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  1. Article ; Online: Pediatric nurse practitioner workforce shortage threatens child health equity: Key contributors and recommendations.

    Courtwright, Suzanne E / Barr, Emily A

    Journal of the American Association of Nurse Practitioners

    2023  Volume 35, Issue 11, Page(s) 661–665

    Abstract: Abstract: The pediatric nurse practitioner (PNP) workforce shortage has begun to limit access to providers participating in Medicaid and/or the Children's Health Insurance Program, threatening child health equity in the United States. The following are ... ...

    Abstract Abstract: The pediatric nurse practitioner (PNP) workforce shortage has begun to limit access to providers participating in Medicaid and/or the Children's Health Insurance Program, threatening child health equity in the United States. The following are key contributors: an emphasis on adult-focused NP programs and subsequent reduction in undergraduate pediatric content, common practice of student advisement to choose family NP programs, decreased PNP student enrollment leading to nonurban pediatric program closures, an acute shortage of PNP preceptors, and invisibility of the PNP workforce in national workforce data and strategic planning. We outline feasible action steps that nurses, NPs, educators, physicians, and policymakers can take to support PNP workforce growth to advance child health equity in the United States.
    MeSH term(s) Child ; Humans ; United States ; Pediatric Nurse Practitioners ; Health Equity ; Nurse Practitioners ; Students ; Workforce
    Language English
    Publishing date 2023-11-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2716317-9
    ISSN 2327-6924 ; 1745-7599 ; 2327-6886 ; 1041-2972
    ISSN (online) 2327-6924 ; 1745-7599
    ISSN 2327-6886 ; 1041-2972
    DOI 10.1097/JXX.0000000000000954
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2909: Show issues Location:
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  2. Article ; Online: A Review of Updated Guidelines on Breastfeeding with Human Immunodeficiency Virus Using Relational Decision-Making and Intellectual Humility to Support Infant Feeding Choices.

    Barr, Emily A / Abuogi, Lisa L / Smith, Christiana

    The Nursing clinics of North America

    2024  Volume 59, Issue 2, Page(s) 309–327

    Abstract: This article summarizes the updated guidelines on breastfeeding with HIV with an emphasis on using relational decision-making and intellectual humility to support the conversation around infant feeding choices. The complex cultural experiences and ... ...

    Abstract This article summarizes the updated guidelines on breastfeeding with HIV with an emphasis on using relational decision-making and intellectual humility to support the conversation around infant feeding choices. The complex cultural experiences and historical disparities that influence these decisions are highlighted, along with an overview of the recent changes to recommendations for breastfeeding in people with HIV. The article describes individualized clinical scenarios that consider infant feeding decisions, outlines communication and support strategies for health care providers, and proposes a relational decision-making model to guide discussions on infant feeding options.
    MeSH term(s) Humans ; Breast Feeding/psychology ; HIV Infections/psychology ; Infant ; Female ; Decision Making ; Infectious Disease Transmission, Vertical/prevention & control ; Infant, Newborn ; Practice Guidelines as Topic
    Language English
    Publishing date 2024-03-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604296-x
    ISSN 1558-1357 ; 0029-6465
    ISSN (online) 1558-1357
    ISSN 0029-6465
    DOI 10.1016/j.cnur.2023.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Facilitators and Barriers to Pediatric Nurse Practitioner Practice in the United States: A Systematic Review.

    Courtwright, Suzanne E / Turi, Eleanor / Barr, Emily A / Burns, Jade C / Gigli, Kristin Hittle / Bennett, C Robert / Sonney, Jennifer / Francis, Lucine / Poghosyan, Lusine

    Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners

    2024  

    Abstract: Introduction: The pediatric nurse practitioner (PNP) workforce was designed to improve child health equity. We aimed to systematically review the evidence on facilitators and barriers to PNP practice.: Method: We included empirical studies on PNP ... ...

    Abstract Introduction: The pediatric nurse practitioner (PNP) workforce was designed to improve child health equity. We aimed to systematically review the evidence on facilitators and barriers to PNP practice.
    Method: We included empirical studies on PNP practice in the United States and excluded studies with non-identifiable PNP data. We applied Joanna Briggs Institute tools to appraise studies and applied critical interpretive synthesis principles to synthesize.
    Results: The final sample is 26 studies, mostly published before 2013 and observational. Prescriptive privileges, training program availability, organizational climate, and telehealth are facilitators. Mandated physician supervision, reduced pediatric curricula, geographically disparate training programs, and poor data infrastructure are barriers. The sample is limited by a moderate to high risk of bias.
    Discussion: Evidence suggests modifiable factors impact PNP practice and could have important implications for child health equity. We offer a theoretical model to guide robust research studying the PNP workforce and health equity.
    Language English
    Publishing date 2024-01-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1036356-7
    ISSN 1532-656X ; 0891-5245
    ISSN (online) 1532-656X
    ISSN 0891-5245
    DOI 10.1016/j.pedhc.2023.12.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2641: Show issues Location:
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  4. Article ; Online: Transition From Pediatric and Adolescent HIV Care to Adult HIV Care and the Patient-Provider Relationship: A Qualitative Metasynthesis.

    Barr, Emily A / Raybin, Jennifer L / Dunlevy, Hillary / Abuogi, Lisa / Jones, Jacqueline

    The Journal of the Association of Nurses in AIDS Care : JANAC

    2021  Volume 33, Issue 2, Page(s) 132–154

    Abstract: Abstract: Approximately 5 million adolescents (ages 15-24 years) living with HIV will transition to adult care in the next decade. Only half are engaged in care 12 months post-transition. This qualitative metasynthesis aimed to answer: What effect did ... ...

    Abstract Abstract: Approximately 5 million adolescents (ages 15-24 years) living with HIV will transition to adult care in the next decade. Only half are engaged in care 12 months post-transition. This qualitative metasynthesis aimed to answer: What effect did the patient-provider relationship (PPR) have on adolescent living with HIV transition? What strategies were suggested to develop trusting relationships to promote engagement and retention in care? Primary qualitative studies from PubMed, CINAHL, and EBSCO (January 2008 to December 2019) were identified. Data were analyzed using team-based thematic synthesis techniques and international standards. Fourteen articles with 478 participants from eight countries were included. Four themes emerged: the familial nature of the PPR, stigma as a bond and barrier, the provider knowing the patient and getting to know new providers, and recommendations supporting transition. The PPR is integral. Collaborative strategies used to build new relationships will support autonomy, decrease stigma, and facilitate trust.
    MeSH term(s) Adolescent ; Adult ; Child ; HIV Infections/therapy ; Humans ; Professional-Patient Relations ; Qualitative Research ; Social Stigma ; Transition to Adult Care ; Trust ; Young Adult
    Language English
    Publishing date 2021-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1159376-3
    ISSN 1552-6917 ; 1055-3290
    ISSN (online) 1552-6917
    ISSN 1055-3290
    DOI 10.1097/JNC.0000000000000239
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3748: Show issues Location:
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  5. Article ; Online: Resistance to antiretrovirals in HIV-infected pregnant women.

    Weinberg, Adriana / Forster-Harwood, Jeri / McFarland, Elizabeth J / Pappas, Jennifer / Davies, Jill K / Kinzie, Kay / Barr, Emily A / Paul, Suzanne M / Salbenblatt, Carol R / Soda, Elizabeth / Vazquez, Anna / Levin, Myron J

    Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

    2009  Volume 45, Issue 1, Page(s) 39–42

    Abstract: Background: Antiretrovirals suppress HIV replication and prevent mother-to-child-transmission of HIV (PMTCT). Resistance to antiretrovirals may reduce the efficacy of PMTCT and/or complicate treatment of maternal or infant infection.: Objectives: To ... ...

    Abstract Background: Antiretrovirals suppress HIV replication and prevent mother-to-child-transmission of HIV (PMTCT). Resistance to antiretrovirals may reduce the efficacy of PMTCT and/or complicate treatment of maternal or infant infection.
    Objectives: To assess resistance to antiretrovirals during pregnancy.
    Design: Retrospective chart review of 44 pregnancies.
    Results: Twenty-two patients were antiretroviral treatment-naïve, 8 were on therapy, and 14 had prior therapy, but were off medication when the genotyping was performed. Major mutations were found in 10 antiretroviral-experienced women, including 5 women with major mutations to 2 classes of drugs (none to 3 classes). Major mutations were most common for lamivudine, nevirapine, zidovudine, stavudine, and abacavir. Three women had significant resistance to zidovudine/lamivudine, a combination recommended in PMTCT guidelines. Despite significant antiretroviral resistance, 6 of 8 women with plasma HIV RNA measured within 4 weeks of delivery achieved <50 copies/mL. All neonates were uninfected. Among 6 women who received antiretrovirals exclusively for PMTCT, there were no remarkable changes of the HIV genotype before and after pregnancy.
    Conclusions: Resistance to antiretrovirals was common in antiretroviral-experienced pregnant women, but not in naïve women. The 14% prevalence of resistance to zidovudine and lamivudine in antiretroviral-experienced women suggests that alternative NRTI are desirable for this group of patients.
    MeSH term(s) Adult ; Anti-HIV Agents/pharmacology ; Anti-HIV Agents/therapeutic use ; Data Interpretation, Statistical ; Drug Resistance, Viral/drug effects ; Drug Resistance, Viral/genetics ; Female ; HIV/drug effects ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/transmission ; HIV Infections/virology ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical/prevention & control ; Lamivudine/pharmacology ; Lamivudine/therapeutic use ; Mutation ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/virology ; Retrospective Studies ; Viral Load ; Zidovudine/pharmacology ; Zidovudine/therapeutic use
    Chemical Substances Anti-HIV Agents ; Lamivudine (2T8Q726O95) ; Zidovudine (4B9XT59T7S)
    Language English
    Publishing date 2009-05
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1446080-4
    ISSN 1873-5967 ; 1386-6532
    ISSN (online) 1873-5967
    ISSN 1386-6532
    DOI 10.1016/j.jcv.2009.02.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3790: Show issues Location:
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