Almost half of Special Guardians are grandparents, typically single grandmothers, who are required to facilitate and maintain relationships between parents and children if deemed in the child’s best ...interests. Current literature suggests that Special Guardians navigate complex family situations, support children with developmental trauma histories and receive scant support. Only limited research has examined the lived experiences of Special Guardians, especially using qualitative methods. Further exploration into such experiences may allow for better understanding and more specialised support for Special Guardians and the children they care for. The current research involved semi-structured interviews with six grandparent Special Guardians. Using Interpretative Phenomenological Analysis (IPA) five themes were constructed that highlighted some of the social, emotional, relational and financial difficulties they experienced from taking on the role. Compared to foster or adoptive carers, Special Guardians felt undervalued and abandoned by services. After a Special Guardianship Order (SGO) has been awarded, to encourage positive relationships Special Guardians may benefit from trauma training, peer and therapeutic support, as well as more whole family support.
Plain Language Summary
This study aimed to develop further insights into the experiences of grandparents taking on the role of Special Guardianship and the subsequent impact on relationships within the family. Interviews with six grandmothers were used to create space for grandparent Special Guardians to share and reflect on their experiences. Using Interpretative Phenomenological Analysis (IPA), interviews identified five key themes that appeared particularly meaningful or common across those who took part.
The findings suggest that grandparent Special Guardians are navigating a complex role in the absence of support around them. This can lead to or increase difficulties in relationships with their own children and can affect relationships and dynamics in the wider family. Many grandparent Special Guardians had experienced social, emotional, relational and financial difficulties since taking on the role, supporting their grandchildren alongside managing these difficulties, often alone. This can increase the likelihood of negative outcomes for themselves, their children, their grandchildren and the wider family.
While grandparent Special Guardians are responsible for caring for their grandchildren under a Special Guardianship Order (SGO), local authorities (LAs) have a shared responsibility to provide families with relevant support. The findings suggest that LAs are largely failing in their duty to do so. Support with facilitating contact, trauma and attachment training, support around the family unit and respite opportunities could lead to more positive outcomes for such families and their wider relationships.
This keynote paper is the first installment in the six-part Nursing Outlook special edition based on the 2022 Emory University Business Case for Nursing Summit. The summit, which took place in March ...2022, was led by Emory School of Nursing in partnership with Emory School of Business. It convened national nursing, health care, and business leaders to explore possible solutions to nursing workforce crises. Each of the summit’s panels authored a paper in this special edition on their respective topic(s). Those topics included the growth, distribution, resilience, and value of the nursing workforce. As on the day of the event, the keynote frames the panelists’ discussions by sharing nursing workforce trends, expert workforce insights, and data-informed questions to help promote dialogue in this series and beyond.
•Written by the keynote speaker of the 2022 Emory Business Case for Nursing Summit.•Provides context for the Business Case for Nursing special edition.•Discusses important strengths of the nursing workforce.•Highlights continued nursing workforce needs.•Recommends ways to invest in nursing & leverage nursing strengths moving forward.
•Highlights pivotal nursing contributions to environmental science throughout history, from Florence Nightingale, to science activists in the 60’s and 70’s, to changemakers today•Describes the ...programs of research of leading environmental nursing scientists and how their work has paved the way for future generations of researchers•Emphasizes that all nurses must incorporate environmental science and translation into their research and practice; this is especially critical today in the context of urgent threats like climate change, significant racial health disparities, and emerging pathogens like COVID-19.
Since its founding, professional nursing has applied an environmental lens to healing.
This CANS 2020 Keynote article describes the history of nursing environmental science and nurses important contributions to the US Environmental Justice Movement. Starting with Florence Nightingale's Notes on Nursing, which established Environmental Theory, the paper introduces key figures throughout nursing history who have studied and advocated for environmental health and justice.
The paper emphasizes that nursing has always been about environmental health and that, regardless of specialty or practice setting, all nurses are called to incorporate environmental science and translation into their research and practice.
This call to action is especially critical today in the context of urgent issues like climate change, environmental racism and racial health disparities, emerging infectious diseases like COVID-19, and chemical exposures in the home and workplace (among others).
Summary
Pearl millet (Pennisetum glaucum) is one of the most promising but underutilised crops in sub‐Saharan Africa. Here, we evaluated the use of extrusion cooking of wholegrain pearl millet ...related to the formation of amylose–lipid complexes (ALCs) and their potential effect on slowing starch digestion. Thermal properties (differential scanning calorimetry), fatty acid (FA) profiles (derivatization followed by gas chromatography), ALC dissociation (hexane extraction followed by derivatization and gas chromatography) and in vitro starch digestibility (α‐amylase digestion assay) were determined for wholegrain and decorticated pearl millet flours in both native and extruded states. Extrusion cooking melted stable type II complexes naturally present in native flours into type I complexes characterised by a melting endotherm in the 82–112 °C range. Extrusion caused the formation of ALC‐containing mono‐ and polyunsaturated fatty acids, which were not found in native flours. Extruded instant flours exhibited a moderated release of reducing sugars compared to cooked native samples and the effect was more pronounced in the wholegrain flour. This effect was lost when the extruded samples were cooked, though instant flours would retain the effect if rehydrated with warm rather than boiling hot water. When extruded, wholegrain millet had some enhancement of a slow digestion effect.
Delayed digestion with α‐amylase of wholegrain extruded flour due to the presence of amylose‐lipid complexes.
Although the United States is one of the wealthiest countries in the world and a leader in biomedical innovation, its health care system is consistently ranked among the worst in terms of cost and ...health outcomes. Americans have short life expectancies, high infant mortality and obesity rates, and soaring chronic disease rates compared with other wealthy nations. In 2021, the National Academy of Medicine (NAM) was charged with examining what it would take to improve US primary care. The NAM report described the practice of siloing public health from primary care or treating these areas as separate fields of scientific inquiry, practice, and billable service.1 NAM identified this separation as a key driver of poor health outcomes and health inequities in the United States. The Institute of Medicine (IOM) examined similar phenomena in a 2012 report, noting how the two fields tend to operate independently, despite complementary functions and common goals.2Where these silos persist, we see communication and process breakdowns at the point of care. For instance, when large swaths of Americans turned to trusted primary care providers for COVID-19 vaccine insights, their primary care providers did not always have the most up-todate information, in part because of a lack of interprofessional cohesion (including fragmented public health messaging and data systems). If we are to remedy such issues, a substantive paradigm shift must take place: We must move toward what DeSalvo et al.3 termed "Public Health 3.0." In this model, multiple sectors, specialties, and stakeholders form coalitions to mobilize data, people power, and resources in a strategic manner to advance health for all. To be truly strategic, we must think carefully about how to leverage nurses-who care for patients across the lifespan and in nearly all public health nursing (PHN) and primary care settings-within these coalitions.The 2021 NAM report urges health care teams to undertake the mission of integrating systems. However, NAM stops short of describing exactly how teams ought to accomplish this aim and the proposed makeup ofsaid teams. Like any group project, success will depend on the ability of teams to identify leaders and clearly delineate responsibilities. The purpose of this editorial is to explore the potential of PHN and primary care nurses and to describe the roles they might assume in the collaborative integration of their respective silos.
COVID-19 has tested the capacity of every nursing school, but its impact has varied according to the size, location, and baseline infrastructure of each school. This makes the pandemic an important ...lens through which to study crisis management principles, such as flexibility and scalability (the ability to expand and reduce efforts based on situational demands).
This article provides a roadmap for academic crisis management, modeled on the National Incident Management System (NIMS). It is tailored to the unique needs of nursing schools and applies COVID-19 as a case study.
The authors explore the elements of the NIMS that were deployed within 1 top-ranked school of nursing during COVID-19.
The article includes best practices, tips, and resources to help academic nurse leaders and educators navigate large-scale or unprecedented crises, such as COVID-19.
Health systems are facing historic staffing crises, and they require efficient pipelines of qualified students into practice. Accelerated second-degree students are helping to address pressing health ...care market needs.
Few publications have assessed the second-degree program landscape or offered comparisons of second-degree pathways.
This article discusses the second-degree program landscape, including challenges in second-degree education; compares graduate-level second-degree entry against other pathway options; and presents strategies to optimize and sustain second-degree student pipelines based on these insights.
The second-degree program landscape is characterized by variability. Challenges include inconsistent program nomenclature and limited national data collection. Graduate-level second-degree pathways offer financial and career advantages compared with other pathways.
Nursing education should standardize second-degree nomenclature, refine national data capture mechanisms, standardize program scope and requirements, and encourage second-degree pathways at the graduate level or above.
Severe nursing shortages threaten the sustainability of US health systems. Rural and underserved communities are disproportionately affected by staffing crises and associated facility closures, as ...well as health disparities. A major factor contributing to geographic gaps in care is the absence of nursing schools, nursing faculty, and locations for clinical rotations in many rural and underserved areas. Emory School of Nursing is helping to solve for these issues through the Distance Accelerated Bachelor of Science in Nursing (DABSN) program. The DABSN is establishing accelerated pipelines of nursing students into practice in locations where nursing education has historically been difficult or impossible to access. This innovative nursing education model allows students to enroll in a top-ranked nursing school while remaining in their home communities. Students complete synchronous didactic coursework with peers in every US time zone while performing clinical rotations in local healthcare facilities. This paper details the growth and development of the DABSN. It describes the challenges and opportunities we have navigated in implementing the program, along with information about its pedagogy, clinical placement practices, and student/faculty characteristics. We share program outcomes and conclude with recommendations for the future.
•Emory School of Nursing has established a distance, accelerated pre-licensure program.•The Distance Accelerated BSN (DABSN) increases access to nursing education.•Allows students to complete clinical rotations in their home communities.•Offers innovative, remote-connected, synchronous didactic learning.•Creates nursing shortage solutions, improves access to care in rural areas.
This commentary paper concludes the Business Case for Nursing special edition. The special edition covered major areas of dialogue from the 2022 Emory Business Case for Nursing Summit. The 2022 ...summit, led by Emory School of Nursing in partnership with Emory School of Business, convened national nursing, health care, and business leaders. Its aim was to explore possible solutions to nursing workforce crises, including nursing shortages. Each of the summit’s four panels authored a paper in this special edition on their respective topic(s) of discussion. This paper is written by the summit’s hosting deans and closing speaker in response to those discussions. It shares major policy and regulatory reforms that have taken place since the summit and highlights workforce needs that will require continued attention in 2023 and beyond. Topics include issues driving nurse turnover and workforce distribution, the relationship(s) between working conditions and nursing retention, the importance of competitive nursing salaries, and the need for systems to protect resilience in nursing.
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