Construct validity and reliability of the Practice Environment Scale of the Nursing Work Index for Queensland nurses

Parker D, Tuckett A, Eley R, Hegney D. International Journal of Nursing Practice 2010; 16 : 352–358
Construct validity and reliability of the Practice Environment Scale of the Nursing Work Index for Queensland nurses This article reports on construct validity and reliability of 30 items of the Practice Environment Scale of the Nursing Work Index (PES‐NWI). Australia, like other countries, is experiencing a shortage of nurses; a multifactor approach to retention of nurses is required. One significant factor that has received increasing attention in the last decade, particularly in the USA, is the nursing practice environment. The reliability of the 30 items of the PES‐NWI was assessed by Cronbach's alpha and factor analysis was performed using principal component analysis. The PES‐NWI was completed by nurses working in the aged‐care, private and public sectors in Queensland, Australia. A total of 3000 surveys were distributed to a random sample of members of the Queensland Nurses Union. Of these, 1192 surveys were returned, a response rate of 40%. The PES‐NWI was shown to be reliable demonstrating internal consistency with a Cronbach's alpha of the total scale of 0.948. The 30 items loaded onto five factors explaining 57.7% of the variance. The items across the factors differed slightly from those reported by the original author of the PES‐NWI. This study indicates that the PES‐NWI has construct validity and reliability in the Australian setting for nurses.     

Proteomic characterization of HIV-modulated membrane receptors, kinases and signaling proteins involved in novel angiogenic pathways

Background  

Kaposi's sarcoma (KS), hemangioma, and other angioproliferative diseases are highly prevalent in HIV-infected individuals. While KS is etiologically linked to the human herpesvirus-8 (HHV8) infection, HIV-patients without HHV-8 and those infected with unrelated viruses also develop angiopathies. Further, HIV-Tat can activate protein-tyrosine-kinase (PTK-activity) of the vascular endothelial growth factor receptor involved in stimulating angiogenic processes. However, Tat by itself or HHV8-genes alone cannot induce angiogenesis in vivo unless specific proteins/enzymes are produced synchronously by different cell-types. We therefore tested a hypothesis that chronic HIV-replication in non-endothelial cells may produce novel factors that provoke angiogenic pathways.     

Onset of Vocal Interaction Between Parents and Newborns in Skin‐to‐Skin Contact Immediately After Elective Cesarean Section

Abstract: Background: Cesarean section is associated with delayed mother‐infant interaction because neither the mother nor the father routinely maintains skin‐to‐skin contact with the infant after birth. The aim of the study was to explore and compare parent‐newborn vocal interaction when the infant is placed in skin‐to‐skin contact either with the mother or the father immediately after a planned cesarean section. Methods: A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin‐to‐skin contact either with fathers or mothers after an initial 5 minutes of skin‐to‐skin contact with the mothers after birth. The newborns’ and parents’ vocal interaction were recorded on a videotape and audiotape. The following variables were explored: newborns’ and parents’ soliciting, newborns’ crying and whining, and parental speech directed to the other parent and to the newborn. Results: Newborns’ soliciting increased over time (p = 0.032). Both fathers and mothers in skin‐to‐skin contact communicated more vocally with the newborn than did fathers (p = 0.003) and mothers (p = 0.009) without skin‐to‐skin contact. Fathers in skin‐to‐skin contact also communicated more with the mother (p = 0.046) and performed more soliciting responses than the control fathers (p = 0.010). Infants in skin‐to‐skin contact with their fathers cried significantly less than those in skin‐to‐skin contact with their mothers (p = 0.002) and shifted to a relaxed state earlier than in skin‐to‐skin contact with mothers (p = 0.029). Conclusions: Skin‐to‐skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin‐to‐skin contact and exposed to the parents’ speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin‐to‐skin contact after cesarean section, to support the early onset of the first vocal communication. (BIRTH 37:3 September 2010)     

Factors Influencing the Infant Feeding Decision for Socioeconomically Deprived Pregnant Teenagers: The Moral Dimension

Abstract: Background: The importance of breastfeeding‐related health outcomes in reducing inequalities in health has been recognized as a National Health Service target to increase initiation rates especially among disadvantaged groups in England. This study examined the psychosocial factors influencing infant feeding intention among pregnant teenagers expecting their first baby and living in deprived urban areas in England. Methods: A mixed methods study, using a quantitative questionnaire based on the Theory of Planned Behaviour, was conducted in four English regions with predominantly white and Asian teenagers (n = 71). This method identified which of all known Theory of Planned Behaviour variables were the most important in influencing feeding intentions. Focus groups provided contextual insight into the meaning of these variables for white pregnant teenagers living in a northern English inner city (n = 17). Results: Moral norms were identified as the most predictive variable influencing teenage intention to formula feed or breastfeed. The likelihood that breastfeeding “will be embarrassing” was the only attitudinal belief rated as significantly important in influencing teenage intention to breastfeed. Three overarching themes emerged from the focus group data: “moral norms,”“sexuality of the breast,” and “self‐esteem,” with concerns relating to breastfeeding in public cutting across all themes. Conclusions: Breastfeeding was viewed as a morally inappropriate behavior by most of these teenagers, with formula feeding being perceived as the appropriate behavior. Existing breastfeeding promotion activities are likely to continue to fail to reach teenagers experiencing deprivation in England in the absence of effective strategies to change the underlying negative moral norms toward breastfeeding. (BIRTH 37:2 June 2010)     

Impact of Baby‐Friendly Hospital Practices on Breastfeeding in Hong Kong

Abstract: Background: The World Health Organization (WHO) developed the Baby‐Friendly Hospital Initiative to improve hospital maternity care practices that support breastfeeding. In Hong Kong, although no hospitals have yet received the Baby‐Friendly status, efforts have been made to improve breastfeeding support. The aim of this study was to examine the impact of Baby‐Friendly hospital practices on breastfeeding duration. Methods: A sample of 1,242 breastfeeding mother‐infant pairs was recruited from four public hospitals in Hong Kong and followed up prospectively for up to 12 months. The primary outcome variable was defined as breastfeeding for 8 weeks or less. Predictor variables included six Baby‐Friendly practices: breastfeeding initiation within 1 hour of birth, exclusive breastfeeding while in hospital, rooming‐in, breastfeeding on demand, no pacifiers or artificial nipples, and information on breastfeeding support groups provided on discharge. Results: Only 46.6 percent of women breastfed for more than 8 weeks, and only 4.8 percent of mothers experienced all six Baby‐Friendly practices. After controlling for all other Baby‐Friendly practices and possible confounding variables, exclusive breastfeeding while in hospital was protective against early breastfeeding cessation (OR: 0.61; 95% CI: 0.42–0.88). Compared with mothers who experienced all six Baby‐Friendly practices, those who experienced one or fewer Baby‐Friendly practices were almost three times more likely to discontinue breastfeeding (OR: 3.13; 95% CI: 1.41–6.95). Conclusions: Greater exposure to Baby‐Friendly practices would substantially increase new mothers’ chances of breastfeeding beyond 8 weeks postpartum. To further improve maternity care practices in hospitals, institutional and administrative support are required to ensure all mothers receive adequate breastfeeding support in accordance with WHO guidelines. (BIRTH 38:3 September 2011)