Quality of Life Health Outcomes Among People Who Lived in a Nursing Home Prior to and During the COVID-19 Pandemic.

The purpose of the current study was to compare quality of life health outcomes during the year prior to and first year of the coronavirus disease 2019 (COVID-19) pandemic among people who lived in a nursing home. This study used quarterly cross-sectional data from Minimum Data Sets between March 2019 and March 2021 among 96 people who resided in a nursing home. Health outcomes were cognitive function, transfer ability, depression, rejecting care, falls, urinary tract infections, physical conflict, and verbal conflict. Data were analyzed using Stuart-Maxwell test to compare differences in health outcomes in the year prior to and first year of the COVID-19 pandemic. There were statistically significant differences between the two time periods for the worsening of health outcomes related to transfer ability, rejecting care, physical conflict, and verbal conflict. Understanding the influence of the COVID-19 pandemic on health outcomes among people who live in nursing homes is critical for improving individual health and health system preparedness. [Journal of Gerontological Nursing, 49(12), 41-48.].

Growing Up on an Appalachian Farm: A Centenarian Perspective.

Background Research on centenarians to date has focused on areas with a high population of centenarians. However, there is limited literature on centenarians' perspectives about growing up on farms from the heartland of Appalachia in Eastern Tennessee. Purpose This qualitative descriptive study was designed to characterize the role of a farming childhood by exploring the viewpoints of community-dwelling centenarians who grew up on farms in south central Appalachia. Methods A qualitative descriptive design was used with a convenience sample ( n = 16). Cognitive status was determined with the Short Portable Mental Status Questionnaire. Demographic data were collected. Interviews were transcribed and analyzed with the Neuendorf method of content analysis. Results Main emerging themes were the farm, the family, and the environment. Conclusion The farm was at the center of these centenarians' childhood, influencing their family, community relations, and social interactions, which provided lessons that they utilized throughout their long lives.

An Exploratory Study Using Cortisol to Describe the Response of Incarcerated Women IPV Survivors to MAMBRA Intervention.

Objective. To determine if incarcerated women survivors of IPV had a physiological response to the Music and Account-Making for Behavioral-Related Adaptation (MAMBRA) intervention, as measured by cortisol levels. Methods. A single-group repeated measures designed exploratory study was used to pilot-test MAMBRA. A convenience sample (n = 33) was recruited in a Midwestern women's correctional facility. Serving as their own control, participants provided demographics and pre-/post-MAMBRA salivary samples while attending four MAMBRA sessions. Baseline data were compared to participants' data collected over the remaining 3 MAMBRA sessions. Data were analyzed with descriptive and univariate statistics with an alpha of .05 and post-hoc power of .65. Results. Participants were predominantly White (52%), single (80%), and early middle-aged ([Formula: see text]), with a history of physical/nonphysical spousal abuse. Using a subsample (n = 26), salivary cortisol decreased between the pre-/post-MAMBRA over the sessions (F(3,75) = 4.59, p < .01). Conclusion. Participants had a physiological response to the MAMBRA intervention as evidenced by the decreased cortisol between the pre-/post-MAMBRA. This is the first step in examining MAMBRA's clinical utility as an intervention for female IPV survivors. Future longitudinal studies will examine MAMBRA's effectiveness given this change in cortisol.

The Electrophysiological Phenomenon of Alzheimer's Disease: A Psychopathology Theory.

The current understanding of Alzheimer's disease (AD) is based on the Aß and tau pathology and the resulting neuropathological changes, which are associated with manifested clinical symptoms. However, electrophysiological brain changes may provide a more expansive understanding of AD. Hence, the objective of this systematic review is to propose a theory about the electrophysiological phenomenon of Alzheimer's disease (EPAD). The review of literature resulted from an extensive search of PubMed and MEDLINE databases. One-hundred articles were purposively selected. They provided an understanding of the concepts establishing the theory of EPAD (neuropathological changes, neurochemical changes, metabolic changes, and electrophysiological brain changes). Changes in the electrophysiology of the brain are foundational to the association or interaction of the concepts. Building on Berger's Psychophysical Model, it is evident that electrophysiological brain changes occur and affect cortical areas to generate or manifest symptoms from onset and across the stages of AD, which may be prior to pathological changes. Therefore, the interaction of the concepts demonstrates how the psychopathology results from affected electrophysiology of the brain. The theory of the EPAD provides a theoretical foundation for appropriate measurements of AD without dependence on neuropathological changes. Future research is warranted to further test this theory. Ultimately, this theory contributes to existing knowledge because it shows how electrophysiological changes are useful in understanding the risk and progression of AD across the stages.

Describing brain activity of persons with AD and depressive symptoms.

The purpose of this retrospective pilot study was to characterize depression of AD using electrophysiological changes in the brain activity of persons with AD and depressive symptoms. Participants had a mean age of 70.12±12.68. Participants manifested an increase in absolute/relative theta activity (p=.000) over entire brain when compared to normative population-based database. Electrophysiological changes did not differ by age or gender except for increased absolute theta activity in the right lateral frontal areas (t-test=-2.31 to -2.39, p=.04) in females. An increased theta activity suggests that depressive symptoms may be part of AD symptomatology, not a co-morbid feature.

Are they family or friends? Social support instrument reliability in studying older lesbians.

We know little about the support needs and health of older lesbians because participant sexual identity has typically not been identified in aging studies. The Lubben Social Network Scale, Revised (LSNS-R) is found widely reliable for testing perceived social support among elders but has never been tested with an exclusively lesbian population. This pilot tested the instrument with an exclusively lesbian population in the Midwest. Our analysis suggests it may not be reliable with this population, even with minor modifications that were made. Further examination adding a category for "family of choice" is warranted and supported by the originator of the tool.

MAMBRA's impact on IPV symptoms of incarcerated and formerly incarcerated women.

This repeated measures, descriptive study investigated the effect of Music and Account-Making for Behavioral-Related Adaptation (MAMBRA), a group psychoeducation music intervention, on symptoms reported by 41 incarcerated and community women survivors of intimate partner violence (IPV). Psychosocial measurements included: the Center for Epidemiologic Studies Depression Scale; Speilberger State Anxiety Inventory; Rosenberg's Self Esteem Scale; the UCLA Loneliness Scale, version 3; and the Index of Spouse Abuse. MAMBRA was administered over four sessions for five groups of women. Through descriptive and univariate statistics, psychosocial measures positively changed across the MAMBRA sessions. These findings suggest MAMBRA impacted IPV symptoms and may be an efficacious intervention. Future longitudinal studies with diverse samples are warranted.

Broadening definitions of family for older lesbians: modifying the Lubben social network scale.

Lesbian seniors have triple vulnerability (gender, sexual orientation, and age), necessitating inquiry into their social support needs, yet research about that is scare. Investigators identify relationships between social support and senior health. The Lubben Social Network Scale, Revised (LSNS-R), has provided such evidence and has been used to study many diverse senior groups. We modified it to include a Family of Choice category and qualitative questions to give context to responses among a sample of older lesbians. Our pilot demonstrated that the modification made a difference in accurately measuring social support among the sample, yet further investigation is warranted.

Nursing genomics: practice implications every nurse should know.

Twenty-first century nurse clinicians, scientists, and educators must be informed of and become proficient in genetic competencies to provide the best available evidenced-based patient care. This article presents a historical context and basic applications of genetics, along with the attendant legal and ethical issues, to provide a framework for understanding genetics and the genomics applications used in clinical nursing practice. The implications of genomics are relevant to all areas of nursing practice, including risk assessment, education, clinical management, and future research.

Participant satisfaction with Wellness Recovery Action Plan (WRAP).

Outpatient programs are often promoted as vehicles for mental health recovery. Yet, few programs include patients' perspectives about their satisfaction with these programs. This descriptive, cross-sectional survey investigated patients' satisfaction with Wellness Recovery Action Plan (WRAP). Participants completed the Mental Health Statistics Improvement Program instrument (n = 26) and qualitative interviews (n = 18). Data were analyzed using multivariate statistics (α = .05) and content analysis. Three composite variables explained 48% of the variance (p = .00) in patient satisfaction. Four themes emerged: Retrospective Desire for Early WRAP Introduction, Pay It Forward, Unconditional Relational Support, and It Takes Time. Future research is warranted to promote WRAP's use in broader settings.

Understanding health literacy in patients receiving hematopoietic stem cell transplantation.

PURPOSE/OBJECTIVES: To describe the meaning of patients' experiences with hematopoietic stem cell transplantation (HSCT), with a focus on health literacy. RESEARCH APPROACH: A hermeneutic phenomenologic approach that combines descriptive and interpretive methods. SETTING: A National Cancer Institute-designated comprehensive cancer center in the southern United States. SAMPLE: 60 individuals who underwent HSCT; 20 Latino, 20 African American, and 20 Caucasian. METHODOLOGIC APPROACH: In-depth interviews were conducted on five separate occasions. Interviews and analysis of verbatim transcripts used phenomenologic techniques. FINDINGS: The themes were as follows: they did not tell me, decision dilemmas, fears of dying, tough symptoms and side effects, and relying on others. These themes were found in all ethnic groups, both genders, and at all time points. CONCLUSIONS: The themes from this study demonstrate that health literacy concerns are vital to patients' understanding, decision making, and having active roles in their health care. Assessing patients' understanding is important and requires a comprehensive approach because patients may not know what they need to ask and may not feel comfortable asking or raising objections because their fears, particularly that of dying, are barriers. INTERPRETATION: This article provides evidence that health literacy is not a simple function of age, ethnicity, race, or education. Health literacy and communication concerns require a more nuanced approach to provide optimal patient-centered outcomes. KNOWLEDGE TRANSLATION: Understanding patients' perspectives is vital to knowing what to communicate, how to communicate, and when to provide information. Providing information in a way patients can understand reduces risks for negative outcomes. A comprehensive assessment of patients' understanding using improved education materials, clearer forms and communication techniques, teach-back methods, and reinforcement is needed to improve communication, particularly when illness and treatment evoke fears.

Physical activity, depressive symptoms, and social support among African-American women with type 2 diabetes.

This descriptive-correlational study examined the associations among physical activity, depressive symptoms, and perceived social support in 45 middle-aged and older African-American women with type 2 diabetes receiving care in 1 of 3 community-based primary care centres in the southeastern United States. Of the participants, 82% reported weekly physical activity and 88% reported a high degree of social support.The prevalence of depressive symptoms was also high in the sample (n = 15; 30%), and depressive symptoms were associated with younger age and less social support. Further investigation of physical activity characteristics, depressive symptoms, and social support in African-American women with type 2 diabetes is warranted.

Depressive symptoms, cardiovascular risk, and diabetes self-care strategies in African American women with type 2 diabetes.

This descriptive study examined depressive symptoms, cardiovascular risk, and diabetes self-care strategies in African American women (N = 45) with type 2 diabetes (T2D). All completed a questionnaire packet during structured interviews. Significant associations were found between two individual depressive symptoms and mean cardiovascular disease (CVD) risk scores, which suggest that in African American women with T2D, depressive symptoms may be correlated with a specific CVD profile and/or are unrecognized and/or unexpressed. Further analysis is warranted to determine the extent of this relationship in African American women with T2D.

Chronic dementing conditions, genomics, and new opportunities for nursing interventions.

PURPOSE: To (a) provide an overview of chronic dementing conditions; (b) discuss the etiologic and clinical characteristics of Alzheimer disease (AD) and Parkinson disease (PD) within the framework of the family systems genetic illness model; and (c) to explore opportunities to enhance outcomes through the integration of genomics information and technologies into nursing practice. DESIGN: An integrated review of the literature, including the organizing construct of the family systems genetic illness model. FINDINGS: AD and PD are both influenced by genetic and environmental factors; in a small percentage of families, gene mutations are the primary etiologic factor. Genetic testing is an option for some families experiencing early-onset, familial disease. Presymptomatic and diagnostic genetic testing have limited clinical utility for the more common late-onset AD and PD. CONCLUSIONS: The current abilities of healthcare professionals to effectively intervene in people with AD and PD are limited by an incomplete understanding of the biologic basis of these diseases. Advances in genomics research and technology are providing the information and tools necessary to understand the molecular basis of these devastating disorders toward the goal of more specific and effective interventions.

Stigmatization in Alzheimer's disease research on African American elders.

Stigmatization in research sustains the spread of the silent epidemic of Alzheimer's disease (AD) in African American populations. Researchers use stereotypes and inappropriate assumptions to select a paradigm to examine the symptoms of AD. This paradigm fails to encompass the symptoms as manifested by African American elders. Yet, stigmatization can be minimized by recognizing the genetic heterogeneity of the symptoms within the general population, especially those manifested by African American elders. Thus, researchers can utilize pioneering genetic analyses to identify other paradigms critical in the assessment and proactive treatment of the symptoms of AD needed for this vulnerable population.

The clinical utility of genetic information in the care of persons with Alzheimer's disease.

Genetic research about Alzheimer's disease (AD) is advancing quickly, but the clinical utility of these gene discoveries remains unclear. The clinical context of genetic research in AD is discussed.

Black and white men at risk for memory impairment.

BACKGROUND: Blacks are under-represented in government-funded research. Epidemiological data indicate that morbidity and mortality in the United States are higher in Blacks than in Whites. OBJECTIVE: To examine memory performance in a sample of Black and White healthy men 70 years of age and older. METHOD: Sixty-nine (24 Black, 45 White) men participated in a study of memory performance. All individuals lived either in private homes or subsidized high-rise apartments. RESULTS: Black men had higher anxiety about their memories, used fewer internal and external memory strategies, and had less confidence and less understanding of their everyday memory than White men. Based on their depression scores, more Black men (35%) were at risk for depression than White men (10%). Even though there were no differences in the numbers of men who lived alone, White men were five times more likely to be married and live with a spouse (27 vs. 5). CONCLUSION: In this sample of Black and White men, there were no differences in actual memory performance, but significant differences were found in the subjective aspects of memory evaluation.