Publications by authors named "Joseph Laly"

5 Publications

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Using virtual simulation and electronic health records to assess student nurses' documentation and critical thinking skills.

Nurse Educ Today 2021 Apr 22;99:104770. Epub 2021 Jan 22.

University of Miami School of Nursing & Health Studies, 5030 Brunson Drive, Coral Gables, FL 33147, United States of America. Electronic address:

Introduction: Electronic health records have become a standard documentation platform to house patient information in most US hospitals. To improve documentation, providers suggest establishing electronic health record user education at the classroom level so students can interact with patient data early. The purpose of this study was to assess student nurses' clinical documentation and critical thinking skills using virtual patients and a simulated electronic health record system.

Methods: Eighty-four undergraduate nursing students completed assessments on four assigned virtual patients and entered their findings into a simulated electronic health record system. Benner's five stage novice to expert theory was used to evaluate performance of six assessment items.

Results: Significant differences (p = 0.046) were seen in median scores between the first and second assignments, and between the second and fourth assignments (p = 0.021) with minimal improvements from one assignment to the next.

Discussion: Data entered in the electronic health record showed that students started at an advance beginner's level and moved to be proficient in documenting basic patient information using critical thinking skills by the end of the first semester.

Conclusion: It is important to expose students to electronic health record systems before entering the workforce or while training in a hospital setting to enhance readiness for clinical practice with electronic documentation and critical thinking skills.
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April 2021

Disclosing Gender-Based Violence During Health Care Visits: A Patient-Centered Approach.

J Interpers Violence 2020 11 27;35(23-24):5552-5573. Epub 2017 Jul 27.

University of Miami, Coral Gables, FL, USA.

The purpose of this study was to better understand victims' perspectives regarding decisions to disclose gender-based violence, namely, intimate partner violence (IPV) and human trafficking, to health care providers and what outcomes matter to them when discussing these issues with their provider. Twenty-five participants from racially/ethnically diverse backgrounds were recruited from a family justice center located in the southeastern United States. Two fifths had experienced human trafficking, and the remaining had experienced IPV. Upon obtaining informed consent, semistructured, in-depth interviews were conducted. Interviews were audio recorded and transcribed verbatim. Qualitative content analysis was used to examine interview data. Five primary themes emerged. Three themes focused on factors that may facilitate or impede disclosure: patient-provider connectedness, children, and social support. The fourth theme was related to ambiguity in the role of the health care system in addressing gender-based violence. The final theme focused on outcomes participants hope to achieve when discussing their experiences with health care providers. Similar themes emerged from both IPV and human trafficking victims; however, victims of human trafficking were more fearful of judgment and had a stronger desire to keep experiences private. Cultural factors also played an important role in decisions around disclosure and may interact with the general disparities racial/ethnic minority groups face within the health care system. Recognizing factors that influence patient engagement with the health care system as it relates to gender-based violence is critical. The health care system can respond to gender-based violence and its associated comorbidities in numerous ways and interventions must be driven by the patient's goals and desired outcomes of disclosure. These interventions may be better served by taking patient-centered factors into account and viewing the effectiveness of intervention programs through a behavioral, patient-centered lens.
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November 2020

Women's and Healthcare Workers' Beliefs and Experiences Surrounding Abortion: The Case of Haiti.

J Nurs Scholarsh 2017 03 1;49(2):170-176. Epub 2017 Feb 1.

Alpha Lambda & Beta Tau, Associate Professor, Pontifica Universidad, Catolica de Chile Escuela de Enfermeria, Macul, Santiago, Chile.

Purpose: Women in developing countries usually encounter serious inequities in terms of women's health. To date, there is limited understanding of abortion from the perspective of Haitian women. As a limited-resource country, Haiti faces complex social issues and healthcare challenges. With abortion being illegal, many adult and teenage women seek clandestine abortions. The aim of this study was to explore and gain a greater understanding of women's and healthcare workers' beliefs and experiences about abortion in Haiti.

Methods: Descriptive qualitative design was used to elicit information for the study. Eight focus groups were conducted with Haitian women and healthcare workers in five communities in the south of Haiti: Les Cayes, Aquin, St. Louis du Sud, Cavaillon, Maniche, and Ile a Vache. Participants were purposively selected and consented to participate and to be tape recorded. Content analysis followed using the verbatim transcripts, with triangulation of four researchers; saturation was reached with this number of focus groups.

Findings: The transcripts revealed six main themes regarding beliefs and experiences about abortion in Haiti: cultural aspects, consumers, perils of care, and legal concerns. Both women and healthcare workers discussed the repercussions of illegal abortion and the role of the government and hospitals. Participants identified similar perils and complications of unsafe abortions, such as postpartum hemorrhage and infection.

Conclusions: Results showed an urgent need to create a public health response that addresses different dimensions of abortion by engaging women and healthcare providers in rapid and concrete actions that promote access and safe care of women. It is imperative to conduct more research related to abortion in order to examine other associated factors to better understand the links between abortion and sexual health disparities among Haitian women. These results highlight the need for a rapid response to the need of this vulnerable group, who are experiencing high rates of mortality. This can also serve as a directive to approach this issue in other developing countries in the Caribbean region, particularly from its clinical relevance.

Clinical Relevance: Unsafe abortions are prevalent in developing countries; yet limited research exists on the topic. It is paramount to gain an understanding of the women's and healthcare workers' beliefs and experiences surrounding abortion, in order to develop interventions that prevent abortion complications in Haitian women.
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March 2017

Heroin use.

J Psychosoc Nurs Ment Health Serv 2016 Jun;54(6):30-7

Heroin use has increased significantly in the United States over the past decade. According to the Centers for Disease Control and Prevention, heroin use has increased 63% between 2002 and 2013. Heroin-related overdose deaths have increased four-fold over the same time period. The National Center for Health Statistics reported heroin-related deaths were higher for men (N = 6,525) than women (N = 1,732). Traditionally, heroin users are men ages 18 to 25 with low incomes, but the demographics of heroin users have changed to include individuals with higher incomes and private insurance, as well as non-Hispanic White women. Individuals who use heroin also tend to use alcohol and other drugs, such as marijuana, cocaine, and prescription opioid painkillers. [Journal of Psychosocial Nursing and Mental Health Services, 54(6), 30-37.].
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June 2016

A combined chloroplast atpB-rbcL and trnL-F phylogeny unveils the ancestry of balsams (Impatiens spp.) in the Western Ghats of India.

3 Biotech 2016 Dec 2;6(2):258. Epub 2016 Dec 2.

School of Biosciences, Mahatma Gandhi University, Kottayam, Kerala, 686 560, India.

Only a few Impatiens spp. from South India (one of the five centers of diversity for Impatiens species) were included in the published datum of molecular phylogeny of the family Balsaminaceae. The present investigation is a novel attempt to reveal the phylogenetic association of Impatiens species of South India, by placing them in the global phylogeny of Impatiens based on a combined analysis of two chloroplast genes. Thirty species of genus Impatiens were collected from different locations of South India. Total genomic DNA was extracted from fresh plant leaf, and polymerase chain reaction was carried out using atpB-rbcL and trnL-F intergenic spacer-specific forward and reverse primers. Thirteen sequences of Impatiens species from three centers of diversity were obtained from GenBank for reconstructing the evolutionary relationships within the genus Impatiens. Bayesian inference analysis was carried out in MrBayes v.3.2.2. This analysis supported Southeast Asia as the ancestral place of origin of extant Impatiens species. Molecular phylogeny of South Indian Impatiens spp. based on combined chloroplast sequences showed the same association as that of morphological taxonomy. Sections Scapigerae, Tomentosae, Sub-Umbellatae, and Racemosae showed Southeast Asian relationship, while sections Annuae and Microsepalae showed African affinity.
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December 2016