The nurse practitioner role in treating the homeless and rough-sleeper population

Homelessness has always existed worldwide and it presents challenges to society. Delivering health care can be challenging but relationships can be built by starting with wound care, a common problem. Often, the homeless and rough-sleepers need expert attention from caring individuals. However, this population does not have access to expert care, advice, or supplies. This column presents techniques for assessment, treatment, and engagement for better health outcomes in a low resource setting

The nurse practitioner role in treating the homeless and rough-sleeper population.

Homelessness has always existed worldwide and it presents challenges to society. Delivering health care can be challenging but relationships can be built by starting with wound care, a common problem. Often, the homeless and rough-sleepers need expert attention from caring individuals. However, this population does not have access to expert care, advice, or supplies. This column presents techniques for assessment, treatment, and engagement for better health outcomes in a low resource setting

The Impact of Obesity and Intentional Weight Loss on the Health-Related Quality of Life in Older Adults

BackgroundThe proportion of older adults who are obese has doubled in the past 30 years. Obesity and aging are associated with an increase in the number of chronic health conditions (metabolic syndrome, diabetes, and hypertension) that negatively impact the health-related quality of life (HRQOL) which is an important health indicator of the patient’s well-being over time. Objectives This dissertation examines the level of HRQOL among obese adults before and after an intensive a weight loss program. Further it examines whether there is difference in HRQOL between gender, age, blood pressure, and BMI, both before and after the weight loss program. The change in weight and the change in blood pressure by gender and age are also explored. MethodsThis study analyzed HRQOL data with the use of a 36 question-survey (SF–36) on obese individuals before and after an intentional weight loss program. The SF–36 physical component summary scores (PCS) and mental component summary scores (MCS) were analyzed with reference to BMI, gender, blood pressure, and age group. Furthermore, this study measured changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and weight that occurred from week 1 to week 17 and how these changes affected the PCS and MCS scores. ResultsAverage weight loss from week 1-week-17 was approximately 47 pounds (18.89 kg) per person, or an average weight loss of 17% from baseline weight. BMI and the week in the program were statistically significant contributors to the PCS score. Participating in the program for 17 weeks was associated with an increase in the PCS score by 0.34% (p = .000) [sr2 = .0724, p = .000]. The SBP was significantly decreased by 12.288 mmHg and the DBP was significantly decreased by 6.705 mmHg on average for all participants. There was no significant drop in the blood pressure between age groups or between genders.ConclusionsThis structured weight loss program improved both physiological health and HRQOL. The youngest participants had the lowest MCS score, before the weight loss program and after the program compared to the older age groups. In older obese adults (60 years of age and older), PCS scores were inversely related to BMI and age: as the BMI increased and age increased, the PCS score decreased