The role of physician oversight on advanced practice nurses' professional autonomy and empowerment.

BACKGROUND AND PURPOSE: Little is known about the effects of physician oversight on advanced practice registered nurses (APRNs). Examination of these relationships provides insight into the strength of independent practice. The purpose of this study was to examine whether APRNs' perceptions of autonomy and empowerment varied according to type of physician oversight, whether facilitative or restrictive. DATA SOURCES: A cross-sectional survey design was used to examine whether APRNs' perceptions of autonomy and empowerment varied according to physician oversight, geographical location, and practice setting. Five hundred questionnaires were mailed in March 2013 with 274 returned. Participants were asked about autonomy, empowerment, demographics, physician oversight, geographical location, and practice setting. CONCLUSIONS: Among surveyed respondents, physician oversight was related to increased empowerment, regardless of whether the oversight was defined in facilitative or restrictive terms; both had similar positive effects on empowerment. IMPLICATIONS FOR PRACTICE: If APRNs are to be part of the solution to the growing problem of healthcare access, it is important to study factors that contribute to their success. We speculate that increasing opportunities for collaboration and interaction with physicians, and possibly other healthcare professionals, could facilitate APRN empowerment, optimizing their contribution.

The Effects of Gendered Social Capital on U.S. Migration: A Comparison of Four Latin American Countries.

This article contributes to understandings of gendered social capital by analyzing the effects of gendered ties on the migration of men and women from four Latin American countries (Mexico, Costa Rica, Nicaragua, and the Dominican Republic) to the United States. The research theorizes the importance of strong and weak ties to men and women in each sending country as a product of the gender equity gap in economic participation (low/high) and incidence of female-led families (low/high). The findings reveal that ties to men increase the odds of migration from countries where gender equity and incidence of female-led families are low, while ties to women are more important for migration from countries where gender equity and female-led families are high. Previous research on migration and social capital details the importance of network ties for providing resources and the role of gender in mediating social capital quality and access to network support. Results reveal that not only are different kinds of ties important to female and male migration, but migrants from different countries look to different sources of social capital for assistance.

Autonomy and empowerment in advanced practice registered nurses: lessons from New Mexico.

PURPOSE: The purpose of this study was to determine the association between autonomy and empowerment of advanced practice registered nurses (APRNs) and predictor variables of physician oversight, geographical location, and practice setting. As the Patient Protection and Affordable Care Act (PPACA) is implemented, these characteristics are vital to understanding how APRNs practice and the relationship of APRNs to other healthcare team members, including physicians. DATA SOURCES: This was a descriptive, correlational survey of APRNs in New Mexico exploring autonomy and empowerment in relation to variables of physician oversight, geographical location, and practice setting. CONCLUSIONS: New Mexico's APRN Nurse Practice Act supports independent practice and prescriptive authority. Results indicated that APRNs are highly empowered and autonomous. However, nearly 40% of respondents identified practicing with physician oversight. Further investigation of subscales of empowerment also provided insight of relationships among healthcare team members, particularly physicians. IMPLICATIONS FOR PRACTICE: This research provides additional knowledge for policy changes that support APRNs assuming more responsibility for primary care. However, understanding the APRN role within the healthcare team is necessary for effective implementation of primary care in New Mexico.

School discipline and disruptive classroom behavior: the moderating effects of student perceptions.

This study examines the relationship between school discipline and student classroom behavior. A traditional deterrence framework predicts that more severe discipline will reduce misbehavior. In contrast, normative perspectives suggest that compliance depends upon commitment to rules and authority, including perceptions of fairness and legitimacy. Using school and individual-level data from the National Education Longitudinal Study of 1988 and multilevel regression modeling, the author finds support for the normative perspective. Students who perceive school authority as legitimate and teacher­student relations as positive are rated as less disruptive. While perceptions of fairness also predict lower disruptions, the effects are mediated by positive teacher­student relations. Contrary to the deterrence framework, more school rules and higher perceived strictness predicts more, not less, disruptive behavior. In addition, a significant interaction effect suggests that attending schools with more severe punishments may have the unintended consequence of generating defiance among certain youth.