Characteristics of late preterm infant readmissions: A systematic review.

BACKGROUND: Prematurity represents a critical health disparity. It is important to note that late preterm (LPT) infants comprise the majority of preterm births, yet they are the least studied within the premature population. Evidence-based practice guidelines are now a decade old, indicating the potential need for review and revision. OBJECTIVES: This systematic review proposed the assessment of sociodemographic characteristics of LPT infants, clinical practice standards, and associated hospital readmission rates, mortality, and morbidity to determine the need for revision of evidence-based practice guidelines for these infants. DATA SOURCES: The Preferred Reporting System Items for Systematic Reviews and Meta Analysis methodology provided the framework for the completion of this review. Literature searches of PubMed/Medline (Ovid), Web of Science, Cumulative Index of Nursing, and Allied Health Literature Plus databases and citation searches included articles published after 2012 using the search terms "late preterm infants," "readmissions," and "readmission rates." CONCLUSIONS: The literature search identified 11 studies meeting search criteria. These studies included quasi experimental, retrospective, and prospective cohort studies. These studies highlighted the characteristics of LPT infants that potentially contribute to increased readmission rates, morbidity and mortality rates, health care costs, and long-term health inequities. Overall findings indicate the need for review and revision of evidence-based practice guidelines for these infants. IMPLICATIONS FOR PRACTICE: This systematic review manifests the vulnerability of LPT infants and the accompanying need for up-to-date clinical practice guidelines to effectively reduce their morbidity and mortality rates, hospital readmissions rates, and burden of health care costs.

The effects and challenges of alcohol use disorder peer support service in South Korea: A focus group study.

Although alcohol use disorder (AUD) is associated with a high disease burden due to medical consequences, people with AUD often do not receive appropriate treatment or community health service support. Peer-support services, intended to bridge the gap between patients with AUD and mental health providers have produced successful results. However, the number of studies on peer supporters in South Korea, especially those with AUD, is limited. Therefore, research on the effectiveness or challenges faced by AUD peer supporters in Korea is required to meet the challenges posed by increases in the numbers and capabilities of peer supporters in the mental health field. This qualitative study (N = 13), included focus group interviews of AUD peer supporters (n = 7), and supervisors of peer supporters (n = 6). Focus group data were analysed using thematic analysis methods. These analyses identified themes including 'Life before AUD peer supporters: The moment of change', 'Effects of peer support services: Working as peer supporters changed our lives', 'Challenges of peer supporter services: Things experienced as a team' and 'Future directions: How we can improve peer support services'? Findings indicate that healthcare professionals, educated to maintain clear boundaries, are discouraged from disclosing personal information or developing personal relationships with patients. On the other hand, peer supporters discuss personal histories and prioritize personal connections. By acting as comrades, peer supporters have positive effects. By sharing their experiences, peer supporters formed appropriate relationships with AUD patients and families resulting in more active engagement in treatment programmes and increased numbers of patients receiving outpatient treatment.

The Impact of COVID-19 on Body Mass Index Among Hispanic Children Accessing a Primary Care Clinic in Central Texas: An Epidemic Amidst a Pandemic.

INTRODUCTION: The COVID-19 pandemic led to lifestyle disruptions that increased the risk for pediatric obesity and health disparities among Hispanic children. This study aimed to assess weight and body mass index (BMI) trends longitudinally, pre- and intra-COVID-19 pandemic, among Hispanic children. METHOD: A retrospective chart review included Hispanic children (n = 88) accessing a Federally Qualified Health Center, including six pediatric primary care clinics 6 months prepandemic and 6-, 12- and 18-month intrapandemic intervals. Descriptive statistical analyses included paired t tests, repeated-measures analysis of variance, and correlations for weight and BMI percentiles comparisons at prepandemic and intrapandemic intervals. RESULTS: Comparison of prepandemic and 6-month intrapandemic intervals did not identify differences in BMI percentiles. A significant difference in BMI percentiles was found in comparisons of prepandemic and 12- and 18-month intrapandemic intervals, with no differences identified by age or sex. DISCUSSION: Hispanic children experienced a significant increase in BMI percentiles throughout the pandemic. Addressing this social determinant of health among Hispanic children presenting with anomalous weight gain is imperative to promote health equity by focusing on the pediatric obesity epidemic.

The Moderating Role of Insecure Attachments on the Relationship between Controlling Behaviors and Violence Perpetration in Intimate Relationships.

This study sought to examine the association between male-to-female physical, psychological, and sexual violence and controlling behaviors of male partners. Further, the moderating effect of insecure attachment style on this association was examined in the context of South Korea. Existing national data collected from a representative Korean sample of 2,000 unmarried men was utilized. Findings indicated controlling behaviors among men were positively and negatively associated with psychological and physical violence, respectively, and no association was observed with sexual violence against female partners. Anxious attachment moderated the relationship between control over partner and psychological abuse. The avoidant attachment was identified as a quasi and pure moderator for the associations between control over the partner and physical and sexual violence, respectively.

An Assessment of HIV Risk, Perceptions of Risk, and Potential Adherence to Preexposure Prophylaxis Among HIV-Negative People With Injection Drug Use Who Access Mobile Outreach Services.

OBJECTIVE: The purpose of this study was to assess HIV risk, perceptions of risk, and potential adherence to preexposure prophylaxis (PrEP) for the prevention of HIV infection among people who inject drugs (PWID), who self-report HIV negative status and access mobile outreach intravenous drug use (IVDU) services. METHODS/SAMPLE: Participants (N = 93) were non-Hispanic White (59.1%) and Hispanic (36.6%), between the ages of 18 and 63 years, primarily male (58.1%), who reported a length of IVDU between 1 and >20 years and accessed mobile outreach IVDU services in a metropolitan area of the Southwestern United States; all self-reported HIV-negative status. Self-report questionnaires completed via iPad included HIV risk behavior, perceived risk of HIV, and beliefs about medicines. RESULTS: PWID perceived themselves at a low risk for HIV with minimal concerns about contracting HIV. High levels of comorbidities (schizophrenia, anxiety, depression, hepatitis, diabetes, and hypertension), substance use, and limited HIV protective behavior and social support existed; women reported significantly more risk behaviors and comorbidities. Positive attitudes toward and interest in use of medication for HIV prevention were present, however, with concurrent concerns regarding long-term medication use and the potential to forget medications. CONCLUSIONS: PrEP adherence for PWID presents challenges for clinicians. Addressing perceptions of PrEP, perceived and actual risk for contracting HIV, potential barriers to PrEP adherence, social support, and treatment of comorbidities in primary care and IVDU outreach services potentially enhances PrEP maintenance among PWID, notably women.

Personal, Interpersonal, and Sociocultural Factors of Condom Use in Rural Indigenous Nahuas Adolescents in Mexico.

The goal of this research was to determine the personal, interpersonal, and sociocultural predictors of condom use among rural Indigenous adolescents. Predictor variables were selected from Bandura's Social Cognitive Theory and Leininger's Transcultural Theory. The sample consisted of 419 Nahuas adolescents randomly selected from the total number of neighborhood blocks in a rural community in Puebla, Mexico. The instruments had acceptable psychometric characteristics (Cronbach alpha and validity scores). Multiple linear regression models were used. Results: 56.8% of participants were female, and 50.40% were students. Mean age was M = 17.5 (SD = 0.97), and the majority (63%) identified as Catholic. Age at menarche/first ejaculation (ß = -1.2, p = 0.038), attitude toward condom use (ß = 0.13, p < 0.001), ethnic identity (ß = 0.21, p < 0.001), and ability to negotiate condom use (ß = 0.13, p = 0.003) predicted (R2 = 22.3) condom use. This study provided a basis for integration of the cultural values of Indigenous adolescents within interventions for sexual health promotion.

Technology-facilitated Sexual Violence in South Korea: A Content Analysis of a Website for Victims.

Technology-facilitated sexual violence (TFSV) is an emerging form of gender-based violence. An understanding regarding the circumstance of TFSV and related health outcomes is limited. This qualitative study analyzed postings from an anonymous Korean website on which women suffering from TFSV freely posted messages asking for help and voicing concerns. Victims made efforts to solve problems that remained unresolved, thereby creating difficulties in their daily lives, and compelling them to quit jobs or break social relationships. They reported mental health concerns including suicide ideation, anxiety, frustration, sleep disorders, and depression. Results infer the imperative nature of research, intervention, and political action.

Development, Pre-Testing and Feasibility Testing of Multi-Component Interventions, Critical for Mental Health Promotion in Primary Care among Mexican-American Adolescents Living in Rural America.

Rural America is often viewed as bereft of social problems facing urban America. Rural families, however, experience stressors due to low employment rates, fewer educational opportunities, a relatively increased incidence of poverty and limited access to mental health care. These families are at increased risk for substance use, violence and associated psychological distress that occurs when failing to cope with stress. Rural children, experiencing these stressors and affected by barriers of culture, poverty and remote access to mental health care, are at higher risk for these negative health outcomes. The need for culturally appropriate intervention tailored to the target population, rural Mexican-American adolescent women, is consistently supported by evidence. A one-size-fits-all approach most likely will not effectively impact behavior and health outcomes. The fact that few studies evaluated effects of mental health interventions on multiple outcomes including substance use, violence, unintended pregnancy and STI is problematic given previously noted associations. Evidence is needed to evaluate associations between mental health interventions and these outcomes. This manuscript presents results of preliminary studies, conducted using a multi-method research approach for development, pre-testing and feasibility testing of interventions for rural primary care settings. This methodology is appropriate when dealing with the complexity of social phenomena. It provides a look at an issue from all angles and thereby the cultural context and perspective informing intervention development. These multi-component interventions are critical for mental health promotion among Mexican-American adolescent women living in rural America.

Identification of provider and patient characteristics associated with antibiotic prescription in the treatment of acute sinusitis.

BACKGROUND: Inappropriate antibiotic use contributes to the development of antibiotic resistance. Sinusitis is the fifth most common diagnosis responsible for antibiotic use. Appropriate antibiotic prescribing for acute sinusitis treatment is crucial to mitigate antibiotic resistance threats. PURPOSE: The purpose of this study was to identify patient and provider characteristics associated with antibiotic prescription and to assess provider adherence to antibiotic prescribing guidelines for acute sinusitis treatment. METHODOLOGY: Retrospective chart review including acute sinusitis cases diagnosed over 12 months, at two express care clinics in the Southwestern United States. Data extraction identified 371 cases meeting inclusion criteria (age >18 years). Descriptive statistical data analyses included Chi square tests. RESULTS: A majority of cases received antibiotic prescriptions (90.8%, n = 337). Sociodemographic characteristics significantly associated with antibiotic prescription ( p < .05) included race, ethnicity, insurance type, and smoking status. Patient-reported nature of symptoms, sinus tenderness, and erythema/edema nasal turbinates were also significantly associated with antibiotic prescription ( p < .05). Antibiotic prescription and watchful waiting for acute sinusitis treatment were significantly associated with provider types ( p < .05). CONCLUSIONS: A gap exists between current guidelines and clinical practice for acute sinusitis treatment in outpatient settings. Antibiotic prescription occurred, although not indicated, along with incorrect antibiotic choice, dose, and duration of therapy. IMPLICATIONS: Outpatient antimicrobial stewardship programs for acute sinusitis treatment with a focus on educational interventions for providers may reduce antibiotic overprescribing for acute sinusitis.

Stories of Hope and Health: Wisdom From Older Mexican-American Women Who Broke Free From the Entangled Web of Love and Violence.

This interpretive qualitative study explores the lived experience of intimate partner violence (IPV) among 12 older Mexican-American women aged 55-85 with past experiences of IPV to understand how it shaped their lives. Sociocultural factors that influenced the IPV experience and sustained health amidst adversity were explored. Denzin's interpretive interactionism along with Antonovsky's salutogenic theory guided this study. These women survived IPV and discovered ways to foster health and thrive in later years. They all vowed to break the cycle of violence for future generations. Their wisdom offers hope and has implications for healthcare professionals, future research, and advocacy efforts.

A qualitative thematic analysis of mentorship for new psychiatric-mental health nurse practitioners.

BACKGROUND: A volume of literature reflects that mentorship is key in producing quality nurse practitioners. Mentoring leads to increased confidence, role clarity, and other benefits improving practice. However, there is little to no research focusing specifically on the impact of mentoring in psychiatric nurse mental health nurse practitioners (PMHNPs). PURPOSE: To explore process of acquiring mentorship and mentoring experiences of newly graduated PMHNPs, all of whom obtained their respective degrees partially or completely online. The study also seeks to describe perceptions of mentoring in PMHNP leaders. METHODS: Nine new graduate PMHNPs and 10 PMHNP leaders were recruited from membership rosters of professional organizations in the Southwestern United States. Informants participated in semi-structured interviews with questions sourced from an interview guide. Interviews were conducted via videoconference or telephone from informants' homes. Data were coded via an in vivo approach and analyzed by thematic methods. RESULTS: New graduates reported that mentoring was dependent on four themes: connectivity, educational stewardship, practice confidence, and luck. Mentor access via work, institutions, or schools was inconsistent. Leaders were concerned about limited educational and professional investment in mentorship because this process is an important component of professional development. CONCLUSION: Mentorship for new graduates is based on a variety of factors, some of which are out of their control. Lack of mentoring may affect practice, which affects patient care. Dialogue between educators, professionals, and organizations may improve mentoring stewardship. IMPLICATIONS: Enhanced communication between educational institutions and professional organizations to create a more fluid process from graduate to mentorship is needed.

Telemedicine practices in adult patients with atrial fibrillation.

BACKGROUND: Atrial fibrillation is a cardiac rhythm disorder associated with embolic stroke risk, decreased functional capacity, and worsening quality of life. Increasing patient access to atrial fibrillation specialists via telemedicine has the potential to improve patient outcomes. OBJECTIVES: The purpose of this systematic review was to describe atrial fibrillation telehealth education treatment programs unrelated to postablation or early detection of atrial fibrillation. DATA SOURCES: PubMed and CINAHL databases were searched using key terms identified by the authors and informed by a panel of clinicians with expertise in cardiac electrophysiology. CONCLUSIONS: Little literature exists on educational telehealth programs for atrial fibrillation treatment unrelated to postablation or early detection of atrial fibrillation. Only three studies met our inclusion criteria. Three themes emerged from review of these studies: (a) atrial fibrillation requires specialty care that is difficult to obtain; (b) comprehensive atrial fibrillation education should include a broad overview of the condition, management options, stroke prevention, and symptom management; and (c) telemedicine is effective for diagnosing and managing atrial fibrillation. IMPLICATIONS FOR PRACTICE: Telemedicine clinics for atrial fibrillation represent an emerging form of clinically important health care delivery. These clinics can potentially decrease wait time for specialty care access, reduce unnecessary emergency department visits, reduce stroke risk, and increase guideline adherence. Nurse practitioners are well suited to create and lead telemedicine atrial fibrillation clinics with relevant clinical expertise and collaborative skills.

Factors influencing terrestriality in primates of the Americas and Madagascar.

Among mammals, the order Primates is exceptional in having a high taxonomic richness in which the taxa are arboreal, semiterrestrial, or terrestrial. Although habitual terrestriality is pervasive among the apes and African and Asian monkeys (catarrhines), it is largely absent among monkeys of the Americas (platyrrhines), as well as galagos, lemurs, and lorises (strepsirrhines), which are mostly arboreal. Numerous ecological drivers and species-specific factors are suggested to set the conditions for an evolutionary shift from arboreality to terrestriality, and current environmental conditions may provide analogous scenarios to those transitional periods. Therefore, we investigated predominantly arboreal, diurnal primate genera from the Americas and Madagascar that lack fully terrestrial taxa, to determine whether ecological drivers (habitat canopy cover, predation risk, maximum temperature, precipitation, primate species richness, human population density, and distance to roads) or species-specific traits (body mass, group size, and degree of frugivory) associate with increased terrestriality. We collated 150,961 observation hours across 2,227 months from 47 species at 20 sites in Madagascar and 48 sites in the Americas. Multiple factors were associated with ground use in these otherwise arboreal species, including increased temperature, a decrease in canopy cover, a dietary shift away from frugivory, and larger group size. These factors mostly explain intraspecific differences in terrestriality. As humanity modifies habitats and causes climate change, our results suggest that species already inhabiting hot, sparsely canopied sites, and exhibiting more generalized diets, are more likely to shift toward greater ground use.

Predictors of Acute Care Transfers From Skilled Nursing Facilities: Recommendations for Preventing Unnecessary Hospitalization.

Preventing acute care transfers from skilled nursing facilities (SNFs) is a challenge secondary to residents' associated debilitated status and comorbidities. Acute care transfers often result in serious complications and unnecessary health care expenditure. Literature implies that approximately two thirds of these acute care transfers could be prevented using proactive interventions. The purpose of the current study was to identify the predictors of acute care transfers for SNF residents in developing relevant prevention strategies. A retrospective chart review using multivariate logistic regression analysis showed increased odds of SNF hospitalization was significantly associated with impaired cognition, chronic obstructive pulmonary disease, and chronic kidney disease, whereas decreased odds of hospitalization was identified among non-Hispanic White residents. Study recommendations include prompt assessment of comorbid symptomatology among SNF residents for the timely management and prevention of unnecessary acute care transfers. [Research in Gerontological Nursing, 15(4), 172-178.].

Nonpharmacological Interventions for Management of Behavioral and Psychological Symptoms of Dementia in Long-Term Care Facilities by Direct Caregivers: A Systematic Review.

Behavioral and psychological symptoms of dementia (BPSD) are a worldwide problem. Estimates indicate approximately 96% of persons with dementia (PWD) exhibit BPSD that are directly associated with long-term care (LTC) placement and approximately one half of these persons experience symptoms classified as severe. BPSD are associated with lost days of work, high turnover, and poor job satisfaction for direct caregivers. Nonpharmacological interventions (NPIs) are effective for management of BPSD when used properly. NPIs are more likely to be used by direct caregivers who are knowledgeable about and have confidence in BPSD effectiveness. Various training techniques promote development of this self-efficacy. The current systematic review synthesizes evidence concerning the use of NPIs for management of BPSD by direct caregivers in LTC settings. Gaps in the literature include evaluation of positive impact of NPIs on PWD and behavior precedent factors. This review emphasizes the need for development and provision of quality NPI education for direct caregivers in LTC settings. [Journal of Gerontological Nursing, 48(7), 18-23.].

Intimate Partner Femicide in South Korea: An Integrative Review of the Literature.

BACKGROUND: Intimate partner femicide (IPF) is a severe form of violence perpetrated against women in intimate relationships. The purpose of this integrative literature review was to identify studies of IPF in South Korea. METHODS: A web-based literature search was performed in six databases: PubMed, CINAHL, PsycINFO, MEDLINE, SocINDEX, and RISS (Korean academic online database). Because of the limited number of findings, Google Scholar was used to find additional studies. RESULTS: Nine articles were selected. There were no studies of IPF in South Korea utilizing a healthcare perspective. The studies were primarily designed to understand the characteristics of the cases and the perpetrators. Through the application of the ecological model to these studies, risk factors at the individual, relationship, community, and societal levels were identified. Although these studies identified that risk factors at the societal level-Korean culture, policy, and law-have a considerable influence on femicide, a clear solution is not proposed. CONCLUSION: It is imperative to understand IPF in South Korea from a female societal perspective to facilitate violence prevention and recovery for those experiencing intimate partner violence.

Attitude and Acceptability of the Self-Sampling in HPV Carrier Women.

METHODS: The descriptive, cross-sectional design included a convenience sample of Mexican women with a previous diagnosis of cervical dysplasia. RESULTS: Women (n = 61) were young adults (M = 27 years, SD = 6.92) reporting single marital status (55%) and sexually active (93%). Mean age at onset of sexual activity was 17 years; a majority of women (78.8%) had more than one sexual partner in their lifetime with 56.6% reporting between two and five partners. All (100%) of the women indicated that they would "choose self-sampling for HPV detection" and would recommend it to other women. Concerning "attitudes toward HPV," the women responded that it is necessary to comply with HPV treatment and understand that preventative measures can avoid HPV transmission. CONCLUSION: Women reported high acceptability for self-sampling and positive attitudes toward HPV diagnostic procedures. Women indicated substantial interest in learning more about HPV, its transmission, preventive measures, routine testing, and recommended self-sampling for HPV detection.

The Embodiment of Traditional Partería in the Colombian Pacific Region.

A Traditional Partera refers to a woman who assists, by traditional practices, women during gestation, birth, and reproductive life, aside of the formal health care system. Their practice, Traditional Partería, is considered a key ancestral cultural component in marginalized communities in Colombia. A comprehensive description of the essence of Colombian Traditional Partería is currently missing, and this practice is facing the loss of its body of knowledge. Here, we describe the essence of being a Colombian Traditional Partera. Eight Traditional Parteras participated in phenomenological interviews and body maps focused on their embodied conscious experience of being a Traditional Partera in Colombia. Seventeen general meaning units were identified and grouped in three embodied components (Head, Heart, and Hands) related to practice, knowledge, feelings, perceptions, context, and culture. We discuss philosophical reflections and implications of knowing other's world perspectives, describing a sensitive triad central in the Traditional Partería practice.

Rural Women in Colombia, Facing the Postconflict: A Qualitative Synthesis.

Women have been the major victims of the Colombian armed conflict for more than 50 years. Nowadays, when the country faces an aftermath focused on reconciliation, understanding women's experiences during the conflict is key to providing them tools for social justice and effective fulfilling of their needs. This qualitative synthesis of literature includes publications in Spanish and English of electronic databases over the past 20 years regarding rural women and the Colombian armed conflict. Studies were included for review if they were published between 2000 and 2019, were qualitative peer-reviewed articles, and addressed directly or indirectly the pregnancy process as well as the women's sexual and reproductive health in rural Colombia. Seven of 169 articles initially identified were included for an inductive analysis of categories and themes. After the analysis process, three main themes emerged from the literature: (a) crumbling families, (b) being a woman: the challenges between being a peacemaker and a victim, and (c) protecting and caring of life. These three themes comprise 10 categories and 20 subcategories that provide support to the inductive qualitative synthesis. This review provides a comprehensive synthesis of the Colombian armed conflict focused on the victimization of women. It concludes with reflections about the Colombian women's role in transitioning toward peace.