Dorothy L. Powell

Children : The unwitting target of environmental injustices

Children have little control over where they live, what they eat, the financial circumstances of their families, or the developmental activities and behaviors that make them vulnerable to environmental contaminants. Minority and poor families disproportionately live in communities with landfills, hazardous waste facilities, incinerators, industrial plants, and old housing with poor indoor air quality and lead-based paint. Residents of these communities are also more likely than are more affluent communities to consume fish on a regular basis from local waters, many of which have banned fishing. Consequently, these children and their families are exposed more frequently than are children in other communities to potentially dangerous chemicals that can affect health. Data indicate that poor and minority children have higher rates of asthma, elevated blood lead levels, learning disabilities, and hyperactivity than do non-minority and more affluent children. When a group of people is exposed unfairly and inequitably to toxins in their communities, workplaces, and schools, a phenomenon called environmental discrimination or environmental racism exists. Environmental justice is a US governmental remedy that requires the application of fair strategies and processes in the resolution of inequality related to environmental contamination. The US response resulted in the establishment of offices of Environmental Justice within the EPA and ATSDR and passage of important legislation and policies, such as the Community Planning and Right-to-Know Act of 1986, Executive Order 12898 (Federal Actions to Address Environmental Justice in Minority Populations), and Executive Order 13045, a parallel order to protect low-income and minority children from actual and potential environmental hazards. Communities and advocacy groups play an important role in promoting healthier environments for children. Frequently, low-income and minority communities are perceived as less powerful, less organized, and ill equipped to defend against actual and potential sources of environmental contamination. Health care professionals are in a strategic position to assist with community development, organizing, and empowerment through educational programming, networking, and supporting other activities that bring attention to the plight of environmentally vulnerable communities.

Application of a Partnership Model for Transformative and Sustainable International Development

There are differences of intent and impact between short-term and long-term engagement of U.S. academic institutions with communities of need in developing nations. Global health programs that produce long-term transformative change rather than transient relief are more likely to be sustainable and in ethical harmony with expressed needs of a region or community. This article explores characteristics of successful ethical partnerships in global health and the challenges that threaten them, introducing a consensus community engagement model as a framework for building relationships, evolving an understanding of needs, and collaboratively developing solutions and responses to priority health needs in underserved regions of the world. The community engagement model is applied to a case study of an initiative by a U.S. school of nursing to establish long-term relationships with the nursing community in the Caribbean region with the goal of promoting transformative change through collaborative development of programs and services addressing health care needs of the regions growing elderly population and the increasing prevalence of noncommunicable chronic diseases. Progress of this ongoing long-term relationship is analyzed in the context of the organizational, philosophical, ethical, and resource commitments embodied in this approach to initiation of transformative and sustainable improvements in public health.

Global health diplomacy: An integrative review of the literature and implications for nursing

Abstract The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy.

Recruiting and retaining a diverse workforce in nursing: from evidence to best practices to policy.

Health policy makers, providers, clinicians, and social scientists are among those who have identified racial and ethnic diversification of the health care workforce as one strategy for solving the seemingly intractable problem of health disparities in the U.S. population. But evidence supporting the impact of such diversification on narrowing health disparities is lacking, thus making it unclear if the push for workforce diversification is empirically or politically driven. Moreover, data are largely derived from the study of physicians, making it difficult to generalize findings to nursing and other health professions. This article reviews the evidence that supports the impact of a diverse workforce on patient outcomes and delivery services. Assuming a positive social value in the absence of the data, the authors review the approaches that have been successful in diversifying the nursing workforce. The authors conclude with recommendations for research and policies, including best practices, for enhancing recruitment and retention of a diverse nursing workforce.

Chronic paroxysmal hemicrania in a South African black. A case report.

A 35-year-old black man with a 4-year continuous history of multiple paroxysms of unilateral temporal and ocular pain is reported. Multiple (that is, 15–20) attacks occurred in 24 h. There were no symptom-free periods. Mild exophthalmos, marked sweating, nasal congestion, and lacrimation were present on the affected side. There was no response to ergot preparations, steroids, or lithium but dramatic and sustained relief with indomethacin.

Essential nursing competencies related to HIV and AIDS.

With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug–drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of task-shifting, task-sharing, and scope of nursing practices. This is an online Supplement to the Journal of the Association of Nurses in AIDS Care. Visit www.nursesinaidscarejournal.org for easy navigation. A Supplement Preview was published in the January/February 2011 issue, Volume 22, Number 1. The Supplement Preview and Online Supplement are supported by grant number U92HA07230 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, funded by the Presidents Emergency Plan for AIDS Relief.

Essential core competencies related to HIV and AIDS are critically needed in nursing.

Michael V. Relf, PhD, RN, ACNS-BC, AACRN, FAAN Julia Mekwa, PhD, RN, RM Cynthia Chasokela, PhD(c), MEd, BScN, SRN, RMN, SCM Christina Booth, BA Lisa Deng, Student R. Kevin Mallinson, PhD, RN, AACRN, FAAN Keabitsa Ramantele, BSEd, RN, RM Elizabeth Letsie, BSEd, RN, RM Jasintha Mtengezo, MPH, BScN, UCM, DipN Winnie Nhlengethwa, PhD, RN, SRM, FNP, SRH Dorothy Powell, EdD, RN, FAAN Adele Webb, PhD, RN, AACRN, FAAN Tony Diesel, BA Cur (Admin & Education), Dipl (Gen Nursing), Dipl (Psychiatric Nursing), RN Amanda Liddle, DrPH, RN, FAAN Michael V. Relf, PhD, RN, ACNS-BC, AACRN, FAAN, is an associate professor and assistant dean for Undergraduate Education, Duke University School of Nursing, Durham, NC. Julia Mekwa, PhD, RN, RM, Head of Department, Department of Nursing Science, University of Zululand, Republic of South Africa. Cynthia Chasokela, PhD(c), MEd, BScN, SRN, RMN, SCM, Director of Nursing Services/Chief Nursing Officer, Ministry of Health and Child Welfare, Zimbabwe. Christina Booth, BA, Duke University, Durham, NC. Lisa Deng, Student, Duke University, Durham, NC. R. Kevin Mallinson, PhD, RN, AACRN, FAAN, Assistant Professor, Department of Nursing, Georgetown University School of Nursing & Health Studies, Washington, DC. Keabitsa Ramantele, BSEd, RN, RM, President, Botswana Nurses Association, Botswana. Elizabeth Letsie, BSEd, RN, RM, Chairperson, Lesotho Nursing Council, Lesotho. Jasintha Mtengezo, MPH, BScN, UCM, DipN, Director of Education Programs, Nurses and Midwives Council of Malawi, Malawi. Winnie Nhlengethwa, PhD, RN, SRM, FNP, SRH, Rector, Nazarene Higher Education Consortium & Principal, Nazarene College of Nursing, Swaziland. Dorothy Powell, EdD, RN, FAAN, Associate Dean, Global and Community Health Initiatives, Duke University School of Nursing, Durham, NC. Adele Webb, PhD, RN, AACRN, FAAN, Executive Director, Association of Nurses in AIDS Care, Akron, OH. Tony Diesel, BA Cur (Admin & Education), Dipl (Gen Nursing), Dipl (Psychiatric Nursing), RN, Regional Director, Nurses SOAR! Durban, Republic of South Africa. Amanda Liddle, DrPH, RN, FAAN, Project Director, Nurses SOAR! Georgetown University, School of Nursing and Health Studies, Washington, DC.

Beginning With the End in Mind: Cultivating Minority Nurse Leaders

In response to the need for increased racial and ethnic diversity in the nursing profession, the Duke University School of Nursing (DUSON) established the Making a Difference in Nursing II (MADIN II) Program. The aim of the MADIN II Program is to improve the diversity of the nursing workforce by expanding nursing education opportunities for economically disadvantaged underrepresented minority (URM) students to prepare for, enroll in, and graduate from the DUSONs Accelerated Bachelors of Science in Nursing program. Adapted from the highly successful Meyerhoff Scholarship Program model, the program is to cultivate URM nursing graduates with advanced knowledge and leadership skills who can address health disparities and positively influence health care issues currently plaguing underrepresented populations. The article discusses the MADIN II framework consisting of four unique components: recruitment of students, the Summer Socialization Nursing Preentry Program, the Continued Connectivity Program, and the Succeed to Excellence Program, providing a framework for other academic programs interested in cultivating a pipeline of minority nurse leaders.

Essential nursing competencies related to HIV and AIDS: Executive summary.

With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug-drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of taskshifting, task-sharing, and scope of nursing practices.

Socializing Students Toward a Career in Nursing Research

Abstract As the number of students entering nursing programs declines and as graduate education focuses on advanced practice, the number of undergraduates who aspire to careers as nurse researchers is seriously compromised. This article describes three examples of how undergraduate nursing students at a historically black college and university were cultivated as future researchers through focused research experiences. The first project employed faculty-student collaboration with a community coalition on environmental justice. Students increased their awareness of environmental health and large-scale survey methodology by participating in a telephone survey of community residents. The second project, a replication of an earlier study, determined compliance with a health advisory and awareness of contamination in the fish supply among persons fishing in a contaminated river. The project was extended in a second course and focused on student-faculty preparation of manuscripts. The third project was a pilot ...