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Comparison of Second-Degree and Traditional Baccalaureate Nursing Students’ Performance in Managing Acute Patient Deterioration
Comparison of Second-Degree and Traditional Baccalaureate Nursing Students’ Performance in Managing Acute Patient Deterioration
Background: Students in accelerated second-degree programs are reported to be highly motivated, older, competitive, maintain higher grade point averages than their traditional counterparts, and score higher on standardized nursing achievement tests. However, studies that directly measure clinical performance parameters of students in accelerated second-degree programs in direct side-by-side comparison with traditional students under similarly controlled conditions have not been reported. Aim: The purpose of this study was to compare traditional and second-degree baccalaureate nursing students’ performance of key assessments and interventions in the management of deteriorating patients in a simulated task environment. Methods: A convenience sample of 20 traditional and 20 accelerated undergraduate baccalaureate-nursing students participated. The four high-fidelity simulation exercises required the participants to detect early signs of patient deterioration and initiate treatment-based interventions. Two research personnel independently coded audio and videotaped data. The coders recorded the first time in which an assessment or intervention was performed. An independent samples t-test was performed to determine differences in nursing students’ performance of key assessments and interventions. Results: Second-degree accelerated nursing students were in general more likely to recognize and respond to indicators of patient deterioration more promptly than their traditional counterparts. Conclusions: Second-degree students appear to possess attributes that increase the likelihood that they will appreciate stimuli in the clinical environment, which is a precursor to effective intervention. Further research is required to substantiate the factors that account for performance differences between these traditional and second-degree baccalaureate nursing students., Keywords: Patient deterioration, Nursing student, Simulation, Clinical performance, Publication Note: Publisher's Version Also Available at http://sciedupress.com/journal/index.php/jnep/article/view/8000/5639, Preferred Citation: Cormier, E. M., & Whyte IV, J. (2016). Comparison of second-degree and traditional baccalaureate nursing students’ performance in managing acute patient deterioration events. Journal of Nursing Education and Practice, 6(8), p138.
Effect of Tailored Web-Based Interventions on Pain in Adults
Effect of Tailored Web-Based Interventions on Pain in Adults
Background Information technologies can facilitate the implementation of health interventions, especially in the case of widespread conditions such as pain. Tailored Web-based interventions have been recognized for health behavior change among diverse populations. However, none of the systematic reviews looking at Web-based interventions for pain management has specifically addressed the contribution of tailoring. Methods The aims of this systematic review are to assess the effect of tailored Web-based pain management interventions on pain intensity and physical and psychological functions. Randomized controlled trials including adults suffering from any type of pain and involving Web-based interventions for pain management, using at least one of the three tailoring strategies (personalization, feedback, or adaptation), will be considered. The following types of comparisons will be carried out: tailored Web-based intervention with (1) usual care (passive control group), (2) face-to-face intervention, and (3) standardized Web-based intervention. The primary outcome will be pain intensity measured using a self-report measure such as the numeric rating scale (e.g., 0–10) or visual analog scale (e.g., 0–100). Secondary outcomes will include pain interference with activities and psychological well-being. A systematic review of English and French articles using MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library will be conducted from January 2000 to December 2015. Eligibility assessment will be performed independently in an unblinded standardized manner by two reviewers. Extracted data will include the following: sample size, demographics, dropout rate, number and type of study groups, type of pain, inclusion and exclusion criteria, study setting, type of Web-based intervention, tailoring strategy, comparator, type of pain intensity measure, pain-related disability and psychological well-being outcomes, and times of measurement. Disagreements between reviewers at the full-text level will be resolved by consulting a third reviewer, a senior researcher. Discussion This systematic review is the first one looking at the specific ingredients and effects of tailored and Web-based interventions for pain management. Results of this systematic review could contribute to a better understanding of the mechanisms by which Web-based interventions could be helpful for people facing pain problems., Keywords: Web-based, Internet-based, Tailored, Pain, Adults, Systematic review, Publication Note: Publisher's Version Also Available at https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0233-5, Preferred Citation: Martorella, G., Gélinas, C., Bérubé, M., Boitor, M., Fredericks, S., & LeMay, S. (2016). The effect of tailored Web-based interventions on pain in adults: a systematic review protocol. Systematic reviews, 5(1), 1.
Improving Cardiovascular Disease Knowledge among Rural Participants
Improving Cardiovascular Disease Knowledge among Rural Participants
Cardiovascular disease (CVD) is a major cause of death and disability, especially among people living in the rural, southern United States. Rural African Americans are often diagnosed with CVD earlier in life, and they bear a disproportionate burden of CVD risk factors, morbidity, and mortality. Health equity among historically underserved, rural populations can potentially be attained through culturally relevant interventions that teach people skills to stay well and avoid CVD-related risk and diagnoses. The purpose of this secondary analysis was to determine the effect of an evidence-based intervention on cardiovascular health knowledge and the stages of change toward the action and maintenance phases. The pre-test-post-test data were obtained during a cluster randomized trial involving twelve rural churches that were randomized to intervention ( = 6) and control ( = 6) groups. Participants ( = 115) in the intervention group received a cardiovascular health intervention, and those ( = 114) in the control group could receive the intervention following the study’s completion. The data were analyzed using a linear mixed model to compare group differences from pre-test to post-test. The cardiovascular health promotion intervention significantly improved cardiovascular health knowledge and was associated with advancements in the stages of change toward the action and maintenance phases., Keywords: Cardiovascular disease, Community health, Health promotion, Rural health, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164969.
Quality of Life Among Black Prostate Cancer Survivors
Quality of Life Among Black Prostate Cancer Survivors
The purpose of this integrative review was to explore the impact of prostate cancer (PCa) on the quality of life (QoL) and factors that contribute to the QoL for Black men with PCa. Prostate is recognized as the prevalent cancer among men in the United States. Compared to other men, Black men are diagnosed more frequently and with more advanced stages of PCa. Black men also experience disproportionately higher morbidity and mortality rates of PCa, among all racial and ethnic groups. The initial diagnosis of PCa is often associated with a barrage of concerns for one's well-being including one's QoL. As a result, men must contend with various psychosocial and physiological symptoms of PCa survivorship. Whittemore and Knafl's integrative review method was utilized to examine empirical articles from the electronic databases of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, PubMed, Project Muse, and Google Scholar. The time frame for the literature was January 2005 to December 2016. A synthesis of the literature yielded 18 studies that met the inclusion criteria for the integrative review. A conceptual framework that examined QoL among cancer survivors identified four domains that measured the QoL among Black PCa survivors: (a) physical; (b) psychological; (c) social; and (d) spiritual well-being. Social well-being was the dominant factor among the studies in the review, followed by physical, psychological, and spiritual. Results indicate the need for additional studies that examine the factors impacting the QoL among Black PCa survivors, using a theoretical framework so as to develop culturally appropriate interventions for Black PCa survivors., Keywords: Black men, General health and wellness, Health-related quality of life, Oncology/cancer, Prostate cancer, Quality of life, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142144.
Relation among Prostate Cancer Knowledge and Psychosocial Factors for Prostate Cancer Screening among African American Men
Relation among Prostate Cancer Knowledge and Psychosocial Factors for Prostate Cancer Screening among African American Men
African American (AA) men face disproportionately higher rates of prostate cancer (PCa) in comparison to other races. In addition, higher mortality rates from PCa amongst AA men signifies PCa as a formidable health disparity. Inconsistent PCa screening guidelines among medical organizations, further clouds one's decision on receiving a PCa screening. Examining various relations among factors which influence PCa screening may provide insight into their decision whether or not to receive a PCa screening. The purpose of the study was to examine the presence of associations among PCa knowledge, psychosocial factors, and PCa screening over a six month time frame. There were 76 participants at baseline, intervention group (n = 37) and control group (n = 35) and 54 participants, intervention group (n = 26) and control group (n = 28) remained at the 6 month follow up. At the six month follow up, the control group was more likely to have not received a PCa screening and the intervention group was more likely to have received a PCa screening, < 0.01. PCa knowledge scores rose from 49% to 71%, intervention group, and 52% to 58%, control group. Significant associations were found among the following covariates, age and religion ( = 0.499, < 0.01), income and education ( = 0.535, < 0.01), income and healthcare coverage ( = 0.528, < 0.01), income and PCa knowledge at 6 months ( = 0.424, < 0.01), PCa screening and religion ( = 0.353, < 0.01), healthcare empowerment and preparation for decision making ( = 0.421, < 0.01), decisional self-efficacy and active surveillance knowledge ( = 0.377, < 0.01), and active surveillance knowledge and PCa knowledge ( = 0.497, < 0.01). The study revealed associations among PCa knowledge and psychosocial factors regarding a decision for PCa screening among the PCa high risk group, AA men., Keywords: African American men, Prostate cancer, Prostate cancer knowledge, Prostate cancer screening, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111273.
Remote Health Monitoring for Older Adults and Those with Heart Failure
Remote Health Monitoring for Older Adults and Those with Heart Failure
Remote health monitoring technology has been suggested as part of an early intervention and prevention care model. Older adults with a chronic health condition have been shown to benefit from remote monitoring but often have challenges with complex technology. The current study reports on the usability of and adherence with an integrated, real-time monitoring system over an extended period of time by older adults with and without a chronic health condition. Older adults 55 years of age and over with and without heart failure participated in a study in which a telehealth system was used for 6 months each. The system consisted of a wireless wristwatch-based monitoring device that continuously collected temperature and motion data. Other health information was collected daily using a weight scale, blood pressure cuff, and tablet that participants used for health surveys. Data were automatically analyzed and summarized by the system and presented to study nurses. Forty-one older adults participated. Seventy-one percent of surveys, 75% of blood pressure readings, and 81% of daily weight measurements were taken. Participants wore the watch monitor 77% of the overall 24/7 time requested. The weight scale had the highest usability rating in both groups. The groups did not otherwise differ on device usage. The findings indicate that a health monitoring system designed for older adults can and will be used for an extended period of time and may help older adults with chronic conditions reside longer in their own homes in partnership with the healthcare system., Keywords: Adherence, E-health, Home health monitoring, Mobile health, Telehealth, Usability, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892222.
Self-management of cardiac pain in women
Self-management of cardiac pain in women
To describe the current evidence related to the self-management of cardiac pain in women using the process and methodology of evidence mapping. Literature search for studies that describe the self-management of cardiac pain in women greater than 18 years of age, managed in community, primary care or outpatient settings, published in English or a Scandinavian language between 1 January 1990 and 24 June 2016 using AMED, CINAHL, ERIC, EMBASE, MEDLINE, Proquest, PsychInfo, the Cochrane Library, Scopus, Swemed+, Web of Science, the Clinical Trials Registry, International Register of Controlled Trials, MetaRegister of Controlled Trials, theses and dissertations, published conference abstracts and relevant websites using GreyNet International, ISI proceedings, BIOSIS and Conference papers index. Two independent reviewers screened using predefined eligibility criteria. Included articles were classified according to study design, pain category, publication year, sample size, per cent women and mean age. Self-management interventions for cardiac pain or non-intervention studies that described views and perspectives of women who self-managed cardiac pain. Outcomes included those related to knowledge, self-efficacy, function and health-related quality of life. The literature search identified 5940 unique articles, of which 220 were included in the evidence map. Only 22% (n=49) were intervention studies. Sixty-nine per cent (n=151) of the studies described cardiac pain related to obstructive coronary artery disease (CAD), 2% (n=5) non-obstructive CAD and 15% (n=34) postpercutaneous coronary intervention/cardiac surgery. Most were published after 2000, the median sample size was 90 with 25%-100% women and the mean age was 63 years. Our evidence map suggests that while much is known about the differing presentations of obstructive cardiac pain in middle-aged women, little research focused on young and old women, non-obstructive cardiac pain or self-management interventions to assist women to manage cardiac pain. CRD42016042806., Keywords: Myocardial ischaemia, Pain management, Postoperative pain, Self-care, Women, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719283.
Stress Management among Parents of Neonates Hospitalized in NICU
Stress Management among Parents of Neonates Hospitalized in NICU
Infant hospitalization is stressful event for parent in NICU. Parents think that they have lost control because of unfamiliar environment. Therefore, stress management is very important in this period. The family as the main factor of strength and protection for infant is required as the bases of standard care in NICU. Therefore the aim of this study was to investigate stress management in Iranian NICU Parents. Using qualitative content analysis approach helped to collect and analysis data for open coding, classification, and theme abstraction. Twenty one parents with hospitalized neonates, physicians and nurses in the city of Isfahan were purposely recruited and selected for in-depth interviews. The analyzed content revealed unique stress management approaches among the parents. The main themes were: 1) spirituality, 2) seeking information, 3) Seeking hope, 4) maintaining calm, 5) attachment to infant, and 6) communicating with the medical team Findings of this study highlights the importance of medical team's attention to stressed parents who are trying to make adjustment or adapt to the hospitalization of their infant. A revised management approach to address the emotional needs of parents of neonates in Iran seems essential for improving communication with physicians and nurses., Keywords: Infant, NICU, Parents, Qualitative content analysis, Stress, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348660.
Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure
Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure
Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N=201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (B=34.265, R2 = 0.19 , P= 0.001 ). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one’s social network may be appropriate when assessing self-care., Publication Note: Publisher's Version Also Available at https://www.hindawi.com/journals/nrp/2015/840240/abs/, Preferred Citation: Graven, L. J., Grant, J. S., & Gordon, G. (2015). Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure. Nursing research and practice, 2015.
Two Obese Patients with Presumptive Diagnosis of Anaphylactoid Syndrome of Pregnancy Presenting at a Community Hospital.
Two Obese Patients with Presumptive Diagnosis of Anaphylactoid Syndrome of Pregnancy Presenting at a Community Hospital.
Anaphylactoid syndrome of pregnancy (ASP) is a rare but extremely serious complication, with an estimated incidence in North America of 1 in 15 200 deliveries. Despite its rarity, ASP is responsible for approximately 10% of all childbirth-associated deaths in the United States. At present, there is no validated biomarker or specific set of risk factors sufficiently predictive of ASP risk to incorporate into clinical practice. Toward the goal of developing a methodology predictive of an impending ASP event for use by obstetricians, anesthesiologists, and other practitioners participating in infant deliveries, physicians encountering an ASP event have been encouraged to report the occurrence of a case and its biologically plausible risk factors. Herein, we report on 2 patients who presented with a presumptive diagnosis of ASP to the delivery unit of a community hospital. Patient One was a 21-year-old, obese (5'11" tall, 250 lbs., BMI 34.9) white female, 1 pregnancy, no live births (G1P0), estimated gestational age (EGA) 40.2 weeks. Patient Two was a 29-year-old, obese (5'7" tall, 307 lbs., BMI 48.1) Hispanic female, second pregnancy, with 1 previous live birth via C-section (G2P1-0-0-1). Her pregnancy was at gestational age 38 weeks plus 2 days. Patient One had 2 possible risk factors: administration of Pitocin to induce labor and post-coital spotting from recent intercourse. Patient Two suffered premature rupture of the placental membranes. Both Patient One and Patient Two had very high body mass indices (BMIs), at the 97th and 99th percentiles, respectively. In the relatively few cases of anaphylactoid syndrome of pregnancy described to date, this is the first report of a possible association with high BMI., Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933560.
absence of specific yeast heat-shock proteins leads to abnormal aggregation and compromised autophagic clearance of mutant Huntingtin proteins.
absence of specific yeast heat-shock proteins leads to abnormal aggregation and compromised autophagic clearance of mutant Huntingtin proteins.
The functionality of a protein depends on its correct folding, but newly synthesized proteins are susceptible to aberrant folding and aggregation. Heat shock proteins (HSPs) function as molecular chaperones that aid in protein folding and the degradation of misfolded proteins. Trinucleotide (CAG) repeat expansion in the Huntingtin gene (HTT) results in the expression of misfolded Huntingtin protein (Htt), which contributes to the development of Huntington's disease. We previously found that the degradation of mutated Htt with polyQ expansion (Htt103QP) depends on both ubiquitin proteasome system and autophagy. However, the role of heat shock proteins in the clearance of mutated Htt remains poorly understood. Here, we report that cytosolic Hsp70 (Ssa family), its nucleotide exchange factors (Sse1 and Fes1), and a Hsp40 co-chaperone (Ydj1) are required for inclusion body formation of Htt103QP proteins and their clearance via autophagy. Extended induction of Htt103QP-GFP leads to the formation of a single inclusion body in wild-type yeast cells, but mutant cells lacking these HSPs exhibit increased number of Htt103QP aggregates. Most notably, we detected more aggregated forms of Htt103QP in sse1Δ mutant cells using an agarose gel assay. Increased protein aggregates are also observed in these HSP mutants even in the absence Htt103QP overexpression. Importantly, these HSPs are required for autophagy-mediated Htt103QP clearance, but are less critical for proteasome-dependent degradation. These findings suggest a chaperone network that facilitates inclusion body formation of misfolded proteins and the subsequent autophagic clearance., Grant Number: R01 GM102115, RO1GM102115, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773196.
effect of psychological interventions on the prevention of chronic pain in adults
effect of psychological interventions on the prevention of chronic pain in adults
Numerous psychological risk and protective factors have been identified as contributing to or preventing the development of the prevalent issue of chronic pain. Systematic reviews of studies on psychological interventions that tackle these factors have shown limited effects on chronic pain. Therefore, implementing psychological interventions before pain becomes chronic has been put forward. However, the efficacy of such interventions in preventing the transition from acute to chronic pain has not yet been systematically assessed. The aims of this systematic review are to assess the effects of psychological interventions applied in the acute pain phase on pain severity as well as on physical, psychological, and social functions at 3 months and beyond. Randomized controlled trials including psychological intervention as a treatment of primary interest and participants with pain of less than 3 months duration will be considered. The following comparisons will be undertaken: psychological interventions with (1) standard treatment, (2) information, (3) waiting-list, and (4) active treatment. The primary outcome will be pain severity using indicators such the presence or absence of pain and self-report measures such as the numeric pain intensity rating scale. Secondary outcomes will include pain-related disability, mood, coping with pain, quality of life, health care utilization, and work capability. A systematic review of English and French articles in MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials will be conducted without date restriction. Extracted data will include demographics and clinical characteristics, sample size, intervention and control group types, assessment tools used, time interval of measurement, fidelity of the intervention, and attrition rate. Standardized mean differences (SMD) and risk ratios with 95% confidence intervals (CI) will be used to assess treatment effects. This systematic review is the first in examining the effects of psychological interventions implemented in the acute pain phase with the objective of preventing chronic pain. Results of this systematic review could provide information on psychological intervention characteristics that are most helpful for individuals with pain and guidance as to when such interventions should be applied in the continuum of care. PROSPERO CRD42016049312., Keywords: Acute to chronic pain transition, Adults, Cognitive-behavioral approach, Psychological risk factors, Secondary prevention, Systematic review, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609012.
effect of tailored Web-based interventions on pain in adults
effect of tailored Web-based interventions on pain in adults
Information technologies can facilitate the implementation of health interventions, especially in the case of widespread conditions such as pain. Tailored Web-based interventions have been recognized for health behavior change among diverse populations. However, none of the systematic reviews looking at Web-based interventions for pain management has specifically addressed the contribution of tailoring. The aims of this systematic review are to assess the effect of tailored Web-based pain management interventions on pain intensity and physical and psychological functions. Randomized controlled trials including adults suffering from any type of pain and involving Web-based interventions for pain management, using at least one of the three tailoring strategies (personalization, feedback, or adaptation), will be considered. The following types of comparisons will be carried out: tailored Web-based intervention with (1) usual care (passive control group), (2) face-to-face intervention, and (3) standardized Web-based intervention. The primary outcome will be pain intensity measured using a self-report measure such as the numeric rating scale (e.g., 0-10) or visual analog scale (e.g., 0-100). Secondary outcomes will include pain interference with activities and psychological well-being. A systematic review of English and French articles using MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library will be conducted from January 2000 to December 2015. Eligibility assessment will be performed independently in an unblinded standardized manner by two reviewers. Extracted data will include the following: sample size, demographics, dropout rate, number and type of study groups, type of pain, inclusion and exclusion criteria, study setting, type of Web-based intervention, tailoring strategy, comparator, type of pain intensity measure, pain-related disability and psychological well-being outcomes, and times of measurement. Disagreements between reviewers at the full-text level will be resolved by consulting a third reviewer, a senior researcher. This systematic review is the first one looking at the specific ingredients and effects of tailored and Web-based interventions for pain management. Results of this systematic review could contribute to a better understanding of the mechanisms by which Web-based interventions could be helpful for people facing pain problems. PROSPERO CRD42015027669., Keywords: Adults, Internet-based, Pain, Systematic review, Tailored, Web-based, Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830009.