Introduction: Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another's expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors.
View Article and Find Full Text PDFIntroduction: Emerging evidence suggests neuroprotective effects of bisphosphonates. We aim to investigate whether nitrogen-containing bisphosphonates (NBPs) could reduce the risk of Alzheimer's disease and related dementia (ADRD).
Methods: We identified patients aged 60+ with osteoporosis or fragility fracture in 2005-2020 from a healthcare database in Hong Kong.
Dysregulation of the TAR DNA-binding protein 43 (TDP-43), including intraneuronal cytoplasmic mislocalisation and aggregation is a feature of multiple neurodegenerative diseases including amyotrophic lateral sclerosis (ALS), frontotemporal lobar dementia (FTLD), limbic-predominant age-related TDP-43 encephalopathy (LATE) and alzheimers disease (AD). Unravelling the causes and functional consequences of TDP-43 dysregulation is paramount to understanding disease mechanisms as well as identifying effective therapeutic targets. Here we present a comprehensive characterisation of three stable transgenic zebrafish models that express human TDP-43 variants in motor neurons.
View Article and Find Full Text PDFCanadian nursing regulators have implemented various innovations to reform regulatory approaches to address workforce challenges, system demands, governance reforms, and a drive for efficiency. Given the significant role that regulators play in influencing patient safety, workforce, and health system outcomes, decision-making must be evidence-informed. This review examined the nature, extent, and range of literature related to nursing regulation in Canada and how the existing scholarship aligns with emerging regulatory and health system trends to inform the development of a research agenda.
View Article and Find Full Text PDFHealth practitioner regulation plays a fundamental role in public protection by overseeing and governing healthcare professionals to ensure they deliver safe health services. It also serves as a strategic lever to strengthen broader health system goals such as improving the accessibility of services, the sustainability of health workforces, and health system resilience. Although the goals of health practitioner regulation are easily articulated, achieving and evaluating these goals are far more challenging.
View Article and Find Full Text PDFBackground: Genomics is a foundational element of precision health and can be used to identify inherited cancers, cancer related risks, therapeutic decisions, and to address health disparities. However, there are structural barriers across the cancer care continuum, including an underprepared nursing workforce, long wait times for service, and inadequate policy infrastructure that limit equitable access to the benefits of genomic discoveries. These barriers have persisted for decades, yet they are modifiable.
View Article and Find Full Text PDFBackground: RNs are integral to achieving the United Nations' 17 Sustainable Development Goals (SDGs). Professional nursing organizations can play a significant role in educating and preparing nurses to work more effectively toward achieving the SDGs. While there is much literature that speaks to the importance of nurses engaging in these goals, there is a lack of research that has explored nurses' perceptions of the role of professional nursing organizations in promoting SDG-related knowledge and engagement.
View Article and Find Full Text PDFNurs Leadersh (Tor Ont)
October 2024
The demand for genomic services has outpaced the capacity of the health system, thus creating opportunities for nurse practitioners (NPs) to develop genomic literacy and expand the genomics-informed services that NPs can offer to optimize safe and equitable healthcare. The new model of NP regulation that aims to educate all NPs, based on a set of common entry-level competencies, has the potential to accelerate the integration of genomics into education and practice. In this commentary, we explore opportunities within a new NP regulatory framework and highlight how NPs can strengthen Canadians' access to genomic technologies as clinicians, advocates, leaders, scholars and educators.
View Article and Find Full Text PDFNurs Leadersh (Tor Ont)
October 2024
A skilled nursing workforce can ensure that Canadians have safe and equitable access to genomics-informed healthcare. Evidence-informed frameworks designed to support the implementation of genomics across nursing indicate that leadership and collaboration are critical to success. However, siloed provincial and territorial healthcare systems create challenges for harmonizing efforts.
View Article and Find Full Text PDFJBI Evid Synth
November 2024
Objective: The objective of this review was to map the available global evidence on strategies that nurses can use to facilitate genomics-informed health care to address health disparities to inform the development of a research and action agenda.
Introduction: The integration of genomics into health care is improving patient outcomes through better prevention, diagnostics, and treatment; however, scholars have noted concerns with widening health disparities. Nurses work across the health system and can address health disparities from a clinical, research, education, policy, and leadership perspective.
Background: Significant reforms are occurring in health practitioner regulation across Canada. Within the nursing profession, growing workforce challenges and health system demands have accelerated the pace of changes to nursing regulation policies and practices. There is significant political investment to modernize and harmonize nursing regulation across Canada, and evidence is needed to guide regulatory decision-making.
View Article and Find Full Text PDFRationale And Objectives: Prior to clinical presentations of Alzheimer's Disease (AD), neuropathological changes, such as amyloid-β and brain atrophy, have accumulated at the earlier stages of the disease. The combination of such biomarkers assessed by multiple modalities commonly improves the likelihood of AD etiology. We aimed to explore the discriminative ability of Aβ PET features and whether combining Aβ PET and structural MRI features can improve the classification performance of the machine learning model in older healthy control (OHC) and mild cognitive impairment (MCI) from AD.
View Article and Find Full Text PDFIntroduction: Racism in healthcare leads to significant harm to healthcare professionals and the clients, families and communities they serve. Increasingly, health practitioner regulators-responsible for protecting the public and ensuring practitioner competence-are recognising the importance of reforming policies and practices to contribute to antiracist regulatory approaches. Examples of this work include developing specific standards of practice related to antiracism and antidiscrimination, supporting education and training, re-evaluating discriminatory licensure policies for internationally educated professionals and reforming internal governance structures to address unconscious bias.
View Article and Find Full Text PDFBackground: Nurses have a critical role to play in achieving the United Nations' 17 Sustainable Development Goals (SDGs). While Goal 3 (good health and well-being) is of particular importance to nursing, every SDG contributes to the advancement of universal health and well-being. Yet many nurses are unfamiliar with the SDGs and how they relate to everyday nursing practices.
View Article and Find Full Text PDFTechnology is transforming service delivery and practice in many regulated professions, altering required skills, scopes of practice, and the organization of professional work. Professional regulators face considerable pressure to facilitate technology-enabled work while adapting to digital changes in their practices and procedures. However, our understanding of how regulators are responding to technology-driven risks and the impact of technology on regulatory policy is limited.
View Article and Find Full Text PDFBackground: Genomic technologies such as genetic testing and precision treatments are rapidly becoming routine in oncology care, and nurses play an increasingly important role in supporting the growing demands for genomics-informed healthcare. Policy infrastructure such as competencies, standards, scope of practice statements, and education and curriculum frameworks are urgently needed to guide these practice and education changes.
Purpose: This study is part of a larger three-phase project to develop recommendations and catalyze action for genomics-informed oncology nursing education and practice for the Canadian Association of Nurses in Oncology and the Canadian Association of Schools of Nursing.
Aim: To learn from two jurisdictions with mature genomics-informed nursing policy infrastructure-the United States (US) and the United Kingdom (UK)-to inform policy development for genomics-informed oncology nursing practice and education in Canada.
Design: Comparative document and policy analysis drawing on the 3i + E framework.
Methods: We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee.
Objective: The objective of this scoping review is to map the available evidence on strategies that nurses can use to facilitate genomics-informed healthcare to address health disparities.
Introduction: Advancements in genomics over the last two decades have led to an increase in the delivery of genomics-informed health care. Although the integration of genomics into health care services continues to enhance patient outcomes, access to genomic technologies is not equitable, exacerbating existing health disparities amongst certain populations.
Nurs Leadersh (Tor Ont)
April 2023
Founded in 1945, the United Nations (UN) system has become the place where countries come together to discuss complex and multifaceted issues that no one country can tackle alone. Civil society continues to be an integral part of the UN system, supporting the work of various entities and providing expertise on core pillars such as development, human rights and peace and security. Some global nursing leaders have made considerable progress in increasing nursing engagement and visibility across the system; however, representation remains small.
View Article and Find Full Text PDFBackground: Dementia presents a significant burden to patients and healthcare systems worldwide. Early and accurate diagnosis, as well as differential diagnosis of various types of dementia, are crucial for timely intervention and management. However, there is currently a lack of clinical tools for accurately distinguishing between these types.
View Article and Find Full Text PDFStructural and diffusion kurtosis imaging (DKI) can be used to assess hippocampal macrostructural and microstructural alterations respectively, in Alzheimer's disease (AD) spectrum, spanning from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) and AD. In this study, we explored the diagnostic performance of structural imaging and DKI of the hippocampus in the AD spectrum. Eleven SCD, thirty-seven MCI, sixteen AD, and nineteen age- and sex-matched normal controls (NCs) were included.
View Article and Find Full Text PDFCan J Nurs Res
September 2023
Background: The rising rates of anti-Asian sentiments has recently been called into question by several community activists and scholars. While this collective work has heightened awareness to address anti-Asian racism, the experiences of Asian healthcare workers in particular remains limited.
Purpose: To map the existing literature on anti-Asian racism experienced by Asian healthcare workers in North American healthcare settings, identify gaps in the current literature base, and inform future areas of anti-Asian racism research.
Background: Professional nursing associations across jurisdictions engaged in significant policy advocacy during the COVID-19 pandemic to support nurses, the public and health systems. While professional nursing associations have a long history of engaging in policy advocacy, scholars have rarely critically examined this important function.
Purpose: The purpose of this study was twofold: (a) to examine how professional nursing associations engage in the process of policy advocacy and (b) to develop knowledge specific to policy advocacy in the context of a global pandemic.
Aims: To explore the nuances of theory utilization in qualitative methodologies, discuss the different relationships that applied qualitative methodologies have with theory and use the foundational underpinnings of interpretive description to challenge strongly entrenched ideas of theory that have extended into applied qualitative nursing research.
Design: Methodology discussion paper.
Data Sources: Narrative literature review and personal observations.