Maya Clark-Cutaia

Abstract

BACKGROUND: Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood.PURPOSE: The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States. We also explored the relationship between food insecurity and pregnancy outcomes.METHODS: PubMed, CINAHL, Web of Science, and Food and Nutrition Science databases were used. The inclusion criteria were peer-reviewed studies about food (in)security, position articles from professional organizations, and policy articles about pregnancy outcomes and breastfeeding practices. Studies conducted outside of the United States and those without an adequate definition of food (in)security were excluded. Neonatal health outcomes were also excluded. Included articles were critically appraised with the STROBE and Critical Appraisal Skills Program checklists.RESULTS: Nineteen studies met the inclusion criteria. Inconsistencies exist in defining and measuring household food (in)security. Pregnant and postpartum people experienced several adverse physiological and psychological outcomes that impact pregnancy compared with those who do not. Intersections between neighborhood conditions and other economic hardships were identified. Findings regarding the impact of food insecurity on breastfeeding behaviors were mixed, but generally food insecurity was not associated with poor breastfeeding outcomes in adjusted models.CONCLUSION: Inconsistencies in definitions and measures of food security limit definitive conclusions. There is a need for standardizing definitions and measures of food insecurity, as well as a heightened awareness and policy change to alleviate experiences of food insecurity.

Abstract

Background: The National Institutes of Health supports professional development of diverse researchers through diversity supplements. Limited awareness and understanding of the application process have hindered utilization of this funding mechanism. Purpose: We describe perspectives and recommendations of mentee and mentor recipients of diversity supplements. Methods: Our working group, comprised of faculty from an Historically Black College and University and an R1 research university, conducted stakeholder interviews with three mentees and four mentors from various institutions. We used content analysis to derive categories of experiences and recommendations. Discussion: Interviewees reported on advantages of diversity supplements, ensuring institutional support, identifying a good mentee-mentor match, developing grantsmanship specific to diversity supplements, and increasing numbers of these applications. Conclusion: We identify opportunities for stakeholders to increase awareness of diversity supplements. Our data support greater understanding of this mechanism, establishing strong mentoring relationships, and submitting robust applications. Findings can enhance diversity among the scientific community.

Abstract

Chronic kidney disease (CKD) is more prevalent in individuals with obesity, diabetes mellitus, or hypertension. Individuals with CKD are prone to kidney failure, with symptom experiences that rival those of patients with cancer. We explored symptom burden in individuals with CKD via a systematic review of 30 quantitative and qualitative articles. The most common CKD symptoms were fatigue, weakness, pain, sleep disturbances and itchy skin. Instruments used to assess symptoms were the Kidney Disease Quality of Life (KDQOL)-36, the Palliative Outcome Symptom-Scale renal (POS-r)-13, and the Dialysis Symptom Index (DSI)-10. The included qualitative studies expand and expound on the quantitative data presented. This article describes the prevalence of symptom burden in individuals with CKD in relation to psychosocial and demographic factors and discuss the importance of symptom management.

Abstract

Background: The NIH Diversity Administrative Supplement is a funding mechanism that provides support for diverse early-stage researchers. There is limited guidance on how to apply for these awards. Purpose: We describe perspectives of NIH program/diversity officers and university research administrators offering recommendations for diversity supplement submission. Methods: This article is the product of a working group exploring diversity in research. Nursing faculty from an R2 Historically Black College and University and an R1 research intensive university conducted stakeholder interviews with NIH program/diversity officers and university research administrators. We used content analysis to categorize respondents’ recommendations. Findings: Recommendations centered on harmonizing the applicant with the program announcement, communication with program/diversity officers, mentor/mentee relationship, scientific plan, and systematic institutional approaches to the diversity supplement. Discussion: Successful strategies in submitting diversity supplements will facilitate inclusion of diverse researchers in NIH-sponsored programs. Systematic approaches are needed to support development of diverse voices to enhance the scientific community.

Abstract

Background: The COVID-19 pandemic had its first peak in the United States between April and July of 2020, with incidence and prevalence rates of the virus the greatest in the northeastern coast of the country. At the time of study implementation, there were few studies capturing the perspectives of nurses working the frontlines of the pandemic in any setting as research output in the United States focused largely on treating the disease. Objective: The purpose of this study was to capture the perspectives of nurses in the United States working the frontlines of the COVID-19 pandemic's first wave. We were specifically interested in examining the impact of the pandemic on nurses' roles, professional relationships, and the organizational cultures of their employers. Design: We conducted an online qualitative study with a pragmatic design to capture the perspectives of nurses working during the first wave of the United States COVID-19 pandemic. Through social networking recruitment, frontline nurses from across the country were invited to participate. Participants provided long form, text-based responses to four questions designed to capture their experiences. A combination of Latent Dirichlet Allocation–a natural language processing technique–along with traditional summative content analysis techniques were used to analyze the data. Setting: The United States during the COVID-19 pandemic's first wave between May and July of 2020. Results: A total of 318 nurses participated from 29 out of 50 states, with 242 fully completing all questions. Findings suggested that the place of work mattered significantly in terms of the frontline working experience. It influenced role changes, risk assumption, interprofessional teamwork experiences, and ultimately, likelihood to leave their jobs or the profession altogether. Organizational culture and its influence on pandemic response implementation was a critical feature of their experiences. Conclusions: Findings suggest that organizational performance during the pandemic may be reflected in nursing workforce retention as the risk for workforce attrition appears high. It was also clear from the reports that nurses appear to have assumed higher occupational risks during the pandemic when compared to other providers. The 2020 data from this study also offered a number of signals about potential threats to the stability and sustainability of the US nursing workforce that are now manifesting. The findings underscore the importance of conducting health workforce research during a crisis in order to discern the signals of future problems or for long-term crisis response. Tweetable abstract: @US nurses report assuming higher risks when delivering care than other healthcare personnel. @Healthcare leaders made the difference for nurses during the pandemic. How many nurses leave their employer in the next year will tell you who was good, who wasn't. @It was all about the team. Organizations with nurses' reporting effective interprofessional teamwork had a more resilient pandemic workforce.

Abstract

Purpose of review The purpose of this review was to assess the prevalence of United States chronic kidney disease (CKD) health disparities, focusing on racial/ethnic groups, immigrants and refugees, sex or gender, and older adults. Recent findings There are major racial/ethnic disparities in CKD, with possible contributions from the social determinants of health, socioeconomics, and racial discrimination. Racial/ethnic minority patients experience faster progression to end-stage kidney disease (ESKD) and higher mortality predialysis, however, once on dialysis, appear to live longer. Similarly, men are quicker to progress to ESKD than women, with potential biological, behavioral, and measurement error factors. There is a lack of substantial evidence for intersex, nonbinary, or transgender patients. There are also strikingly few studies about US immigrants or older adults with CKD despite the fact that they are at high risk for CKD due to a variety of factors. Summary As providers and scientists, we must combat both conscious and unconscious biases, advocate for minority patient populations, and be inclusive and diverse in our treatment regimens and provision of care. We need to acknowledge that sufficient evidence exists to change treatment guidelines, and that more is required to support the diversity of our patient population.