Experiences of Undergraduate Male Students in Nursing: On the Outside Looking in.

BACKGROUND: Measures to improve gender diversity of the profession have yielded only a modicum of progress. PURPOSE: To investigate the relationship between marginalization and gender minorities in baccalaureate nursing programs in the United States. METHODS: A descriptive cross-sectional study compared self-reported marginalization in male and female baccalaureate nursing students. The sample was drawn from the American Association of Colleges of Nursing database of US baccalaureate nursing programs, and the Englund Marginality Index (EMI) was used to measure marginalization, along with a demographic survey. RESULTS: In the study, 6480 full-time baccalaureate students from a traditional face-to-face nursing program in the United States participated. The results show that male participants had higher EMI scores (mean = 40.0, SD = 9.1) compared with female nursing students (mean = 35.1, SD = 9.0); t(6478) = 14.9, P < .001. CONCLUSIONS: Marginalizing behaviors must not be tolerated or promulgated. More needs to be done to better support and integrate men into nursing programs as they bring forth a unique perspective and skill set to the profession.

Board Leaders' Perspectives of the Impact of Nurses on Boards.

OBJECTIVE: The purpose of the study was to explore the impact of nurses on boards (NOBs) from the perspectives of board leaders who are not nurses. BACKGROUND: Research about the impact of NOBs derives from nurses' recall of board experiences. No studies explore the impact of NOBs from perspectives other than nurses. METHODS: Researchers used an exploratory qualitative design with purposive sampling and interviewed 16 participants. RESULTS: According to participants, NOBs impact board governance as boundary spanners within the healthcare ecosystem. The overarching pattern is supported by 6 traversing themes. CONCLUSIONS: Board leaders' perspectives of NOBs as boundary spanners illustrate the far-reaching impact nurses have in the board role and on the direction of healthcare organizations.

Male Caregiving: It Often Looks Different.

Men are taking on a caregiving role more often in society. This article will explore the history of men in the caregiving role, how men provide care and practical strategies on how to assist men who find themselves in the caregiving role.

Men in Female-Dominated Nursing Specialties.

While numbers of men in the nursing profession have slowly increased, men in female-dominated specialty areas have not changed. Male nurses and nursing students encounter gender bias and discrimination in certain specialty nursing environments. This has implications for the quality of care provided, parental engagement, and job satisfaction. By diversifying the nursing workforce, there is a potential to enhance patient comfort, improve satisfaction, and promote a more inclusive, creative, and patient-focused health care environment.

A Critical Minority: The Marginalization of Male Faculty in Nursing Academia.

AIM: The purpose of this study was to investigate the relationship between gender and marginalization in nursing academia. BACKGROUND: Men continue to be significantly underrepresented in nursing academia because they experience numerous barriers to their integration and success in the profession. METHOD: A descriptive cross-sectional design was implemented in this pilot study to investigate differences in perceived marginalization between male versus female faculty teaching in Commission on Collegiate Nursing Education-accredited colleges. Marginality was measured using the Englund Marginality Index (EMI). RESULTS: Male nursing faculty participants reported higher scores on the EMI ( M = 43.6, SD = 9.9) than female faculty ( M = 37.2, SD = 9.6), t (1428) = 6.0, p < .001. CONCLUSION: As the nursing faculty shortage continues to increase, it is imperative that leaders in nursing education steer their efforts toward attracting a more robust and diverse faculty population.

Exploring telehealth in the graduate curriculum.

BACKGROUND: With an increase in patient demand and a decrease in healthcare professionals, telehealth is able to provide needed services to patients, but appropriate training in telehealth is crucial for providers to deliver excellent patient care. METHOD: Nurse researchers developed a quality improvement project targeting telehealth in the graduate nursing curriculum. A two-part evidence-based curriculum was developed for graduate family nurse practitioner (FNP) students. Part one consisted of a lecture that focused on increasing students' knowledge, and part two enhanced skills through simulation. RESULTS: Data were collected through qualitative and quantitative surveys. The qualitative data were analyzed for themes and statistical analysis of the quantitative data was completed (t-scores and descriptive statistics). Results showed that FNP students perceived the telehealth curriculum as educational and recommend it be continued for future FNP cohorts. CONCLUSION: Using evidence-based practice and telehealth experts graduate nursing programs should introduce the telehealth curriculum for FNP students through in class lecture and simulation.

Professional Nursing Values in Men: An NPVS-R Instrument Validation Study.

BACKGROUND AND PURPOSE: Although the Nurses Professional Values Scale-Revised (NPVS-R) has been validated in predominantly female samples, this instrument has not been validated with adequate samples of men. The purpose of the study was to assess the reliability and validity of the NPVS-R in a sample of male nurses and nursing students. METHODS: Psychometric testing was performed, using principal component analysis (PCA), on a convenience sample of 329 men in nursing from the United States. Reliability was assessed using Cronbach's alpha. RESULTS: Participants rated the values in the NPVS-R as important, although undergraduate students significantly less so than graduate students or nurses. Factor labels of caring, professionalism, and activism were similar to those in previous studies. Variations across responses to particular items may reflect cultural variations. CONCLUSIONS: Although further testing is needed, results from the current study indicate that the NPVS-R is a valid and reliable scale when administered to a sample of male nurses and nursing students.

Male Caregivers: Shifting Roles Among Family Caregivers.

BACKGROUND: More than 16 million men in the United States are acting in the role of family caregiver. Men are usually viewed as not being caring simply because they provide care differently than women. However, this is not the case. OBJECTIVES: This article explores male caregiving from the perspective of family and professional roles. METHODS: A review of the literature related to men in the caregiving role was conducted. This review included only men providing care to a family member and was limited to men caring for an adult. FINDINGS: The main traits of male caregivers were defined as masculinization of caregiving behaviors, social support needs, and caregiver role strain/emotional aspects of caring. Men in the caregiving role must be supported. Education related to how men provide care is needed. Hands-on education should also be provided to men in the family caregiving role.

Professional male caregiving: A concept analysis.

The number of men in professional caregiving roles has increased. While still a small percentage, the numbers of men in these roles continues to expand. Too often, the methods that professional male caregivers use to provide care differ from their female counterparts. There has not been much research conducted to understand how males in the professional role differ from their female counterparts in terms of caregiving characteristics.

Navigating unfamiliar waters: Men in nursing academia.

INTRODUCTION: Despite small numbers, men in nursing faculty positions provide unique diverse perspectives that are important to the strength of the profession. Nationwide, calls for increased numbers of diverse faculty continue. Despite this, the numbers of male nurses entering academic remain low. The purpose of this study was to identify and describe experiences of male nursing faculty in an effort to better understand what attracts male nurses to a role in academia, and what advice is most important when considering entering academia. METHOD: A qualitative descriptive approach was utilized to describe the findings from 12 participant interviews. RESULTS: The following themes immerged: reasons why men enter into academia, navigation of unfamiliar waters, and being the odd man out.

Undergraduate nursing student experiences with faculty bullies.

Incivility literature has focused primarily on student-to-faculty incivility, whereas less focus has been placed on faculty-to-student bullying. This study examined the lived experiences of undergraduate nursing students with faculty bullying. Using descriptive phenomenology, this study explored these lived experiences. Themes emerged including the emotional experience of bullying, the giving and gaining of mutual respect, the value of resilience and persistence, and that perception is reality.

Characterization of a therapeutic model of inhalational anthrax using an increase in body temperature in New Zealand white rabbits as a trigger for treatment.

The development of an appropriate animal therapeutic model is essential to assess the potential efficacy of therapeutics for use in the event of a Bacillus anthracis exposure. We conducted a natural history study that showed New Zealand White rabbits exhibited a significant increase in body temperature (SIBT), changes in hematologic parameters, and increases in C-reactive protein and succumbed to disease with an average time to death of approximately 73 h following aerosol challenge with B. anthracis Ames spores. The SIBT was used as a trigger to treat with a fully human monoclonal antibody directed at protective antigen (PA). Ninety percent (9/10) of the treated rabbits survived the lethal inhalational challenge of B. anthracis. Further characterization investigated the protective window of opportunity for anti-PA antibody administration up to 12 h post-onset of SIBT. Eighty-three percent (5/6) of the rabbits treated at SIBT and 100% (6/6) of those treated at 6 h after SIBT survived challenge. Only 67% (4/6) of the rabbits treated at 12 h after SIBT survived. The increase in body temperature corresponded with both bacteremia and antigenemia (PA in the blood), indicating that SIBT is a suitable trigger to initiate treatment in a therapeutic model of inhalational anthrax.

Implementation of an intraoperative clinical experience for senior level baccalaureate nursing students.

Perioperative nursing is a specialty that has been eliminated from many nursing education programs. With the loss of perioperative clinical experiences, the number of students pursuing a career in perioperative nursing after graduation has declined. A faculty member at one Midwestern school of nursing developed and implemented a perioperative clinical experience for senior-level baccalaureate nursing students in a critical care nursing course. This program, developed with the assistance of four local hospitals and the college of nursing, included an eight-hour OR orientation and 56 clinical hours. Students were placed in the OR under preceptor guidance and supervision. Feedback from evaluations was positive and provided recommendations for improving the program, in particular, to allow more clinical hours and more hands-on experience for the students.

Genistein, a general kinase inhibitor, as a potential antiviral for arenaviral hemorrhagic fever as described in the Pirital virus-Syrian golden hamster model.

Arenaviruses are rodent-borne negative strand RNA viruses and infection of these viruses in humans may result in disease and hemorrhagic fever. To date, supportive care, ribavirin, and in some cases immune plasma remain the foremost treatment options for arenaviral hemorrhagic fever. Research with the hemorrhagic fever causing-arenaviruses usually requires a Biosafety level (BSL)-4 environment; however, surrogate animal model systems have been developed to preliminarily study and screen various vaccines and antivirals. The Syrian golden hamster-Pirital virus (PIRV) surrogate model of hemorrhagic fever provides an opportunity to test new antivirals in an ABSL-3 setting. Thus, we challenged hamsters, implanted with telemetry, with PIRV and observed viremia and tissue viral titers, and changes in core body temperature, hematology, clinical chemistry, and coagulation parameters. Physical signs of disease of the PIRV-infected hamsters included weight loss, lethargy, petechial rashes, epistaxis, ocular orbital and rectal hemorrhage, and visible signs of neurologic disorders. However, treating animals with genistein, a plant derived isoflavone and general kinase inhibitor, resulted in increased survival rates and led to an improved clinical profile. In all, the results from this study demonstrate the potential of a general kinase inhibitor genistein as an antiviral against arenaviral hemorrhagic fever.

Raxibacumab for the treatment of inhalational anthrax.

BACKGROUND: Inhalational anthrax caused by Bacillus anthracis is associated with high mortality primarily due to toxin-mediated injury. Raxibacumab is a human IgG1lambda monoclonal antibody directed against protective antigen, a component of the anthrax toxin. METHODS: We evaluated the efficacy of raxibacumab as a prophylactic agent and after disease onset in a total of four randomized, placebo-controlled studies conducted in rabbits and monkeys. Animals were exposed to an aerosolized target exposure of B. anthracis spores that was approximately 100 times (in the prophylactic studies) and 200 times (in the therapeutic-intervention studies) the median lethal dose. In the therapeutic-intervention studies, animals were monitored for the onset of symptoms. Animals with detectable protective antigen in serum, a significant increase in temperature, or both received a single intravenous bolus of placebo or raxibacumab at a dose of either 20 mg per kilogram of body weight or 40 mg per kilogram. The primary end point was survival at day 14 (in rabbits) or at day 28 (in monkeys). Safety studies were conducted with intravenous raxibacumab (40 mg per kilogram) in 333 healthy human volunteers. RESULTS: In both rabbits and monkeys, the time to detection of protective antigen correlated with the time to bacteremia (r=0.9, P<0.001). In the therapeutic-intervention studies, the survival rate was significantly higher among rabbits that received raxibacumab at a dose of 40 mg per kilogram (44% [8 of 18]) than among rabbits that received placebo (0% [0 of 18]; P=0.003). Raxibacumab treatment also significantly increased survival in monkeys (64% [9 of 14], vs. 0% [0 of 12] with placebo; P<0.001). In human subjects, intravenous raxibacumab at a dose of 40 mg per kilogram had a half-life of 20 to 22 days and provided a maximum concentration of the drug in excess of levels that are protective in animals. Concentrations of raxibacumab provide a surrogate end point that should be predictive of clinical benefit. CONCLUSIONS: A single dose of raxibacumab improved survival in rabbits and monkeys with symptomatic inhalational anthrax. (ClinicalTrials.gov number, NCT00639678.)

Neurovirulence evaluation of Venezuelan equine encephalitis (VEE) vaccine candidate V3526 in nonhuman primates.

Assessment of neurovirulence is a standard test for vaccines derived from virulent neurotropic viruses. This study evaluated the potential neurovirulence of V3526, a live attenuated vaccine derived from a full-length infectious clone of Venezuelan equine encephalitis virus (VEEV) Trinidad donkey strain (TrD), a comparator VEEV vaccine (TC-83), TrD, and process control material (PCM) in juvenile rhesus macaques. Following intrathalamic/intraspinal (i.t./i.s. ) or subcutaneous (s.c.) inoculations, animals were observed for periods of 18, 91 or 181 days for paresis, paralysis, neurological disorders and other signs of clinical illness. Blood was collected for measurement of viremia, VEEV neutralizing antibodies, hematologic parameters, and liver enzymes. Gross necropsies and histopathological examinations were conducted with emphasis on detecting lesions in the brain and spinal cord. Elevated temperatures (1-2 degrees C) were noted in several of the TrD and vaccine inoculated animals on Day 6 following inoculation and mean temperatures for the V3526 i.t./i.s. and TC-83 groups were higher than PCM group throughout the study Day 18. No significant differences were seen for weight or clinical chemistry results between vaccine and PCM inoculated groups. Clinically significant signs (Grades 3 or 4) were noted in three of 21 V3526 i.t./i.s. and three of 12 TC-83 inoculated animals, however, these signs resolved within 3 weeks for all V3526 i.t./i.s. and for two of three TC-83 inoculated animals. At Day 18 extensive lesions indicative of a viral infection were seen in brain sections of all four TrD inoculated animals and one of seven V3526 i.t./i.s. inoculated animals. Only scattered lesions, characterized by foci of gliosis and vessels with perivascular inflammation, were found in the sections from four TC-83 and six V3526 i.t./i.s. inoculated animals. The minimal histological changes observed at Day 18 resolved to baseline levels by Day 181 comparable to the PCM group. V3526 was immunogenic and essentially nonneurovirulent when administered via the clinically relevant subcutaneous route.

Cytokine gene expression by peripheral blood leukocytes in horses experimentally infected with Anaplasma phagocytophila.

Human granulocytic ehrlichiosis (HGE), a tick-borne zoonosis, is caused by an obligatory intragranulocytic bacterium, the HGE agent, a strain of Anaplasma phagocytophila. The equine model of HGE is considered valuable in understanding pathogenic and immune mechanisms of HGE. In the present study, cytokine mRNA expression by peripheral blood leukocytes (PBLs) in horses was examined during the course of infection by intravenous inoculation of A. phagocytophila or by allowing feeding by infected ticks. The p44 genes encoding the major outer membrane protein P44s of A. phagocytophila were detected by PCR in PBLs of all four horses from 4 to 20 days postexposure. During the 20-day infection period, interleukin-1beta (IL-1beta) and tumor necrosis factor alpha (TNF-alpha) mRNA expression was upregulated in PBLs of all four horses, and IL-8 mRNA expression was upregulated in three horses. Gamma interferon, IL-10, and IL-12 p35 mRNAs were weakly expressed in only one horse each. IL-2, IL-4, IL-6, and IL-12 p40 mRNA expression, however, could not be detected in the PBLs of any of the four horses. These results suggest that IL-1beta, TNF-alpha, and IL-8 generation during A. phagocytophila infection has a primary role in HGE pathogenesis and immunomodulation.

Transcript heterogeneity of the p44 multigene family in a human granulocytic ehrlichiosis agent transmitted by ticks.

Human granulocytic ehrlichiosis (HGE) is an emerging tick-borne zoonosis caused by a strain of Anaplasma phagocytophila called the HGE agent, an obligatory intracellular bacterium. The agent expresses immunodominant 44-kDa outer membrane proteins (P44s) encoded by a multigene family. The present study established an experimental process for transmission of the HGE agent from infected mice (a reservoir model) to nymphal Ixodes scapularis ticks (a biological vector) and subsequently to horses (a patient model) by the adult infected ticks. Overall, a total of 20 different p44 transcripts were detected in the mammals, ticks, and cell cultures. Among them, a transcript from a p44-18 gene was major at acute stage in mice and horses but minor in ticks. Both mRNA and protein produced from the p44-18 gene were detected in the HGE agent cultivated in HL-60 cells at 37 degrees C, but their expression levels decreased in the organisms cultivated at 24 degrees C, suggesting that temperature is one of the factors that influence the expression of members of the p44 multigene family. Several additional p44 transcripts that were not detected in the mammals at the acute stage of infection were detected in ticks. Phylogenetic analysis of the 20 different p44 transcripts revealed that the major transcripts found in mammals and ticks were distinct, suggesting a difference in surface properties between populations of the HGE agent in different host environments. The present study provides new information for understanding the role of the p44 multigene family in transmission of the HGE agent between mammals and ticks.