Lower Wages of Nurses in Long-Term Care: Does Racial and Ethnic Diversity Explain the Difference?

Registered nurses (RNs) are a key component of the long-term care (LTC) workforce and prior research demonstrates their importance to ensuring patient safety in LTC settings. RNs who work in LTC settings earn less than those who work in hospitals and also are more likely to be from racial and ethnic minority groups. This study seeks to measure wage differences between Registered Nurses (RNs) working in LTC and other settings (e.g., hospitals) and whether differences are associated with the characteristics of the RN workforce between and within settings. We used the 2018 National Sample Survey of Registered Nurses (NSSRN) public-use file to examine RN employment and earnings. Our study population included a sample of 15,373 employed RNs who provided patient care. Characteristics such as race/ethnicity, type of RN degree completed, census region, and union status were included in bivariate analyses and multiple regression analyses to examine the effect of these characteristics on wages. Logistic regression was used to predict RN employment in LTC settings. We found that RNs in LTC experienced lower wages compared to those in non-LTC settings, yet this difference was not associated with racial/ethnic or international educational differences. LTC nurses were also significantly less likely to be represented by a labor union, and there was not a statistically significant wage difference for LTC RNs who were unionized. Because RNs in LTC earn lower wages than RNs in other settings, policies to minimize pay inequities are needed to support the RN workforce caring for frail older adults.

Father Involvement in Different Family Systems Across Cultural Communities

This chapter discusses paternal involvement in diverse living arrangements in high-, middle-, and low-income countries and their implications for childhood development. Men’s ideas about fathering roles and responsibilities are changing noticeably in the high-income countries but at a far slower pace in the rest of the world. This is a major hindrance to engaged fathering. Despite the prevalence of masculine norms in most regions of the world, men display levels of warmth toward children that are comparable to that of mothers, and in a few instances fathers exceed mothers in the display of affection to children. An area in which fathers seem to lag behind mothers is in their engagement in cognitively rich language and numeracy activities with children. This is particularly so in the low- and middle-income countries. Ultimately, the associations between father engagement and childhood outcomes are more consistent for families in high-income than low-income countries, and the associations are sometimes tempered by family union status, the quality of partner relationship, and material resources.

Diaphyseal Proximal Phalangeal Shortening Osteotomy for Correction of Hammertoe Deformity: Operative Technique and Radiological Outcomes

Background Correction of hammertoe deformities at the proximal interphalangeal (PIP) joint results in an inherent loss of motion that can be a concern for active patients who want to maintain toe function and grip strength. Diaphyseal proximal phalangeal shortening osteotomy (DPPSO) is a joint-sparing procedure resecting a cylindrical portion of the proximal phalanx on the middiaphysis. Patients/Methods This was a retrospective review including patients treated using DPPSO with at least a 1-year follow-up. Demographic, comorbidity, and Visual Analogue Scale (VAS) scores and complication data were obtained. Radiological assessment included union status and alignment. Medial frontal anatomical (mFAA), frontal proximal interphalangeal (mFIA), plantar lateral anatomical (pLAA), and medial and plantar lateral interphalangeal angles (pLIA) were measured. Results A total of 31 patients (45 toes) were included, with a mean age of 59 years (range: 24-72) and follow-up of 35 months (range: 12-60; mean preoperative VAS score was 4.9 ± 1.72 improving to 1.62 ± 2.28; P < .01). Union occurred in all patients at an average of 11.2 weeks. Complications were present on 4 toes (8.8%), with no recurrences. The pLIA significantly changed from 44.9° to 17.9°. There were no significant differences in the preoperative and postoperative values of the mFAA, pLAA, and mFIA. Conclusions DPPSO provides adequate pain relief and corrects the PIP joint in the lateral plane without significantly affecting the coronal plane or the anatomical axis of the phalanx in the frontal and lateral views, nor producing secondary deformities. DPPSO is a safe, effective, and reproducible technique with a low complication rate. Levels of Evidence: Level IV: Retrospective case series

The Impact of Abortion Underreporting on Pregnancy Data and Related Research

Introduction The impact on research findings that use pregnancy data from surveys with underreported abortions is not well-established. We estimate the percent of all pregnancies missing from women’s self-reported pregnancy histories because of abortion underreporting. Methods We obtained abortion and fetal loss data from the 2006–2015 National Survey of Family Growth (NSFG), annual counts of births from US vital statistics, and external abortion counts from the Guttmacher Institute. We estimated the completeness of abortion reporting in the NSFG as compared to the external counts, the proportion of pregnancies resolving in abortion, and the proportion of pregnancies missing in the NSFG due to missing abortions. Each measure was examined overall and by age, race/ethnicity, union status, and survey period. Results Fewer than half of abortions (40%, 95% CI 36–44) that occurred in the five calendar years preceding respondents’ interviews were reported in the NSFG. In 2006–2015, 18% of pregnancies resolved in abortion, with significant variation across demographic groups. Nearly 11% of pregnancies (95% CI 10–11) were missing from the 2006–2015 NSFG due to abortion underreporting. The extent of missing pregnancies varied across demographic groups and was highest among Black women and unmarried women (18% each); differences reflect both the patterns of abortion underreporting and the share of pregnancies ending in abortion. Discussion Incomplete reporting of pregnancy remains a fundamental shortcoming to the study of US fertility-related experiences. Efforts to improve abortion reporting are needed to strengthen the quality of pregnancy data to support maternal, child, and reproductive health research.

Sessional Contract Faculty, Unionization, and Academic Freedom

This article explores the relationship between unionization and academic freedom protections for sessional faculty in Ontario universities. Specifically, we compare university policies and contract provisions with a view to determining whether unionized sessionals hired on a per-course basis have stronger academic freedom protections than their non-union counterparts. We then explore whether particular kinds of bargaining unit structures are more conducive to achieving stronger academic freedom provisions. Finally, we consider whether academic freedom can be exercised effectively by sessionals, whether unionized or not. We conclude that unionization does help to produce stronger academic freedom protections for sessionalfaculty and that faculty association bargaining unit structures are most likely to help deliver this outcome. We further conclude that academic freedom is difficult to exercise for sessional faculty, regardless of union status, but that unionization offers greater protections for sessionals facing repercussions as a result of asserting their academic freedom.

Fpemlocal: Estimating family planning indicators in R for a single population of interest

The global Family Planning Estimation model (FPEM) combines a Bayesian hierarchical model with country-specific time trends to yield estimates of contraceptive prevalence and unmet need for family planning for countries worldwide. In this paper, we introduce the R package fpemlocal that carries out the estimation of family planning indicators for a single population, for example, for a single country or smaller area. In this implementation of FPEM, all non-population-specific parameters are fixed at outcomes obtained in a prior global FPEM run. The development of this model was motivated by the demand for computational efficiency, without loss of model accuracy, when estimates and projections from FPEM were needed only for a single country. We present use cases to produce estimates for a single population of women by union status or all women based on package-provided data bases and user-specified data. We also explain how to aggregate estimates across multiple populations. The R package forms the basis of the Track20 Family Planning Estimation Tool to monitor trends in family planning indicators for the FP2020 initiative. Fpemlocal is available from: https://github.com/AlkemaLab/fpemlocal

Genetic Polymorphisms Related to VO2max Adaptation Are Associated With Elite Rugby Union Status and Competitive Marathon Performance

Purpose: Genetic polymorphisms have been associated with the adaptation to training in maximal oxygen uptake (). However, the genotype distribution of selected polymorphisms in athletic cohorts is unknown, with their influence on performance characteristics also undetermined. This study investigated whether the genotype distributions of 3 polymorphisms previously associated with training adaptation are associated with elite athlete status and performance characteristics in runners and rugby athletes, competitors for whom aerobic metabolism is important. Methods: Genomic DNA was collected from 732 men including 165 long-distance runners, 212 elite rugby union athletes, and 355 nonathletes. Genotype and allele frequencies of PRDM1 rs10499043 C/T, GRIN3A rs1535628 G/A, and KCNH8 rs4973706 T/C were compared between athletes and nonathletes. Personal-best marathon times in runners, as well as in-game performance variables and playing position, of rugby athletes were analyzed according to genotype. Results: Runners with PRDM1 T alleles recorded marathon times ∼3 minutes faster than CC homozygotes (02:27:55 [00:07:32] h vs 02:31:03 [00:08:24] h, P = .023). Rugby athletes had 1.57 times greater odds of possessing the KCNH8 TT genotype than nonathletes (65.5% vs 54.7%, χ2 = 6.494, P = .013). No other associations were identified. Conclusions: This study is the first to demonstrate that polymorphisms previously associated with training adaptations in nonathletes are also associated with marathon performance (PRDM1) and elite rugby union status (KCNH8). The genotypes and alleles previously associated with superior endurance-training adaptation appear to be advantageous in long-distance running and achieving elite status in rugby union.