Brian Bednarski, Miguel Rodriguez-Bigas, George Chang, Y. Nancy You. Circulating tumor cell-defined minimal residual disease in locally advanced rectal cancer treated with multimodality therapy [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr A47.

BACKGROUND Unintentional injuries are an important global public health problem. Potentially, some senior managers have a major role to play in the prevention of home injuries. AIMS To explore senior managers' perceptions and practices regarding the prevention of home injuries among children and the potential factors that might influence such practice in Ramallah District of Palestine. METHOD Qualitative interviews were undertaken using a purposive sampling strategy of 18 senior-level managers. Thematic analysis was undertaken. RESULTS The study revealed that half of the interviewed managers' thought that injury prevention was a priority, and the majority of their institutions had worked on increasing parental awareness regarding injury prevention. Nevertheless, their practice in providing financial and psychological support to the parents was reported less. The participants stated that many factors had interchangeably influenced the practice in injury prevention, including factors related to staff, parents, and environment. CONCLUSION This study highlights the importance of managers' role in injury prevention and draws attention to the numerous obstacles that they face. Attempts to prevent injuries should use a combination of interventions at many levels including: parents, health staff, as well as the wilder governmental, physical.

Unintentional injuries are a growing global public health problem, causing mortality, morbidity, and disability among children. The rates of injuries were highest among children under the age of 5 years, and this forms a significant burden on health care systems, particularly in low- and middle-income countries. Mothers have a major role to play in the prevention of home injuries, as expressed in many international reports. There is a paucity of research in this area regarding Palestine. Therefore, this study aimed to explore mothers’ perceptions about the prevention of home injuries among children aged under 5 and the potential factors that might influence their injury prevention practices. A qualitative approach was followed, whereby 12 mothers from three settings (rural, refugee camp, and urban) in Ramallah District were purposively selected to participate in this study. The data were collected through semi-structured interviews, and the derived data were analyzed using thematic analysis. The study findings suggested that there are many similarities between the perspectives of mothers within the three settings. Most of them had a positive attitude toward preventing home injuries. However, many environmental factors affected their practice, including low economic status, the physical environment of the house, the social environment (e.g., fatalism), and the political environment. The study concluded that the causes of in-home injuries in Ramallah District are embedded within the families’ social and economic status and are influenced by the surrounding environment. Consequently, it supports the use of multiple intervention strategies within a holistic approach that acknowledges these factors to help prevent future home injuries.

Previously published equine temperature ranges often fail to state the population of animals or the method of temperature measurement used to establish the range. An inappropriate reference range can negatively affect the interpretation of measurements, resulting in animals being misdiagnosed. A yard specific equine rectal temperature reference range was therefore calculated. 652 rectal temperatures were collected from a population of 41 healthy adult horses, including a range of breeds aged 2-23 years old. Rectal temperature was measured at a depth of 5cm, using lubricated digital predictive thermometers. The normal rectal temperature range of horses on this yard was 36.0 – 38.0°C (90% confidence interval [CI] = 35.97–36.03°C at the lower limit, CI = 37.97–38.03°C at the upper limit). A Mann Whitney test showed significant difference between geldings and mares (Z = - 1.389, p = 0.165). Spearman’s correlation showed no significant correlations between rectal temperature and ambient temperature (Rs = 0.137, p = 0.052), or rectal temperature and horse height (Rs = -0.047, p = 0.791). The upper limit of the range is lower than most previously suggested temperature ranges, which may reflect the low stress environment in which temperatures were measured; horses were housed in a familiar environment and examined and handled by familiar equine technicians. The findings of this study suggest that establishing yard specific normal temperature ranges could improve early detection of fever, and support biosecurity protocols in the face of infectious disease outbreaks. Additionally, the results suggest that existing equine temperature ranges may need reviewing

Unintentional injuries are a growing global public health problem that causes mortality, morbidity, and disability among children. These injuries are common among under-fives and form a significant burden on healthcare systems, particularly in low- and middle-income countries. Nurses and doctors have a major role to play in the prevention of home injuries, as expressed in many international reports. In Palestine, there is a paucity of research in this area. Therefore, this study aims to explore nurses' and doctors' perceptions and practices regarding the prevention of home injuries among children aged under-five years. A qualitative approach was followed, whereby semi-structured interviews were undertaken with 24 nurses and doctors who worked with children in a primary health care setting. The derived data were analyzed using thematic analysis. This study found that most of the nurses and doctors who were interviewed reported positive attitudes toward working on this topic; the majority of them attempted to work on injury prevention. Nevertheless, they needed further support to fulfil this potential role, as they faced many barriers in their daily practice in this area. Policy makers could potentially take advantage of this attitude and support them by providing training, resources, and time for them to implement this role.

The scientific study of animal emotion has recently become an important focus for animal behaviour and welfare researchers. For horses used by humans for work, recreation or sport, the question of the significance of their life experiences in terms of their emotional response, is an important one if we are to provide for their welfare needs. Horses have received relatively less scientific attention than many livestock species when it comes to investigating emotional state or affective experience, although their behavioural responses during sporting or recreational performance are often described anecdotally using terminology indicating an underlying presumption of equine emotions. Indeed, the international governing body for equestrian sport, the Federation Equestre Internationale (FEI), include the concept of ‘the Happy Equine Athlete’ into their rules, as a key objective during training and competition. This review presents available evidence to date of the physiological, behavioural and cognitive components of equine emotion and evaluates the extent to which the question concerning ‘how horses feel’ can be answered. The characterization of equine emotion in terms of level of arousal and valence, based on physiological, behavioural and cognitive indicators, offers a way forward to determine the impact of different situations and experiences on horses during their working lives. There is a need to develop robust validated methods for accessing equine emotions, to underpin a universally agreed method for/approach to providing an accurate assessment of equine welfare that can be utilized in a variety of contexts. This will provide a means of monitoring and improving the horse’s experience, ensuring that the horse enjoys a good life, rather than one that is just worth living.

Aim A national survey was conducted to examine the relationship between individual students' experiences and nursing PhD program characteristics and program outcomes. Background In light of the shortage of doctorally prepared nurse scientists and a growth in nursing PhD programs, an examination of the PhD nursing education experience in relation to educational outcomes is timely. Method Data were collected from graduates of a 50 percent random sample of nursing PhD programs in the United States. Results Graduates who had worked as research assistants, attended classroom-based programs, and worked as a nurse no more than 12 hours per week during their PhD education were more likely to have successful publication records and receive external research grant funding than graduates who did not have these experiences. Conclusion On the basis of traditionally accepted measures of research productivity, our results indicate that nursing PhD programs have limited success in producing nurse researchers.

Nurse leaders and health-care experts agree that nurses have a responsibility to address the health problems facing the nation by participating in health policy development. However, nurses have not fully realized their potential when it comes to engaging in health policy advocacy and leadership. Nurse leaders, professional nursing organizations, accrediting bodies, and the Institute of Medicine have all identified the need to educate nurses in heath policy. Valuable recommendations for content and learning activities in health policy have been made. We argue that nursing education in health policy and the many recommendations offered have been broad and overly ambitious. This article presents a proposal for a staged approach to educating nurses. This approach would tailor content to the role of the nurse at each level of nursing education. The focus of health policy content would progress from the organizational level to local, state, and finally national level health policies. The goal of this approach is to better prepare all levels of nursing students to participate in shaping effective health policies.

Stress is a generic concept describing the body’s reaction to external stimuli, including both physiological and psychological factors. Therefore, by definition, the assessment of psychological stress in the exercising horse encompasses the problem of teasing apart the psychological and physiological factors both of which result in stress responses. The present study reviews the existing literature on various measures of stress taken specifically in the context of equitation science. Particular attention has been paid to short-term effects, and commonly used measurements of short-term stress include heart rate, a number of heart rate variability parameters, blood or saliva cortisol levels, eye temperature, and various behaviour parameters including in particular behaviour patterns presumably indicative of conflict with the rider’s/trainer’s aids. Inspection of the individual studies’ results revealed that disagreement between these different measures of stress is commonplace. For physiological parameters, the largest proportion of agreement (i.e. both parameters simultaneously indicated either higher, insignificant or lower stress compared to a control treatment) was found for heart rate and heart rate variability parameters, while generally limited agreement was found for cortisol. It appears that cortisol levels may not be particularly useful for assessing/assessment of the valence of a situation in the exercising horse as cortisol levels are predominantly linked to activation and exercise levels. Although heart rate variability parameters reflect in theory more closely sympathovagal balance compared to cortisol levels, great care has to be taken regarding the use of appropriate time-frames, appropriate raw data correction methods as well as the use of appropriate equipment. In spite of its wide-spread and apparently successful use, popular equipment may in fact not be accurate enough under field conditions. Eye temperature is another promising parameter for assessment of psychological stress, but the technique is likewise susceptible to application errors. Given the high susceptibility of physiological parameters to errors at various experimental stages, behavioural rather than physiological parameters may in fact provide more accurate measures of valence when conducting experiments in the exercising horse. Behavioural parameters that appear to be particularly practical in assessing stress in ridden horses’ behaviour are associated with frequencies of behaviour indicative of conflict. However, while increased frequencies of are a good indicator of stress, the absence of conflict behaviour does not provide proof of the absence of stress due to the possible occurrence of conditions such as Learned Helplessness. In future studies, the above issues should be taken into consideration when designing experiments to assess psychological stress in ridden horses.

It is vital for the healthcare system that nurses of children and young people have the ability and courage to lead. These qualities can affect all elements of healthcare, from direct care through service commissioning ( Royal College of Nursing 2014 ) to staff satisfaction and retention ( Kerfoot 2000 , Corning 2002 , Heller et al 2004 ).

Background The concept of a ‘specialist nurse’ has existed for many years and related education programmes are proliferating. However, while literature clearly outlines the roles and practice of registered nurses and advanced practice nurses, those of specialist nurses remain unclear and nursing specializations across Europe need clarifying. Aim This pilot study aimed to explore the competencies, education requirements and regulation of specialist nurses in Europe. Design A descriptive cross-sectional survey. Methods An online questionnaire named ‘Specialist nurse and specialization in Europe’ was sent to 550 members of the European Federation of Nurse Educators and ten members of the European Specialist Nurses Organizations. Snowball sampling was then used to build a convenience sample of nurse educators, clinical nurses and specialist nurses, national nursing association members, and chief nursing officers from all European countries. Besides quantitative aspects, responses to open-ended questions were analysed using a qualitative content analysis process. Results A total of 77 experts from 29 European countries responded to the questionnaire. Findings highlighted variations in titles, levels and length of education, certification, regulation and scope of practice for specialized nurses in Europe. Analysis of the promoted competencies revealed dominant clinical and technical aspects of the role with a high level of knowledge. Conclusions The study emphasized the need to improve standards for education, certification and regulation for specialist nurses. Interpretation of the role and competencies is diverse with a weak presence of health policy that would enhance and develop the specialities. Implications for nursing and health policy To address the current lack of provisions for automatic recognition of specialist nurses, common training frameworks corresponding to the relevant level of the European Qualifications Framework should promote lifelong learning and mobility, and enhance levels of health care and patient safety.

Protected areas play a fundamental role in national, regional, and global climate change adaptation strategies. They safeguard and enhance the resilience of ecosystems and protect clean water and other vital services that human communities rely on for their well-being. This paper highlights how protected areas agencies and their partners in four countries have begun working together to implement ecosystem-based approaches to climate change adaptation. By sharing experiences and knowledge, protected area agencies in Kenya, Mexico, Chile and Colombia have increased local and national capacity to contribute to climate adaptation strategies through research, monitoring, planning, active management and ecological restoration projects. By also identifying opportunities to engage communities and offer meaningful visitor and learning experiences as part of on-the-ground activities, the projects are inspiring citizens and building understanding of how protected areas help address global challenges like climate change.

Using the Outcome and Assessment Information Set (OASIS), this study examined the feasibility of using OASIS items to identify direct and indirect factors contributing to rehospitalization among elderly patients receiving home health care. The outcomes revealed that being male, having a median level of cognitive impairment, a lower level of functional ability, and the absence of support, such as environmental support, psychosocial support, or facilitated medical care directly contributed to rehospitalization. While being older, obese, having a poorer clinical status, receiving ADL and/or IADL and less frequent informal care contributed to rehospitalization indirectly through decreased functional ability. Home health care providers may take full advantage of OASIS data, assessing both the direct and indirect factors leading to rehospitalization to identify patients at risk and intervene when needed.

This paper reports a key educational initiative undertaken by NHS Education for Scotland (NES), based upon recommendations from a 'Numeracy in Healthcare' consultation. We report here the design of a web-based technical measurement authentic assessment environment evolved from the safeMedicate suite of programs that provided a model for an environment within which a medication dosage calculation problem-solving (MDC-PS) benchmark could be articulated. A sample of 63 third-year pre-registration nursing students was recruited from four participating universities in the UK. A counterbalanced design was employed where the virtual authentic assessment environment was evaluated for internal consistency reliability and criterion-related validity against an objective structured clinical assessment (OSCE) undertaken in high-fidelity simulated clinical environments. Outcome measures indicated an extremely high internal consistency of the web-based environment. It was concluded that the combination of a web-based authentic assessment environment and further assessment of safe technical measurement interpretation and dexterity in a practice/practice simulation setting, populated with a benchmark and a criterion referenced rubric validated by the profession, is an innovative, viable, valid and reliable assessment method for the safe administration of medicines. As a result, the rubric for assessment of the appropriate range of calculation type and complexity informed the NMC's revised Essential Skills Clusters for Medicines Management (NMC, 2010a; NMC, 2010b). This inclusion provides a particularly strong example of both research directly influencing policy and of evidence-based regulation.

Assessments of the behavior of ridden horses form the basis of performance evaluation. The purpose of any performance being evaluated will determine the factors considered important, factors indicative of “poor” performance, and what makes a successful equine athlete. Currently, there is no consistent objective means of assessing ridden horse behavior, and inevitably, given the different equestrian disciplines, the likelihood of a universal standard of good and bad performance is remote. Nevertheless, to protect the welfare of the ridden horse regardless of its specific role, we should strive for consensus on an objective means of identifying behavioral signs indicative of mental state. Current technological developments enable objective evaluation of movement patterns, but many aspects of the assessment of ridden behavior still rely on subjective judgment. The development of a list of behaviors exhibited by ridden horses, a ridden horse ethogram, will facilitate recording of observable behavioral events. However, without objective evidence of the relevance of these behavioral events, such a resource has limited value. The aim of this review was to investigate potential sources of such evidence and relate these to the assessment of ridden horse behavior. The current and potential contribution that further objective measures can make in this process is evaluated. We believe that the only way to improve the welfare of the ridden horse is by objectively identifying behavioral signs that indicate that the horse is either comfortable or uncomfortable with the activity in which it is participating. After there is clear evidence to support this, appropriate adaptation of performance criteria in all disciplines can proceed along with alignment in training systems that ensures a mutually positive experience for both horse and human partners.

Theme: Nursing education, management and leadership.

Response to Intervention (RTI) provides a framework for effective prevention and intervention to students who have difficulty reading at all achievement levels by using a school-wide, tiered system. RTI is the means for helping struggling students become successful readers before they have a chance to fall behind. Using evidence-based reading strategies within multiple classrooms such as the inclusive classroom or the resource classroom provides students with learning disabilities the opportunity to succeed in all content areas while applying these reading strategies. All teachers can use these strategies to assist the at-risk and struggling reader make progress. The purpose of this chapter is to share research, resources, and reading instructional methods appropriate for students at the secondary level that can help them meet their academic needs.

Aim To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China. Background Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown. Design A cross-sectional design was selected for this descriptive correlation study. Methods Cross-sectional study of critical care nurses (n = 446) and general ward nurses (n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010–November 2010. Results Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job. Conclusion Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse.

Guided by Orem's theory, this study examined the influence of social environmental factors on rehospitalization among home health care patients. Living arrangement, frequency of caregiving, and type of primary informal care were found to be related to functional ability. Measurable differences in clinical status and functional ability were related to the duration that patients received home health care services until rehospitalization, with the likelihood of rehospitalization increasing proportionately to the magnitude of the differences. Social environmental factors contributed to rehospitalization (self-care deficit) through functional ability (self-care agency) by altering the balance between self-care demand (clinical status) and self-care agency.

Home care nurses report increased stress in their jobs due to work environment characteristics that impact professional practice. Stressors and characteristics of the professional practice environment that moderate nurses' experience of job stress were examined in this embedded multiple case study. Real life experiences within a complex environment were drawn from interviews and observations with 29 participants across two home care agencies from one eastern U.S. state. Findings suggest that role overload, role conflict, and lack of control can be moderated in agencies where there are meaningful opportunities for shared decision making and the nurse-patient relationship is supported.

Aim To investigate predictors of hospital nurses' intent to stay in the nursing profession. Methods A cross-sectional survey design was adopted. Over 1000 nurses working in hospitals in Shanghai, China, were invited to complete a survey questionnaire between May and October 2009 and 919 nurses responded for an 82% response rate. Findings Regression models explained 41.3% of variance in nurse intent to stay. Although the proposed model hypothesized 18 predictors of intent to stay, only seven were statistically significant factors of nurse intent to stay: normative commitment, economic costs commitment, age, limited alternatives commitment, praise/recognition, professional advancement opportunities and the hospital classification. Of these, the strongest predictors were normative commitment, economic costs commitment and age, which explained 37.3% of variance in nurse intent to stay. Conclusion Possible strategies to improve nurses' intent to stay include employment practices that improve the work environment, increased wages and benefits, and greater professional opportunity for nurses' personal growth development and promotion. Healthcare organizations should establish an asserting and nurturing environment for nurses and improve nurses' normative commitment and economic costs commitment. Increased effort should be made to improve nurses' conditions in primary and secondary hospitals where nurses report a lower level of intent to stay in nursing. Study limitations Participants came from a limited number of hospitals in Shanghai. A larger sample from different hospitals in Shanghai and other districts in Mainland China could have enhanced the generalizability of the results and increased the power of the study.

ellenbecker c.h. & cushman m. (2011) Home healthcare nurse retention and patient outcome model: discussion and model development. Journal of Advanced Nursing68(6), 1881–1893. Abstract Aim. This paper discusses additions to an empirically tested model of home healthcare nurse retention. An argument is made that the variables of shared decision-making and organizational commitment be added to the model based on the authors’ previous research and additional evidence from the literature. Background. Previous research testing the home healthcare nurse retention model established empirical relationships between nurse, agency, and area characteristics to nurse job satisfaction, intent to stay, and retention. Unexplained model variance prompted a new literature search to augment understanding of nurse retention and patient and agency outcomes. Data sources. Data come from the authors’ previous research, and a literature search from 1990 to 2011 on the topics organizational commitment, shared decision-making, nurse retention, patient outcomes and agency performance. Discussion. The literature provides a rationale for the additional variables of shared decision-making and affective and continuous organizational commitment, linking these variables to nurse job satisfaction, nurse intent to stay, nurse retention and patient outcomes and agency performance. Implications for nursing. The new variables in the model suggest that all agencies, even those not struggling to retain nurses, should develop interventions to enhance nurse job satisfaction to assure quality patient outcomes. Conclusion. The new nurse retention and patient outcome model increases our understanding of nurse retention. An understanding of the relationship among these variables will guide future research and the development of interventions to create and maintain nursing work environments that contribute to nurse affective agency commitment, nurse retention and quality of patient outcomes.

Wang L, Tao H, Ellenbecker CH & Liu X (2012) Job satisfaction, occupational commitment and intent to stay among Chinese nurses: a cross-sectional questionnaire survey. Journal of Advanced Nursing68(3), 539–549. Abstract Aim. This study was designed to identify the level of nurses’ job satisfaction, occupational commitment and intent to stay among mainland Chinese nurses, to explore the relationship among them. Background. Little is known about the magnitude of Chinese nurses’ intent to stay. Understanding the association among demographic characteristics and job satisfaction, occupational commitment and intent to stay among Chinese nurses is most important in a time of nurse shortages. Methods. A descriptive correlation design was used to examine the relationship among variables related to intent to stay. Data were collected by a self-administered survey questionnaire from 560 nurses working in four large hospital facilities in Shanghai in 2009. Results. The mean scores for nurses’ job satisfaction, occupational commitment and intent to stay were 3·25(0·48), 3·11(0·40) and 3·56(0·65), respectively. Job satisfaction and occupational commitment were significantly related to intent to stay. A statistically significant positive correlation was found between occupational commitment and job satisfaction. Age and job position were significantly related to job satisfaction, occupational commitment and intent to stay. Conclusion. Levels of job satisfaction, occupational commitment and intent to stay reported by nurses in this study can be improved. Suggested strategies for improvement are: increasing salaries, decreasing workloads, modifying task structure, cultivating work passion and creating more professional opportunity for nurses’ personal growth development and promotion. Enhancing nurses’ job satisfaction and occupational commitment are vital to improve nurses’ intent to stay and for strategies to address the nursing shortage.

Wenger describes an educational community of practice (CoP) as a group of professionals who share a passionate concern for practice‐based issues and who voluntarily choose to deepen their knowledge, understanding and skills through collaborative and critical dialogue. Peer collaboration of this kind, which involves social interaction, reflection and a critical engagement with practice issues, has been widely suggested to be effective for teacher learning and professional development. The online continuing professional development for teachers (e‐CPDelT) Vision 2020 model outlined here aims to bring about innovation in practice through an online or virtual CoP (VCoP). Twenty Malaysian teachers in five Smart Schools were invited to take part in a Higher Education (HE) project, funded by one of the main universities in Malaysia. By participating collaboratively in this CoP, it was anticipated that the teachers would form an active online CoP that would lead in turn to innovation in teaching and learning prac...

The new healthcare legislation was substantially informed by nursing research. In this column Carol Ellenbecker discusses some of the key elements.

BACKGROUND: Patients receiving warfarin therapy after coronary artery bypass graft (CABG) or valve surgery have longer length of stay (LOS) than those not receiving warfarin therapy. Longer LOS increases patient costs, postdischarge recovery time, and rehabilitation. It is important to identify variables of longer postoperative LOS in this patient population so that the healthcare team can develop and facilitate interventions to minimize length of hospitalization. METHODS: Using a hospital registry and medical record review of cases completed in 2004, data from cardiac surgery patients having CABG and/or valve procedures and given warfarin postoperatively were analyzed based on short ( or =7 days, CABG; > or =9 days, valve procedure) postoperative LOS. By groups, significant associations were assessed using chi or Fisher exact test for categorical variables and Wilcoxon 2-sample test or Student t test for continuous variables. RESULTS: In 82 patients (33 CABG and 49 valve +/- CABG) who were given warfarin, most demographic, medical history, postoperative complications, and use of cardiac drugs did not predict longer LOS. Longer postoperative LOS was associated with being older (mean age, 73.5 vs 68.5 years), being not married, having postoperative respiratory insufficiency, and receiving more red blood cell transfusions, all P < .05; and having more healthcare consultations, longer critical care stay, and longer time between surgery date and start of warfarin; all P < .001. CONCLUSIONS: Variables associated with longer LOS were nonmodifiable by nursing services and were difficult to assess preoperatively. They primarily involved intraoperative or postoperative bleeding that led to red blood cell infusion and longer critical care stays that delayed warfarin initiation. However, older age and marital status are nursing targets because they may be associated with social isolation and other psychosocial issues. Transition of care programs can be developed to promote earlier discharge.

The School of Education, University of Nottingham (UoN), UK and Beiwai Online, Beijing Foreign Studies University (BFSU) Beijing, China have been engaged on a collaborative research project to develop a generic module for the training of online tutors globally as part of the eChina-UK programme with funding from the Higher Education Funding Council for England. This has led to a learner centred approach to the training that takes analysis of transitions within the learning and teaching process as a key focus. It provides trainee tutors with a range of online reflective analytic tools to support their developing understanding of effective practice in order to consider appropriate support for these transitions. This article describes the rationale behind the design of the various components and activities of the tutor training module including aspects of the development process and the research pilot into localisation at the Universiti Sains Malaysia.

Children’s nurses are most likely to have long involvement with the care of dying children in hospital and at home. As students they expect to be taught how to manage the complex technical needs of children, however, the needs of dying children may not receive the same degree of attention. Review of the literature revealed that student nurses may be exposed to the death of a child with little education to help them deal with specific needs of the children and minimal preparation in coping with personal emotional reactions. This study closely examined student nurses’ educational needs in relation to end-of-life care for children. Eight semi-structured interviews were conducted with final-year child-branch students to identify their experiences and perceptions. Themes identified included: anxieties regarding providing end-of-life care to children; negative aspects of end-of-life education; positive aspects of end-of-life education; and perceptions of how end-of-life education could be improved. Students perceived that education could be improved to fully prepare them to care for children at the end of life. Additionally, students identified some of the strengths of their education including providing practical nursing care to children at the end of life and receiving good support from both university and clinical staff.

Sustaining the needs of people with chronic illness is a challenge facing health and social care services. Patients' knowledge about their disease can impact on improving the management of their care and may offer opportunity for increasing support (Department of Health, 2000, 2001, 2003, 2005). This small phenomenological enquiry sought to understand how six young women aged between 16 and 19 years experienced learning about their rheumatological illness, and their preferred learning options relating to treatment and management. Data was collected through the use of semi-structured interviews. Interviews were analysed using a modified version of Colaizzi's seven stage process (Hantikainen and Kappeli, 2000). Findings offer insight into perceived health knowledge needs of young women with rheumatological illness in the UK. Data gathered indicated that communication was of concern for the sample, particularly within lay environments such as schools, work and home. Opportunities for service improvement are discussed within the context of existing evidence, including tailoring of materials for young people, and development of services that facilitate effective communication. The involvement of `experienced patients' may be beneficial in facilitating self-care management of young women with rheumatological disease.

This phenomenological study explored the decision-making experience of parents whose children joined Special Olympics programs. The experiences of 16 families with children 10-22 years old were gathered through interviews, artifacts, and field notes. Three themes emerged from the thematic analysis (a) thoughtful instruction, (b) finding the fit, and (c) security of acceptance. Parents sought instructors who were interested in building relationships with their children and creating anxiety-free instructional environments for them. A good program fit occurred when instructors had expectations for motor skill development and increased independence. Parents also preferred environments that encouraged meaningful peer interactions. The findings were interpreted within the context of self-determination theory.

Six horses (Equus caballus) were trained to discriminate color from grays in a counterbalanced sequence in which lightness cues were irrelevant. Subsequently, the pretrained colors were presented in a different sequence. Two sets of novel colors paired with novel grays were also tested. Performance was just as good in these transfer tests. Once the horse had learned to select the chromatic from the achromatic stimulus, regardless of the specific color, they were immediately able to apply this rule to novel stimuli. In terms of the underlying visual mechanisms, the present study showed for the first time that the spectral sensitivity of horse cone photopigments, measured as cone excitation ratios, was correlated with color discrimination performance, measured as accuracy, repeated errors, and latency of approach.

The purpose of this study was to explore the factors that contribute to variability in home healthcare nurses' job satisfaction. Nurses completed the 30-item Home Healthcare Nurses Job Satisfaction Scale specifically designed to measure job satisfaction of home healthcare nurses. Results suggest that the greatest amount of variability in satisfaction for home healthcare nurses are salary and benefits, stress and workload, and organizational factors, that is, factors over which organizations and management have the most control.

Aims. This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity. Background. Numerous scales have been developed to measure nurses’ job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction. Methods. A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's α internal consistency reliability coefficients. The data were collected in 2003. Results. Nine factors contributing to home healthcare nurses’ job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0·4. Cronbach's α coefficients for each of the nine subscales ranged from 0·64 to 0·83; the α for the global scale was 0·89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0·79, indicating good criterion-related validity. Conclusions. The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.

This article describes the Nursing PhD Program specialty in health policy conceived and developed at the University of Massachusetts Boston. The rationale for a specialty in health policy is that nurses have valuable knowledge and a unique perspective of the health care system. Nurses belong to the largest group of health care providers and are the providers that spend the most time with patients. The nursing profession has a responsibility to help assure members of society have access to safe and effective quality health care. As a group, nurses need to be politically savvy to translate their knowledge and perspective to benefit society. Nurses need to direct their attention to understanding issues and policy arguments and to contribute to policy discussion with reasoned arguments and objectivity. The PhD program at the University of Massachusetts Boston prepares nurses as policy analysts, researchers, and educators who will positively contribute to the health of society.

Background. Predicted severe nursing shortages and an increasing demand for home health care services have made the retention of experienced, qualified nursing staff a priority for health care organizations. Aims. The purpose of this paper is to describe a theoretical model of job retention for home health care nurses. Methods. The theoretical model is an integration of the findings of empirical research related to intent to stay and retention, components of Neal's theory of home health care nursing practice and findings from earlier work to develop an instrument to measure home health care nurses’ job satisfaction. Discussion. The theoretical model identifies antecedents to job satisfaction of home health care nurses. The antecedents are intrinsic and extrinsic job characteristics. The model also proposes that job satisfaction is directly related to retention and indirectly related to retention though intent to stay. Individual nurse characteristics are indirectly related to retention through intent to stay. The individual characteristic of tenure is indirectly related to retention through autonomy, as an intrinsic characteristic of job satisfaction, and intent to stay. Conclusions. The proposed model can be used to guide research that explores gaps in knowledge about intent to stay and retention among home health care nurses.

We investigated the adaptive significance of a sexually monomorphic ornament in the black swan Cygnus atratus. Both sexes grow curled feathers on their wings (range 7‐22 curled feathers per wing), which are displayed prominently in a range of social interactions. The number of curled feathers increased until the birds reached sexual maturity (at 2 years of age) but did not vary with age thereafter. We found evidence for both sexual and social functions of the ornament. Paired, mature individuals of both sexes had higher numbers of curled feathers than unpaired, mature birds, and individuals paired assortatively with respect to curled feather number, suggesting the feathers may be involved in mutual sexual selection. More ornamented individuals were dominant in agonistic interactions with birds of the same sex and pairing status. Highly ornamented pairs were also more likely to maintain extended tenancy of preferred cygnet feeding areas, which resulted in improved offspring survival. The curled feathers thus appear to function as a signal of social dominance, which is highly correlated with reproductive success and is therefore a reliable signal of parental quality in mate choice. Key words: black swans, Cygnus atratus, dominance, mutual sexual selection, ornamentation, signaling, social selection. [Behav Ecol 15:380–389 (2004)]

This study investigated the effect of stimulus height on the ability of horses to learn a simple visual discrimination task. Eight horses were trained to perform a two-choice, black/white discrimination with stimuli presented at one of two heights: ground level or at a height of 70 cm from the ground. The height at which the stimuli were presented was alternated from one session to the next. All trials within a single session were presented at the same height. The criterion for learning was four consecutive sessions of 70% correct responses. Performance was found to be better when stimuli were presented at ground level with respect to the number of trials taken to reach the criterion (P < 0.05), percentage of correct first choices (P < 0.01), and repeated errors made (P < 0.01). Thus, training horses to carry out tasks of visual discrimination could be enhanced by placing the stimuli on the ground. In addition, the results of the present study suggest that the visual appearance of ground surfaces is an important factor in both horse management and training.

Within the emerging discipline of Equitation Science, the application of consistent methodology, including robust objective measures, is required for sound scientific evaluation. This report aims to provide an evaluation of current methodology and to propose some initial guidelines for future research. The value of research, especially that involving small sample sizes, can be enhanced by the application of consistent methodology and reporting enabling results to be compared across studies. This article includes guidelines for experimental design in studies involving the ridden horse. Equine ethograms currently used are reviewed and factors to be considered in the development of a ridden-horse ethogram are evaluated. An assessment of methods used to collect behavioral and physiological data is included and the use of equipment for measurements (e.g., rein-tension and pressure-sensing instruments) is discussed. Equitation science is a new discipline, subject to evolving viewpoints on research foci and design. Technological advances may improve the accuracy and detail of measurements but must be used within appropriate and valid experimental designs.

Changes in health care have created an increasingly complex home health care environment, one in which knowledge derived from research is essential to provide patient care. The development of knowledge is enhanced when nurse researchers, nurse providers, and graduate nursing students collaborate to conduct research. Collaboration in research has many benefits. It benefits graduate students by providing opportunities to gain the skills needed for the advance practice role. It benefits academic researchers by advancing their programs of research, providing additional student resources and a fresh perspective. It benefits providers and the nursing profession by expanding knowledge that defines the profession, drives practice, and holds nurses accountable. Most important, collaborative research efforts benefit patients by assuring that nurses in the future are experienced in research and have the abilities to design, implement, and evaluate nursing care based on scientific evidence, ensuring access to safe and effective care.

Nursing education is currently faced with many changes in both the academic and clinical environments. A significant challenge is to provide students with meaningful clinical placements. Experiences in clinical placements allow students to test assessment, critical thinking, communication, and decision-making skills in real and culturally diverse world situations. Nursing faculties need to develop new and innovative approaches for students to gain the necessary clinical experience. This article describes a community health clinical placement designed and implemented through a partnership of academic and social service organizations. It details the conception, growth, and development of student nursing clinics based in elderly and disabled housing sites.