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1.
Int J Older People Nurs ; : e12463, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35362239

RESUMO

BACKGROUND: Hospitalised older persons with dementia are commonly discharged with intensified sleep disturbances. These disturbances can impede the recovery process. Nurses are well-positioned to assist persons with dementia and their family caregivers in managing sleep disturbances during the transition from hospital to home. OBJECTIVES: To describe the development of a multi-component intervention to promote sleep. METHODS: We applied three stages of the intervention mapping method to develop a non-pharmacological, multi-component sleep intervention. The first stage involved a review of the literature to generate an understanding of the determinants of sleep disturbances experienced by persons with dementia in hospital and home settings. The second stage consisted of a literature review to identify therapies for managing commonly reported determinants of sleep disturbances. The third stage entailed delineation of the intervention components. RESULTS: The most common determinants of sleep disturbances experienced by persons with dementia in hospital and home settings were: physiological changes associated with ageing, sleep environments non-conducive to sleep, limited exposure to light and engagement in physical activity, stress and sleep-related beliefs and behaviours. Therapies found effective included: light therapy, physical activity therapy, sleep hygiene, and stimulus control therapy. These therapies were integrated into a multi-component sleep intervention to be provided using the teach-back technique, during and following hospitalisation. DISCUSSION: Consistent with the principles of patient engagement, the multi-component sleep intervention will be evaluated for its acceptability and feasibility. IMPLICATIONS FOR PRACTICE: The intervention has potentials to improve sleep during the transition from hospital to home.

2.
Artigo em Inglês | MEDLINE | ID: mdl-35255147

RESUMO

Culturally grounded after-school programs (ASPs) aim to promote health and well-being among Indigenous youth. Native Spirit is a 10-session ASP that focuses on local cultural values and activities facilitated by local cultural practitioners. This pilot study used a single group, pretest-posttest design (N = 18) with Indigenous adolescents in grades 7-12 and conducted participant interviews (N = 11) to assess the impact of the program on cultural identity, self-esteem, and resilience. There were immediate post-program increases in mean strength in cultural identity (p = 0.002), resilience (p = 0.161), and self-esteem (p = 0.268). Themes related to benefits of program participation included curiosity and commitment to cultural identity, increases in self-esteem, and ability to build resilience. This study provides new insights on the relationship between cultural engagement and adolescent health.


Assuntos
Índios Norte-Americanos , Adolescente , Promoção da Saúde , Humanos , Projetos Piloto , Autoimagem , Identificação Social
3.
Artigo em Inglês | MEDLINE | ID: mdl-35194803

RESUMO

Culturally grounded after-school programs (ASPs), based on local cultural values and practices, are often developed and implemented by and for the local community. Culturally grounded programs promote health and well-being for American Indian and Alaska Native (AI/AN) adolescents by allowing them to reconnect to cultural teachings that have faced attempted historical and contemporary erasure. This article is a first-person account that describes the development and implementation of a culturally grounded ASP, Native Spirit (NS), for AI adolescents (grades 7-12) living on a Southwest urban-based reservation. NS, a 13-session culturally grounded ASP, was developed by an academic-community partnership that focuses on increasing cultural engagement as a form of positive youth development. Each session was guided by one to two local cultural practitioners and community leaders. The development of the NS program contributed to an Indigenous prevention science that emphasizes the positive impacts of Indigenous culture and community on health and well-being. The use of the ASP format, in partnership with the Boys & Girls Club, increased the feasibility of dissemination and refinement of the NS program by tribal communities and organizations.

4.
Environ Health Perspect ; 130(2): 25003, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35195451

RESUMO

BACKGROUND: In 2016, Congress enacted the Frank R. Lautenberg Chemical Safety for the 21st Century Act ("the Lautenberg Act"), which made major revisions to the main U.S. chemical safety law, the 1976 Toxic Substances Control Act (TSCA). Among other reforms, the Lautenberg Act mandates that the U.S. Environmental Protection Agency (U.S. EPA) conduct comprehensive risk evaluations of chemicals in commerce. The U.S. EPA recently finalized the first set of such chemical risk evaluations. OBJECTIVES: We examine the first 10 TSCA risk evaluations in relation to risk science recommendations from the National Academies to determine consistency with these recommendations and to identify opportunities to improve future TSCA risk evaluations by further implementing these key approaches and methods. DISCUSSION: Our review of the first set of TSCA risk evaluations identified substantial deviations from best practices in risk assessment, including overly narrow problem formulations and scopes; insufficient characterization of uncertainty in the evidence; inadequate consideration of population variability; lack of consideration of background exposures, combined exposures, and cumulative risk; divergent approaches to dose-response assessment for carcinogens and noncarcinogens; and a flawed approach to systematic review. We believe these deviations result in underestimation of population exposures and health risks. We are hopeful that the agency can use these insights and have provided suggestions to produce chemical risk evaluations aligned with the intent and requirements of the Lautenberg Act and the best available science to better protect health and the environment-including the health of those most vulnerable to chemical exposures. https://doi.org/10.1289/EHP9649.


Assuntos
United States Environmental Protection Agency , Medição de Risco , Estados Unidos
5.
BMC Nurs ; 20(1): 192, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627234

RESUMO

BACKGROUND: Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses-the largest and most trusted group of healthcare professionals-to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies. METHODS: To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies. DISCUSSION: Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses' perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging-older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.

7.
Implement Sci Commun ; 2(1): 81, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34294145

RESUMO

BACKGROUND: Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities. METHODS: In this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15-20 people with dementia and 15-20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions' acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8-10 healthcare providers per focus group) will be held for a total of 8-12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings. DISCUSSION: Findings will (1) include a set of acceptable interventions for rural transitional care that promote older patients' functioning and family-caregivers' ability to support patients' functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.

8.
Int J Older People Nurs ; 16(6): e12407, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34288414

RESUMO

BACKGROUND: The increasing numbers of older people (age 65+) make it important to understand how to attract nurses to work with this population. METHODS: A secondary analysis using qualitative descriptive methods was used to understand how student nurses' perceptions about older people may influence their desire to work with older people. RESULTS: Student nurses perceive a generational divide between them and older people, regardless of practice settings. They believe working with older people is heavy work, and not high acuity, and although good to learn skills as a student, not a population they want to work with until they are close to retirement themselves. CONCLUSIONS: It is important to enhance nursing education so that students understand the older generation, how to communicate with them and the prevalence of older people in healthcare settings, so that they are more likely to choose to work with older people.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Idoso , Atitude do Pessoal de Saúde , Humanos
9.
Artigo em Inglês | MEDLINE | ID: mdl-34072475

RESUMO

Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.


Assuntos
COVID-19 , Exposição Ocupacional , Saúde do Trabalhador , Humanos , Pandemias , Medição de Risco , Fatores de Risco , SARS-CoV-2 , Local de Trabalho
10.
Can J Nurs Res ; : 8445621211014421, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042538

RESUMO

OBJECTIVES: The study aimed to describe and compare nurses' perceptions of role conflict by professional designation [registered nurse (RN) vs registered practical nurse (RPN)] in three primary areas of practice (emergency department, medical unit, and surgical unit). METHODS: This analysis used data (n = 1,981) from a large cross-sectional survey of a random sample of RNs and RPNs working as staff nurses in acute care hospitals in Ontario, Canada. Role conflict was measured by the Role Conflict Scale. RESULTS: A total of 1,981 participants (RN = 1,427, RPN = 554) met this study's eligibility criteria and provided complete data. In general, RN and RPN mean total scale scores on role conflict hovered around the scale's mid-point (2.72 to 3.22); however, RNs reported a higher mean score than RPNs in the emergency department (3.22 vs. 2.81), medical unit (2.95 vs 2.81) and surgical unit (2.90 vs 2.72). Where statistically significant differences were found, the effect sizes were negligible to medium in magnitude with the largest differences noted between RNs and RPNs working in the emergency department. CONCLUSIONS: The results suggest the need to implement strategies that diminish role conflict for both RNs and RPNs.

11.
Artigo em Inglês | MEDLINE | ID: mdl-33671888

RESUMO

Tens of millions of individuals go to gasoline stations on a daily basis in the United States. One of the constituents of gasoline is benzene, a Group 1 carcinogen that has been strongly linked to both occupational and non-occupational leukemias. While benzene content in gasoline is federally regulated, there is approximately a thirty-year data gap in United States research on benzene exposures from pumping gasoline. Using a novel self-sampling protocol with whole air canisters, we conducted a gasoline pumping exposure assessment for benzene, toluene, ethylbenzene, and xylene (BTEX) on Baltimore, MD consumers. Geometric mean exposures (geometric standard deviations) were 3.2 (2.7) ppb,9.5 (3.5) ppb, 2.0 (2.8) ppb, and 7.3 (3.0) ppb, respectively, on 32 samples. Using the benzene exposures, we conducted consumer and occupational probabilistic risk assessments and contextualized the risk with ambient benzene exposure risk. We found that the consumer scenarios did not approach the 1:1,000,000 excess risk management threshold and that the occupational scenario did not exceed the 1:10,000 excess risk management threshold. Further, in all Monte Carlo trials, the ambient risk from benzene exposure exceeded that of pumping risk for consumers, but that in approximately 30% of occupational trials, the pumping risk exceeded the ambient risk.


Assuntos
Neoplasias , Exposição Ocupacional , Baltimore , Benzeno/análise , Benzeno/toxicidade , Derivados de Benzeno/análise , Derivados de Benzeno/toxicidade , Gasolina/análise , Humanos , Exposição Ocupacional/análise , Tolueno/análise , Tolueno/toxicidade , Estados Unidos , Xilenos/análise
12.
Health Qual Life Outcomes ; 19(1): 98, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33743742

RESUMO

OBJECTIVE: The aim of this systematic review was to summarize and assess the literature on quality of life (QoL) among cancer patients 80 years and older admitted to hospitals and what QoL instruments have been used. METHODS: We searched systematically in Medline, Embase and Cinahl. Eligibility criteria included studies with any design measuring QoL among cancer patients 80 years and older hospitalized for treatment (surgery, chemotherapy or radiation therapy). EXCLUSION CRITERIA: studies not available in English, French, German or Spanish. We screened the titles and abstracts according to a predefined set of inclusion criteria. All the included studies were assessed according to the Critical Appraisal Skills Programme checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement checklist was used to ensure rigor in conducting and reporting. This systematic review was registered in PROSPERO (CRD42017058290). RESULTS: We included 17 studies with 2005 participants with various cancer diagnoses and Classification of Malignant Tumors stages (TNM). The included studies used a range of different QoL instruments and had different aims and outcomes. Both cancer-specific and generic instruments were used. Only one of the 17 studies used an age-specific instrument. All the studies included patients 80 years and older in their cohort, but none specifically analyzed QoL outcomes in this particular subgroup. Based on findings in the age-heterogeneous population (age range 20-100 years), QoL seems to be correlated with the type of diagnosed carcinoma, length of stay, depression and severe symptom burden. CONCLUSION: We were unable to find any research directly exploring QoL and its determinants among cancer patients 80 years and older since none of the included studies presented specific analysis of data in this particular age subgroup. This finding represents a major gap in the knowledge base in this patient group. Based on this finding, we strongly recommend future studies that include this increasingly important and challenging patient group to use valid age- and diagnosis-specific QoL instruments.


Assuntos
Pacientes Internados/psicologia , Neoplasias/psicologia , Qualidade de Vida , Idoso de 80 Anos ou mais , Hospitalização , Humanos , Neoplasias/terapia , Inquéritos e Questionários
13.
Nutrients ; 13(2)2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-33573299

RESUMO

Research is limited on added sugars in school meals and children's dietary intakes after the 2015-2020 Dietary Guidelines for Americans (DGA) recommended that added sugars be limited to less than 10% of total calories. This analysis uses data from the School Nutrition and Meal Cost Study (SNMCS) to examine levels of added sugars in: (1) school meals and (2) children's dietary intakes at breakfast, lunch, and over 24 h on school days. SNMCS data were collected in the 2014-2015 school year after updated nutrition standards for school meals were implemented. Most schools exceeded the DGA limit for added sugars at breakfast (92%), while 69% exceeded the limit at lunch. The leading source of added sugars in school meals (both breakfasts and lunches) was flavored skim milk. More than 62% of children consumed breakfasts that exceeded the DGA limit, and almost half (47%) consumed lunches that exceeded the limit. Leading sources of added sugars in the breakfasts consumed by children were sweetened cold cereals and condiments and toppings; leading sources of added sugars in children's lunches were flavored skim milk and cake. Over 24 h, 63% of children exceeded the DGA limit. These findings show that school meals and children's dietary intakes are high in added sugars relative to the DGA limit and provide insights into the types of foods that should be targeted in order to decrease levels of added sugars.


Assuntos
Dieta/estatística & dados numéricos , Açúcares da Dieta/administração & dosagem , Serviços de Alimentação/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Criança , Inquéritos sobre Dietas , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Política Nutricional , Estados Unidos
14.
J Diet Suppl ; 18(3): 293-315, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32319852

RESUMO

Military personnel use dietary supplements (DS) for performance enhancement, bodybuilding, weight loss, and to maintain health. Adverse events, including cardiovascular (CV) effects, have been reported in military personnel taking supplements. Previous research determined that ingestion of multi-ingredient dietary supplements (MIDS), can lead to signals of safety concerns. Therefore, to assess the safety of MIDS, the Department of Defense via a contractor explored the development of a model-based risk assessment tool. We present a strategy and preliminary novel multi-criteria decision analysis (MCDA)-based tool for assessing the risk of adverse CV effects from MIDS. The tool integrates toxicology and other relevant data available on MIDS; likelihood of exposure, and biologic plausibility that could contribute to specific aspects of risk.Inputs for the model are values of four measures assigned based on the available evidence supplemented with the opinion of experts in toxicology, modeling, risk assessment etc. Measures were weighted based on the experts' assessment of measures' relative importance. Finally, all data for the four measures were integrated to provide a risk potential of 0 (low risk) to 100 (high risk) that defines the relative risk of a MIDS to cause adverse reactions.We conclude that the best available evidence must be supplemented with the opinion of experts in medicine, toxicology and pharmacology. Model-based approaches are useful to inform risk assessment in the absence of data. This MCDA model provides a foundation for refinement and validation of accuracy of the model predictions as new evidence becomes available.


Assuntos
Técnicas de Apoio para a Decisão , Suplementos Nutricionais , Medição de Risco , Suplementos Nutricionais/efeitos adversos , Humanos , Militares
15.
Clin Nurs Res ; 30(1): 12-22, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-30318907

RESUMO

The prevalence of chronic insomnia is on the rise among young, middle-aged, and older adults. This secondary data analysis examined age-group differences in the experience of and factors perpetuating insomnia severity. Pretest data, obtained from a trial of behavioral interventions, were collected from 742 participants, using psychometrically sound measures of perpetuating factors (sleep habits, unhelpful beliefs, presleep arousal), insomnia experience (symptoms, perceived severity), and consequences or impact on daytime functioning. The age groups reported different insomnia symptoms (difficulty maintaining sleep in older adults) and impact on daytime functioning (poorer in older adults), but the same level of perceived insomnia severity. Unhelpful beliefs about sleep predicted insomnia severity in all age groups, and presleep arousal contributed to insomnia in young adults. The results highlight the importance of adequately managing chronic insomnia to minimize its impact on daytime functioning in all age groups, and of tailoring therapy to their experiences.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Idoso , Nível de Alerta , Humanos , Pessoa de Meia-Idade , Prevalência , Sono , Adulto Jovem
16.
Nutrients ; 12(12)2020 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-33352695

RESUMO

Prior research has shown that participation in the United States' National School Lunch Program (NSLP) is associated with consuming higher-quality lunches and diets overall, but little is known about differences by income and race/ethnicity. This analysis used 24 h dietary recall data from the School Nutrition and Meal Cost Study to examine how NSLP participation affects the diet quality of students in different income and racial/ethnic subgroups. Diet quality at lunch and over 24 h was assessed using the Healthy Eating Index (HEI)-2010, where higher scores indicate higher-quality intakes. HEI-2010 scores for NSLP participants and nonparticipants in each subgroup were estimated, and two-tailed t-tests were conducted to determine whether participant-nonparticipant differences in scores within each subgroup were statistically significant. NSLP participants' lunches received significantly higher total HEI-2010 scores than those of nonparticipants for lower-income, higher-income, non-Hispanic White, and non-Hispanic Black students, suggesting that participating in the NSLP helps most students consume healthier lunches. These significantly higher total scores for participants' lunch intakes persisted over 24 h for higher-income students and non-Hispanic White students but not for lower-income students or students of other races/ethnicities. For NSLP participants in all subgroups, the nutritional quality of their 24 h intakes was much lower than at lunch, suggesting that the positive influence of the NSLP on their overall diet quality was negatively influenced by foods consumed the rest of the day (outside of lunch).


Assuntos
Dieta Saudável/estatística & dados numéricos , Serviços de Alimentação/estatística & dados numéricos , Almoço , Serviços de Saúde Escolar/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Afro-Americanos/estatística & dados numéricos , Criança , Inquéritos sobre Dietas , Dieta Saudável/etnologia , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Valor Nutritivo , Estados Unidos , Adulto Jovem
17.
Child Obes ; 16(7): 479-487, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33030989

RESUMO

Background: Although the increases in overweight and obesity observed for several decades have appeared to have leveled off, the prevalence of overweight and obesity remains exceptionally high among children of color. This article estimates the effect of Healthy Harlem's Get Fit-a 12-week after-school program aimed at helping students improve physical activity and eating habits-on BMI and weight status of adolescents. Methods: Participants were 436 students who had overweight or obesity in 12 Harlem Children's Zone after-school programs in New York. The evaluation was a randomized controlled trial where students were assigned to an intervention group that received Get Fit plus Prevention services or a control group that only received Prevention services in 2013 or 2014. Impacts were assessed on BMI z-score, percentage with overweight or obesity, and percentage with obesity using regression analysis. Results: Relative to the control group, students randomized to Get Fit experienced a decrease in BMI z-score (mean difference = -0.04; p = 0.02). The percentage of students with overweight or obesity was also lower (mean difference = -5.3; p = 0.02), but there was no effect on the percentage of students with obesity. Get Fit had an impact on BMI for girls, but not boys. Conclusions: Get Fit improved middle- and high-school students' BMI outcomes and weight status. Schools continue to face pressure to allocate time for physical education and activity while meeting their academic demands, underscoring the importance of after-school student-level interventions like Get Fit.


Assuntos
Obesidade Pediátrica , Adolescente , Criança , Exercício Físico , Comportamento Alimentar , Feminino , Humanos , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Serviços de Saúde Escolar , Instituições Acadêmicas
18.
Nurse Educ Today ; 93: 104537, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32717698

RESUMO

BACKGROUND: Despite efforts to incorporate information about older people in pre-licensure nursing programs, there are inconsistent results from studies examining student nurses' perceptions towards the aging population. There is research suggesting that healthcare settings and nursing practice is perpetuating negative perspectives towards older people. OBJECTIVE: To gain an understanding of how social contexts are influencing student nurses' experiences when learning to work with older people. DESIGN: Descriptive case study guided by the theoretical framework of social learning theory. SETTING: A university in Western Canada that offers a pre-licensure nursing program. PARTICIPANTS: 28 student nurses and 13 faculty in the nursing program. METHODS: Participant interviews and focus groups were conducted with nursing faculty and students. RESULTS: Key findings from this study are that students' previous experiences with older people, through family or work experiences, and their first clinical experience in long- term care negatively influenced their perceptions about working with older people. Clinical nurses and faculty influenced students' perceptions about nursing practice with older people, sometimes in subtle ways, underscoring that students are learning from what they see and hear in practice. Students were ill-prepared for the complexity of the aging population, particularly those with cognitive impairment. CONCLUSIONS: Learning activities that engage students in active learning, such as simulation, providing students with a positive lexicon of how to describe older patients, and more overt attention to the perspectives students and faculty bring to the learning environment need to be carefully explored. Meaningful learning experiences with older people in multiple contexts are needed to thoughtfully plan how to disrupt negative perceptions that might emerge through the nursing education program.


Assuntos
Docentes de Enfermagem/psicologia , Enfermagem Geriátrica , Teoria Social , Estudantes de Enfermagem/psicologia , Adulto , Idoso , Atitude do Pessoal de Saúde , Canadá , Disfunção Cognitiva , Bacharelado em Enfermagem , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
BMJ Glob Health ; 5(7)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32641292

RESUMO

As a marginalised subpopulation, migrant workers often fall short from protection by public policies, they take precarious jobs with unsafe working and living conditions and they grapple with cultural and linguistic barriers. In light of the current COVID-19 pandemic, migrant workers are now exposed to additional stressors of the virus and related responses. We applied a comprehensive qualitative cumulative risk assessment framework for migrant workers living in Kuwait. This pandemic could be one of the few examples where the stressors overlap all domains of migrant workers' lives. No single intervention can solve all the problems; there must be a set of interventions to address all domains. Local authorities and employers must act quickly to stop the spread, ensure easy access to testing and treatment, provide adequate housing and clear communication, encourage wide social support, safeguard financial protection and mental well-being and continuously re-evaluate the situation as more data are collected.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Medição de Risco , Migrantes , Adulto , COVID-19 , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Kuweit/epidemiologia , Masculino , Saúde do Trabalhador , Ocupações , Pesquisa Qualitativa , Fatores de Risco
20.
Int J Health Serv ; 50(3): 264-270, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32517569

RESUMO

The early 2020 response to COVID-19 revealed major gaps in public health systems around the world as many were overwhelmed by a quickly-spreading new coronavirus. While the critical task at hand is turning the tide on COVID-19, this pandemic serves as a clarion call to governments and citizens alike to ensure public health systems are better prepared to meet the emergencies of the future, many of which will be climate-related. Learning from the successes as well as the failures of the pandemic response provides some guidance. We apply several recommendations of a recent World Health Organization Policy Brief on COVID-19 response to 5 key areas of public health systems - governance, information, services, determinants, and capacity - to suggest early lessons from the coronavirus pandemic for climate change preparedness. COVID-19 has demonstrated how essential public health is to well-functioning human societies and how high the economic cost of an unprepared health system can be. This pandemic provides valuable early warnings, with lessons for building public health resilience.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Atenção à Saúde/organização & administração , Pneumonia Viral/epidemiologia , COVID-19 , Fortalecimento Institucional/organização & administração , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Nível de Saúde , Humanos , Sistemas de Informação/organização & administração , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Administração em Saúde Pública , SARS-CoV-2
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