Jennifer Blythe - Academia.edu (original) (raw)
Papers by Jennifer Blythe
Evidence-Based Nursing, Jul 1, 1998
International Nursing Review, Jun 1, 2009
Aim: Nurses with diverse educational and cultural backgrounds are likely to adapt differently to ... more Aim: Nurses with diverse educational and cultural backgrounds are likely to adapt differently to new workforces. The aim of this study was to provide a profile of nurses educated in different countries who are employed in a major settlement jurisdiction. Background: Despite difficulties in measuring its magnitude, it is evident that nurse migration has increased as a result of globalization. Major destinations for internationally educated nurses (IENs) include the USA, Canada, the UK, Australia and the Gulf States. Chief donor countries include the Philippines, India and other South Asian countries. Half of all IENs registered in Canada work in the province of Ontario. Methods: Published literature and secondary data were used to profile cohorts of nurses educated in different countries who are employed in the Ontario workforce. Findings: Statistics available on IENs in Ontario reveal a largely urban settlement pattern. There are major differences among IEN cohorts in terms of age, gender, work status, and type and place of employment. Discussion and conclusions: Although IENs resident in Ontario could not be quantified, a relatively detailed description of IENs in the workforce was possible. Comparison of nurse cohorts indicated that generalizations about IENs should be made with caution. Changes in regulatory conditions have a significant effect on IEN employment. Difficulties associated with international educational and regulatory differences illustrate the need to create global nursing standards. Further investigation of differences in workforce profiles should provide insights leading to improved utilization of IENs.
Health reform observer, Oct 30, 2021
There is consensus that a professional full-time nursing workforce leads to better patient outcom... more There is consensus that a professional full-time nursing workforce leads to better patient outcomes and a safer health care environment. In 2007, the Ontario Ministry of Health and Long-Term Care introduced the Nursing Graduate Guarantee (NGG), a policy mechanism designed to strengthen the nursing workforce by increasing full-time (FT) employment for newly graduated nurses. Several factors have affected the supply and employment status of nurses in the province over the past two decades, including the introduction of unregulated health care workers and crises such as SARS and COVID-19. A secondary analysis of the College of Nurses of Ontario registration database was conducted to identify and evaluate trends in the supply and employment of nurses in Ontario prior to and following introduction of the NGG. The results demonstrate that full-time employment of new registered nurses and new registered practical nurses initially increased but has since fallen to below pre-policy levels. Part-time work among newly graduated nurses is increasing across all sectors, signaling a diminishing effect of the NGG investments over time. Investments in health human resources have a stabilizing effect on the nursing workforce. Ensuring an adequate number of nurses is necessary for crisis preparation, management and recovery, particularly in sectors with low surge capacity such as long-term care. However, sustained financial, political, public, and professional support is required.
한국간호과학회 학술대회, Oct 1, 2011
Canadian Journal of Nursing Leadership, 2021
BACKGROUND Internationally educated nurses (IENs) face multiple challenges in entering and integr... more BACKGROUND Internationally educated nurses (IENs) face multiple challenges in entering and integrating into the Canadian workforce. These challenges include getting to know the Canadian culture, nursing accountabilities, professional practice requirements and experience or qualifications deemed not equivalent to the Canadian standard. Hamilton Health Sciences' (HHS') IEN Integration Project has been funded by the Ontario and Canadian governments to support IENs in overcoming these challenges and contribute to the healthcare system. AIM The aim of this article is to describe a multiorganizational project that prepares IENs for employment in Canadian healthcare. STRATEGY HHS invited partners in education and immigrant support services to co-design the project. A community collaboration employment model (CCEM) was developed to leverage each partner's strengths in targeted interventions to address the needs of IENs, as identified in focus groups. The interventions pertain to professional practice and accountability in the Canadian healthcare setting, workplace language, communication and selected clinical skills. RESULTS Between project initiation in 2009 and early 2021, 591 IENs obtained employment. CONCLUSION Multiorganizational partnerships can help build and sustain a strong nursing workforce, and IENs can fill gaps in care. A needs-based approach and the CCEM increased the likelihood of IEN employment. The ability of the CCEM to engage partners makes it relevant for healthcare organizations.
Social Science Research Network, 2006
ABSTRACT Governments are concerned about the supply of health care workers but attempts to foreca... more ABSTRACT Governments are concerned about the supply of health care workers but attempts to forecast supply generally fail. The effectiveness of health care planning rests partly on the quality of evidence about health human resources available to decision-makers. However evidence supplied by health care employers depends on the accuracy of organizational reporting systems Publicly funded health care organizations report on their expenditures on an annual basis but their human resource data is not necessarily either accurate or consistent. Organizations vary in how well they define, collect, organize and use data. A study of human resource data in the largest hospital corporation in Canada revealed data issues relevant to human resource planning at all stages of data input and management. For example, there was a lack of standardized definitions for data elements. Data was input by unskilled operatives in many departments and was far from accurate. Information relevant to human resources was included in a number of databases and the databases themselves were not integrated. As a result extraction of data was time consuming and correlation of data from different resources complicated. When organizations report to government funders, they translate data collected for their own purposes to fit government specifications. Given original data quality and inaccuracies due to the translation process, governments have only imperfect data as a basis for decision-making. An example of a data problem relevant both to in-house planning and government policy related to the difficulty of correlating formal contracts with hours of work. Many nurses at the study hospital worked full-time hours and were reported as full-time workers. However, a proportion of these nurses had part-time status. Defining nurses by hours worked rather than employment status became an issue when a government policy targeted greater full-time employment. Another problem related to government use of hospital vacancy data to indicate shortage, based on the assumption that vacancy indicated external turnover. However the study hospital, in common with many others, did not differentiate internal and external turnover. The data they provided did not fit the government's assumptions. Currently, the Ontario Government is reorganizing its information systems as a part of an initiative to increase accountability in the health care system. Considerable attention will need to be paid to what information they need to support human resource decisions for health care professionals. Specifically, they will need to consider how health care organizations can be mobilized to produce information useful both in their own human resource planners and the government.
Oncology Nursing Forum, Aug 26, 2014
Tous droits réservés © Département des relations industrielles de l'Université Laval, 2007 Ce doc... more Tous droits réservés © Département des relations industrielles de l'Université Laval, 2007 Ce document est protégé par la loi sur le droit d'auteur. L'utilisation des services d'Érudit (y compris la reproduction) est assujettie à sa politique d'utilisation que vous pouvez consulter en ligne. https://apropos.erudit.org/fr/usagers/politique-dutilisation/ Cet article est diffusé et préservé par Érudit. Érudit est un consortium interuniversitaire sans but lucratif composé de l'
Canadian Journal of Nursing Research Archive, Dec 1, 2015
PubMed, Sep 1, 1997
While access to information resources and the skills to use them do not ensure that nurses will u... more While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.
Orthopaedic Nursing, 1999
Emergency Medicine Journal, Dec 1, 2005
Pragmatic and observational research, Oct 1, 2018
Background: For decades, the optimal timing of surgery for acute cholecystitis has been controver... more Background: For decades, the optimal timing of surgery for acute cholecystitis has been controversial. Recent meta-analyses and population-based studies favor early surgery. One recent large randomized trial has demonstrated that a delayed approach increases morbidity and cost compared to early surgery within 24 hours of hospital admission. Since cases of severe cholecystitis were excluded from this trial, we argue that these results do not reflect real-world clinical situations. From our point of view, these results were in contrast to the clinical experience with our patients; so, we decided to analyze critically all our patients with the null hypothesis that the patients treated with a delayed cholecystectomy after an acute cholecystitis have a similar or even better outcome than those treated with an early operative approach. Patients and methods: We retrospectively analyzed clinical data from all patients with cholecystectomies in the period between January 2006 and September 2015. A total of 1,723 patients were categorized into four groups: early (n=138): urgent surgery of patients with acute cholecystitis within the first 72 hours of the onset of symptoms; intermediate (n=297): surgery of patients with acute cholecystitis within an average of 10 days after the onset of symptoms; delayed (n=427): initial non-surgical treatment of acute cholecystitis with surgery performed within 6-12 weeks of the onset of symptoms; and elective (n=868): cholecystectomy within a symptom-free interval of choice in patients with symptomatic cholecystolithiasis without signs of acute cholecystitis. Results: In a real-world scenario, early/intermediate cholecystectomy in acute cholecystitis was associated with a significant increase in morbidity and mortality (Clavien-Dindo score) compared to a delayed approach with surgery performed 6-12 weeks after the onset of symptoms. The adjusted linear rank statistics showed a decrease in the complication score with values of 2.29 in the early group, 0.48 in the intermediate group,-0.26 in the delayed group and-2.12 in the elective group. The results translate into a continuous decrease of the complication score from early over intermediate and delayed to the elective group. Conclusion: These results demonstrate that delayed cholecystectomy can be performed safely. In cases with severe cholecystitis, early and/or intermediate approaches still have a relatively high risk of morbidity and mortality.
Online journal of issues in nursing, May 31, 2008
The demand for higher education has increased worldwide and the response has been an impressive e... more The demand for higher education has increased worldwide and the response has been an impressive expansion of educational offerings both within and across countries. The purpose of this manuscript is to emphasize the necessity of common educational standards for nurses in a globalized world. Common standards are crucial in regulated professions, such as nursing, in which lives depend on the possession of specific competencies. This article defines and describes globalization and the internationalization of education, including nursing education, discusses the exporting of nursing education, identifies the challenges and current solutions related to nurse migration, and presents current standards and future trends in harmonizing nursing education internationally.
International Journal of Nursing Studies, Dec 1, 2012
Internationally, nurse migration in border cities has received little attention. Nurses who gradu... more Internationally, nurse migration in border cities has received little attention. Nurses who graduate from nursing programs in Canadian border communities have the option of working in Canada or the United States. They are able to cross the international border each day as commuter migrants returning to their home country after work. Despite recent investment by Canada to increase the number of nursing students, the migration intentions of graduating nurses and the factors influencing their decision making has not been explored. The objective of this study is to explore the migration intentions of a graduating class of baccalaureate nursing students in a Canadian border community and the factors influencing their decision making. An explanatory sequential mixed methods design was used. In the first quantitative phase, data was collected by a web-based self-report survey. In the qualitative phase, semi-structured interviews were conducted. Data collection took place between February and July 2011. The response rate to the survey was 40.9% (n=115). Eighty-six percent of graduates preferred to work in Canada although two thirds identified that they were considering migrating for work outside of Canada. Knowing a nurse who worked in the US (Michigan) influenced intention to migrate and living in a border community was a strong predictor of migration. Migrants had significantly higher expectations that their economic, professional development, healthy work environment, adventure and autonomy values would be met in another country than Canada. Evidence from the interviews revealed that clinical instructors and clinical experiences played a significant role in framing students' perceptions of the work environment, influencing their choice of specialty, and where they secured their first job. The value-expectancy framework offered a novel approach to identifying job factors driving migration intentions. The study offered a snapshot of the graduates' perception of the work environment before entering the workforce. The graduates doubted that their future work environment would meet many of their job expectations, a troubling finding requiring further investigation. Expectations influenced their migration intentions and may be relevant to their integration and retention in the workforce.
Journal of Colonialism and Colonial History, 2019
Economic development was a primary objective in the German New Guinea Protectorate (1884-1914). A... more Economic development was a primary objective in the German New Guinea Protectorate (1884-1914). Although much of the Protectorate remained uncontrolled, Indigenous people found their lives and external relations transformed where trading posts and plantations were introduced. The small but coconut-rich Vitu Islands are exemplary. This paper discusses relations between Garove and Mundua Islanders and the trader Peter Hansen, from his arrival in 1888 to his departure in 1904. Ultimately, Hansen's personal behaviour prompted the islanders to oust him. However, by this time they had become enmeshed in a wider economy through village copra production and labour within and outside the island. Background German commercial interest in the Bismarck and Solomon Seas began in the 1870s when the Hamburg firm J.C. Godeffroy & Sohn established stations in the Gazelle Peninsula and Duke of York Islands in East New Britain. The firm became bankrupt in 1878 and was replaced by the Deutsche Handels-und Plantagen-Gesellschaft (DHPG). Eduard Hernsheim acquired land in 1878, and, in 1879, Thomas Farrell and Queen Emma (Emma Forsayth) who had previously worked for Godeffroy, set up independently. 1 In 1884, the German government proclaimed Northeastern New Guinea (Kaiser-Wilhelms-Land), the Bismarck Archipelago, including New Britain (Neu Pommern) and New Ireland (Neu-Mecklenburg), and the Admiralty Islands (Admiralitäts-Inseln) a German protectorate. Between 1885 and 1899 administration was delegated to the Neuguinea Companie (NGC) under an Imperial German Charter.
Canadian oncology nursing journal, Oct 1, 2010
Cette étude exploratoire a dégagé les besoins en matière de soins de soutien des proches d'hommes... more Cette étude exploratoire a dégagé les besoins en matière de soins de soutien des proches d'hommes atteints d'un cancer de la prostate hormono-sensible (HS) et d'un cancer de la prostate androgénoindépendant (AI). Dans le cadre de groupes de discussion et d'entrevues individuelles, nous avons demandé à huit membres de la famille d'hommes atteints d'un cancer HS et à 11 membres de la famille d'hommes atteints d'un cancer AI d'indiquer leurs besoins en matière de soins de soutien et de recommander des stratégies susceptibles d'améliorer les soins de façon à répondre à ces besoins. Les besoins non comblés signalés par les deux groupes comprenaient le manque d'information et l'incertitude par rapport à l'avenir. Les besoins non comblés particuliers au groupe AI concernaient le fardeau des soignants, l'assistance pratique et l'isolement. Cet article comprend les implications de la recherche concernant l'amélioration des services de soutien offerts aux familles touchées par le cancer prostatique avancé. Le groupe le plus touché par le cancer de la prostate est celui des hommes de plus de 65 ans. Dans les cas de cancer de la prostate avancé ou métastatique (CPA), les problèmes courants, dont les atteintes à la fonction urinaire, la fatigue et la douleur, sont aggravés par d'autres enjeux de santé liés à l'âge et à la comorbidité (Harden, 2005). Il existe deux groupes de patients distincts qui vivent avec le CPA. Les hommes atteints d'un cancer de la prostate hormono-sensible (HS) reçoivent un traitement de privation androgénique, qui a un effet de féminisation, dont la dysfonction érectile. Tôt ou tard, la maladie de la plupart des patients finit par « résister » aux hormones, c'est-à-dire qu'elle devient androgéno-indépendante (AI), et on se tourne alors vers les traitements palliatifs accompagnés de chimiothérapie, de radiothérapie et de soins de soutien (McMurtry & McMurtry, 2003). Comme toute maladie grave, le cancer de la prostate touche la famille au complet, en particulier les conjointes ou les partenaires (Maliski, Heilemann & McCorkle, 2002). Le traitement du cancer de la prostate a des effets secondaires sur la sexualité qui nuisent aux relations intimes et accroissent le niveau de stress lié à l'adaptation à la maladie d'un proche. Des études passées indiquent que les partenaires de vie des hommes ayant un cancer prostatique signalent souvent des niveaux de détresse plus élevés que les patients eux-mêmes (Couper et coll., 2006; Resendes & McCorkle, 2006) et que la qualité de vie des partenaires diminue à mesure que les problèmes des patients s'aggravent (Kornblith, Herr, Ofman, Scher & Holland, 1994). Les difficultés signalées par les partenaires comprennent la détresse liée à l'inquiétude et à les tensions liées au rôle (Harden, 2005), le manque d'information (Butler et coll., 2000), les difficultés liées à l'intimité et à la sexualité (
Evidence-Based Nursing, Jul 1, 1998
International Nursing Review, Jun 1, 2009
Aim: Nurses with diverse educational and cultural backgrounds are likely to adapt differently to ... more Aim: Nurses with diverse educational and cultural backgrounds are likely to adapt differently to new workforces. The aim of this study was to provide a profile of nurses educated in different countries who are employed in a major settlement jurisdiction. Background: Despite difficulties in measuring its magnitude, it is evident that nurse migration has increased as a result of globalization. Major destinations for internationally educated nurses (IENs) include the USA, Canada, the UK, Australia and the Gulf States. Chief donor countries include the Philippines, India and other South Asian countries. Half of all IENs registered in Canada work in the province of Ontario. Methods: Published literature and secondary data were used to profile cohorts of nurses educated in different countries who are employed in the Ontario workforce. Findings: Statistics available on IENs in Ontario reveal a largely urban settlement pattern. There are major differences among IEN cohorts in terms of age, gender, work status, and type and place of employment. Discussion and conclusions: Although IENs resident in Ontario could not be quantified, a relatively detailed description of IENs in the workforce was possible. Comparison of nurse cohorts indicated that generalizations about IENs should be made with caution. Changes in regulatory conditions have a significant effect on IEN employment. Difficulties associated with international educational and regulatory differences illustrate the need to create global nursing standards. Further investigation of differences in workforce profiles should provide insights leading to improved utilization of IENs.
Health reform observer, Oct 30, 2021
There is consensus that a professional full-time nursing workforce leads to better patient outcom... more There is consensus that a professional full-time nursing workforce leads to better patient outcomes and a safer health care environment. In 2007, the Ontario Ministry of Health and Long-Term Care introduced the Nursing Graduate Guarantee (NGG), a policy mechanism designed to strengthen the nursing workforce by increasing full-time (FT) employment for newly graduated nurses. Several factors have affected the supply and employment status of nurses in the province over the past two decades, including the introduction of unregulated health care workers and crises such as SARS and COVID-19. A secondary analysis of the College of Nurses of Ontario registration database was conducted to identify and evaluate trends in the supply and employment of nurses in Ontario prior to and following introduction of the NGG. The results demonstrate that full-time employment of new registered nurses and new registered practical nurses initially increased but has since fallen to below pre-policy levels. Part-time work among newly graduated nurses is increasing across all sectors, signaling a diminishing effect of the NGG investments over time. Investments in health human resources have a stabilizing effect on the nursing workforce. Ensuring an adequate number of nurses is necessary for crisis preparation, management and recovery, particularly in sectors with low surge capacity such as long-term care. However, sustained financial, political, public, and professional support is required.
한국간호과학회 학술대회, Oct 1, 2011
Canadian Journal of Nursing Leadership, 2021
BACKGROUND Internationally educated nurses (IENs) face multiple challenges in entering and integr... more BACKGROUND Internationally educated nurses (IENs) face multiple challenges in entering and integrating into the Canadian workforce. These challenges include getting to know the Canadian culture, nursing accountabilities, professional practice requirements and experience or qualifications deemed not equivalent to the Canadian standard. Hamilton Health Sciences' (HHS') IEN Integration Project has been funded by the Ontario and Canadian governments to support IENs in overcoming these challenges and contribute to the healthcare system. AIM The aim of this article is to describe a multiorganizational project that prepares IENs for employment in Canadian healthcare. STRATEGY HHS invited partners in education and immigrant support services to co-design the project. A community collaboration employment model (CCEM) was developed to leverage each partner's strengths in targeted interventions to address the needs of IENs, as identified in focus groups. The interventions pertain to professional practice and accountability in the Canadian healthcare setting, workplace language, communication and selected clinical skills. RESULTS Between project initiation in 2009 and early 2021, 591 IENs obtained employment. CONCLUSION Multiorganizational partnerships can help build and sustain a strong nursing workforce, and IENs can fill gaps in care. A needs-based approach and the CCEM increased the likelihood of IEN employment. The ability of the CCEM to engage partners makes it relevant for healthcare organizations.
Social Science Research Network, 2006
ABSTRACT Governments are concerned about the supply of health care workers but attempts to foreca... more ABSTRACT Governments are concerned about the supply of health care workers but attempts to forecast supply generally fail. The effectiveness of health care planning rests partly on the quality of evidence about health human resources available to decision-makers. However evidence supplied by health care employers depends on the accuracy of organizational reporting systems Publicly funded health care organizations report on their expenditures on an annual basis but their human resource data is not necessarily either accurate or consistent. Organizations vary in how well they define, collect, organize and use data. A study of human resource data in the largest hospital corporation in Canada revealed data issues relevant to human resource planning at all stages of data input and management. For example, there was a lack of standardized definitions for data elements. Data was input by unskilled operatives in many departments and was far from accurate. Information relevant to human resources was included in a number of databases and the databases themselves were not integrated. As a result extraction of data was time consuming and correlation of data from different resources complicated. When organizations report to government funders, they translate data collected for their own purposes to fit government specifications. Given original data quality and inaccuracies due to the translation process, governments have only imperfect data as a basis for decision-making. An example of a data problem relevant both to in-house planning and government policy related to the difficulty of correlating formal contracts with hours of work. Many nurses at the study hospital worked full-time hours and were reported as full-time workers. However, a proportion of these nurses had part-time status. Defining nurses by hours worked rather than employment status became an issue when a government policy targeted greater full-time employment. Another problem related to government use of hospital vacancy data to indicate shortage, based on the assumption that vacancy indicated external turnover. However the study hospital, in common with many others, did not differentiate internal and external turnover. The data they provided did not fit the government's assumptions. Currently, the Ontario Government is reorganizing its information systems as a part of an initiative to increase accountability in the health care system. Considerable attention will need to be paid to what information they need to support human resource decisions for health care professionals. Specifically, they will need to consider how health care organizations can be mobilized to produce information useful both in their own human resource planners and the government.
Oncology Nursing Forum, Aug 26, 2014
Tous droits réservés © Département des relations industrielles de l'Université Laval, 2007 Ce doc... more Tous droits réservés © Département des relations industrielles de l'Université Laval, 2007 Ce document est protégé par la loi sur le droit d'auteur. L'utilisation des services d'Érudit (y compris la reproduction) est assujettie à sa politique d'utilisation que vous pouvez consulter en ligne. https://apropos.erudit.org/fr/usagers/politique-dutilisation/ Cet article est diffusé et préservé par Érudit. Érudit est un consortium interuniversitaire sans but lucratif composé de l'
Canadian Journal of Nursing Research Archive, Dec 1, 2015
PubMed, Sep 1, 1997
While access to information resources and the skills to use them do not ensure that nurses will u... more While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.
Orthopaedic Nursing, 1999
Emergency Medicine Journal, Dec 1, 2005
Pragmatic and observational research, Oct 1, 2018
Background: For decades, the optimal timing of surgery for acute cholecystitis has been controver... more Background: For decades, the optimal timing of surgery for acute cholecystitis has been controversial. Recent meta-analyses and population-based studies favor early surgery. One recent large randomized trial has demonstrated that a delayed approach increases morbidity and cost compared to early surgery within 24 hours of hospital admission. Since cases of severe cholecystitis were excluded from this trial, we argue that these results do not reflect real-world clinical situations. From our point of view, these results were in contrast to the clinical experience with our patients; so, we decided to analyze critically all our patients with the null hypothesis that the patients treated with a delayed cholecystectomy after an acute cholecystitis have a similar or even better outcome than those treated with an early operative approach. Patients and methods: We retrospectively analyzed clinical data from all patients with cholecystectomies in the period between January 2006 and September 2015. A total of 1,723 patients were categorized into four groups: early (n=138): urgent surgery of patients with acute cholecystitis within the first 72 hours of the onset of symptoms; intermediate (n=297): surgery of patients with acute cholecystitis within an average of 10 days after the onset of symptoms; delayed (n=427): initial non-surgical treatment of acute cholecystitis with surgery performed within 6-12 weeks of the onset of symptoms; and elective (n=868): cholecystectomy within a symptom-free interval of choice in patients with symptomatic cholecystolithiasis without signs of acute cholecystitis. Results: In a real-world scenario, early/intermediate cholecystectomy in acute cholecystitis was associated with a significant increase in morbidity and mortality (Clavien-Dindo score) compared to a delayed approach with surgery performed 6-12 weeks after the onset of symptoms. The adjusted linear rank statistics showed a decrease in the complication score with values of 2.29 in the early group, 0.48 in the intermediate group,-0.26 in the delayed group and-2.12 in the elective group. The results translate into a continuous decrease of the complication score from early over intermediate and delayed to the elective group. Conclusion: These results demonstrate that delayed cholecystectomy can be performed safely. In cases with severe cholecystitis, early and/or intermediate approaches still have a relatively high risk of morbidity and mortality.
Online journal of issues in nursing, May 31, 2008
The demand for higher education has increased worldwide and the response has been an impressive e... more The demand for higher education has increased worldwide and the response has been an impressive expansion of educational offerings both within and across countries. The purpose of this manuscript is to emphasize the necessity of common educational standards for nurses in a globalized world. Common standards are crucial in regulated professions, such as nursing, in which lives depend on the possession of specific competencies. This article defines and describes globalization and the internationalization of education, including nursing education, discusses the exporting of nursing education, identifies the challenges and current solutions related to nurse migration, and presents current standards and future trends in harmonizing nursing education internationally.
International Journal of Nursing Studies, Dec 1, 2012
Internationally, nurse migration in border cities has received little attention. Nurses who gradu... more Internationally, nurse migration in border cities has received little attention. Nurses who graduate from nursing programs in Canadian border communities have the option of working in Canada or the United States. They are able to cross the international border each day as commuter migrants returning to their home country after work. Despite recent investment by Canada to increase the number of nursing students, the migration intentions of graduating nurses and the factors influencing their decision making has not been explored. The objective of this study is to explore the migration intentions of a graduating class of baccalaureate nursing students in a Canadian border community and the factors influencing their decision making. An explanatory sequential mixed methods design was used. In the first quantitative phase, data was collected by a web-based self-report survey. In the qualitative phase, semi-structured interviews were conducted. Data collection took place between February and July 2011. The response rate to the survey was 40.9% (n=115). Eighty-six percent of graduates preferred to work in Canada although two thirds identified that they were considering migrating for work outside of Canada. Knowing a nurse who worked in the US (Michigan) influenced intention to migrate and living in a border community was a strong predictor of migration. Migrants had significantly higher expectations that their economic, professional development, healthy work environment, adventure and autonomy values would be met in another country than Canada. Evidence from the interviews revealed that clinical instructors and clinical experiences played a significant role in framing students' perceptions of the work environment, influencing their choice of specialty, and where they secured their first job. The value-expectancy framework offered a novel approach to identifying job factors driving migration intentions. The study offered a snapshot of the graduates' perception of the work environment before entering the workforce. The graduates doubted that their future work environment would meet many of their job expectations, a troubling finding requiring further investigation. Expectations influenced their migration intentions and may be relevant to their integration and retention in the workforce.
Journal of Colonialism and Colonial History, 2019
Economic development was a primary objective in the German New Guinea Protectorate (1884-1914). A... more Economic development was a primary objective in the German New Guinea Protectorate (1884-1914). Although much of the Protectorate remained uncontrolled, Indigenous people found their lives and external relations transformed where trading posts and plantations were introduced. The small but coconut-rich Vitu Islands are exemplary. This paper discusses relations between Garove and Mundua Islanders and the trader Peter Hansen, from his arrival in 1888 to his departure in 1904. Ultimately, Hansen's personal behaviour prompted the islanders to oust him. However, by this time they had become enmeshed in a wider economy through village copra production and labour within and outside the island. Background German commercial interest in the Bismarck and Solomon Seas began in the 1870s when the Hamburg firm J.C. Godeffroy & Sohn established stations in the Gazelle Peninsula and Duke of York Islands in East New Britain. The firm became bankrupt in 1878 and was replaced by the Deutsche Handels-und Plantagen-Gesellschaft (DHPG). Eduard Hernsheim acquired land in 1878, and, in 1879, Thomas Farrell and Queen Emma (Emma Forsayth) who had previously worked for Godeffroy, set up independently. 1 In 1884, the German government proclaimed Northeastern New Guinea (Kaiser-Wilhelms-Land), the Bismarck Archipelago, including New Britain (Neu Pommern) and New Ireland (Neu-Mecklenburg), and the Admiralty Islands (Admiralitäts-Inseln) a German protectorate. Between 1885 and 1899 administration was delegated to the Neuguinea Companie (NGC) under an Imperial German Charter.
Canadian oncology nursing journal, Oct 1, 2010
Cette étude exploratoire a dégagé les besoins en matière de soins de soutien des proches d'hommes... more Cette étude exploratoire a dégagé les besoins en matière de soins de soutien des proches d'hommes atteints d'un cancer de la prostate hormono-sensible (HS) et d'un cancer de la prostate androgénoindépendant (AI). Dans le cadre de groupes de discussion et d'entrevues individuelles, nous avons demandé à huit membres de la famille d'hommes atteints d'un cancer HS et à 11 membres de la famille d'hommes atteints d'un cancer AI d'indiquer leurs besoins en matière de soins de soutien et de recommander des stratégies susceptibles d'améliorer les soins de façon à répondre à ces besoins. Les besoins non comblés signalés par les deux groupes comprenaient le manque d'information et l'incertitude par rapport à l'avenir. Les besoins non comblés particuliers au groupe AI concernaient le fardeau des soignants, l'assistance pratique et l'isolement. Cet article comprend les implications de la recherche concernant l'amélioration des services de soutien offerts aux familles touchées par le cancer prostatique avancé. Le groupe le plus touché par le cancer de la prostate est celui des hommes de plus de 65 ans. Dans les cas de cancer de la prostate avancé ou métastatique (CPA), les problèmes courants, dont les atteintes à la fonction urinaire, la fatigue et la douleur, sont aggravés par d'autres enjeux de santé liés à l'âge et à la comorbidité (Harden, 2005). Il existe deux groupes de patients distincts qui vivent avec le CPA. Les hommes atteints d'un cancer de la prostate hormono-sensible (HS) reçoivent un traitement de privation androgénique, qui a un effet de féminisation, dont la dysfonction érectile. Tôt ou tard, la maladie de la plupart des patients finit par « résister » aux hormones, c'est-à-dire qu'elle devient androgéno-indépendante (AI), et on se tourne alors vers les traitements palliatifs accompagnés de chimiothérapie, de radiothérapie et de soins de soutien (McMurtry & McMurtry, 2003). Comme toute maladie grave, le cancer de la prostate touche la famille au complet, en particulier les conjointes ou les partenaires (Maliski, Heilemann & McCorkle, 2002). Le traitement du cancer de la prostate a des effets secondaires sur la sexualité qui nuisent aux relations intimes et accroissent le niveau de stress lié à l'adaptation à la maladie d'un proche. Des études passées indiquent que les partenaires de vie des hommes ayant un cancer prostatique signalent souvent des niveaux de détresse plus élevés que les patients eux-mêmes (Couper et coll., 2006; Resendes & McCorkle, 2006) et que la qualité de vie des partenaires diminue à mesure que les problèmes des patients s'aggravent (Kornblith, Herr, Ofman, Scher & Holland, 1994). Les difficultés signalées par les partenaires comprennent la détresse liée à l'inquiétude et à les tensions liées au rôle (Harden, 2005), le manque d'information (Butler et coll., 2000), les difficultés liées à l'intimité et à la sexualité (