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To critically examine the structural exclusion of Doctor of Nursing Practice (DNP)-prepared faculty from academic advancement and promotion pathways and to propose reforms grounded in Boyer's model of scholarship.
The DNP is a practice-focused doctorate established in the United States, distinct from the research-oriented PhD. Similar professional doctorates in the United Kingdom and Australia share the goal of integrating clinical expertise with scholarly inquiry. Despite the rapid growth of DNP programs and the increasing recognition of applied scholarship, many universities continue to privilege traditional research metrics in academic tenure and promotion. This narrow focus on discovery-based outputs marginalises the contributions of DNP faculty in implementation science, systems leadership, and education.
Discursive position paper.
Analysis of policy reports, faculty promotion guidelines, AACN Essentials, and peer-reviewed literature on doctoral education, professional doctorates, and academic equity, 2000–2025.
Current academic evaluation systems sustain hierarchical norms that undervalue practice-based scholarship. This misalignment restricts the career trajectories of DNP-prepared faculty and constrains nursing's leadership in applied innovation. Reframing scholarly legitimacy through Boyer's model of discovery, integration, application, and teaching enables recognition of diverse expertise without compromising academic rigour.
Fully integrating professional doctorates into academic structures requires deliberate reforms in evaluation frameworks, mentorship programs, and institutional policies. Such changes would advance equity, reflect the realities of modern nursing, and align doctoral education with the evolving needs of healthcare systems.
This paper contributes to the international discourse on the future of doctoral education by offering a practical model for inclusive faculty advancement. It also advocates adopting pluralistic definitions of scholarship to support diverse academic career paths in nursing.
No patients, service users, caregivers, or members of the public were involved in the development of this discursive paper. The analysis synthesises existing scholarship, policy documents, and theoretical frameworks and does not draw on primary data requiring patient or public involvement.
by Paula Tatiana Angarita-Melo, Karen Panche-Castellanos, Víctor Zein Rizo-Tello, Ana Yibby Forero-Torres, Alexandra Porras-Ramírez
AimTo determine the independent association and quantify the magnitude of influence of clinical and social determinants on the ten-year cardiovascular disease risk (estimated using the Framingham scale) in individuals diagnosed with arterial hypertension or type 2 diabetes mellitus in Maicao, La Guajira.
MethodsA cross-sectional analytical study was conducted among 273 adults enrolled in noncommunicable disease programs. Anthropometric, biochemical, and sociodemographic data were collected using standardized instruments. Multivariable logistic regression was used to identify and quantify factors associated with high cardiovascular disease risk (defined as 10% or greater Framingham score).
ResultsThe prevalence of high ten-year cardiovascular disease risk was 16.9%, being significantly higher in women (23.5%) compared to men (3.3%). The multivariable analysis quantified the influence of the determinants. Key clinical factors associated with the highest magnitude of risk were Type 2 Diabetes Mellitus (Adjusted Odds Ratio: 21.87) and High Blood Pressure (Adjusted Odds Ratio: 16.04). The independent effect of a social determinant, receiving a monthly salary, was also strongly associated with high risk (Adjusted Odds Ratio: 4.62). Conversely, being male and having normal High Density Lipoprotein cholesterol levels were identified as protective factors.
ConclusionThis study quantifies that, in addition to the strong influence of traditional clinical factors (T2DM and HBP), social determinants such as income-related work status exert a significant and independent effect on cardiovascular risk in this vulnerable population. The findings underscore the critical need for integrated public health strategies in Maicao, La Guajira, that not only target metabolic control but also effectively address structural social and gender inequalities to achieve a meaningful reduction in the cardiovascular disease burden.
Oesophageal cancer (EC) is a common cause of cancer mortality. Evidence on the burden, risk factors and treatment outcomes is limited in low-income and middle-income countries. This study aimed to describe the features of EC cases and determine associated factors among patients attending surgical and oncology clinics in Garissa County Referral Hospital (GCRH).
We conducted a case–control study in which cases were patients with EC and positive histological confirmation and controls were patients admitted to GCRH for other diseases. Data on exposures were extracted from patient files. Data on tobacco and alcohol use were based on current or past use as documented in the records; hot tea intake referred to habitual consumption. Mixed-effect logistic regression model was used to determine EC-associated factors.
141 cases and 282 controls were recruited. Of the 141 cases, 59 (42%) had cancer in the lower third of the oesophagus, whereas 72 (51%) and 10 (7%) had cancers in the middle and upper thirds, respectively. EC was associated with tobacco use (adjusted OR (AOR), 21.02, 95% CI 5.41 to 81.69), consumption of hot tea (AOR 59.87, 95% CI 5.45 to 657.35), chewing khat (miraa, AOR 9.94, 95% CI 3.59 to 27.52), gastro-oesophageal reflux disease (GERD) (AOR 54.12, 95% CI 24.48 to 119.62), gastritis (AOR 17.89, 95% CI 2.94 to 108.989) and peptic ulcer disease (PUD) (AOR 69.31, 95% CI 14.09 to 340.9). Among the case group, 95 (65%) had surgery or gastrostomy tube placement as treatments for EC.
The study findings highlight modifiable risk factors for EC, including tobacco use, hot tea consumption, chewing miraa, GERD, gastritis and PUD. Targeted screening of high-risk patients may improve early detection and outcomes.
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