ABSTRACT
BACKGROUND: Serologic analysis is an important tool towards assessing the humoral response to COVID-19 infection and vaccination. Numerous serologic tests and platforms are currently available to support this line of testing. Two broad antibody testing categories are point-of-care lateral flow immunoassays and semi-quantitative immunoassays performed in clinical laboratories, which typically require blood collected from a finger-stick and a standard venipuncture blood draw, respectively. This study evaluated the use of dried blood spot (DBS) collections as a sample source for COVID-19 antibody testing using an automated clinical laboratory test system. METHODS: Two hundred and ninety-four participants in the BLAST COVID-19 seroprevalence study (NCT04349202) were recruited at the time of a scheduled blood draw to have an additional sample taken via finger stick as a DBS collection. Using the EUROIMMUN assay to assess SARS-CoV-2 anti-spike IgG status, DBS specimens were tested on 7, 14, 21, and 28 days post- collection and compared to the reference serum sample obtained from a blood draw for the BLAST COVID-19 study. RESULTS: SARS-CoV-2 anti-spike IgG status from DBS collections demonstrated high concordance with serum across all time points (7-28 days). However, the semi-quantitative value from DBS collections was lower on average than that from serum, resulting in increased uncertainty around the equivocal-to-positive analytical decision point. CONCLUSIONS: DBS collections can be substituted for venipuncture when assaying for COVID-19 IgG antibody, with samples being stable for at least 28 days at room temperature. Finger-stick sampling can therefore be advantageous for testing large populations for SARS-CoV-2 antibodies without the need for phlebotomists or immediate processing of samples. We have high confidence in serostaus determination from DBS collections, although the reduced semi-quantitative value may cause some low-level positives to fall into the equivocal or even negative range.
Subject(s)
COVID-19 , Humans , Antibodies, Viral , COVID-19/diagnosis , COVID-19 Serological Testing , COVID-19 Testing , Dried Blood Spot Testing , Immunoglobulin G , Phlebotomy , SARS-CoV-2 , Sensitivity and Specificity , Seroepidemiologic StudiesABSTRACT
BACKGROUND AND PURPOSE: Self-employed nurse practitioners (NPs) have been part of the American health care landscape since the 1970s, owning practices throughout the United States. The purpose of this study was to explore and measure the 2 characteristics of job satisfaction and empowerment in self-employed NPs practicing within the 50 states and District of Columbia and to explore factors that influence these characteristics. METHODS: A convergent parallel design, mixed methods study, using a survey and semistructured interviews, was completed. The survey included the Misener Job Satisfaction Survey and Conditions of Work Effectiveness Questionnaire II. CONCLUSIONS: Self-employed NPs are satisfied and empowered. The more empowered, the higher their level of job satisfaction. Over 40% practiced with full practice authority in a rural location, and 50% had over 10 years of experience as both an RN and NP. Their experience in private practice was explored further in the interviews. IMPLICATIONS FOR PRACTICE: This study identifies barriers to job satisfaction and empowerment in self-employed NPs, including physician oversight and lack of business management education. Continuing work to remove restricted and reduced state regulatory environments and to provide education on business management may increase the number of NPs in private practice, expanding access to health care in the United States.
Subject(s)
Employment/methods , Job Satisfaction , Nurse Practitioners/psychology , Power, Psychological , Adult , Cross-Sectional Studies , Employment/standards , Female , Humans , Male , Middle Aged , Nurse Practitioners/education , Nursing, Private Duty/trends , Professional Autonomy , Psychometrics/instrumentation , Psychometrics/methods , Qualitative Research , Surveys and Questionnaires , United StatesABSTRACT
The Resources for Enhancing Alzheimer's Caregivers Health in the VA (REACH VA) dementia caregiving intervention has been implemented in the VA, in community agencies, and internationally. As identified in the 2013 and 2015 National Plan to Address Alzheimer's Disease, REACH is being made available to American Indian and Alaska Native communities. Implementation activities are carried out by local Public Health Nursing programs operated by Indian Health Service and Tribal Health programs, and Administration for Community Living/Administration on Aging funded Tribal Aging program staff already working in each community. The implementation is described using the Fixsen and Blasé implementation process model. Cultural, community, health system, and tribe-specific adaptations occur during the six implementation stages of exploration and adoption, program installation, initial implementation, full operation, innovation, and sustainability. Adaptations are made by local staff delivering the program. Implementation challenges in serving AI/AN dementia caregivers include the need to adapt the program to fit the unique communities and the cultural perceptions of dementia and caregiving. Lessons learned highlight the importance of using a clinically successful intervention, the need for support and buy-in from leadership and staff, the fit of the intervention into ongoing routines and practices, the critical role of modifications based on caregiver, staff, and organization needs and feedback, the need for a simple and easily learned intervention, and the critical importance of community receptivity to the services offered.
Subject(s)
Caregivers , Dementia , Indians, North American , Caregivers/psychology , Dementia/therapy , Evidence-Based Practice , Health Plan Implementation , Humans , Program Evaluation , United States , United States Indian Health ServiceABSTRACT
A group of nursing leaders from several organizations in the central and northern regions of the state established the Maine Nursing Practice Consortium (MNPC). The MNPC has created educational opportunities through workshops that assist nurses with the development and implementation of evidence-based practice (EBP) in rural Maine. Through collaboration and consultation with EBP leaders, members have ignited a spirit of inquiry and gained the support of nurses from varied backgrounds to engage actively in EBP initiatives. This article briefly summarizes the process of establishing these collaborative partnerships, describes some of the outcomes from the workshops, and describes the organizational and individual commitment that was essential to the work.
Subject(s)
Diffusion of Innovation , Education, Nursing, Continuing/organization & administration , Evidence-Based Nursing , Nursing Research , Rural Health , Benchmarking/organization & administration , Cooperative Behavior , Evidence-Based Nursing/education , Evidence-Based Nursing/organization & administration , Humans , Interinstitutional Relations , Leadership , Maine , Models, Nursing , Nursing Research/education , Nursing Research/organization & administration , Organizational Culture , Patient-Centered Care/organization & administration , Philosophy, Nursing , Program Development , Safety Management/organization & administration , Total Quality Management/organization & administrationABSTRACT
The first report of Philornis angustifrons and P. deceptiva infesting nests of Suiriri affinis and S. islerorum in area of Distrito Federal's savanna is presented. It is known that larvae of these species have a strict relationship of parasitism with birds. The pupae were collected after the abandonment of the nests and the flies emerged in a period of about 13 days.
