Your phrases matter: Third waves in research approaches and new contexts for formulaic language.

BACKGROUND: This study reports on new contexts in which formulaic language has been used in the years since 2013 when the last synthesis was carried out. The background presents an old but still useful definition and lists themes under which research was arranged in 2013 and which continue to be used. AIMS: This study has a particular emphasis on the relevance of formulaic language to people living with dementia. METHODS: Section 3, identifying new directions, reviews new 'third waves' of research priorities in several fields in which formulaic sequences play a major role, including sociolinguistic variation, corpus-based and corpus-driven analyses, pragmatics, human-computer interaction, and psycholinguistics, all of which are relevant to speech-language therapists. Section 4, outreach and expansions, illustrates new contributions from cognitively impaired person-to-person exchanges in online environments, recent examinations of infant- and pet-directed speech incorporating formulaic language, and online graphic explorations such as emojis. Section 5 focuses on growth of research in theoretical and clinical applications by Van Lancker Sidtis, as illustrated by references to her recent work. MAIN CONTRIBUTION: The paper's main contribution is to summarize the work on formulaic language over the last 10 years, to indicate its continued importance and relevance in ordinary conversation, and especially in allowing people living with dementia to continue to interact with others. CONCLUSION: The paper concludes by suggesting that more focus be placed on the analysis of formulaic language with an emphasis on its relevance for speech-language therapists and other clinicians. WHAT THIS PAPER ADDS: What is already known on the subject Research has been growing since the late 1970s and early 1980s on non-propositional language (as opposed at that time to the Chomskyan paradigm) and especially on lexical bundles, idioms, second language acquisition and multiword expressions. Studies beginning with Hughlings Jackson (1874) have been annotated through early 2012 (Wray, 2013). What this study adds This study examines 'third waves' in pragmatics, sociolinguistics and areas of neurology and speech perception contributing to what Van Lancker Sidtis (2021) calls the third wave of acceptance of the range and depth of formulaic sequences in ordinary or familiar language. What are the clinical implications of this work? Conversations with pet robots or web-based composition with emojis are but two of the developing areas built on formulaic sequences currently being used for communication interventions with persons living with dementia or other major neurocognitive disorder. Overviews of major contributions in theory and social contexts by Wray (2020, 2021) and theoretical and cognitive applications by Van Lancker Sidtis (2021) detail new areas for the study of formulaic sequences and their contributions to a range of neurocognitive disorders.

"Turn It over to God": Faith Enhances Mental Health of Rural Appalachian Older Adults.

In Appalachia, rates of depression and suicidality are higher than national averages. Additional disparities of age, geographic isolation, economic distress, and mental healthcare provider shortages contribute to mental health challenges among rural Appalachian older adults (RAOAs). Based on ethnonursing research in East Tennessee, this article expands on findings about how RAOA faith beliefs and practices enhance mental health. Faith was found to decrease worry, improve coping, facilitate a sense of peace, and deepen thankfulness and joy. Implications for nursing practice and education indicate the importance of providing spiritual care to promote mental health and well-being for this vulnerable population.

Influence of Spiritual Engagement on Appalachian Older Adults' Health: A Systematic Review.

Appalachia leads the country in mortality related to chronic comorbidities, such as heart disease, cancer, depression, and suicide. Appalachian older adults experience disproportionate risks for poor health outcomes. Spirituality is integral to Appalachian culture, and many older adults use spiritual engagement (SE) to cope with health challenges. Despite these connections, there is limited evidence about SE and well-being in this population. Therefore, the current systematic review addresses the literature gap of how SE influences health of Appalachian older adults. Using thematic synthesis, we analyzed 11 qualitative and three mixed methods studies. Major findings indicate that SE positively impacts holistic health through adaptive coping, guided partnerships with God, decreased loneliness, and enhanced sense of purpose. Future studies could examine SE practices among diverse populations, SE virtual experiences, and SE nursing assessments. Understanding how SE influences health of Appalachian older adults could prepare nurses to reduce disparities and improve health outcomes for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 61(5), 45-52.].

Older Adults' Views and Attitudes on Physical Activity; Reasons to Participate and Abstain.

Purpose: Despite numerous established benefits of exercise, many older adults do not get enough. The purpose of this study was to identify facilitators and barriers to physical activity/exercise; gain greater understanding of older adults' physical activity self-efficacy; and increase understanding of how to reduce sedentary behavior.Design: Cross-sectional descriptiveMethods: Quantitative with convenience sample of 66 older adultsFindings: Nearly one third of participants reported engaging in regular physical activity. They tended to have rather strong physical activity self-efficacy and limited barriers to being active.Conclusions: The sample had limited involvement in physical activity or exercise, despite feeling confident in their ability to be active. There could be additional barriers or motivating factors that are preventing them from being more active.Clinical Evidence: Honest and directed conversation about older adults' understanding and attitudes towards exercise, paired with an individualized plan tailored to their interests and lifestyle could help increase physical activity/exercise.

Effectiveness of eHealth Technology-Based Interventions in Reducing Substance Misuse Among Older Adults: A Systematic Review.

Generally considered an epidemic among young people, substance misuse has been a growing issue among older Americans for the past 40 years. Legal substances, such as alcohol, tobacco, and prescription drugs, including opioids and marijuana, are of primary concern when it comes to aging Baby Boomers. By 2050, 22% of Americans will be aged ≥65 years. Currently, eHealth interventions are receiving attention in treating substance misuse among younger Americans. The current study has two aims: to evaluate the effectiveness of eHealth interventions for older adults treated for substance misuse problems, as well as to investigate behavioral outcomes in reducing substance misuse. A comprehensive search of databases yielded 35,041 articles that examined reductions in substance misuse and problem behaviors as a primary outcome with eHealth interventions delivered to older adults. Once duplicate and irrelevant articles were removed, seven were left to be analyzed. Findings suggest use of technology to assess and intervene with older adults using various substances shows promise and, as a whole, older adults are receptive to online learning, screening and assessment, and interventions. [Journal of Gerontological Nursing, 47(10), 23-29.].

Physical activity, cardiovascular health and mood state in older adults.

Many older adults eat poorly balanced diets and are physically inactive, posing a risk to their cardiovascular and mental health. The benefits of healthful living extend beyond cardiovascular health and disease risk reduction such that physical activity has been shown to positively affect mood state. This was a cross-sectional investigation completed at three senior lunch program sites in Charlotte, NC to assess the status and relationship of nutrition, physical activity patterns, and mood state in older adults, prior to the center offering a new nutritional and physical activity intervention. Some significant relationships between cardiovascular indicators and mood were found.

Acceptability of wristband activity trackers among community dwelling older adults.

Wristband activity trackers have become widely used among young adults. However, few studies have explored their use for monitoring and improving health outcomes among older adults. The purpose of this study was to evaluate the feasibility and utility of activity tracker use among older adults for monitoring activity, improving self-efficacy, and health outcomes. A 12-week pilot study was conducted to evaluate the feasibility and utility of mobile wristband activity trackers. The sample (N = 34) was 65% women 73.5 ± 9.4 years of age who had a high school diploma or GED (38%) and reported an income ≤$35,000 (58%). Participants completing the study (95%) experienced a decrease in waist circumference (p > 0.009), however no change in self-efficacy. Participants found activity trackers easy to use which contributed to minimal study withdrawals. It was concluded that activity trackers could be useful for monitoring and promoting physical activity and improving older adults' health.

Gerotranscendence, Hope, and Coherence in the Face of Life Adversity.

Background and Purpose: Older adults are living longer and becoming more diverse. The current study examined the relationship between traumatic life events, hope, coherence, and successful aging in Black and White older adults with at least one chronic health condition, and the influence of life events on gerotranscendence. Methods: Fifty older adults from two senior centers participated. Participants completed the Successful Aging Inventory, Life Events Checklist, Herth Hope Index, and Sense of Coherence Scale. Results: Significant correlations were found between successful aging and gerotranscendence (r = .290; p = .048) and hope (r = .585; p = <.001). Simple linear regression found that Successful Aging Index (SAI) scores significantly predicted gerotranscendence (R2 = .10, F(1, 46) = 5.157, p = .028) and Herth Hope Index scores (R2 = .36, F(1, 46) = 25.850, p <.001). Higher Sense of Coherence (SoC) and Gerotranscendence Scale scores among those with no firsthand trauma experience suggest that experiencing traumatic events firsthand may adversely affect the aging process. Implications: Therefore, exploration of trauma experiences, with mental health referrals as appropriate are clinical implications to consider.

Influences of Faith on Rural Appalachian Older Adult Health: An Ethnonursing Study.

INTRODUCTION: Rural Appalachian older adults (RAOAs) constitute a vulnerable population and experience significant health disparities. The combination of age, poverty, rural residence, health care provider shortages, and limited transportation increases risks for poor health outcomes. Spirituality enhances older adult health; however, little is known about spirituality-health linkages of RAOAs. Therefore, the purpose of this study was to discover the influences of spirituality on RAOA health. METHODOLOGY: Culture Care Theory and ethnonursing method guided analysis of 32 RAOA interviews in community settings in East Tennessee. RESULTS: "Faith" is an integral component of RAOA culture and health. Three themes were extrapolated: (a) Relationship with God is personal; (b) faith beliefs and practices influence health, illness, death, and dying; and [the need to] (c) "Open the door" for spiritual care. DISCUSSION: Faith assessment and spiritual care recommendations contribute to culturally congruent care for RAOAs and may be transferable to care for other older adults.

Successful aging among assisted living community older adults.

PURPOSE: This study investigated the suitability of using the Successful Aging Inventory (SAI) in an effort to describe successful aging among older adults currently living in assisted living communities (ALCs) and to further assess some of the characteristics of successful aging in this group. DESIGN: This study used a cross-sectional descriptive quantitative research design. Recruitment garnered 200 participants 65 years of age or older from eight ALCs in North Carolina. METHODS: Screening was done using the Mini-Cog; instrumentation was composed of the SAI, Purpose in Life Test, Life Satisfaction Inventory-A, and Centers for Epidemiologic Studies Depression Scale. FINDINGS: Among the differences were those influenced by gender, with females tending to score higher on successful aging (p < .004). CONCLUSIONS: This research demonstrated that successful aging does exist in ALC residents. CLINICAL RELEVANCE: The size of the older adult population will proliferate dramatically during the next two decades. Many of these individuals will find themselves living in ALCs; therefore, it is important to continue to strive to understand what successful aging looks like in these individuals in order to adopt meaningful practices and interventions aimed at eliciting successful aging responses in those living in these communities.

An examination of successful aging among Southern Black and White older adults.

Research on successful aging in minority older adults and those from certain regions of the United States, such as the South, is lacking. It is important to learn whether disparities exist in Southern Black older adults' perceptions of successful aging compared to those of majority older adults. Thus, this study examined successful aging using focus groups to obtain a regionally and racially sensitive understanding of the phenomenon. Focus group sessions were facilitated with Southern Black and White older adults with questions on successful aging, using content analysis to interpret the findings. Four central themes were found: Connecting and Relating; Temporality; Perception and Interpretation; and Activity. Beliefs and decisions about managing oneself through life events, including health problems and disability, may have a major influence on the trajectory of progressive, chronic illness, and consequently, successful aging.

Physical activity preferences for low-income sedentary urban African American older adults.

The objective of this study was to determine (a) activity preferences for low-income sedentary urban African American older adults and (b) information needed to deliver a lay physical activity intervention in the community for this population. This descriptive qualitative study used six focus groups. Participants were African American, 55 and older, had low incomes, and had sedentary behavior. Physical activity themes included excitement/emotion for physical activity, group physical activity, and location of physical activity. Themes regarding aspects of being a lay community health worker included beneficial service, uncertainty, logistics concerns, and delivery method preferences. The findings from this study will provide the basis for an intervention for low-income sedentary African American older adults. Preferences for physical activity, concerns about and supports needed for individuals to serve as lay community health workers, various types of training materials, and preferred technology for physical activity participation are identified and discussed.

Relationships between Interpersonal Goals and Loneliness in Older Adults: A Cross-Sectional Study.

Loneliness is linked to many physiological and psychological issues and disproportionately affects older adults. Interpersonal goals (compassion and self-image) are essential to interpersonal relationships; however, how they relate to loneliness in older adults is unknown. We investigated the impact of interpersonal goals on loneliness using the Ecosystem-Egosystem Theory of Social Motivation. This study, adopting a descriptive cross-sectional correlational design, used data from the 2016 Health and Retirement Study. Participants (n = 3212) included people aged >65 years (mean age: 75; female: 60.1%). We performed exploratory factor analysis with principal axis factoring and varimax rotation to examine the suitability of compassionate and self-image goals as separate factors. The complex samples general linear model was used to assess the relationship between loneliness and interpersonal goals. Interpersonal goals were significantly negatively associated with loneliness. Respondents with higher compassion and self-image goals reported lower loneliness levels. Our results contribute to understanding how interpersonal goals relate to loneliness in older adults. These initial findings warrant further investigation.

Mentoring nurse scientists to meet nursing faculty workforce needs.

Research indicates that mentoring has been highly effective in promoting faculty success. Strong mentors in the area of scholarship are extremely valuable for junior faculty, not only because of their research and academic expertise but also for their role modeling behaviors. This paper highlights key components of research mentoring used by a senior nursing faculty member. The senior faculty mentor and junior faculty mentee developed a common vision, relating to research interests in health promotion for vulnerable populations. Impact at the individual, school, university, and society level is discussed, and benefits of mentoring to meet nursing faculty workforce needs are emphasized.

What's Your Position? Strategies for Safely Reaching Patient Comfort Goals After Cardiac Catheterization via Femoral Approach.

BACKGROUND: Patients frequently complain of back pain after cardiac catheterization, and there is a lack of evidence to guide practice regarding patient comfort while maintaining hemostasis at femoral access site after cardiac catheterization. OBJECTIVE: The aim of this study was to examine if frequent position changes affect a patient's pain level or increase incidents of bleeding in the recovery period after cardiac catheterization. METHODS: A quasi-experimental pretest/posttest design was used to evaluate a patient's reported pain levels and positioning changes during bed rest period postprocedure. Twenty charts were reviewed to note documentation of patient position, self-reported pain rating related to pain relief goals, and occurrence of bleeding at the procedure site. A survey was conducted to reveal nurse attitudes, knowledge, and beliefs regarding positioning and pain management for patients in the post-cardiac catheterization period. Results from this survey were used to develop education and data collection tools. Education regarding perceived barriers and importance of maximizing activity orders for patient comfort was provided to nursing staff. After nurse education, an additional 20 charts were reviewed to note if increasing frequency of position change affects pain levels reported by patients or if any increased incidence of bleeding was noted with greater frequency of position change. RESULTS: Data were analyzed using correlation analyses. Greater levels of pain were associated with higher pain ratings (r = 0.796, P < .000). Use of position change only as a comfort measure was negatively associated with pain ratings; in other words, lower patient pain ratings were associated with use of positioning only without addition of medications to address complaint (r = -0.493, P < .023). There was a significant increase in number of pain management goals met from before to after education intervention (P < .046). DISCUSSION: Nurse concern for increased bleeding was found to be the most common barrier for use of position changes for comfort after cardiac catheterization. This initial analysis suggests position changes in conjunction with pain medication are beneficial in managing pain after cardiac catheterization. There was no increase in bleeding or complications reported; however this study had a small sample size, and caution should be used regarding generalization of findings.

Successful aging from the viewpoint of older adults.

The purpose of this study was to investigate older adults' perceptions of successful aging within the context of the theory of successful aging to validate and further inform this theory. This research was a secondary, qualitative analysis of data from two earlier studies in which participants were asked to provide a response to the open-ended question, "What does successful aging mean to you?" Content analysis using multiple coding was independently conducted by the investigators. Eight broad themes emerged: active independence, relationships with people, relationship with God, comfort resources, health, beneficial contribution, positive perspective/coping, and freedom. Differences and similarities of themes by study subgroups were also explored. The coping processes, functional performance mechanisms, and intrapsychic factors from the theory of successful aging were well represented in the findings of this study. The coping process of spirituality was less frequently represented, whereas that of gerotranscendence was slightly more often described. Interventions that enhance these factors associated with successful aging have the potential to improve quality of life and provide appealing, meaningful activities for older adults.

Construction, Deconstruction, and Reconstruction: The Roots of Successful Aging Theories.

The authors' goals are to examine the evolution of the concept of successful aging and its relevance to nursing science and practice. First, the history of positivist construction of aging in light of disengagement and activity theories is presented. Second, an analysis of the postmodern deconstruction of aging is illustrated with the development of the ageism phenomenon. Third, the beginning of the reconstruction of aging is presented and exemplified by Troutman's middle-range nursing theory of successful aging, as connected to Roy's model. Finally, ways in which these theories can be made applicable to nursing practice and research are proposed.

Presence of medical home and school attendance: an analysis of the 2005-2006 National Survey of Children With Special Healthcare Needs.

BACKGROUND: Children with special healthcare needs (CSHCN) tend to miss more school because of illness. Medical homes are a model of primary health care that coordinate services to better meet the needs of the child. The purpose of this study was to examine the association between presence of medical home and missed school days among CSHCN. METHODS: A secondary analysis of cross-sectional data from the 2005 National Survey of Children With Special Healthcare Needs (NS-CSHCN) was conducted. Multivariate ordinal logistic regression was done to analyze the relationship between presence of a medical home and number of missed school days. RESULTS: The presence of a medical home among CSHCN was associated with being in the highest category of missed school days. The adjusted odds ratios for the number of missed school days, after adjustment for poverty, metropolitan statistical area status, education in the household, age, race and ethnicity, demonstrated that access to a medical home does not decrease school absences. CONCLUSION: Although the data did not support the hypothesis that CSHCN with a medical home would have fewer missed school days due to illness, this study does evoke future research questions, such as what is the relationship between parental perception of child health status with number of missed school days and how adequate is the communication between families and healthcare providers in the medical home.

Medical home and emergency department utilization among children with special health care needs: an analysis of the 2005-2006 National Survey of Children with Special Health Care Needs.

The purpose of this article was to determine whether medical home associated with reduction in emergency department utilization by children with special health care needs. The study comprised 40 723 children participating in the National Survey of Children with Special Health Care Needs. For whole sample, presence of medical home was not associated with a decrease in emergency department (ED) utilization. However, children aged 0 to 5 years and those with severe functional limitations derived the most benefit from a medical home. Presence of medical home for severely limited children was associated with fewer ED visits (odds ratio, 0.59; 95% confidence interval, 0.50-0.70). Additional studies are warranted to explore specific components of a medical home and ED use.