Nursing satisfaction in caring for elders

Despite the increasing number of Americans who are over 65 years of age, little research exists about the satisfaction of nurses who care for this population. This qualitative descriptive study investigated the factors that influence the satisfaction of such nurses, and yielded five main themes. Registered Nurses (RNs) reported providing high-quality care, developing relationships, and making a difference to be rewarding components of geriatric nursing. The nurses also discussed challenges, which included caring for elders with dementia and being unable to deliver the high-quality care they felt patients deserve. Several of these finding were consistent with existing studies that addressed nurse satisfaction in general. The results of the present study implied that recognizing nurses for their work and providing RNs with training related to caring for older adults may be effective ways to improve satisfaction. Recommendations for further research include conducting similar investigations that are both larger and inclusive of nurses who choose to work exclusively with geriatric patients. Research regarding effective ways to implement dementia-related education programs in the workplace is also suggested

Developing A Trauma-Informed Lens In The College Classroom And Empowering Students Through Building Positive Relationships

In many social science college courses, professors cover a wide variety of topics that may act as triggers for victims of trauma in both traditional and online courses. At the same time, we may also encounter students who suffer trauma during their college experience. The purpose of this paper is to emphasize the importance of creating a safe and empowering environment in college classrooms regardless of what subjects we teach. Safe environments and the relationships we build with our students play a vital role in student success by understanding the importance of being trauma-informed

Physical Activity and Insulin Sensitivity: The RISC Study

OBJECTIVE— Physical activity is a modifiable risk factor for type 2 diabetes, partly through its action on insulin sensitivity. We report the relation between insulin sensitivity and physical activity measured by accelerometry

Desigualdades na saúde: desafios, oportunidades e o que você pode fazer sobre isso: English

Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person’s health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.  Disparidades raciais nos resultados de saúde, acesso a cuidados de saúde, cobertura de seguro e qualidade de atendimento nos Estados Unidos existem há muitos anos. O desenvolvimento e a implementação de estratégias efetivas para reduzir ou eliminar as disparidades de saúde são dificultadas pela nossa incapacidade de avaliar com precisão a extensão e os tipos de disparidades de saúde devido à disponibilidade limitada de informações específicas de raça / etnia, confiabilidade limitada dos dados e informações existentes. e a crescente diversidade da população americana. Variações na classificação racial e étnica usadas para coletar dados dificultam a obtenção de índices confiáveis e precisos de indicadores de saúde e, em alguns casos, causam viés na estimativa de medidas de saúde específicas de raça / etnia. Em 1978, o Escritório de Administração e Orçamento (OMB) publicou a "Diretriz 15" intitulada "Normas Raciais e Étnicas para Estatísticas Federais e Relatórios Administrativos" e forneceu um conjunto de diretrizes claras para classificar as pessoas por raça e etnia. O acesso a cuidados de saúde, factores comportamentais e psicossociais, bem como diferenças culturais, contribuem para as variações raciais e étnicas que existem na saúde de uma pessoa. Para ajudar a eliminar as disparidades de saúde, devemos garantir a igualdade de acesso aos serviços de saúde, bem como a qualidade do atendimento. Os prestadores de cuidados de saúde devem tornar-se culturalmente competentes e compreender as diferenças existentes entre as pessoas que servem para eliminar as disparidades. O aprimoramento dos sistemas de coleta de dados é essencial para desenvolver e implementar intervenções direcionadas para lidar com problemas específicos da população. O desenvolvimento de programas abrangentes e multiníveis para eliminar as disparidades na atenção à saúde exige coordenação e colaboração entre os setores público, privado e profissional (departamentos de saúde locais, estaduais e federais), privados (empresas de seguro-saúde, provedores privados de saúde) e profissionais (médicos e enfermeiros), farmacêuticos, laboratórios, etc)

Practice and Malpractice: Physician Responses to the Liability \u27Crisis\u27

Mississippi is a largely rural state with many poor and unhealthy residents who are chronically underserved by the smallest per capita physician workforce in the nation. Anecdotal reports claimed Mississippi‘s medical malpractice climate jeopardized patient access to health care even further. Using survey data from Mississippi physicians, we document how medical liability perceptions shaped their practices at the height of the Mississippi malpractice crisis. Our findings show that physicians‘ risk profiles strongly influenced the extent to which physicians reported practicing defensive medicine or considered relocating or retiring early in response to malpractice conditions. This raises the specter of further compromising access to physician care in an already underserved state

Teaching Wellness in a College Physical Education Course: Pre/Post Outcomes over the Semester

Background: Over the years, college student wellness has become an issue of concern. This study reports the results that physical education classes and effects they on college student overall wellness over the course of a semester.Aim: This study examines the pre/post outcomes of a physical education course on 12 dimensions of wellness from the start of the semester to the end of the semester.Methods: College students (N = 1,497) taking a PED101 were assessed at the beginning (pre) and end (post) of the semester for wellbeing outcomes according to the Wellness Inventory. Quantitative outcomes from the Wellness Inventory were compared pre/post as well as demographic variables (e.g., gender and health status).Results: All 12 dimensions of wellness showed increases from the start of the semester to the end of the semester. The results found statistically significant changes between the pre and post assessments for all dimensions of wellness outcomes. There were also significant changes between the pre and post assessments when investigating differences based on sex and health status.Conclusion: PED101 courses can be useful interventions to help move college students towards wellness

Wellness and Motivation in a Physical Education Course Over a Semester: Examining the Interaction Effects that Motivation has on Wellness Outcomes

Objective: This study reports the results that physical education classes have on college students' overall wellbeing and motivation over the course of a semester. This study examines the pre/post outcomes of a physical education course on 12 dimensions of wellness and motivation from the start of the semester to the end of the semester.Participants: College students (N = 1193) taking Physical Education 101 (PED101) over the course of a semester.Methods: Beginning (pre) and end (post) of the semester assessments for wellbeing and motivation were conducted using the Wellness Inventory. Quantitative outcomes from the Wellness Inventory were compared pre/post as well as demographic variables (e.g., gender & exercise frequency). Regression analysis was also conducted to examine how motivation may affect wellness. Results: All 12 dimensions of wellness and motivation showed increases from the start of the semester to the end of the semester. Motivation was also positively correlated with increases in wellness scores. The results found statistically significant changes between the pre- and post-assessments for all dimensions of wellness outcomes and motivation scores. There were also significant changes between the pre- and post-assessments when investigating differences based on sex.Conclusion: PED101 courses can be useful interventions to help move college students towards wellness

Recent Developments in Antipoverty Policies in the United States

I survey recent developments in antipoverty policy in the United States over the past decade and examine how the safety net and tax system affects poverty and its correlates using data from the 2000 to 2010 waves of the Current Population Survey-Annual Social and Economic Supplement. Unlike the 1980s and 1990s, and until the health care overhaul in 2009, the first decade of the 21st Century was relatively tepid in terms of major transfer policy reforms. However, real spending on most major social program increased significantly, and in some cases doubled or tripled, in response to demographic shifts and the deep recession. In spite of the real growth in social insurance and means-tested transfer programs, the trends in after-tax and transfer poverty rates were little affected, and if anything, suggest the safety net has lost some of its antipoverty bite in terms of alleviating hardship among those living in deep poverty

Exploring the efficacy of evidence-based practice within public mental health agencies

The aim of this project was to explore the efficacy of evidence-based practice within public mental health agencies. It is hoped that this research project will create dialog surrounding evidence-based practice as well as push for a more clear understanding of it and its implementation in public mental health agencies

Effectiveness of smoking cessation therapies: a systematic review and meta-analysis

BACKGROUND: Smoking remains the leading preventable cause of premature deaths. Several pharmacological interventions now exist to aid smokers in cessation. These include Nicotine Replacement Therapy [NRT], bupropion, and varenicline. We aimed to assess their relative efficacy in smoking cessation by conducting a systematic review and meta-analysis. METHODS: We searched 10 electronic medical databases (inception to Sept. 2006) and bibliographies of published reviews. We selected randomized controlled trials [RCTs] evaluating interventions for smoking cessation at 1 year, through chemical confirmation. Our primary endpoint was smoking cessation at 1 year. Secondary endpoints included short-term smoking cessation (~3 months) and adverse events. We conducted random-effects meta-analysis and meta-regression. We compared treatment effects across interventions using head-to-head trials and when these did not exist, we calculated indirect comparisons. RESULTS: We identified 70 trials of NRT versus control at 1 year, Odds Ratio [OR] 1.71, 95% Confidence Interval [CI], 1.55–1.88, P =< 0.0001). This was consistent when examining all placebo-controlled trials (49 RCTs, OR 1.78, 95% CI, 1.60–1.99), NRT gum (OR 1.60, 95% CI, 1.37–1.86) or patch (OR 1.63, 95% CI, 1.41–1.89). NRT also reduced smoking at 3 months (OR 1.98, 95% CI, 1.77–2.21). Bupropion trials were superior to controls at 1 year (12 RCTs, OR1.56, 95% CI, 1.10–2.21, P = 0.01) and at 3 months (OR 2.13, 95% CI, 1.72–2.64). Two RCTs evaluated the superiority of bupropion versus NRT at 1 year (OR 1.14, 95% CI, 0.20–6.42). Varenicline was superior to placebo at 1 year (4 RCTs, OR 2.96, 95% CI, 2.12–4.12, P =< 0.0001) and also at approximately 3 months (OR 3.75, 95% CI, 2.65–5.30). Three RCTs evaluated the effectiveness of varenicline versus bupropion at 1 year (OR 1.58, 95% CI, 1.22–2.05) and at approximately 3 months (OR 1.61, 95% CI, 1.16–2.21). Using indirect comparisons, varenicline was superior to NRT when compared to placebo controls (OR 1.66, 95% CI 1.17–2.36, P = 0.004) or to all controls at 1 year (OR 1.73, 95% CI 1.22–2.45, P = 0.001). This was also the case for 3-month data. Adverse events were not systematically different across studies. CONCLUSION: NRT, bupropion and varenicline all provide therapeutic effects in assisting with smoking cessation. Direct and indirect comparisons identify a hierarchy of effectiveness