Sensitizing nurses for a changing environmental health role

Building Environmental Health and Genomics Literacy among Healthcare Providers Serving Vulnerable Communities: An Innovative Educational Framework

This study addresses healthcare providers’ knowledge deficits in environmental health and genetics, and primarily focuses on student nurses and nurses serving marginalized, low-income communities frequently exposed to environmental toxicants. Our approach to improve public health is unique, combining hands-on modeling exercises with case-based lessons in addition to three targeted 40 min lectures on toxicology. These lectures included the team’s community-based environmental health research among Indigenous peoples of the U.S. The hands-on approach employed DNA and protein molecular models designed to demonstrate normal and dysfunctional molecules, as well as genetic variants in world populations. The models provided learners with visuals and an experience of “learning by doing.” Increased awareness of the effects of environmental toxicants is the first step toward improving health care for exposed communities. We measured knowledge gains by pre- and post-tests among student nurses and nurses serving Native Americans living both in urban and rural areas of the U.S. (n = 116). The modeling lessons illustrated genetic variants in liver proteins common in Native peoples and their resulting health vulnerabilities. Participants were engaged and enthusiastic; and pre- and post-test results reported substantial knowledge gains and a greater understanding of genetic susceptibility (p < 0.0001). Our study demonstrates the utility of this framework across diverse populations and remote communities.

The concept of exposure in environmental health for nursing

AIM

To report an analysis of the concept of exposure in environmental health for nursing.

BACKGROUND

The importance of the environment has long been recognized in nursing, although the nature and scope of the concept and how it influences health have varied over time. Exposure is the sufficient and necessary link between environment and health. In nursing practice, the word 'exposure' has been used frequently with no clear standard definition.

DESIGN

Concept analysis using Kim's first-level analytics.

DATA SOURCES

Chronological review (1980-2015) of the nursing science literature was conducted through ProQuest Dissertations and Theses and CINAHL, followed by a multi-disciplinary search through PubMed (1980-2015), texts and the Internet to compare definitions and measurements of exposure and related concepts.

METHODS

Explicit and implicit conceptual definitions and measurements of exposure were identified, categorized and analysed.

RESULTS

The newly defined concept of 'exposure' is a process involves three phases: 1, contact is made between a target and one or more agents in the same environment; 2, the agent accesses the target by one or more routes of entry; and 3, the agent enters the target by crossing a barrier or boundary. Existing measurements related to each phase are identified and discussed. Definitions of 'target' and 'agent' were refined for congruency.

CONCLUSION

Consistent use of terms as defined is critical to development of nursing knowledge. These concepts should be incorporated into nursing-related research to evaluate their usefulness to nursing. Alignment of this concept with relevant theories should be critically examined.

As influências ambientais e a interação homem-ecossistema no planejamento e implementação da atenção à saúde materno-infantil na prática de enfermagem

Este ensaio teórico tem como objetivo ressaltar a importância a ser dada pelo enfermeiro à questão ambiental e, especificamente, à poluição ambiental, no planejamento e implementação de ações de saúde, no que se refere à reprodução e a saúde materno-infantil. São apontados alguns efeitos de poluentes sobre a fertilidade, resultados gestacionais e crescimento e desenvolvimento da criança. É questionado o conhecimento do enfermeiro sobre esses aspectos e apresentadas considerações sobre a necessidade de aprofundar a investigação para identificar fatores de risco ambientais para a reprodução e saúde do binômio mãe-filho. A aquisição desse conhecimento pode ser uma das estratégias adotadas para que a atenção ao ambiente, incluindo as inter-relações homem-ecossistema, transforme-se em subsídio real para a adoção, pelo enfermeiro, de novas práticas em saúde. Finalmente, enfatiza a necessidade de que o enfermeiro participe em equipes multidisciplinares, nas quais sejam abordadas questões de risco para a saúde decorrentes do ambiente.

Upstream reflections on environmental health: an abbreviated history and framework for action

Upstream thinking considers the social, economic, and environmental origins of health problems that manifest at the population level. The upstream thinking perspective is applied to an examination of environmentally associated health problems and the opportunities that citizens have (or do not have) to access information and resources to make health-promoting choices in response to environmental health risks. A proposed framework for nurses to reduce environmental health risks includes distributive and strategic actions. Distributive actions include tracking, embedding, and translating; strategic actions include discovering through etiologic research, discovering through community-based research, advocating, and reframing. Together these actions can help formalize nursing's role in responding to citizens' concerns about environmental health problems.

A participatory assessment of environmental health concerns in an Ojibwa community

This research employed a participatory approach to explore environmental health (EH) concerns among Lac Courte Oreilles (LCO) Ojibwa Indians in Sawyer County, Wisconsin. The project was grounded in a broad ecological conceptualization of EH and in principles of health promotion and community participation. Community participation was accomplished through a steering committee that consisted of the primary author and LCO College faculty and community members. The selected assessment methodology was a self-administered survey mailed to LCO members in Sawyer County. Concern for environmental issues was high in this tribal community, especially for future generations. Concern was higher among older members and tribal members living on rather than off the reservation. Local environmental issues of concern were motorized water vehicles, effects from global warming, aging septic systems on waterways, unsafe driving, and contaminated lakes/streams. The LCO community can use survey results to inform further data needs and program development.

[Nursing and the environmental question: proposal of a theoretical model for the professional practice]

Considering the side effects of environmental changes over the population's health, a theoretical model is proposed in this study in order to incorporate ecologic matters into the nursing practices. The reference for this work is the eco-socialist-marxist theory. The model is based on the analysis of the capitalist economic process, its production technologies and consumption. It is known that this economic model generates ecoinequalities and anthropogenic impacts that rebound on the health-disease profile of the population. The nursing action, permeated by ecological awareness, can prevent and also combat ecoinequalities and destructive human actions on the environment.