Information displays for automated surveillance algorithms of in-hospital patient deterioration: a scoping review

OBJECTIVE

Surveillance algorithms that predict patient decompensation are increasingly integrated with clinical workflows to help identify patients at risk of in-hospital deterioration. This scoping review aimed to identify the design features of the information displays, the types of algorithm that drive the display, and the effect of these displays on process and patient outcomes.

MATERIALS AND METHODS

The scoping review followed Arksey and O'Malley's framework. Five databases were searched with dates between January 1, 2009 and January 26, 2022. Inclusion criteria were: participants-clinicians in inpatient settings; concepts-intervention as deterioration information displays that leveraged automated AI algorithms; comparison as usual care or alternative displays; outcomes as clinical, workflow process, and usability outcomes; and context as simulated or real-world in-hospital settings in any country. Screening, full-text review, and data extraction were reviewed independently by 2 researchers in each step. Display categories were identified inductively through consensus.

RESULTS

Of 14 575 articles, 64 were included in the review, describing 61 unique displays. Forty-one displays were designed for specific deteriorations (eg, sepsis), 24 provided simple alerts (ie, text-based prompts without relevant patient data), 48 leveraged well-accepted score-based algorithms, and 47 included nurses as the target users. Only 1 out of the 10 randomized controlled trials reported a significant effect on the primary outcome.

CONCLUSIONS

Despite significant advancements in surveillance algorithms, most information displays continue to leverage well-understood, well-accepted score-based algorithms. Users' trust, algorithmic transparency, and workflow integration are significant hurdles to adopting new algorithms into effective decision support tools.

Recreational-vehicle-dwelling American nomads' experiences seeking healthcare: A qualitative field study

AIM

To explore the experiences of recreational-vehicle-dwelling American nomads when seeking healthcare in the United States.

DESIGN

This exploratory, qualitative study employed interpretive description design to maintain a disciplinary focus in nursing.

METHODS

Twenty-five participants were recruited from campgrounds in eight states. Semi-structured interviews were conducted face-to-face. Thematic analysis was conducted using a phronetic iterative approach.

RESULTS

Three overarching themes described participants' experiences seeking healthcare: overwhelming logistics, don't need healthcare, and orchestrating a web of care.

CONCLUSION

Recreational-vehicle-dwelling nomads in the United States face additional complexity when accessing healthcare related to seeking care in unfamiliar locations and policies that prevent the portability of healthcare across state lines.

IMPLICATIONS

More research is needed to evaluate solutions to improve healthcare access for recreational-vehicle-dwelling nomads. Nurses and policymakers should consider healthcare practices through the lens of nomads' lifestyle mobility. The impact of policy decisions on people who are geographically mobile should be considered, and barriers to healthcare portability should be addressed.

IMPACT

This was the first study focused on the healthcare experiences of recreational-vehicle-dwelling nomads in the United States. Nomads face additional complexity and barriers to healthcare access. Some nomads developed strategies to overcome barriers, while others disengaged from healthcare. The findings will impact researchers and nurses who study and care for nomads.

REPORTING METHOD

The SRQR reporting guidelines were followed.

PATIENT OR PUBLIC CONTRIBUTION

Recreational-vehicle-dwelling nomads reviewed the recruitment flyer and interview guide and provided input on recruitment methods and sites.

Community Engagement in Research: An Updated Systematic Review of Quantitative Engagement Measurement Scales for Health Studies

Though the interest in community engagement in research (CEnR) protocols has increased, studies reporting on the findings of tested CEnR engagement measurement scales for health studies are sparse. A systematic review was conducted from January 1 to March 1, 2023, to identify validated, quantitative CEnR engagement measurement tools for health studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was employed. The rigor of scale development, testing, and implementation was explored, and a `best practices evaluation conducted. Themes on the readiness of scales for implementation in health research studies were narratively compiled. Nineteen studies met the search inclusion criteria-reporting on the development, testing, and implementation of seven CEnR engagement measurement scales for health studies. Scale implementation studies precipitated only two of the studies. None of the scales followed the rigorous process dictated in best practices; however, at this time, three scales have gone through the most robust testing processes. Advancement of the science of engagement measurement requires consensus on terminology, application of best practices for scale development and testing protocols, and consistency of reporting findings.

Renin-Angiotensin System Components and Arachidonic Acid Metabolites as Biomarkers of COVID-19

Through the ACE2, a main enzyme of the renin-angiotensin system (RAS), SARS-CoV-2 gains access into the cell, resulting in different complications which may extend beyond the RAS and impact the Arachidonic Acid (ArA) pathway. The contribution of the RAS through ArA pathways metabolites in the pathogenesis of COVID-19 is unknown. We investigated whether RAS components and ArA metabolites can be considered biomarkers of COVID-19. We measured the plasma levels of RAS and ArA metabolites using an LC-MS/MS. Results indicate that Ang 1-7 levels were significantly lower, whereas Ang II levels were higher in the COVID-19 patients than in healthy control individuals. The ratio of Ang 1-7/Ang II as an indicator of the RAS classical and protective arms balance was dramatically lower in COVID-19 patients. There was no significant increase in inflammatory 19-HETE and 20-HETE levels. The concentration of EETs was significantly increased in COVID-19 patients, whereas the DHETs concentration was repressed. Their plasma levels were correlated with Ang II concentration in COVID-19 patients. In conclusion, evaluating the RAS and ArA pathway biomarkers could provide helpful information for the early detection of high-risk groups, avoid delayed medical attention, facilitate resource allocation, and improve patient clinical outcomes to prevent long COVID incidence.

Our Patients Need Empathy Training across Healthcare Professions

Vulnerable populations are those who experience disparity at a disproportionate rate. For this article, specific vulnerable populations of interest include people who experience intellectual or developmental disorders, mental illness, or substance misuse. Vulnerable populations are some of the most stigmatized populations in our society. Research shows that vulnerable populations receive less empathic care than general health care populations, resulting in reduced quality of care and disparities in health outcomes. Empathy, a necessary health care competency, is associated with improved patient outcomes, enhanced job satisfaction, and increased retention and resilience across health care professions. However, there is no current standard for how empathy is taught, assessed, or sustained. Even when empathy education is implemented in healthcare professions curricula, research has demonstrated that it appears to erode with experience and time. In addition, the COVID-19 pandemic has exacerbated inequities in health care systems, with consequences for both patients and providers. There is an urgent need to develop efficacious training in empathy across health care professions to foster and sustain a robust workforce and improve health care experiences and outcomes.

Factors contributing to vaccine hesitancy and reduced vaccine confidence in rural underserved populations

Vaccination remains one of the most effective ways to limit the spread of infectious diseases, and reduce mortality and morbidity in rural areas. Waning public confidence in vaccines, especially the COVID-19 vaccine, remains a cause for concern. A number of individuals in the US and worldwide remain complacent, choosing not to be vaccinated and/or delay COVID-19 vaccination, resulting in suboptimal herd immunity. The primary goal of this study is to identify modifiable factors contributing to COVID-19 vaccine hesitancy among vaccine-eligible individuals with access to vaccines in two under-resourced rural states, Alaska and Idaho. This qualitative study used semi-structured interviews with providers and focus groups with community participants in Alaska and Idaho. A moderator's guide was used to facilitate interviews and focus groups conducted and recorded using Zoom and transcribed verbatim. Thematic, qualitative analysis was conducted using QDA Miner. Themes and subthemes that emerged were labeled, categorized, and compared to previously described determinants of general vaccine hesitancy: established contextual, individual and/or social influences, vaccine and vaccination-specific concerns. Themes (n = 9) and sub-themes (n = 51) identified during the qualitative analysis highlighted a factor's contributing to COVID-19 vaccine hesitancy and poor vaccine uptake. Relevant influenceable factors were grouped into three main categories: confidence, complacency, and convenience. Vaccines are effective public health interventions to promote health and prevent diseases in rural areas. Practical solutions to engage healthcare providers, researchers, vaccine advocates, vaccine manufacturers, and other partners in local communities are needed to increase public trust in immunization systems to achieve community immunity.

Social Networks in Retirement and Assisted Living Communities: A Literature Review

Research has substantiated that social isolation and loneliness are linked to poorer health, earlier death, and reduced quality of life among older adults. Although there has been research focusing on social networks of nursing home residents and interventions to decrease loneliness and improve social interactions for older adults in varied settings, there is a gap in research relating to social networks of older adults in assisted living and retirement communities. The goal of the current review was to summarize relevant research findings related to this topic published in the past 5 years. The literature review included searching three electronic databases (CINAHL, EBSCOhost, and PubMed) for research articles published between January 2015 and March 2020. A total of 475 articles were identified, which was narrowed to 16 articles included for full review after inclusion and exclusion criteria were applied. Following analysis, three themes were identified in the literature: Social Connections Within an Assisted Living Community, Social Networks Between Residents and Their Adult Children, and Influence of Physical Structure on Social Networks of Residents. [Journal of Gerontological Nursing, 48(1), 42-46.].

Examination of parental knowledge of child weight status and associated potential health risks

BACKGROUND

The identification of parental health knowledge related to obesity and overweight status in children is an important area. Its importance relates to understanding gaps in knowledge that can be used to create targeted intervention and prevention strategies to improve the management of child's weight.

AIM

There is a growing awareness of the potential health risks associated with increased childhood weight. It is currently unclear how well the public understands these risks and if understanding is linked to improvement in obesity or overweight levels in children. This review focused on determining if the current research is available to describe parental knowledge and whether it is connected to improved outcomes in the child's weight status.

METHODS

The search for original research articles published between 2003 and 2018 involved six databases, including CINAHL, EBSCOhost, PubMed, PsycINFO, Psychology, and Behavioral Sciences Collection, and OneSearch. The OneSearch database is a comprehensive search engine that allows simultaneous searching of the entire library category and results that are ranked by relevance to the search terms. The terms used included for the keyword search in each database included: "knowledge" or "awareness," "health risk" or "consequence," "obesity" or "overweight," and "weight" or "body mass index," "child," and "parent" or "parental." A content analysis of included articles was performed to synthesize available literature into a review.

RESULTS

This review included nine articles dealing specifically with parents of children and their knowledge levels. As there was limited information about if child's weight status connected to parental knowledge, an additional seven articles addressing how knowledge affects weight at any age was examined. The findings for parental knowledge and its effect have mixed results and varying methods of measurement.

CONCLUSIONS

While some studies have indicated the importance of knowledge, it is difficult to establish a reliable connection due to the limited examination of this subject. This is, therefore, an underexplored area that needs further study.

Challenges and Strategies in Providing Home Based Primary Care for Refugees in the US

The recent crisis in the Middle East has prompted the exodus of millions of refugees from the region who are at present seeking shelter across Europe and in the United States. Among the most immediate needs of refugees upon arrival in a host country is health care, and it is one of the most sustained interactions they experience. Home visits are a common form of primary care for refugees. The authors review the literature to identify themes related to challenges and strategies for providing home based primary care to refugees. The literature review was performed by searching cross-disciplinary databases utilizing Onesearch, but focusing primarily on results produced through CINAHL, EBSCOHOST, and Pub Med databases. To maximize the number of studies included, there was no time frame placed upon publication dates of articles within the search. A total of 55 articles were included in this paper.

Transforming nursing education in a 140-character world: The efficacy of becoming social

A generational gap exists across educational settings today. The potential and actual mismatch of learning styles and curriculum delivery suggests that the current educational models are in need of change. The advent of social media has transformed students from passive recipients of information to co-creators and engaged members of a global and information rich community. Responding proactively with social media integration through a responsive curriculum delivery system would serve to enhance student engagement and improve collaborative learning opportunities. Future implications for social media use in research and education will allow for rapid and efficient research to practice dissemination.

Importance of Interprofessional Healthcare for Vulnerable Refugee Populations

The refugee population in the United States is steadily increasing. These populations face a plethora of diseases and chronic health problems (i.e. obesity, hypertension and depression) as they resettle into their new environment. Due to the lack of understanding, minority population refugee health is scarce and minimal at best. Refugees and healthcare professionals face similar barriers when it comes to seeking treatment and treatment itself. For example, refugees might not be able to communicate efficiently and understand the referral process while healthcare professionals do not understand the culture and language of their patients. However, more data is needed to determine if interprofessional teams consisting of differing healthcare professionals such as nurses, pharmacists, and dieticians that conduct home visits might be able to bridge the health care gap between individualized treatment and refugee needs.

Doctor of Nursing Practice Student Perceptions of Providing Care to Refugees: Implications for Doctoral Nursing Practice

Although there is no doubt that expanding scientific innovations provide timely information, in the case of refugees and their primary care providers, it is possible their voices have been partially obscured by this rapidly expanding technological and global society. The authors are currently involved in addressing health disparities by providing education and training for doctoral nursing students, in the delivery of home based primary care to culturally diverse and marginalized populations in a mountain west state. Doctor of nursing practice (DNP) student perspectives may provide essential information to improve patient-centered care for this very vulnerable population. The purpose of this article is to relay the perceptions of DNP nursing students providing care to refugees.

Informed Consent and the Limited English Patient: A Pilot Project with Dental Hygiene Students to Assess Student Knowledge, Perceptions, and Attitudes

Informed consent is the process by which a patient agrees to or rejects a proposed plan of treatment after a discussion with the provider about the benefits, risks, and alternative treatments available. In the United States, a signed informed consent form is required before any treatment plan may be implemented. However, there is no literature addressing how students in health professions understand informed consent in the context of encounters with limited English proficient (LEP) patients. The purpose of this interprofessional, interdisciplinary pilot project was to explore and assess Idaho State University's dental hygiene students' knowledge, perceptions, and attitudes associated with the process of informed consent when working with LEP patients in a dental hygiene setting. Using mixed-methods methodology, we administered a pre-immersion survey to 28 second-year dental hygiene students. These students then participated in a simulated encounter with Spanish-speaking mock-patients and trained interpreters. After the immersive experience, students completed a post-immersion survey. Study results indicate overall positive increases in student knowledge, perceptions, and attitudes toward various aspects of the provider-LEP patient encounter.

A Community and Academic Partnership to Improve Breast Cancer Outcomes for African Americans on Long Island: A Ministry of Health Dissemination

Communities on Long Island have a widespread interest and a pressing need for approaches to promote early detection and prompt treatment of breast cancer given the overall high rates of morbidity and mortality in the region. African American communities have a special concern given that population's disproportionately high mortality rates from this disease. This article presents a success story for the development of a collaborative network creating a community, government, and academic partnership to address this disparity in African American women on Long Island. The development process utilized focus group and case story methodologies to work with the community to assess needs. Formal educational programs, community events, and a navigational program were then provided to encourage and assist in breast cancer screening and follow-up when needed. Detailed here is a description of the authors’ program development and the far-reaching community impact such a program can have once implemented.

Daily Hassles and Exercise Frequency in Women

Exercise has been associated with a decreased incidence of many chronic diseases that may develop later in life. Today women are working full time, caring for children, husbands, and households. The purpose of this descriptive study was to examine the relationship between daily hassles and exercise frequency of women. The study used a convenience sample of 50 women aged 20 to 46 years. This study found that with increasing hassles related to household activity, family and friends, and personal life, there was a decrease in activity. Home health care nurses and educators can use the findings from this study to influence women to adopt active, healthy lifestyles at home.

Obesity and Poverty: Are Food Stamps to Blame?

Sixty-six percent of adults in the United States are overweight, and 32% of Americans are obese. Although poverty is usually associated with being underfed and underweight, in the United States, the paradoxical relationship between poverty and overweight exists. This article examines the relationship between Food Stamp Program (FSP) participation, food choices, and overweight status. This article examines the practicality of an individual in New York adhering to U.S. Department of Agriculture (USDA) recommendations for a diet rich in whole grains, lean meats, fruits, and vegetables on a FSP budget. The authors concluded that a diet that consists of more processed, high-calorie foods is significantly more agreeable with a FSP budget than a diet that meets USDA recommendations.

Factors Contributing to Women’s Ability to Maintain a Walking Program

Purpose:The purpose of this descriptive study is to determine what strategies were most helpful for women to begin and maintain awalking program. Method:Data from the field notes of a randomized clinical trial to promotewalking in 97women were used for the qualitative analysis discussed in this article. Findings:Overall, the majority of participants met the study goal of walking 90 minutes per week. Conclusions:In addition, the participants reported other benefits, including becoming more physically fit, mental and emotional satisfaction, and stress reduction. Some of the barriers mentioned by participants were personal and/or professional obligations, weather, injuries and/or illnesses, and psychosocial factors. When benefits outweighed barriers, the participants had greater success meeting their walking goals. Implications:Furthermore, the participants stated that making time, problem solving, internal motivation, and the support of family and/or friends were the most helpful factors in achieving their walking goals.

What Does it Mean to be Healthy? Hispanics in the Southeastern Idaho Agricultural Industry

In contrast to many studies of first generation Hispanics residing in the U.S., our study focused on participants of both genders who were formally employed outside the home. The purpose of this study was to explore the meaning of health among southeast Idaho Hispanics employed in the agro-industry. Using qualitative methodology, we interviewed twenty participants employed at a potato processing plant. We found that men and women had differing concepts of health based upon their gender roles and the value placed on work outside the home, which influenced their willingness to access formal health care. Based on our findings, there is a need for public health officials in Idaho to collaborate with employers to develop and implement workplace clinics.

Spatial and Census Data to Evaluate Obese Persons and their Environment (SCOPE)

OBJECTIVE

To evaluate the built environment and its relationship to BMI for individuals in eastern Idaho.

METHODS

Geospatial analyses were coupled to demographic data of adult individuals. ArcGIS Community Analyst was used to compare demographics relative to median BMI.

RESULTS

For every kilometer increase in distance to prepared food sites, BMI went down by 1.3% and every kilometer increase in distance to green space, BMI went down by 0.8% (p < .001). For every kilometer increase in distance to trails, BMI went up by 1.5%. No other built environment variables had a statistically significant association with BMI.

CONCLUSION

The distance to prepared foods and trails was associated with expected changes in BMI. Conversely, increased distance to green space was associated with a lower BMI.

Physical activity in American schools and body mass index percentile

The international physical inactivity epidemic among children has contributed to child obesity. Schools can be an effective source of physical activity opportunity. A cross-sectional sample of 1306 American children was drawn from the Panel Study of Income Dynamics - Child Development Supplement, 2007. The aim of this study was to determine the role of in-school physical activity on body mass index (BMI) percentile among middle and high school-aged children. Multinomial logistic regression was used to assess the associations between the independent variable, physical activity, and the dependent variable, BMI percentile. After adjusting for covariates, children who had no physical activity during physical education (PE) were much more likely to be obese than normal weight in comparison with those who met the US national requirements (odds ratio = 1.58, confidence interval = 1.14, 2.20). This study suggests that meeting US national guidelines for PE-related physical activity may be effective in preventing obesity.

Effects of motivational interviewing intervention on blackouts among college freshmen

PURPOSE

Alcohol and illicit drug abuse is a serious public health issue facing college students. This study examined the impact of motivational interviewing (MI) as an intervention on the rate of blackouts among freshmen who engaged in high-risk drinking and illicit drug use.

DESIGN

A sample of 188 volunteer freshmen from a university were administered the Daily Drinking Questionnaire, the Rutgers Alcohol Problem Index, and the Government Performance and Results Act at baseline and again at 6 months postintervention. MI was applied at baseline and then again at 2 weeks, 3 months, and 6 months.

METHODS

Generalized estimated equations and logistic regression models were used to determine associations between the rate of blackouts and time, ethnicity, gender, illicit drug use, and alcohol consumption.

FINDINGS

At 6 months, the rate of blackouts decreased from 40% at baseline to 16% (p < .0001). The average number, time, and days of drinking and frequency of drug use also decreased significantly (p < .0001). An association between rate of blackouts and gender was observed, but not with ethnicity.

CONCLUSIONS

MI had an impact on reducing alcohol consumption and the rate of blackouts among college freshmen who were engaging in high-risk drinking and illicit drug use.

CLINICAL RELEVANCE

The findings support the importance of using MI with freshmen college students to decrease drinking and the associated negative consequences, including blackouts, which has particular relevance for advanced practice registered nurses, physicians, and community health nurses who conduct MI as an intervention with college students.

Medical home and pediatric primary care utilization among children with special health care needs

INTRODUCTION

The medical home model seeks to improve health care delivery by enhancing primary care. This study examined the relationship between the presence of a medical home and pediatric primary care office visits by children with special health care needs (CSHCN) using the data from 2005-2006 National Survey of Children with Special Healthcare Needs.

METHOD

Survey logistic regression was used to analyze the relationship.

RESULTS

When CSHCN age, gender, ethnicity/race, functional status, insurance status, household education, residence, and income were included in the model, CSHCN with a medical home were 1.6 times more likely to have six or more annual pediatric primary care office visits than were children without a medical home [odds ratio = 1.60, 95% confidence interval = (1.47, 1.75)]. Female CSHCN, younger CSHCN, children with public health insurance, children with severe functional limitations, and CSHCN living in rural areas also were more likely to have a larger number of visits.

DISCUSSION

By controlling for child sociodemographic characteristics, this study provides empirical evidence about how medical home availability affects primary care utilization by CSHCN.

Physical activity preferences for low-income sedentary urban African American older adults

The objective of this study was to determine (a) activity preferences for low-income sedentary urban African American older adults and (b) information needed to deliver a lay physical activity intervention in the community for this population. This descriptive qualitative study used six focus groups. Participants were African American, 55 and older, had low incomes, and had sedentary behavior. Physical activity themes included excitement/emotion for physical activity, group physical activity, and location of physical activity. Themes regarding aspects of being a lay community health worker included beneficial service, uncertainty, logistics concerns, and delivery method preferences. The findings from this study will provide the basis for an intervention for low-income sedentary African American older adults. Preferences for physical activity, concerns about and supports needed for individuals to serve as lay community health workers, various types of training materials, and preferred technology for physical activity participation are identified and discussed.

An examination of successful aging among Southern Black and White older adults

Research on successful aging in minority older adults and those from certain regions of the United States, such as the South, is lacking. It is important to learn whether disparities exist in Southern Black older adults' perceptions of successful aging compared to those of majority older adults. Thus, this study examined successful aging using focus groups to obtain a regionally and racially sensitive understanding of the phenomenon. Focus group sessions were facilitated with Southern Black and White older adults with questions on successful aging, using content analysis to interpret the findings. Four central themes were found: Connecting and Relating; Temporality; Perception and Interpretation; and Activity. Beliefs and decisions about managing oneself through life events, including health problems and disability, may have a major influence on the trajectory of progressive, chronic illness, and consequently, successful aging.

Presence of medical home and school attendance: an analysis of the 2005-2006 National Survey of Children With Special Healthcare Needs

BACKGROUND

Children with special healthcare needs (CSHCN) tend to miss more school because of illness. Medical homes are a model of primary health care that coordinate services to better meet the needs of the child. The purpose of this study was to examine the association between presence of medical home and missed school days among CSHCN.

METHODS

A secondary analysis of cross-sectional data from the 2005 National Survey of Children With Special Healthcare Needs (NS-CSHCN) was conducted. Multivariate ordinal logistic regression was done to analyze the relationship between presence of a medical home and number of missed school days.

RESULTS

The presence of a medical home among CSHCN was associated with being in the highest category of missed school days. The adjusted odds ratios for the number of missed school days, after adjustment for poverty, metropolitan statistical area status, education in the household, age, race and ethnicity, demonstrated that access to a medical home does not decrease school absences.

CONCLUSION

Although the data did not support the hypothesis that CSHCN with a medical home would have fewer missed school days due to illness, this study does evoke future research questions, such as what is the relationship between parental perception of child health status with number of missed school days and how adequate is the communication between families and healthcare providers in the medical home.

Physical activity and BMI: evidence from the Panel Study of Income Dynamics Child Development Supplement

BACKGROUND

This study assessed the association between amount of physical activity and body mass index (BMI) percentile among middle and high school children. Total daily physical activity needs to include both in and out of school physical activity.

METHODS

A secondary data analysis was performed on 1306 children drawn from the Panel Study of Income Dynamics Child Development Supplement (CDS III, 2007). The dependent variable in this study was BMI percentile, while the independent variable was physical activity. The multinomial logistic regression model was used to assess the associations between physical activity and BMI percentile controlling for age, gender, race/ethnicity, parental income, and neighborhood safety.

RESULTS

Children who engaged in low daily physical activity levels had 1.8 times the odds of being obese versus normal weight than those who engaged in moderate levels [odds ratio (OR) = 1.80, confidence interval (CI) = 1.31, 2.48]. African-American children had 1.6 times the odds of being obese than normal weight (OR = 1.55, CI = 0.99, 2.43) and Hispanic children had approximately 1.8 times the odds of being obese than normal weight in comparison to non-Hispanic white children (OR = 1.79, CI = 1.00, 3.21). Females had about 1.5 times the odds of being overweight than normal weight than males (OR = 1.49, CI = 1.04, 2.13).

CONCLUSIONS

This study suggests that the accumulation of 30 minutes or more of daily physical activity may be effective in decreasing obesity prevalence among middle and high school-aged children.

Use of complementary and alternative medicine for physical performance, energy, immune function, and general health among older women and men in the United States

We examined use of complementary and alternative medicine (CAM) for health and well-being by older women and men. Data were from the 2007 National Health Interview Survey, representing 89.5 million Americans ages 50+. Multivariate logistic regression accounted for the survey design. For general health, 52 million people used CAM. The numbers for immune function, physical performance, and energy were 21.6, 15.9, and 10.1 million respectively. In adjusted results, women were much more likely than men to use CAM for all four reasons, especially energy. Older adults, particularly women, could benefit from research on CAM benefits and risks.

Relationship of body mass index to alcohol consumption in college freshmen

Objective. Assess the relationship between body mass index (BMI) and drinking in college freshman. Method. College freshman (N = 199) at a university completed the drinking questionnaires. Drinking amount and the alcohol problem index (RAPI) served as outcomes, and BMI was the independent variable. Results. RAPI scores were associated with gender, amount of drinking, and BMI (P < 0.001, F = 13.44). Increase of RAPI with drinking amount was larger for females (slope = 0.06) than for males (slope = 0.03). Conclusion. This information can be helpful when providing health promotion strategies to college students regarding nutrition modifications that would be most beneficial for their health.

Mentoring nurse scientists to meet nursing faculty workforce needs

Research indicates that mentoring has been highly effective in promoting faculty success. Strong mentors in the area of scholarship are extremely valuable for junior faculty, not only because of their research and academic expertise but also for their role modeling behaviors. This paper highlights key components of research mentoring used by a senior nursing faculty member. The senior faculty mentor and junior faculty mentee developed a common vision, relating to research interests in health promotion for vulnerable populations. Impact at the individual, school, university, and society level is discussed, and benefits of mentoring to meet nursing faculty workforce needs are emphasized.

The Relationship Between Behavior Change Strategies, Physical Activity, and Fruit and Vegetable Intake Following a Cardiac Event

Objective: To assess expectations for recovery and use of behavior change strategies as predictors of subsequent diet and physical activity among adults recently hospitalized for a cardiac event. Design: Quasi-experimental design in which adults with recent cardiac event-related hospitalization completed surveys assessing health behaviors and attitudes immediately post-discharge and three months later. Results: Among those completing the study (n = 323), positive expectations about recovery and more frequent use of behavior change skills predicted greater physical activity and better nutrition at follow-up. In multivariate models, baseline health behavior was a significant predictor of physical activity and fruit and vegetable intake at follow-up (alpha = 0.05). Conclusions: Individuals participating in physical activity and eating a heart-healthy diet approximately three months after cardiac hospitalization possessed behavior change skills. Early intervention is critical as health behaviors occurring just days after hospitalization predicted future health behavior.

Exercise DVD improves exercise expectations in cardiovascular outpatients

OBJECTIVE

To assess impact of exercise education intervention on exercise frequency and attitudes.

METHODS

Cardiovascular outpatients (N=509) were randomized to receive an education DVD or standard care. Outcome measures (baseline and 6 weeks) assessed exercise frequency and cognitive variables.

RESULTS

There was no difference between groups on exercise frequency change from baseline, but DVD group reported greater exercise outcome expectations than control group (P=0.01). There was a greater increase in relapse-prevention behavior in the DVD group, compared to control, for those with low relapse-prevention behavior at baseline (P=0.02).

CONCLUSION

A minimal intervention improves outcome expectations for exercise.

Alcohol screening and brief interventions for college freshmen

This study examined the effectiveness of the Brief Alcohol Screening and Intervention for College Students using theory-driven harm reduction brief motivational interviewing (BMI) for decreasing high-risk drinking and negative consequences. Three surveys were administered to 102 volunteer freshmen college students at baseline and 3 months postintervention. The BMI intervention was administered at baseline and 2 weeks later. Descriptive statistics and summary graphs were used to determine longitudinal changes in drinking quantity, frequency, and negative outcomes. Number of drinks, hours of drinking, and negative consequences decreased, indicating a significant decrease in alcohol consumption and negative consequences. This study contributes valuable implications for the design of theory-driven harm reduction, evidence-based interventions for high-risk drinking among freshmen college students.

Successful Aging: Selected Indicators in a Southern Sample

Given the increasing population of older adults in the United States, it is important to identify indicators of successful aging and the interrelationships among these variables to develop interventions to promote successful aging. This article reports an analysis of indicators of successful aging in a group of older adults from North and South Carolina. Risk factors that may make it harder for older adults to age successfully are identified. The relationships between chronic disease and indicators of successful aging are examined, and potential ideas for interventions to enhance successful aging are discussed.

Hispanic Women and Physical Activity: A Community Approach

Older Hispanic women are at higher risk for chronic debilitating health problems related to higher rates of inactivity and obesity when compared to other ethnic groups. The purpose of this article was to review the literature on the factors which effect levels of physical activity in older Hispanic women. A literature search was conducted using the terms Hispanic or Latina, physical activity, barriers and benefits, self-efficacy, stages of exercise change, and health promotion behaviors. Forty-two studies between 1988 and mid 2007 were selected. Research methods included qualitative, quantitative, interventional, experimental, and cross sectional. There is some research available to guide nurses in assessment of unique factors that may impact the development of culturally appropriate nursing interventions that increase a women’s level of physical activity and promote health and well-being. Practical take home points are presented. Areas for future nursing research are identified.

Improving the Quality of Life of African Americans Receiving Palliative Care

The purpose of this pilot study was to examine the effects of personal characteristics on quality of life (QOL) among African Americans receiving palliative care. Although an important goal of palliative care is to improve the client’s QOL, no studies were found examining the QOL of African Americans receiving palliative care. The study sample included African Americans receiving palliative care in inpatient settings or through enrollment in a hospice program. Data were collected using a structured interview guided by five questionnaires to measure QOL, physical performance, spirituality, social support, and family support/satisfaction. Data were analyzed using descriptive statistics, Pearson r correlation coefficients, and multiple regression analysis. The total sample ( N = 16) was predominately single, female, and 50 to 59 years old. There was a significant relationship between QOL and religious and spiritual coping and between QOL and social support. Participant recruitment was a significant issue in this study.

An Interdisciplinary Team for the Design and Integration of Assistive Robots in Health Care Applications

The integration of assistive robots into the health sector requires an interdisciplinary team of researchers capable of studying and addressing issues that arise in human—robot interaction scenarios. In particular, current and future advancements in technologies demand a unique partnership between engineering and the health sciences to develop clinically relevant assistive robots. In this article, the authors discuss an interdisciplinary team approach for integration of assistive robots in health care applications. In particular, the objective of their interdisciplinary team is to design, integrate, and study socially assistive robots in the resident care practice in long-term care nursing facilities. The authors envision that the model they propose can be easily duplicated in other institutions around the world.

Physical Activity, Social Support, and Family Structure as Determinants of Mood Among European-American and African-American Women

The literature indicates that mood is an important predictor of physical and psychological well-being. Mood influences a person's health perceptions, treatment compliance, and recovery. Given the importance of mood as an outcome, it is important to identify predictors of mood. The current study examined physical activity, social support, and family structure as determinants of mood among women who had recently begun a walking program. Two hundred and fifty-nine European-American and African-American women between the ages of 30 and 60 participated in the study. A significant positive relation was found between physical activity, social support, and mood, while a negative relation was found between number of children and mood. Hierarchical regression revealed that physical activity, social support of friends, mari- tal status, and number of children were significant predictors of women's mood. Race moderated the relation between number of children and mood. This study suggests that physical activity, social support, and family may be important factors in the psychological well-being of women.