Mikki Meadows-Oliver

Abstract

This clinical pilot research project evaluated clinical outcomes for asthmatic children enrolled in a home-based Asthma Outreach Program. Through a quasi-experimental single-group intervention design, a convenience sample of 37 children, ranging in age from 6 to 16 years, was used for this study. At 6 months after enrollment in the Asthma Outreach Program, patients reported significantly fewer nighttime symptoms and primary care provider visits compared with the 6 months preceding enrollment. Patients also reported significantly fewer hospital and intensive care unit admissions and courses of oral steroids. Adherence to therapy and asthma control was also significantly improved.

Abstract

Introduction: Up to 87% of trafficking victims encounter a health care provider while being trafficked but are not recognized as victims. Most health care providers receive little or no training, and awareness remains low. To describe the knowledge, beliefs, and attitudes of pediatric advanced practice registered nurses about human trafficking. Method: A survey of the National Association of Pediatric Nurse Practitioners membership (n = 8,647) before the intervention measured knowledge, beliefs, and experience regarding child trafficking. An awareness campaign was implemented with continuing education, national media presence, Train the Trainer programs, and creation of a nonprofit organization to direct strategic initiatives. Results: Overall, 799 (9%) NAPNAP members completed the survey. Although 87% believed it possible that they might encounter a victim of trafficking in their practice, 35% were unsure if they had provided care for a victim. Only 24% reported confidence in their ability to identify a child at risk for trafficking. Discussion: These survey findings indicate the need for clinical practice guidelines to identify potential and actual victims of human trafficking. Pediatric advanced practice registered nurses are ideally equipped and situated to intervene on behalf of vulnerable children with health disparities in a myriad of care settings, advocating for prevention and optimization of equitable health outcomes.

Abstract

Purpose: The primary purpose of this study was to examine the quality of sponsored and unsponsored asthma websites using the Brief DISCERN instrument and to evaluate whether the Health On the Net Code of Conduct (HONcode) logo was present, thereby indicating that the site met the criteria. The Internet is an important source of health information for patients and their families. The primary purpose of this study was to examine the quality of sponsored and unsupported asthma websites. A secondary aim was to determine the readability and reading ease of the materials for each website along with the grade level. Methods: We queried seven Internet search engines using the keyword “asthma.” The websites were evaluated using the six-item Brief DISCERN instrument and by ascertaining whether the HON code quality label was present. The websites were also evaluated for readability employing Flesch-Kincaid grade level and Flesch reading ease tools using Microsoft Office Word 2013 software. Results: A total of 22 unique websites were included in the study. Approximately 68% of the websites reviewed had a Brief DISCERN cutoff score of ≥16. The overall Brief DISCERN scores ranged from 6 to 30, and the mean score was 17.32 (SD = 6.71). The Flesch-Kincaid grade level scores ranged from 2.9 to 15.4, and the average reading grade score was 9.49 (SD = 2.7). The Flesch reading ease scores ranged from 17 to 82.7, with a mean reading ease score of 53.57 (SD = 15.03). Sites with a HONcode quality label had significantly higher Brief DISCERN scores than those without one (t=2.3795; df=20; p=0.02). Conclusion: Brief DISCERN scores revealed that there is quality asthma information for children and their families available on the Internet. The grade level ranged between 2.9 and 15.4 among the websites. However, the mean grade level scores were 9.3-9.89, which is high for the average consumer. Access to accurate information via the Internet, with appropriate readability, may enable pediatric asthma patients and their caregivers to better control and manage asthma.

Abstract

Reflective functioning (RF), the capacity to envision thoughts, feelings, needs and intentions within the self and others, is thought to be central to sensitive parenting, yet this capacity has been unexamined among pregnant adolescents. We explored how RF was related to the emotional experience of adolescent pregnancy. Design and Methods: This qualitative study was guided by interpretive description. Participants were 30 Latina and African-American adolescents (mean age 17.7 + 1.5 years) residing in a low-income urban community. All adolescents were interviewed with the Pregnancy Interview (a 22 question semi-structured interview) in their third trimester of pregnancy. Interview transcripts had been previously coded for levels of RF (1-9 with higher levels denoting higher reflectiveness), and this secondary analysis focused on the teens' experience of pregnancy and their emerging reflective capacities. We used a priori and inductive coding with all interviews and developed patterns and themes. Results: These interviews provided an in-depth understanding of the complex adolescent emotional experiences of pregnancy. We identified five themes that create a picture of how the participants reflected upon their pregnancies, unborn babies, emerging parental roles, and complicated relationships with family and partners. Conclusions and Practice Implications: Adolescent developmental issues and harsh family and neighborhood environments permeated the teens' experience of pregnancy and limited capacity for RF. Understanding distinctive features of RF in pregnant adolescents may contribute to developing conceptual models and tailored clinical approaches for enhancing parental reflectiveness and sensitivity in these vulnerable young women as they enter into the transition to parenthood.

Abstract

Background. Asthma is the most prevalent chronic illness affecting 10% of the pediatric population. The internet is a useful tool for acquiring information on health topics. In a recent Harris Poll, 154 million adults searched the Internet for health information. The usefulness of asthma materials on the Internet depends on the ability to read and comprehend the information. The goal of this study was to assess the readability of asthma Web sites. Methods. The authors studied the readability of 6 asthma Web sites that have been previously evaluated for quality and accuracy of information. The Flesch/Flesch-Kincaid tools were used to evaluate readability and reading ease of the materials on each of the Web sites with the use of Microsoft Office Word software. Results. Materials included in the 6 Web sites were analyzed. The information included in the Web sites had a readability index between 46.6 and 63.5, with a mean of 54.33 on the Flesch reading ease. The mean Flesch-Kincaid grade level was found to be between 8.0 and 10.3, with an average grade level of 9.73. Conclusions. Findings suggest that readability scores on asthma Web sites are high for the average consumer. Research has shown that patient educational materials should be no higher than a sixth-grade reading level. Practice Implications. Asthma educational materials on the Internet carry the risk of having incomprehensible materials disseminated to patients and their families. Asthma educators need to understand the role of the Internet and health information and guide their patients and their families to accurate, comprehensible, and readable Web sites.

Abstract

Background: Nurses from low-income countries (LICs) face extreme nursing shortages, faculty shortages and a lack of professional development opportunities. Nurses from high-income countries (HICs) can leverage their wealth of resources to collaborate with nursing colleagues in LICs to expand clinical, education and research capacity. In turn, nurses from HICs gain stronger competency in the care they provide, improved communication skills and an increased understanding of global health issues. Aim: The purpose of this literature review is to identify international nursing clinical, education and research partnerships among nurses from LICs and HICs and to analyse the degree of collaboration involved in each partnership using DeSantis' counterpart concept. Methods: We conducted a systematic review of international nursing partnerships in the scientific literature from January 2001 to July 2012. A total of nine articles met inclusion criteria for analysis. Findings: All of the articles discuss lessons learnt in building international nursing partnerships among nurses from HICs and LICs. However, the articles failed to meet the criteria set forth by DeSantis' counterpart concept to achieve fully collaborative nursing partnerships. Conclusions: International nursing partnerships require more foresight and planning to create partnerships in which the benefits derived by nurses from LICs equal those of their colleagues from HICs. By striving for such collaboration, international nursing partnerships can help build nursing clinical, education and research capacity in LICs.