Faculty Bibliography

BACKGROUND: National nursing workforce studies are important for evidence-based policymaking to improve nursing human resources globally. Survey instrument translation and contextual adaptation along with level of experience of the research team are key factors that will influence study implementation and results in countries new to health workforce studies. AIM: This study's aim was to describe the pre-data collection instrument adaptation challenges when designing the first national nursing workforce study in Poland while participating in the Nurse Forecasting: Human Resources Planning in Nursing project. METHODS: A descriptive analysis of the pre-data collection phase of the study. Instrument adaptation was conducted through a two-phase content validity indexing process and pilot testing from 2009 to September 2010 in preparation for primary study implementation in December 2010. Means of both content validation phases were compared with pilot study results to assess for significant patterns in the data. RESULTS: The initial review demonstrated that the instrument had poor level of cross-cultural relevance and multiple translation issues. After revising the translation and re-evaluating using the same process, instrument scores improved significantly. Pilot study results showed floor and ceiling effects on relevance score correlations in each phase of the study. LIMITATIONS: The cross-cultural adaptation process was developed specifically for this study and is, therefore, new. It may require additional replication to further enhance the method. CONCLUSIONS: The approach used by the Polish team helped identify potential problems early in the study. The critical step improved the rigour of the results and improved comparability for between countries analyses, conserving both money and resources. This approach is advised for cross-cultural adaptation of instruments to be used in national nursing workforce studies. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Countries seeking to conduct national nursing workforce surveys to improve nursing human resources policies may find the insights provided by this paper useful to guide national level nursing workforce study implementation.

Transcription factor (TF)-DNA interactions are the primary control point in regulation of gene expression. Characterization of these interactions is essential for understanding genetic regulation of biological systems and developing novel therapies to treat cellular malfunctions. Solid-state nanopores are a highly versatile class of single-molecule sensors that can provide rich information about local properties of long charged biopolymers using the current blockage patterns generated during analyte translocation, and provide a novel platform for characterization of TF-DNA interactions. The DNA-binding domain of the TF Early Growth Response Protein 1 (EGR1), a prototypical zinc finger protein known as zif268, is used as a model system for this study. zif268 adopts two distinct bound conformations corresponding to specific and nonspecific binding, according to the local DNA sequence. Here we implement a solid-state nanopore platform for direct, label- and tether-free single-molecule detection of zif268 bound to DNA. We demonstrate detection of single zif268 TFs bound to DNA according to current blockage sublevels and duration of translocation through the nanopore. We further show that the nanopore can detect and discriminate both specific and nonspecific binding conformations of zif268 on DNA via the distinct current blockage patterns corresponding to each of these two known binding modes.

BACKGROUND: The US Preventive Services Task Force recommends screening for and treating obesity. However, there are many barriers to successfully treating obesity in primary care (PC). Technology-assisted weight loss interventions offer novel ways of improving treatment, but trials are overwhelmingly conducted outside of PC and may not translate well into this setting. We conducted a systematic review of technology-assisted weight loss interventions specifically tested in PC settings. METHODS: We searched the literature from January 2000 to March 2014. INCLUSION CRITERIA: (1) Randomized controlled trial; (2) trials that utilized the Internet, personal computer, and/or mobile device; and (3) occurred in an ambulatory PC setting. We applied the Cochrane Effective Practice and Organization of Care (EPOC) and Delphi criteria to assess bias and the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) criteria to assess pragmatism (whether trials occurred in the real world versus under ideal circumstances). Given heterogeneity, results were not pooled quantitatively. RESULTS: Sixteen trials met inclusion criteria. Twelve (75 %) interventions achieved weight loss (range: 0.08 kg - 5.4 kg) compared to controls, while 5-45 % of patients lost at least 5 % of baseline weight. Trial duration and attrition ranged from 3-36 months and 6-80 %, respectively. Ten (63 %) studies reported results after at least 1 year of follow-up. Interventions used various forms of personnel, technology modalities, and behavior change elements; trials most frequently utilized medical doctors (MDs) (44 %), web-based applications (63 %), and self-monitoring (81 %), respectively. Interventions that included clinician-guiding software or feedback from personnel appeared to promote more weight loss than fully automated interventions. Only two (13 %) studies used publically available technologies. Many studies had fair pragmatism scores (mean: 2.8/4), despite occurring in primary care. DISCUSSION: Compared to usual care, technology-assisted interventions in the PC setting help patients achieve weight loss, offering evidence-based options to PC providers. However, best practices remain undetermined. Despite occurring in PC, studies often fall short in utilizing pragmatic methodology and rarely provide publically available technology. Longitudinal, pragmatic, interdisciplinary, and open-source interventions are needed.