American Public University System

Workplace bullying impacts at least half of the nurses worldwide. Despite the link to increased nurse turnover, few intervention studies have addressed bullying in the workplace. Since most studies report cross-sectional designs that provide little insight into the complexities of this phenomenon, the purpose of this descriptive phenomenology was to describe the lived experiences of nurses as they were actively being bullied in the workplace. Semi-structured interviews were conducted through Skype until data adequacy was realized with 12 participant interviews. Giorgi’s six-step method was used to analyze the data in Atlas.ti. A central theme, “The whole culture of nursing needs to change” described an organizational culture where managers were unable to identify or unwilling to respond to workplace bullying. The four themes identified from the data included “going to work can be really hard,” “not good for patient care,” “learning to live with bullying,” and “changing the culture.” Leaders of organizations should implement comprehensive anti-bullying programs to assess bullying in their workplace and to provide bullied nurses with reporting options. Nurse managers need to prevent workplace bullying by intervening when aware of bullying and cultivating a culture of mutual respect.

Despite working in complex environments, which require managing antagonistic and abusive relationships, sport referees are essential to ensure fair and safe competition. Evidence suggests officiating can positively impact wellbeing and officiating communities provide social support. Despite those positives, there remains a shortage of qualified officials, which is compounded by aging referee populations. These concerns emphasize the need to attract young people and examine wellbeing benefits resulting from involvement in officiating communities. As such, the aim of this study is to help NIRSA professionals better understand how the community or social networks made through officiating intramural sports could better support student employee wellbeing. Semistructured interviews with 44 referees aged, 18 to 23, revealed themes describing the relationship between sense of community and wellbeing. Details about the three major themes, individual wellbeing, community wellbeing, and importance of campus recreation, and seven subthemes will be discussed. Practical implications to help campus recreation professionals understand factors impacting retention, feelings of community, and student referees’ wellbeing will be presented.

Forensic investigation is used in policing immigrants for various investigative tasks, such as forensic psychological evaluations in immigration courts, forensic medical evaluation on immigration relief, forensic genetics and anthropology in identifying decedent migrants, and document examination on immigration documents. Forensic applications in policing immigrants have focused primarily on document examination and individual identification. Although the other forensic methods have been relatively underreported, their significance in serving immigrant policing is evident. Challenges in developing forensic investigation for policing immigrants involve collaboration issues, resource limitations, and technical complications. In order to improve policing immigrants, the above challenges need to be overcome to remove the barriers between forensic investigation and immigrant policing. The authors gathered information from journals, government sources, and nongovernment organizations to identify current and past practices in North America and Europe related to the background of forensic applications in immigrant policing. In this article, the status quo of applications along with case examples are presented; the current challenges are pointed out and the root cause analysis of problems in the challenges is conducted; recommendations for future forensic application, development, and advancement in policing immigrants are discussed.

Objectives: A multifaceted assessment battery is recommended for testing suspected concussed athletes; however, the individual tests have limitations and potentially may lead to false positive outcomes. Therefore, the purpose of this study was to psychometrically evaluate concussion assessment tools used for intercollegiate student-athletes, with a focus on the time interval between baseline and subsequent assessments. Methods: Ninety-two collegiate student-athletes matched between concussion (N = 46. F32/M14) and non-concussion (N = 46, 32F/14 M) completed the standard assessment of concussion, balance error scoring system, symptom questionnaire, and computerized neurocognitive tests at baseline and acutely (<48 h) following a concussion. Test outcomes were compared between time points with three approaches: 1) vs baseline, 2) reliable change scores (RCI), and 3) vs American College of Rehabilitation Medicine (ACRM). Concussion assessment sensitivity, specificity, likelihood ratios, predictive values, and diagnostic odds ratio were calculated. A receiver operator characteristic compared area under the curve (AUC) for the overall battery as well as between academic years. Results: The sensitivity of the battery was high (78.3-95.7%), but specificity was low to moderate (6.5-52.2%) with comparison to the RCI typically performing best. The three approaches yielded AUC values between 0.51 and 0.63 which is below the discriminatory threshold (0.70) with comparison to RCI performing best. By academic year, Juniors was the only year in which the ROC exceeded the threshold (0.75). The number of tests failed did not improve any AUC values (0.51-0.69) to exceed the threshold. Conclusions: The outcomes of this study support the premise that concussion must be evaluated using a comprehensive clinical examination including a variety of assessments to evaluate each clinical domain. Clinicians need to recognize that the multifaceted assessment battery has high sensitivity, but the overall psychometrics do not exceed the threshold for group discrimination and caution must be used in their interpretation.

This study analyzes the linkages between corporate sustainability and financial performance of companies by conducting a systematic review of prior literature. The findings provide insights on the relationship between sustainable practices and companies’ financial outcomes.

Aims To analyse how adolescents and young adults who survived childhood cancer experience their quality of life and to explore their meanings and conceptualisations of quality of life. Design Narrative design following Squire's method. Methods In‐person and virtual recruitment, due to the global COVID‐19 pandemic, was carried out in Brazil between May and November 2021. Eighteen semi‐structured virtual interviews were conducted with childhood cancer survivors. These data were analysed using reflexive thematic analysis and employing a triangulation of investigators. Results Four subthemes were identified, encompassing participants' perceptions and meanings of quality of life. Through the reflection and synthesis of these subthemes, a central theme emerged entitled ‘New self’, capturing the profound impact of the cancer and survival experience on every aspect of the self, along with participants' sense of having gained ‘a new life’ and a ‘second chance’. Conclusion The study provides a rich and nuanced understanding of quality of life for childhood cancer survivors. The results highlight that after all the changes in life due to cancer, integrating the new self becomes a central aspect of quality of life for survivors. Implications for the Profession and/or Patient Care Recognising the profound shifts in self‐perception that survivors of childhood cancer undergo, nurses should engage early in empowering patients and families, offering education, space and support to help adolescents and young adults grow throughout their journey. Impact The richness and depth inherent in qualitative data on quality of life can inform the development of care standards and health policies for survivors, guide the allocation of strategic resources and shape the development of plans and interventions focusing on childhood cancer survivors. Reporting Method The COREQ checklist was used. Patient or Public No patient or public contribution.

The exaltation of the photodegradation performance of dichalcogenide MoS2 grown on top of silver nanoparticles (Ag‐NPs) is reported on. The fabricated MoS2 nanosheets nucleate vertically from Ag‐NPs seeds, enabling the growth of both metallic and semiconductor phases 1T/2H‐MoS2. Findings reveal remarkable enhancement of the Raman scattering and an exceptional broadband optical absorption attributed to plasmonic effects induced by the presence of both metallic 1T‐MoS2 and Ag‐NPS at 2H‐MoS2 interfaces. To leverage this effect, photodegradation tests are conducted to remove methyl orange pollutant. Notably, results reveal a significant increase in photodegradation efficiency and rate constant, reaching up to 120% and 550% over pristine 2H‐MoS2, respectively. This finding underscores the role of Ag‐NPs and 1T‐MoS2 tandem to unlock the superior photodegradation properties of vertically aligned 2H‐MoS2 toward methyl orange, paving the way for the development of dichalcogenide‐based hybrid photocatalyst for wastewater treatment and environmental remediation.

Background We assessed the effects of a 20‐week combined (aerobic and resistance) exercise training programme on the inflammatory profile of prepubertal children with overweight or obesity. Methods Totally 109 participants (10.1 ± 1.1 years, 41% girls) were randomly allocated to an exercise or control group. Adiponectin, C‐reactive protein, epidermal growth factor, insulin‐like growth factor‐1, interleukin (IL)‐1β, IL‐6, leptin, tumour necrosis factor‐α and vascular endothelial growth factor A (VEGFA) were analysed in plasma. Total white blood cell (WBC) count and immune subpopulations (eosinophils, basophils, neutrophils, lymphocytes and monocytes) were also determined. Results No intervention effect was found for any of the analysed biomarkers (all p ≥ 0.05). We observed a significant sex by intervention interaction for IL‐1β (p = 0.03). When stratifying the sample by sex, the exercise programme induced a significant effect on IL‐1β levels (mean Z‐score difference, 0.66 [95% confidence interval 0.32–1.01]) in girls, but not in boys. A lower number of girls in the exercise group showed a meaningful reduction in IL‐1β (i.e., ≥0.2 standard deviations) than in the control group (15% vs. 85%, p = 0.01). Conclusions This exercise programme failed to improve the inflammatory profile in prepubertal children with overweight/obesity. Future studies should explore the effect of longer exercise interventions and in combination with diet.

Maintaining both high sensitivity and large figure of merit (FoM) is crucial in regard to the performance of optical devices, particularly when they are intended for use as biosensors with extremely low limit of detection (LoD). Here, a stack of nano‐assembled layers in the form of 1D photonic crystal, deposited on D‐shaped single‐mode fibers, is created to meet these criteria, resulting in the generation of Bloch surface wave resonances. The increase in the contrast between high and low refractive index (RI) nano‐layers, along with the reduction of losses, enables not only to achieve high sensitivity, but also a narrowed resonance bandwidth, leading to a significant enhancement in the FoM. Preliminary testing for bulk RI sensitivity is carried out, and the effect of an additional nano‐layer that mimics a biological layer where binding interactions occur is also considered. Finally, the biosensing capability is assessed by detecting immunoglobulin G in serum at very low concentrations, and a record LoD of 70 aM is achieved. An optical fiber biosensor that is capable of attaining extraordinarily low LoD in the attomolar range is not only a remarkable technical outcome, but can also be envisaged as a powerful tool for early diagnosis of diseases.

Purpose To characterize nurses' experiences of restrictive visitation during the COVID-19 pandemic. Methods In early 2023, an exploratory study investigated professional RNs' perceptions of restrictive visitation policies and end-of-life care during the COVID-19 pandemic, focusing on experiences between March and September 2020. An 11-question online survey containing qualitative and quantitative elements was sent to postlicensure nursing students and alumni of American Public University System (American Military University/American Public University). Results Among the 41 survey respondents (response rate of 4%), 75.6% observed patients dying alone due to visitation restrictions during March-September 2020, with 87.8% noting strict no-visitation policies, yet only 10% found it effective. A majority (68.3%) supported allowing some family presence, reflecting negative sentiments toward strict policies; suggestions for enhancing family involvement included technology (78%) and employing volunteers or liaisons (34.1%) to improve patient/family well-being and alleviate nurse burden. Conclusion The findings revealed insights into nurses' experiences and perspectives on end-of-life care and visitation limitations during the pandemic. While the isolation of patients during times of strict visitation restrictions has some merit, exploring options for modified family visitation at the end of life is critical.

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open‐ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41‐50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.

This paper aims to describe an educational innovation in teaching-learning based on Project-Based Learning (PBL) carried out in the subjects of "Basic Finance" taught in the Double Bachelor's Degree in Management, Business Administration, and Law of the Public University of Navarre (UPNA). These are Financial Markets and Instruments, Corporate Finance I, and Corporate Finance II. Specifically, in each of the subjects, the project consisted of preparing an advisory report. Thus, the classroom becomes a financial consultancy covering its different areas of work. Furthermore, this study evaluates the educational innovation, analysing both quantitative and qualitative aspects across subjects and gender. In summary, there is a significant improvement in grades after the introduction of PBL. Students also support the implementation of PBL, with gender differences found. Our findings motivate the continued use of dynamic teaching methods and underline the importance of adapting approaches to improve educational outcomes.

We investigate the relationship between education and antisemitism using unique individual-level survey data on antisemitism from more than 100 countries. Our findings show that education is associated with greater favorability toward Jews, but the relationship between education and endorsement of antisemitic stereotypes and conspiracy theories varies between countries. In countries that actively supported recent statements condemning Holocaust denial and antisemitism at the United Nations—which we use as a proxy for country-level opposition to antisemitism in education and politics—greater education is associated with reduced endorsement of antisemitic stereotypes. By contrast, more educated people are more likely to endorse antisemitic stereotypes than less educated people in countries that declined to endorse those statements. These descriptive findings provide new evidence about the association between education and intolerance.

Aim: Evidence suggests low-carbohydrate diets (LCHF) may assist in treating neurodegenerative diseases such as Parkinson's disease (PD); however, gaps exist in the literature. Patients & methods: We conducted a small 24-week pilot study to investigate the effects of an LCHF diet on motor and nonmotor symptoms, health biomarkers, anxiety, and depression in seven people with PD. We also captured patient experiences during the process (quality of life [QoL]). Results: Participants reported improved biomarkers, enhanced cognition, mood, motor and nonmotor symptoms, and reduced pain and anxiety. Participants felt improvements enhanced their QoL. Conclusion: We conclude that an LCHF intervention is safe, feasible, and potentially effective in mitigating the symptoms of this disorder. However, more extensive randomized controlled studies are needed to create generalizable recommendations.

To better connect non-emergent 911 callers to appropriate care, Washington, DC, routed low-acuity callers to nurses. Nurses could provide non-emergent transportation to a health centre, recommend self-care or return callers to the traditional 911 system. Over about one year, 6,053 callers were randomized (1:1) to receive a business-as-usual response (ncontrol = 3,023) or further triage (ntreatment = 3,030). We report on seven of nine outcomes, which were pre-registered (https://osf.io/xderw). The proportion of calls resulting in an ambulance dispatch dropped from 97% to 56% (β = −1.216 (−1.324, −1.108), P < 0.001), and those resulting in an ambulance transport dropped from 73% to 45% (β = −3.376 (−3.615, −3.137), P < 0.001). Among those callers who were Medicaid beneficiaries, within 24 hours, the proportion of calls resulting in an emergency department visit for issues classified as non-emergent or primary care physician (PCP) treatable dropped from 29.5% to 25.1% (β = −0.230 (−0.391, −0.069), P < 0.001), and the proportion resulting in the caller visiting a PCP rose from 2.5% to 8.2% (β = 1.252 (0.889, 1.615), P < 0.001). Over the longer time span of six months, we failed to detect evidence of impacts on emergency department visits, PCP visits or Medicaid expenditures. From a safety perspective, 13 callers randomized to treatment were eventually diagnosed with a time-sensitive illness, all of whom were quickly triaged to an ambulance response. These short-term effects suggest that nurse-led triage of non-emergent calls can safely connect callers to more appropriate, timely care.