A Qualitative Study of Midlevel Nurse Managers' Perspectives of Scholarly Inquiry.

OBJECTIVE: This study explored the key characteristics and needs of midlevel nurse managers (MLNMs) who support and engage clinical nurses (CNs) in scholarly inquiry. BACKGROUND: Healthcare organizations expect CNs to participate in scholarly inquiry, incorporating evidence-based interventions to improve outcomes and safety. How the MLNM supports and engages CNs in scholarly inquiry remains unclear. METHODS: Twelve semistructured interviews of MLNMs occurred at several facilities in the mid-Atlantic region utilizing the institutional review board-acknowledged protocol. Theme interpretation utilized inductive analysis. RESULTS: Four recurrent themes emerged from the interviews related to the value of scholarly inquiry: 1) securing organizational resources to promote scholarly inquiry; 2) knowledge and experience in scholarly inquiry; 3) actions supporting scholarly inquiry; and 4) the value of scholarly inquiry within the organization. CONCLUSIONS: Senior nursing leadership and healthcare organizations must recognize the value and provide the infrastructure to support scholarly inquiry. Infrastructure includes education, dedicated time, access to expertise, and resources.

An academic and regional nurse research collaborative: Implications for nursing research.

INTRODUCTION: A diverse group of nurses and research Network Coordinators formed a collaboration to advance nursing research within Johns Hopkins Clinical Research Network, a partnership of academic and community hospitals in the mid-Atlantic region. The purpose of the Nurse Research Collaborative (NRC) is to provide mentoring, mutual growth, and assist the health care organizations to fulfill nursing research requirements. BACKGROUND: We created a multiinstitutional nursing research organization with diversity of member participants and health care facilities. The NRC structure allowed nonacademic facilities to engage in a variety of nursing research projects. This allows for increases in study sample sizes of diverse populations to support and expand nursing research. The NRC is modeled after a physician clinical research network with an aligned mission, vision, goals, and strategic priorities across member organizations. MAIN IDEAS: To strengthen multiinstitutional nursing research capability, the NRC developed an infrastructure of leadership, regular meetings, and formal educational presentations. The NRC completed three research studies, facilitating the Institutional Review Board application process, reviewing documents and contracts, providing individual institutional support, and coordinating site leader functions. CONCLUSION: A research collaboration of nurses, across multiple hospitals provides efficiencies and expertise not otherwise available in every organization.

Assessing knowledge, attitudes and beliefs of nurses about LGBTQ older adults using a documentary video.

BACKGROUND: Statistics reveal that lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults experience health disparities and barriers to accessing healthcare because of discrimination and fear of disclosing sexual orientation. Nurses receive limited education on LGBTQ health issues and even less information specifically about LGBTQ older adults. This study exposed novice nurses to the documentary, Gen Silent, which details LGBTQ older adult experiences. OBJECTIVES: The objective of the study was to increase participants' understanding of LGBTQ older adult health disparities and experiences. DESIGN: A one-group, pre-/post-test design was conducted to test the effect of the documentary on knowledge and attitudes about LGBTQ older adult issues. SETTINGS: The project was set in five academic and community-based hospitals located in the mid-Atlantic region. PARTICIPANTS: A total of 379 nurses attending a nurse residency program participated in the study. METHODS: A questionnaire including a 16-item standardized scale and an open-ended question asking how participants would change their practice was administered before and immediately after the intervention. We assessed change in pre- and post-test knowledge scores using Wilcoxon Sign Rank test and summarized themes of the open-ended question. RESULTS: Findings revealed statistically significant increases in 9 of the 16 items on the scale showing an increase of knowledge and inclusive attitude. Answers to the open-ended question revealed that most participants would ask patients for preferred pronouns and take steps to increase their own understanding of LGBTQ patients and their needs. CONCLUSION: This research supports the use of a documentary as an intervention to facilitate education related to LGBTQ older adults. Further research is needed exposing healthcare professionals of varied experience in diverse healthcare settings to LGBTQ education.

Creation of an open-access, mutation-defined fibroblast resource for neurological disease research.

Our understanding of the molecular mechanisms of many neurological disorders has been greatly enhanced by the discovery of mutations in genes linked to familial forms of these diseases. These have facilitated the generation of cell and animal models that can be used to understand the underlying molecular pathology. Recently, there has been a surge of interest in the use of patient-derived cells, due to the development of induced pluripotent stem cells and their subsequent differentiation into neurons and glia. Access to patient cell lines carrying the relevant mutations is a limiting factor for many centres wishing to pursue this research. We have therefore generated an open-access collection of fibroblast lines from patients carrying mutations linked to neurological disease. These cell lines have been deposited in the National Institute for Neurological Disorders and Stroke (NINDS) Repository at the Coriell Institute for Medical Research and can be requested by any research group for use in in vitro disease modelling. There are currently 71 mutation-defined cell lines available for request from a wide range of neurological disorders and this collection will be continually expanded. This represents a significant resource that will advance the use of patient cells as disease models by the scientific community.

Ocular motor and sensory function in Parkinson's disease.

PURPOSE: To evaluate the effect of dopaminergic medication and deep brain stimulation on ocular function in Parkinson's disease (PD) and to measure vision-related quality of life in subjects with PD. DESIGN: Prospective, comparative case series. PARTICIPANTS AND CONTROLS: Twenty-seven PD and 16 control subjects were recruited. METHODS: Visual acuity, ocular motor function, convergence, and vision-related quality of life using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) were measured. Visual sensory and motor measurements were obtained during the on and off states of PD dopaminergic treatment. MAIN OUTCOME MEASURES: Convergence ability and vision-related quality of life. RESULTS: The PD subjects had a mean age of 58.8 years; 30% were female. Their mean duration of PD was 10.9 ± 6.8 years. The control subjects had a mean age of 61.6 years; 56% were female. There was no difference in visual acuity, contrast sensitivity, or color vision of the PD subjects in their on state compared with controls. Convergence amplitudes measured with base-out prism were significantly poorer in PD subjects in their on state compared with controls (24.1 ± 8 Δ vs. 14.8 ± 10.3 Δ; P = 0.003). The mean composite VFQ-25 score was significantly worse in the PD subjects compared with the controls (87.1 ± 8.69 vs. 96.6 ± 3.05; P = 0.0001). Comparing the PD subjects in their on with their off states, there was no difference in distance exodeviation, near exodeviation, or ocular ductions. Mean convergence amplitudes and near point of convergence were better in the on state compared with the off state: 14.8 ± 10.3 Δ versus 10.7 ± 9.0 Δ (P = 0.0006) and 13.1 ± 9.1 cm versus 18.1 ± 12.2 cm (P = 0.002), respectively. CONCLUSIONS: Convergence ability is significantly poorer in PD subjects in both the on and off states compared with controls, but improves significantly with systemic dopaminergic treatment. Ocular motor function in PD subjects fluctuates in response to treatment, which complicates ophthalmic management. Parkinson's disease subjects have a significant reduction in vision-related quality of life, especially with near activities, that is not associated with visual acuity. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Atomoxetine for the treatment of executive dysfunction in Parkinson's disease: a pilot open-label study.

Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson's disease (PD). Few studies have examined treatments. Given the role of noradrenergic pathology in ED, atomoxetine, a norepinephrine reuptake inhibitor indicated for attention deficit hyperactivity disorder (ADHD), may be a potential treatment for PD-related ED. Twelve patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25-100 mg/day) trial of atomoxetine. On primary outcome measures, atomoxetine was associated with improved ED based on the Clinical Global Impression-Change Scale (75% positive response rate; 95% CI: 43-95%, P < 05) and behavioral measures of ED [Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction and Connors Adult ADHD Rating Scale (CAARS) inattention/memory subscales]. Adverse effects included sleep and gastrointestinal disturbances and hypomania. Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials.