In Search of a Gold Standard Tool for Assessing Knowledge of Stroke: A Systematic Review.

BACKGROUND: Knowledge of stroke is essential to empower people to reduce their risk of these events. However, valid tools are required for accurate and reliable measurement of stroke knowledge. We aimed to systematically review contemporary stroke knowledge assessment tools and appraise their content validity, feasibility, and measurement properties. METHODS: The protocol was registered in PROSPERO (CRD42023403566). Electronic databases (MEDLINE, PsycInfo, CINAHL, Embase, Scopus, Web of Science) were searched to identify published articles (1 January 2015-1 March 2023), in which stroke knowledge was assessed using a validated tool. Two reviewers independently screened titles and abstracts prior to undertaking full-text review. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methods guided the appraisal of content validity (relevance, comprehensiveness, comprehensibility), feasibility, and measurement properties. RESULTS: After removing duplicates, the titles and abstracts of 718 articles were screened; 323 reviewed in full; with 42 included (N = 23 unique stroke knowledge tools). For content validity, all tools were relevant, two were comprehensive, and seven were comprehensible. Validation metrics were reported for internal consistency (n = 20 tools), construct validity (n = 17 tools), cross-cultural validity (n = 15 tools), responsiveness (n = 9 tools), reliability (n = 7 tools), structural validity (n = 3 tools), and measurement error (n = 1 tool). The Stroke Knowledge Test met all content validity criteria, with validation data for six measurement properties (n = 3 rated "Sufficient"). CONCLUSION: Assessment of stroke knowledge is not standardised and many tools lacked validated content or measurement properties. The Stroke Knowledge Test was the most comprehensive but requires updating and further validation for endorsement as a gold standard.

Opioid-driven disruption of the septal complex reveals a role for neurotensin-expressing neurons in withdrawal.

Because opioid withdrawal is an intensely aversive experience, persons with opioid use disorder (OUD) often relapse to avoid it. The lateral septum (LS) is a forebrain structure that is important in aversion processing, and previous studies have linked the lateral septum (LS) to substance use disorders. It is unclear, however, which precise LS cell types might contribute to the maladaptive state of withdrawal. To address this, we used single-nucleus RNA-sequencing to interrogate cell type specific gene expression changes induced by chronic morphine and withdrawal. We discovered that morphine globally disrupted the transcriptional profile of LS cell types, but Neurotensin-expressing neurons (Nts; LS-Nts neurons) were selectively activated by naloxone. Using two-photon calcium imaging and ex vivo electrophysiology, we next demonstrate that LS-Nts neurons receive enhanced glutamatergic drive in morphine-dependent mice and remain hyperactivated during opioid withdrawal. Finally, we showed that activating and silencing LS-Nts neurons during opioid withdrawal regulates pain coping behaviors and sociability. Together, these results suggest that LS-Nts neurons are a key neural substrate involved in opioid withdrawal and establish the LS as a crucial regulator of adaptive behaviors, specifically pertaining to OUD.

Promoting adherence to stroke secondary prevention behaviours by imparting behaviour change skills: protocol for a single-arm pilot trial of Living Well After Stroke.

INTRODUCTION: Survivors of stroke have an elevated risk of recurrent stroke. Prompt intervention to support healthy lifestyle modification following an initial stroke is crucial for effective secondary prevention of stroke. However, many patients do not receive adequate postdischarge support for secondary prevention, particularly if not referred to inpatient rehabilitation. Living Well After Stroke is a health promotion programme based on the health action process approach (HAPA), which is designed to support this underserviced group to improve and self-manage secondary prevention behavioural performance (eg, diet, exercise, medication-adherence) by equipping participants with a toolkit of theory-based and evidence-based behaviour change strategies and techniques that are transferable to different behavioural contexts. METHODS AND ANALYSIS: The target sample is 118 adults living in Queensland, Australia, with stroke or transient ischaemic attack not referred to inpatient rehabilitation. Adopting a prospective single-arm trial design, the intervention comprises five behaviour change sessions over an 8-week period. Participants will receive a mix of individual-based and group-based assessments and interventions, based on the HAPA theoretical framework, delivered via telehealth or in-person (eg, public library). Measures of primary (ie, goal behaviours 1 and 2) and secondary outcomes (intention, outcome expectancy, risk perception, self-efficacy, planning, action control, subjective well-being) will be taken at 2 weeks, 4 weeks, 8 weeks and 16 weeks. The primary outcomes of the trial will be behavioural performance and transferability of behaviour change skills at 16 weeks. ETHICS AND DISSEMINATION: The study has received ethical approval from the Griffith University Human Research Ethics Committee (Ref no: 2022/308). Informed consent is obtained via telephone prior to data collection. Findings will be presented in the form of peer-reviewed journal articles, industry reports and conference presentations, and will be used to inform the continued development and refinement of the programme for testing in a future fully powered trial.

Measuring self efficacy for mammography screening in older African American women.

African American women utilize mammography services less than white women, resulting in higher mortality rates for this population. The concept of self efficacy has predicted mammography screening behaviors. Thus, the purpose of this pilot descriptive study was to measure self efficacy for mammography screening in older African American women. Results from the study illustrated that older African American women had low self efficacy with regards to mammography screening. Knowing the needs, understanding the fears, and working on solutions as it relates to self efficacy and mammography screening may increase mammography screening rates and decrease breast cancer mortality rates for this population.

Assessing knowledge of breast self exams in older African-American women.

Breast cancer mortality rates for older women increase dramatically with age. This descriptive study assessed the knowledge of breast self-exams (BSEs) via pre-tests and post-tests in older African-American women (> 60) at an initial session (Time 1), and then again at a follow-up session (Time 2) two months later. A sample of 57 older African-American women living in inner city apartment buildings participated in the study. There were significant differences between pre-test Time 1 and post-test Time 1 (p = .000) and pre-test Time 2 and post-test Time 2 (p = .000). In addition, a significant difference was detected between pre-test Time 1 and pre-test Time 2 (p = .039). Additionally, a content analysis revealed what factors would influence older African-American women to continue to perform BSEs in the future. Providing BSE education to older African-American women may be useful in decreasing mortality rates for breast cancer.

Teaching nurses to focus on the health needs of populations: a Master's Degree Program in Population Health Nursing.

Responding to the mandate to prepare nurses for practice in population-based healthcare, the faculty at Cleveland State University (CSU) developed a unique Master of Science in Nursing program to prepare Population Health Nurse Experts. The program prepares nurses to examine the health status of populations and to design, implement, and evaluate nursing interventions accounting for the varied factors impacting on the health of a defined group. The speciality of population health nursing is practiced by nurses who can use population sciences (epidemiology, demography, population projections, and population behavioral theories) along with post-baccalaureate nursing competencies to work with defined populations across care environments. The authors discuss a curriculum that prepares nurses for this emerging speciality.

Using health fairs to examine health promotion behaviors of older African Americans.

Unhealthy behaviors are responsible for high morbidity and mortality rates among older African Americans. For some older African Americans, changing unhealthy behaviors may be difficult to achieve due to limited knowledge and access to preventative health care services. Health fairs are just one venue of examining health promotion behaviors and providing health promotion information to older African Americans. The purpose of this article is to report the health promotion behaviors of older African Americans as a result of conducting two health fairs. The Transtheoretical Model served as the framework for examining health behavior change among older African Americans. Nursing implications will be discussed.

Assessing methicillin-resistant Staphylococcusaureus knowledge among nursing students.

MRSA is becoming more prevalent in healthcare settings and community settings. The purpose of the study is to assess MRSA knowledge among nursing students. A MRSA Survey was administered to nursing students to gauge their general knowledge about MRSA. The scores from the MRSA Survey indicated that nursing students had a knowledge deficit regarding MRSA. Nursing student's need specific MRSA content in the nursing curriculum and need role models in healthcare settings who are following infection control guidelines. A variety of teaching strategies may be used to effectively teach this topic to nursing students. The goal of this education is to prevent the spread of MRSA organisms and decrease the related costs of treating MRSA infections.

Evaluation of an alcohol-based power sanitizing system for decontamination of hospital rooms of patients with methicillin-resistant Staphylococcus aureus carriage.

A power sanitizing system that delivers a sanitizing mist of alcohol, rendered nonflammable by a carbon dioxide carrier, and a low concentration of quaternary ammonium compound, was easy to use, provided thorough coverage of surfaces, and significantly reduced vancomycin-resistant Enterococcus and methicillin-resistant Staphylococcus aureus contamination on commonly touched hospital surfaces. However, it was not as consistently effective for elimination of pathogens as 10% bleach solution.

A case study approach to Hyperemesis Gravidarum: home care implications.

Clients with Hyperemesis Gravidarum (HG) have nausea and/or vomiting that prevents adequate intake of food and fluids. A client could have weight loss, dehydration, nutritional deficiencies, metabolic deficiencies, difficulty with daily activities, psychosocial stress and depression. Managing a client at home with HG is very complex and requires a multidisciplinary approach.

Nursing students' perceptions about disaster nursing.

Man-made or natural disasters are occurring more frequently in the United States and around the world. It is important that all nurses in all specialties be prepared to care for people affected by disasters. This article reports a descriptive study that sought to explore nursing students' perceptions about disaster nursing and to use the findings to suggest recommendations for building the discipline of disaster nursing. Results of this study indicate that nursing students had the following gaps of knowledge regarding disaster nursing: (1) an incomplete definition of disaster nursing; (2) lack of recognition about the importance of knowing community resources, having mock disaster drills, and utilizing disaster planning models; and (3) lack of perception that all nurses could play a significant role in disaster situations. The authors recommend that disaster nursing be taught by nursing faculty as a specialty in nursing programs.

How do nurse case managers care for older women with breast cancer?

PURPOSE/OBJECTIVES: To describe how nurse case managers care for older women with breast cancer. DESIGN: A randomized, prospective trial. SETTING: Thirteen community hospitals and two public hospitals in southeastern Texas. SAMPLE: 335 older women aged 60-89 years newly diagnosed with breast cancer and being cared for by 60 surgeons. Most participants were Caucasian. A total of 166 women were in the control group, and 159 were in the intervention nurse case management group. METHODS: The nurses implemented multiple nursing interventions in each nursing process phase over a period of 12 months. MAIN RESEARCH VARIABLES: Independent variables were participants' demographic characteristics, depressive symptomatology, and cognitive impairment. Nurse case management contact was a dependent variable. FINDINGS: In each nursing phase, a greater number of nurse case management contacts were made in the first quarter. Bivariate analysis illustrated statistical differences among race, income, education, and living alone with respect to the mean amount of nurse case management. Multivariate analysis revealed that age, income, living alone, and stage of cancer predicted more nurse case management contact. CONCLUSIONS: Nurse case managers may play a role in helping older women with breast cancer achieve positive health outcomes. IMPLICATIONS FOR NURSING: Based on the findings of this study, nurses can develop specific nursing interventions to meet the needs of older women with breast cancer. Nurses can use the Model of Nurse Case Management to plan and manage care for older women with breast cancer.

Nurses in adult day care centers.

Adult day care services are community-based group programs designed to support adults' personal independence by promoting their social, physical, and emotional well-being through an individual plan of care. Nurses are in a prime position to care for this population because they deliver holistic care and promote health. Scant literature is available that addresses how nurses provide care for this population. The purpose of this article is to describe how nurses can care for the adult day care population and to present an illustrative case study that demonstrates how nurses can positively affect the health of older adult day care clients.

Teaching disaster nursing by utilizing the Jennings Disaster Nursing Management Model.

Millions of people are affected by disasters or major incidents annually. Disaster preparedness has reached a new level of urgency in the UK and other countries around the world. Thus, nurses need to become involved in disaster management in order to function effectively in these types of situations. Exposing nurses to disaster nursing education may result in positive outcomes for populations involved in a disaster. Currently, there are few models or frameworks to guide nurses through the process of understanding disaster nursing. The purpose of this paper is to describe the Jennings Disaster Nursing Management Model and discuss its application in a Community Health Nursing course.

Older women with breast cancer: perceptions of the effectiveness of nurse case managers.

BACKGROUND: There are many challenges that an older woman and her family face when diagnosed with breast cancer. Utilizing community-based nurse case managers may influence the older client and her family to adapt to the many challenges associated with the diagnosis and treatment of breast cancer. PURPOSE: The purpose of this qualitative study is to describe how older breast cancer clients perceive community-based nurse case managers. From findings generated, recommendations were developed to improve the practice of community-based nurse case managers. METHOD: A randomized prospective trial to evaluate the effect of nurse case management on the treatment of 106 older women with breast cancer provided data for this content analysis. Older women (>65 years of age) newly diagnosed with breast cancer cared for by 60 surgeons practicing at 13 community and 2 public hospitals in southeast Texas were invited to participate. DISCUSSION: Community-based nurse case managers made a positive impact on older women with breast cancer by helping in managing coexisting medical conditions, providing support, providing education, giving assistance with activities of daily living (ADLs), and helping to navigate through the health care system. To increase their effectiveness, it was recommended that nurse case managers communicate well, be well educated about breast cancer, have standard gerontology nurse case management training, and integrate multiple support systems when caring for older clients with breast cancer. CONCLUSION: There are unique challenges that an older woman and her family face when diagnosed with breast cancer. Utilizing community-based nurse case managers may influence the client and her family to adapt to the many challenges associated with the diagnosis and treatment of breast cancer. Community-based nurse case managers can make a positive difference on the outcomes of older women with breast cancer.

Pilot study of the roles of personality, references, and personal statements in relation to performance over the five years of a medical degree.

OBJECTIVES: To compare the power of three traditional selection procedures (A levels, personal statements, and references) and one non-traditional selection procedure (personality) to predict performance over the five years of a medical degree. DESIGN: Cohort study over five years. SETTING: Nottingham medical school. PARTICIPANTS: Entrants in 1995. MAIN OUTCOME MEASURES: A level grades, amounts of information contained in teacher's reference and the student's personal statement, and personality scores examined in relation to 18 different assessments. RESULTS: Information in the teacher's reference did not consistently predict performance. Information in the personal statement was predictive of clinical aspects of training, whereas A level grades primarily predicted preclinical performance. The personality domain of conscientiousness was consistently the best predictor across the course. A structural model indicated that conscientiousness was positively related to A level grades and preclinical performance but was negatively related to clinical grades. CONCLUSION: A teacher's reference is of no practical use in predicting clinical performance of medical students, in contrast to the amount of information contained in the personal statement. Therefore, simple quantification of the personal statement should aid selection. Personality factors, in particular conscientiousness, need to be considered and integrated into selection procedures.