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Background: This study investigated the role of key individual- and community-level determinants to explore persisting racial/ethnic disparities in breast cancer stage at diagnosis in California during 1990 and 2000.Methods: We examined socio-demographic determinants and changes in breast cancer stage at diagnosis in California during 1990 and 2000. In situ, local, regional, and distant diagnoses were examined by individual (age, race/ethnicity, and marital status) and community (income and education by zip code) characteristics. Community variables were constructed using the California Cancer Registry 1990-2000 and the 1990 and 2000 U.S. Census.Results: From 1990 to 2000, there was an overall increase in the percent of in situ diagnoses and a significant decrease in regional and distant diagnoses. Among white and Asian/Pacific Islander women, a significant percent increase was observed for in situ diagnoses, and significant decreases in regional and distant diagnoses. Black women had a significant decrease in distant -stage diagnoses, and Hispanic women showed no significant changes in any diagnosis during this time period. The percent increase of in situ cases diagnosed between 1990 and 2000 was observed even among zip codes with low income and education levels. We also found a significant percent decrease in distant cases for the quartiles with the most poverty and least education.Conclusions: Hispanic women showed the least improvement in breast cancer stage at diagnosis from 1990 to 2000. Breast cancer screening and education programs that target under-served communities, such as the rapidly growing Hispanic population, are needed in California. [ABSTRACT FROM AUTHOR]

The article discusses the role of the chief nurse officer (CNO) in improving quality of healthcare and ensuring patient safety. It highlights a project by the National Center for HealthCare Leadership (NHCL) with the support of the Robert Wood Johnson Foundation, which focused on the role of the senior nursing leadership team in maintaining quality and safety. Information on the purpose, objectives and participants of the study is provided, and details pertaining to approval from the institutional review board (IRB) and the results are presented. The article also discusses the importance of the study and its conclusion.

Objectives: This paper reports on an exploratory study into the perceived benefits and challenges of using an electronic cancer prediction system, C the Signs, for safety netting within a Primary Care Network (PCN) in the East of England., Methods: The study involved semi-structured interviews and a qualitative questionnaire with a sample of 15 clinicians and practice administrators within four GP practices in the PCN., Results: Participants generally perceived benefits of C the Signs for managing and monitoring referrals as part of post-consultation safety netting. Clinicians made little use of the decision support function though, as part of safety netting during the consultation, and referrals were still sent by administrators, rather than directly by clinicians through C the Signs., Conclusion: Emphasising the benefits of C the Signs for post-consultation safety netting is most likely to gain buy-in to the system from clinicians, and can also be used by administrators for shared visibility of referrals. More evidence is needed on the value of C the Signs for safety netting during the consultation, through better diagnosis of cancer, before this is seen as a valued benefit by clinicians and provides motivation to use the system., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: New graduate nurses are the nursing cohort at greatest risk for turnover and attrition in every context internationally. This has possibly been heightened during the COVID-19 pandemic. Workplace conditions significantly impact nursing turnover; however, interventions under the positive psychology umbrella may have a mediating impact on the intention to leave. New graduate nurses are generally challenged most in their first three years of clinical practice, and the need for support to transition is widely accepted. Gratitude practice has been reported to improve individual control and resilient response to setbacks and, therefore, is of interest in testing if this intervention can impact turnover intention in the workforce., Objective: To report on a scoping review undertaken to identify whether 'gratitude practice' as an intervention had the potential to improve new graduate nurses' wellbeing and resilience., Methods: Arksey and O'Malley's scoping review approach. Primary research papers of any methodology, published in English between January 2010 and July 2022 were included. Literature was sourced from seven databases, including CINAHL PLUS, ERIC, MEDLINE, Professional Development Collection, APA PsychInfo, APA PsychArticles, and Psychological and Behavioural Sciences Collection., Results: We identified 130 records, of which we selected 35 for inclusion. A large range of interventions were identified; most had some form of writing, journaling, or diarising. The next most common intervention was teaching gratitude strategies via workshops, and many interventions had some form of list or activity trigger for participants to complete. Five studies had complex combined interventions, while the rest were simple, easily reproducible interventions. Interventions were delivered both face-to-face or asynchronously, with some being online only and others sent out as a 'kit' for participants to work through., Conclusion: Our review of existing literature shows a significant gap in research on gratitude practice and its impact on nursing populations. To ensure robust future studies, we suggest defining concepts clearly and selecting outcome measures and tools that are not closely related. Intervention design may not be as important as the choice of measures and tools to measure outcomes., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Higher education institutions are uniquely placed to introduce emotional coping skills to promote resilience in pre-registration nurses in order to reduce anxiety and increase confidence before they enter clinical placement for the first time. In this qualitative study, we will explore the use of a 360-degree video in developing skills for coping. The participants will be mental health nursing students. We will develop a 360-degree video in collaboration with a mental health service user. All participants will watch the video. A sub-group will receive a supportive clinical supervision discussion within a cognitive reappraisal/solution-focused/VERA framework. We will record the experiences of the participant to explore: (1) how students felt about the use of 360-degree video, as an education tool to build skills of resilience; (2) whether the students involved felt more confident and less anxious about the situation in the video as a result of participating in the cognitive reappraisal/solution-focused/VERA supervision discussion.

Background and Purpose: The National Institutes of Health (NIH) funds training programs to increase the numbers and skills of scientists who obtain NIH research grants, but few programs have been rigorously evaluated. The sizeable recent NIH investment in developing programs to increase the diversity of the NIH-funded workforce, implemented through the Diversity Program Consortium (DPC), is unusual in that it also funds a Consortium-wide evaluation plan, which spans the activities of the 10 BUilding Infrastructure Leading to Diversity (BUILD) awardees and the National Research Mentoring Network (NRMN). The purpose of this article is to describe the evaluation design and innovations of the BUILD Program on students, faculty, and institutions of the 10 primarily undergraduate BUILD sites., Key Highlights of the Project: Our approach to this multi-methods quasi-experimental longitudinal evaluation emphasizes stakeholder participation and collaboration. The evaluation plan specifies the major evaluation questions and key short- to long-term outcome measures (or Hallmarks of Success). The Coordination and Evaluation Center (CEC) embarked on a comprehensive evaluation strategy by developing a set of logic models that incorporate the Hallmarks of Success and other outcomes that were collaboratively identified by the DPC. Data were collected from each BUILD site through national surveys from the Higher Education Research Institute at UCLA (HERI), annual followup surveys that align with the HERI instruments, site visits and case studies, program encounter data ("tracker" data), and institutional data. The analytic approach involves comparing changes in Hallmarks (key outcomes) within institutions for biomedical students who participated versus those who did not participate in the BUILD program at each institution, as well as between institution patterns of biomedical students at the BUILD sites, and matched institutions that were not BUILD grantees. Case studies provide insights into the institutionalization of these new programs and help to explain the processes that lead to the observed outcomes., Implications: Ultimately, the results of the consortium-wide evaluation will be used to inform national policy in higher education and will provide relevant examples of institutional and educational programmatic changes required to diversify the biomedical workforce in the USA., Competing Interests: Not Applicable.Not Applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Introduction: Biosamples and associated clinical data accelerate translational and clinical research discoveries. A lack of high quality biosamples both stalls projects and limits research advances. In this study, we targeted a wide audience of University of California (UC) biobanking stakeholders who were either involved with the collection or the utilization of biosamples to assess the scope of their biobanking activities and their interest in virtual biobanking or cooperating in the formation of the UC-wide biorepository., Materials and Methods: Each institutional review board from the five UC medical campuses' provided a dataset of potential researchers involved with biobanking. Once identified, a brief six item web-based questionnaire was administered electronically to these researchers., Results: Most survey participants (80%) responded "yes" (n = 348) that they were actively collecting biosamples for research, and 68% of participants indicated they would either definitely (30%, n = 131) or maybe (38%, n = 166) request biosample materials now or within the next year. An equal proportion of participants responded yes (42% or n = 184) and maybe (42% or n = 182) when asked if they would voluntarily contribute specimens to a UC-wide virtual biobank., Discussion: The results presented above show high levels of support among UC biobanking stakeholders for both requesting material from and contributing material to a UC-wide virtual biobank. In addition, a considerable number of individual researchers on our five UC medical campuses are conducting biospecimen research (i.e., well over n = 435 respondents).

In 2013, the University of California, Biomedical Research, Acceleration, Integration, and Development (UC BRAID) convened a regional network of contracting directors from the five University of California (UC) health campuses to: (i) increase collaboration, (ii) operationalize and measure common metrics as a basis for performance improvement efforts, and (iii) identify and implement best practices to maintain a competitive edge in the field of biomedical research. This article summarizes an 18-month examination of performance metrics across the five campuses, including methods for data collection and harmonization agreed upon by the UC contracting offices. Some of the most striking, and previously unmeasured, results demonstrate that master agreements are a highly effective and successful strategy for significantly shortening the average time to completion of contract terms. Interestingly, clinical research organizations (CROs) significantly increase the time required to negotiate a contract. Results also point to the intra- and inter-organizational dependencies affecting time to contract execution. Systematic and transparent data collection among UC stakeholders is necessary to continue improvements to the system. However, data collection is only one component of the larger need to develop shared technology both within and between institutions. This study demonstrates that collaboration and sharing of contract terms is an effective way to reduce study activation time, but the greatest improvements will be driven by the sharing of data and technology tools.

We investigated leadership competencies for developing senior and emerging leaders and the perceived effectiveness of leadership development programs in Health Research Organizations (HROs). A pilot study was conducted to interview HRO executives in Southern California. Respondents represented different organizational contexts to ensure a diverse overview of strategic issues, competencies, and development needs. We analyzed qualitative and quantitative data using an innovative framework for analyzing HRO leadership development. The National Center for Healthcare Leadership 'Health Leadership Competency Model' was used as the foundation of our competency research. Top strategic issues included economic downturn and external funding, the influence of governmental policies and regulations, operating in global markets, and forming strategic alliances. High priority NCHL leadership competencies required to successfully lead an HRO include talent development, collaboration, strategic orientation, and team leadership. Senior executives need financial skills and scientific achievement; emerging leaders need technical/scientific competence, information seeking, and a strong work ethic. About half of the respondents reported having no leadership development program (LDP). Almost all reported their organization encourages mentoring, but less than one-third reported an active formalized mentoring program. We conclude that uncertainties and challenges related to healthcare reform and the continued budget deficits will require HRO restructuring to contain costs, remove barriers to innovation, and show value-add in accelerating discovery to improve clinical care, patient outcomes, and community health. Successful leaders will need to become more strategic, entrepreneurial, and resourceful in developing research alliances, executing research operations, and continually improving performance at all levels of the HRO.

Altruistic dentists play a central role in treating minority populations, the poor, the uninsured, and those living in underserved communities. This study examines factors associated with graduating dental students' altruistic attitudes. We use a nationally representative dataset, the 2007 American Dental Education Association Survey of Dental School Seniors (n=3,841), and a comprehensive framework to investigate individual, school, and community characteristics that may influence altruism. Student characteristics were the most significant predictors: women, African Americans, Hispanics, Asian/Pacific Islanders, and students with low socioeconomic status expressed greater altruism than their counterparts. These results inform dental educators and administrators to expand efforts to recruit underrepresented racial/ethnic and low-income students into dentistry. Additionally, we found that students with altruistic personalities attend schools where the social context is more accepting and respectful of diversity. This suggests that schools can promote altruism in their students by creating a positive culture and environment for diverse populations.

This paper attempts to understand the sexual behaviors of young, unmarried women living in rural China with a special focus on sexual debut, sexual risk-taking behaviors, and reproductive health consequences. The analysis is based on forty in-depth interviews with young women who had undergone induced abortion as well as information from focus group discussions. Study participants identified pornographic videos and parents' tacit approval and even encouragement as factors instigating their sexual debut. Reasons for unprotected intercourse include spontaneous sexual activity, misconceptions about fertility and the effective use of contraceptives, and the lack of negotiation skills. The results indicate the importance of making reproductive health education more accessible to rural populations in China, a group usually considered to be more traditional and less likely to engage in premarital sex.

This study examines the effects of community-level and individual-level factors on access to ambulatory care for lower-income adults in 54 urban metropolitan statistical areas in the United States. Drawing on a conceptual behavioral and structural framework of access, the authors developed multivariate models for insured and uninsured lower-income adults to assess the adjusted effects of community- and individual-level factors on two indicators of access: having a usual source of care, and having at least one physician visit in the past year. Several community factors influenced access, but they did so differently for insured and uninsured adults and for the two measures of access used. The findings of this sttudy confirm that public policies and community environment have measurable and substantial impacts on access to care, and that expanded public resources, such as Medicaid payments and safety-net clinics, can lead to measurable improvements in access for vulnerable populations residing in large urban areas.

The framework presented in this article extends the Andersen behavioral model of health services utilization research to examine the effects of contextual determinants of access. A conceptual framework is suggested for selecting and constructing contextual (or community-level) variables representing the social, economic, structural, and public policy environment that influence low-income people's use of medical care. Contextual variables capture the characteristics of the population that disproportionately relies on the health care safety net, the public policy support for low-income and safety-net populations, and the structure of the health care market and safety-net services within that market. Until recently, the literature in this area has been largely qualitative and descriptive and few multivariate studies comprehensively investigated the contextual determinants of access. The comprehensive and systematic approach suggested by the framework will enable researchers to strengthen the external validity of results by accounting for the influence of a consistent set of contextual factors across locations and populations. A subsequent article in this issue of Inquiry applies the framework to examine access to ambulatory care for low-income adults, both insured and uninsured.