The Role of the Nurse Scientist as a Knowledge Broker.

PURPOSE: This article introduces the importance and nature of the role of the nurse scientist as a knowledge broker. DESIGN: A systematic literature review was completed using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) appraisal tool to trace the emergence and characteristics of the knowledge broker role across disciplines internationally and in the United States. METHODS: Salient publications were identified using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sociological Abstracts, and ProQuest Dissertations & Theses, as well as hand searches and searches of the grey literature. Authors used these resources to define the knowledge broker role and with their role-related experiences developed the Thompson Knowledge Brokering Model. FINDINGS: A knowledge broker is one who connects science and society by building networks and facilitating opportunities among knowledge producers and knowledge users. The knowledge broker role includes three components: forming and sustaining partnerships; facilitating knowledge application; and creating new knowledge. There are five major strategies central to each role component: establish, engage, educate, empower, and evaluate. CONCLUSIONS: The knowledge broker role has been increasingly recognized worldwide as key to translating science into practice and policy. The nurse scientist is ideally suited for this role and should be promoted worldwide. The Thompson Knowledge Brokering Model can be used as a guide for nurse scientists. CLINICAL RELEVANCE: The role of the knowledge broker is to facilitate translation of useful research to practice and policy by connecting stakeholders through meaningful engagement.

A Critical Time for Mercury Science to Inform Global Policy.

Mercury is a global pollutant released into the biosphere by varied human activities including coal combustion, mining, artisanal gold mining, cement production, and chemical production. Once released to air, land and water, the addition of carbon atoms to mercury by bacteria results in the production of methylmercury, the toxic form that bioaccumulates in aquatic and terrestrial food chains resulting in elevated exposure to humans and wildlife. Global recognition of the mercury contamination problem has resulted in the Minamata Convention on Mercury, which came into force in 2017. The treaty aims to protect human health and the environment from human-generated releases of mercury curtailing its movement and transformations in the biosphere. Coincident with the treaty's coming into force, the 13th International Conference of Mercury as a Global Pollutant (ICMGP-13) was held in Providence, Rhode Island USA. At ICMGP-13, cutting edge research was summarized and presented to address questions relating to global and regional sources and cycling of mercury, how that mercury is methylated, the effects of mercury exposure on humans and wildlife, and the science needed for successful implementation of the Minamata Convention. Human activities have the potential to enhance mercury methylation by remobilizing previously released mercury, and increasing methylation efficiency. This synthesis concluded that many of the most important factors influencing the fate and effects of mercury and its more toxic form, methylmercury, stem from environmental changes that are much broader in scope than mercury releases alone. Alterations of mercury cycling, methylmercury bioavailability and trophic transfer due to climate and land use changes remain critical uncertainties in effective implementation of the Minamata Convention. In the face of these uncertainties, important policy and management actions are needed over the short-term to support the control of mercury releases to land, water and air. These include adequate monitoring and communication on risk from exposure to various forms of inorganic mercury as well as methylmercury from fish and rice consumption. Successful management of global and local mercury pollution will require integration of mercury research and policy in a changing world.

The concept of exposure in environmental health for nursing.

AIM: To report an analysis of the concept of exposure in environmental health for nursing. BACKGROUND: The importance of the environment has long been recognized in nursing, although the nature and scope of the concept and how it influences health have varied over time. Exposure is the sufficient and necessary link between environment and health. In nursing practice, the word 'exposure' has been used frequently with no clear standard definition. DESIGN: Concept analysis using Kim's first-level analytics. DATA SOURCES: Chronological review (1980-2015) of the nursing science literature was conducted through ProQuest Dissertations and Theses and CINAHL, followed by a multi-disciplinary search through PubMed (1980-2015), texts and the Internet to compare definitions and measurements of exposure and related concepts. METHODS: Explicit and implicit conceptual definitions and measurements of exposure were identified, categorized and analysed. RESULTS: The newly defined concept of 'exposure' is a process involves three phases: 1, contact is made between a target and one or more agents in the same environment; 2, the agent accesses the target by one or more routes of entry; and 3, the agent enters the target by crossing a barrier or boundary. Existing measurements related to each phase are identified and discussed. Definitions of 'target' and 'agent' were refined for congruency. CONCLUSION: Consistent use of terms as defined is critical to development of nursing knowledge. These concepts should be incorporated into nursing-related research to evaluate their usefulness to nursing. Alignment of this concept with relevant theories should be critically examined.

Practice-based evidence informs environmental health policy and regulation: a case study of residential lead-soil contamination in Rhode Island.

Prior to 1978, the exteriors of Rhode Island's municipal water towers were painted with lead-containing paint. Over time, this lead-containing paint either flaked-off or was mechanically removed and deposited on adjacent residential properties. Residents challenged inconsistencies across state agencies and federal requirements for collecting and analyzing soil samples. The purpose of this case study was to evaluate the efficacy of Rhode Island Department of Health (RIDOH) soil sampling regulations in determining the extent of lead contamination on residential properties using real world data. Researchers interviewed key government personnel, reviewed written accounts of events and regulations, and extracted and compiled lead data from environmental soil sampling on 31 residential properties adjacent to six municipal water towers. Data were available for 498 core samples. Approximately 26% of the residential properties had lead soil concentrations >1000 mg/kg. Overall, lead concentration was inversely related to distance from the water tower. Analysis indicated that surface samples alone were insufficient to classify a property as "lead safe". Potential for misclassification using RIDOH regulations was 13%. For properties deemed initially "lead free", the total number of samples was too few to analyze. Post-remediation lead-soil concentrations suggest the extent of lead contamination may have been deeper than initially determined. Additional data would improve the ability to draw more meaningful and generalized conclusions. Inconsistencies among regulatory agencies responsible for environmental health obfuscate transparency and erode the public's trust in the regulatory process. Recommendations for improvement include congruency across departmental regulations and specific modifications to lead-soil sampling regulations reflective of lowered CDC reference blood lead value for children 1 to 5 years old (5 µg/dL). While scientific research informed the initial development of these environmental health policies and regulations, practice-based evidence did not support their efficacy in context of real world practice.

Bridging research and environmental regulatory processes: the role of knowledge brokers.

Federal funding agencies increasingly require research investigators to ensure that federally sponsored research demonstrates broader societal impact. Specifically, the National Institutes of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) requires research centers to include research translation and community engagement cores to achieve broader impacts, with special emphasis on improving environmental health policies through better scientific understanding. This paper draws on theoretical insights from the social sciences to show how incorporating knowledge brokers in research centers can facilitate translation of scientific expertise to influence regulatory processes and thus promote public health. Knowledge brokers connect academic researchers with decision-makers, to facilitate the translation of research findings into policies and programs. In this article, we describe the stages of the regulatory process and highlight the role of the knowledge broker and scientific expert at each stage. We illustrate the cooperation of knowledge brokers, scientific experts and policymakers using a case from the Brown University (Brown) SRP. We show how the Brown SRP incorporated knowledge brokers to engage scientific experts with regulatory officials around the emerging public health problem of vapor intrusion (VI). In the Brown SRP, the knowledge broker brought regulatory officials into the research process, to help scientific experts understand the critical nature of this emerging public health threat, and helped scientific experts develop a research agenda that would inform the development of timely measures to protect public health. Our experience shows that knowledge brokers can enhance the impact of environmental research on public health by connecting policy decision-makers with scientific experts at critical points throughout the regulatory process.

Multiple environmental chemical exposures to lead, mercury and polychlorinated biphenyls among childbearing-aged women (NHANES 1999-2004): Body burden and risk factors.

BACKGROUND: Lead, mercury and polychlorinated biphenyls (PCBs) are neurotoxicants with intergenerational health consequences from maternal body burden and gestational exposures. Little is known about multiple chemical exposures among childbearing-aged women. OBJECTIVES: To determine the percentage of women aged 16-49 of diverse races and ethnicities whose body burdens for all three xenobiotics were at or above the median; to identify mixed exposures; and to describe those women disproportionately burdened by two or more of these chemicals based on susceptibility- and exposure-related attributes, socioeconomic factors and race-ethnicity. METHODS: Secondary data analysis of National Health and Nutrition Examination Survey (1999-2004). RESULTS: The best-fit logistic regression model without interactions contained 12 variables. Four risk factors associated with body burden were notable (P≤0.05). An exponential relationship was demonstrated with increasing age. Any fish consumption in past 30 days more than doubled the odds. Heavy alcohol consumption increased the relative risk. History of breastfeeding reduced this risk. These women were more likely to have two xenobiotics at or above the median than one. More than one-fifth of these childbearing-aged women had three xenobiotic levels at or above the median. CONCLUSIONS: These findings are among the first description of US childbearing-aged women's body burden and risk factors for multiple chemical exposures. This study supports increasing age, any fish consumption and heavy alcohol consumption as significant risk factors for body burden. History of breastfeeding lowered the body burden. Limited evidence was found of increased risk among minority women independent of other risk factors.

Mercury Contamination: Review of a Residential Response.

A residential elemental mercury contamination incident in Rhode Island resulted in the evacuation of an entire apartment complex.To develop recommendations for improved response, all response-related documents were examined; personnel involved in the response were interviewed; policies and procedures were reviewed; and environmental monitoring data were compiled from specific phases of the response for analysis of effect.A significant challenge of responding to residential elemental mercury contamination lies in communicating risk to residents affected py a HazMat spill. An ongoing, open and honest dialogue is emphasized where concerns of the public are heard and addressed, particularly when establishing and/or modifying policies and procedures for responding to residential elemental mercury contamination.

The three Rs of fire safety, emergency action, and fire prevention planning: promoting safety at the worksite.

Fire safety is of paramount importance for everyone. In many workplaces, the occupational health nurse's scope of practice encompasses safety related activities. Included within this role is the responsibility for fire safety, emergency action, and fire prevention planning. The Three Rs of fire safety, emergency action, and fire prevention plans are rules, responsibilities, and resources. Myriad building and fire safety codes, regulations, and standards exist with which an employer must comply. An employer's responsibility for installing, testing, inspecting, and maintaining fire safety related equipment is extensive. Emergency action and fire prevention planning begins with conducting a detailed physical survey and preparing site maps. It includes making key policy decisions, writing procedures, and training employees in those procedures by practicing and executing site drills. The best resources available for emergency planning are the local fire department and the property insurer. Planning ahead means an efficient emergency response if disaster strikes. It saves lives, limits property damage, and preserves the environment.