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BACKGROUND: The International Society of Nursing in Genetics (ISONG) fosters scientific and professional development in the discovery, interpretation, and application of genomic information in nursing research, education, and clinical practice. OBJECTIVES: Assess genomic-related activities of ISONG members in research, education and practice, and competencies to serve as global leaders in genomics. DESIGN: Cross-sectional survey (21-items) assessing genomic-related training, knowledge, and practice. SETTINGS: An email invitation included a link to the anonymous online survey. PARTICIPANTS: All ISONG members (nâ¯=â¯350 globally) were invited to partake. METHODS: Descriptive statistics and Wilcoxon Rank Sum Test for between-group comparisons. RESULTS: Respondents (nâ¯=â¯231, 66%), were mostly Caucasian, female, with a master's degree or higher. Approximately 70% wanted to incorporate genomics in research, teaching, and practice. More than half reported high genomic competency, and over 95% reported that genomics is relevant the next 5â¯years. CONCLUSIONS: Findings provide a foundation for developing additional educational programs for an international nursing workforce in genomics.
Assuntos
Genômica , Internacionalidade , Enfermagem , Sociedades de Enfermagem , Atitude do Pessoal de Saúde , Competência Clínica , Estudos Transversais , Educação em Enfermagem , Feminino , Humanos , Pesquisa em Enfermagem , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Little attention has focused on the integration of mobile health (mHealth) technology with self-management approaches to improve the detection and management of atrial fibrillation (AF) in clinical practice. OBJECTIVE: The objective of this study was to investigate the differences between mHealth and usual care over a 6-month follow-up period among patients with a known history of atrial fibrillation. METHODS: A pilot cohort from within the larger ongoing randomized trial, iPhone® Helping Evaluate Atrial fibrillation Rhythm through Technology (iHEART), was evaluated to determine differences in detection of AF and atrial flutter (AFL) recurrence rates (following treatment to restore normal rhythm) between patients undergoing daily smartphone ECG monitoring and age and gender matched control patients. SF-36v2TM QoL assessments were administered at baseline and 6 months to a subset of the patients undergoing daily ECG monitoring. Differences between groups were assessed by t-test, Fisher's exact test, and Cox proportional hazard models. RESULTS: Among the 23 patients with smartphone ECG monitors (16 males and 7 females, mean age 55 ± 10), 14 (61%) had detection of recurrent AF/AFL versus 30% of controls. During the follow-up period, patients given smartphone ECG monitors were more than twice as likely to have an episode of recurrent AF/AFL detected (hazard ratio: 2.55; 95% CI: 1.06 - 6.11; p = 0.04). Among the 13 patients with baseline and 6 month QoL assessments, significant improvements were observed in the physical functioning (p = 0.009), role physical (p = 0.007), vitality (p = 0.03), and mental health domains (p = 0.02). CONCLUSIONS: Cardiac mHealth self-monitoring is a feasible and effective mechanism for enhancing AF/AFL detection that improves quality of life.
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BACKGROUND: Little attention has focused on gender differences in cardiac comorbidities and outcomes in patients undergoing orthotropic heart transplant. OBJECTIVE: The objective of this study was to investigate gender differences at baseline and during follow-up among heart transplant patients. METHODS: An observational cohort within the NEW HEART study was evaluated to determine gender differences in relation to age, coexisting cardiac comorbidities, and outcomes. Differences were assessed by t-test, Fisher's exact test, and logistic regression analysis. RESULTS: Male transplant recipients ( n = 238) were significantly older than female recipients ( n = 92), with a greater percentage over 60 years of age (45% vs. 24%, p = 0.0006). Males were more likely to have hypertension (63% vs. 49%, p = 0.034), dyslipidemia (62% vs. 45%, p = 0.006), a history of smoking (52% vs. 35%, p = 0.009), and diabetes (42% vs. 21%, p = 0.0002). Analysis of endomyocardial biopsies obtained during the 1-year follow-up period demonstrated that women averaged more episodes of acute rejection than men (3.9 vs. 3.0, p = 0.009). While most episodes of rejection were mild, women were more likely than men to have episodes of moderate or severe rejection (14% vs. 5%, p = 0.012) and to be hospitalized for acute rejection (15% vs. 6%, p = 0.013). There were no significant differences in mortality. CONCLUSIONS: Men were more likely than women to be older and to have diabetes, dyslipidemia, hypertension, and a history of smoking. Women were more likely to experience moderate or severe allograft rejection and to be hospitalized for acute rejection. Future investigation of the reasons for these gender differences is warranted and may improve clinical care of women undergoing cardiac transplantation.
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Transplante de Coração , Resultado do Tratamento , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Atrial fibrillation is a major public health problem and is the most common cardiac arrhythmia, affecting an estimated 2.7 million Americans. The true prevalence of atrial fibrillation is likely underestimated because episodes are often sporadic; therefore, it is challenging to detect and record an occurrence in a "real world" setting. To date, mobile health tools that promote earlier detection and treatment of atrial fibrillation and improvement in self-management behaviors and knowledge have not been evaluated. This study will be the first to address the epidemic problem of atrial fibrillation with a novel approach utilizing advancements in mobile health electrocardiogram technology to empower patients to actively engage in their healthcare and to evaluate impact on quality of life and quality-adjusted life years. Furthermore, sending a daily electrocardiogram transmission, coupled with receiving educational and motivational text messages aimed at promoting self-management and a healthy lifestyle may improve the management of chronic cardiovascular conditions (e.g., hypertension, diabetes, heart failure, etc.). Therefore, we are currently conducting a randomized controlled trial to assess the efficacy of a mobile health intervention, iPhone® Helping Evaluate Atrial fibrillation Rhythm through Technology (iHEART) versus usual cardiac care. METHODS: The iHEART study is a single center, prospective, randomized controlled trial. A total of 300 participants with a recent history of atrial fibrillation will be enrolled. Participants will be randomized 1:1 to receive the iHEART intervention, receiving an iPhone® equipped with an AliveCor® Mobile ECG and accompanying Kardia application and behavioral altering motivational text messages or usual cardiac care for 6 months. DISCUSSION: This will be the first study to investigate the utility of a mobile health intervention in a "real world" setting. We will evaluate the ability of the iHEART intervention to improve the detection and treatment of recurrent atrial fibrillation and assess the intervention's impact on improving clinical outcomes, quality of life, quality-adjusted life-years and disease-specific knowledge. TRIAL REGISTRATION: NCT02731326 ; Verified April 2016.
Assuntos
Fibrilação Atrial/diagnóstico , Eletrocardiografia/instrumentação , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca , Aplicativos Móveis , Smartphone , Telemedicina/instrumentação , Potenciais de Ação , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/terapia , Protocolos Clínicos , Eletrocardiografia/métodos , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Humanos , Motivação , Cidade de Nova Iorque , Educação de Pacientes como Assunto , Valor Preditivo dos Testes , Estudos Prospectivos , Projetos de Pesquisa , Comportamento de Redução do Risco , Autocuidado , Processamento de Sinais Assistido por Computador , Telemedicina/métodos , Envio de Mensagens de TextoRESUMO
OBJECTIVE: To determine whether early social-emotional problems are associated with child feeding practices, maternal-child feeding styles, and child obesity at age 5 years, in the context of a primary care-based brief general parenting intervention led by an integrated behavioral health specialist to offer developmental monitoring, on-site intervention, and/or referrals. METHODS: A retrospective cohort study was conducted of mothers with 5-year-old children previously screened using the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) during the first 3 years of life. ASQ:SE scores were dichotomized "not at risk" versus "at risk." "At risk" subjects were further classified as participating or not participating in the intervention. Regression analyses were performed to determine relationships between social-emotional problems and feeding practices, feeding styles, and weight status at age 5 years based on participation, controlling for potential confounders and using "not at risk" as a reference group. RESULTS: Compared with children "not at risk," children "at risk-no participation" were more likely to be obese at age 5 years (adjusted odds ratio, 3.12; 95% confidence interval, 1.03 to 9.45). Their mothers were less likely to exhibit restriction and limit setting and more likely to pressure to eat than mothers in the "not at risk" group. Children "at risk-participation" did not demonstrate differences in weight status compared with children "not at risk." CONCLUSION: Early social-emotional problems, unmitigated by intervention, were related to several feeding styles and to obesity at age 5 years. Further study is needed to understand how a general parenting intervention may be protective against obesity.
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Desenvolvimento Infantil/fisiologia , Comportamento Alimentar/psicologia , Educação em Saúde/métodos , Mães/psicologia , Avaliação de Resultados em Cuidados de Saúde , Poder Familiar/psicologia , Obesidade Infantil/psicologia , Adulto , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Mães/educação , Cidade de Nova Iorque/epidemiologia , Obesidade Infantil/epidemiologiaRESUMO
BACKGROUND: Although disparities in child obesity exist during infancy, the underlying mechanisms are unclear. Assessing dissimilarities in feeding practices, styles, and beliefs may provide a better understanding of these mechanisms. This study sought to identify modifiable maternal-infant feeding behaviors that may contribute to disparities in early child obesity. METHODS: This study is a cross-sectional analysis comparing mothers with infants (2 weeks to 6 months old) in a low-risk group of high-income white mothers to a high-risk group of low-income Hispanic mothers. Regression analysis was used to explore relationships between each group and (1) infant feeding practices, including breastfeeding, giving juice, and adding cereal to bottles, (2) controlling feeding styles, (3) beliefs about infant hunger and satiety, and (4) infant weight status. RESULTS: The sample included 412 mothers (low-risk group, n = 208; high-risk group, n = 204). The high-risk group was less likely to exclusively breastfeed (adjusted odds ratio [AOR], 0.43; 95% confidence interval [CI], 0.22-0.83), more likely to introduce juice (AOR, 12.25; 95% CI, 3.44-43.62), and add cereal to the bottle (AOR, 10.61; 95% CI, 2.74-41.0). The high-risk group exhibited greater restrictive and pressuring feeding styles and was more likely to believe that mothers can recognize infant hunger and satiety and less likely to believe that infants know their own hunger and satiety. High-risk infants were more likely to have a weight-for-length percentile >85th percentile (AOR, 2.66; 95% CI, 1.10-6.45). CONCLUSIONS: Differences in infant feeding behaviors may contribute to disparities in early child obesity. Longitudinal studies are needed to determine the effect of these differences on child obesity.