Effect of Laughter Yoga on Psychological Well-being and Physiological Measures.

CONTEXT: In 2014, laughter yoga (LY) achieved the intermediate level, tier 2, under the Title III-D Evidence-based Disease Prevention and Health Promotion Program through the Administration on Aging (AOA). Further research is needed to qualify LY under the criteria for the highest tier, tier 3, to assure continued funding for LY classes at senior centers. OBJECTIVES: The study intended to demonstrate further the benefits of LY and to qualify LY as tier 3 under Title III-D. DESIGN: Using a quasi-experimental design, the research team conducted a preintervention/postintervention study in 3 phases. SETTING: The study was done in a variety of community centers. Phase 1, a pilot phase, was limited to North Carolina, and phase 2 was conducted in multiple states. Phase 3 was held at the North Carolina Area Agency on Aging's annual Volunteer Appreciation meeting. PARTICIPANTS: Participants in phases 1 (n = 109) and 2 (n = 247) enrolled in LY classes. Classes were advertised by fliers posted in community and in retirement centers. The ability of participants to participate in a class was based solely on their desire to participate, regardless of age, ability, health status, or physical impairment. Phase 3 (n = 23) was a convenience sample only. All phases were voluntary. OUTCOME MEASURE: The pre- and posttests for all 3 phases were Likert-scale surveys, 10 questions on the Psychological Outcomes of Well-being (POWB) survey. Pulse and other physiological measurements were also assessed pre- and postintervention. Analysis included a t test on each of the 10 POWB and physiological measures for all phases. RESULTS: All 10 POWB measures for phases 1 and 2 showed significant improvements between the pre- and postintervention testing (P < .001). Phase 3, the control, showed no significant improvement. CONCLUSIONS: The initial study demonstrated that LY meets the criteria to qualify for tier 3 under the Title III-D Evidence-based Disease Prevention and Health Promotion Program and that a large number of Americans, regardless of age and physical ability, could benefit from LY.

Barriers to completion of advance care directives among African Americans ages 25-84: a cross-generational study.

Prior studies conducted in the area of Advance Care Directive document completion in African Americans have primarily targeted the elderly who are either institutionalized in skilled nursing facilities or are members of faith communities. Few studies have been done concerning barriers to Advance Care Directive document completion that include non-elderly African Americans. The purpose of this study was to identify the common barriers to advance care directive document completion across generations of African Americans ages 25-84. Using convenience sampling among various Baptist denominations of the African-American faith community of Buncombe County, North Carolina, 40 individuals ranging in age from 25-84 participated in multiple focus group sessions. Findings revealed participants shared three common barriers: 1) surrogate decision-making, 2) lack of education concerning advance care directive discussions and completion, and 3) fear and denial. Also revealed were barriers that varied across generations: 1) fatalism, 2) mistrust of the health care system, 3) spirituality, and 4) economics.

Interevaluator reliability of a mock paramedic practical examination.

INTRODUCTION: Prior to graduation, paramedic students must be assessed for terminal competency and preparedness for national credentialing examinations. Although the procedures for determining competency vary, many academic programs use a practical and/or oral examination, often scored using skill sheets, for evaluating psychomotor skills. However, even with validated testing instruments, the interevaluator reliability of this process is unknown. Objective. We sought to estimate the interevaluator reliability of a subset of paramedic skills as commonly applied in terminal competency testing. METHODS: A mock examinee was videotaped performing staged examinations mimicking adult ventilatory management, oral board, and static and dynamic cardiac stations during which the examinee committed a series of prespecified errors. The videotaped performances were then evaluated by a group of qualified evaluators using standardized skill sheets. Interevaluator variability was measured by standard deviation and range, and reliability was evaluated using Krippendorff's alpha. Correlation between scores and evaluator demographics was assessed by Pearson correlation. RESULTS: Total scores and critical errors varied considerably across all evaluators and stations. The mean (± standard deviation) scores were 24.77 (±2.37) out of a possible 27 points for the adult ventilatory management station, 11.69 (±2.71) out of a possible 15 points for the oral board station, 7.79 (±3.05) out of a possible 12 points for the static cardiology station, and 22.08 (±1.46) out of a possible 24 points for the dynamic cardiology station. Scores ranged from 18 to 27 for adult ventilatory management, 7 to 15 for the oral board, 2 to 12 for static cardiology, and 19 to 24 for dynamic cardiology. Krippendorff's alpha coefficients were 0.30 for adult ventilatory management, 0.01 for the oral board, 0.10 for static cardiology, and 0.48 for dynamic cardiology. Critical criteria errors were assigned by 10 (38.5%) evaluators for adult ventilatory management, five (19.2%) for the oral board, and nine (34.6%) for dynamic cardiology. Total scores were not correlated with evaluator demographics. CONCLUSIONS: There was high variability and low reliability among qualified evaluators using skill sheets as a scoring tool in the evaluation of a mock terminal competency assessment. Further research is needed to determine the true overall interevaluator reliability of this commonly used approach, as well as the ideal number, training, and characteristics of prospective evaluators.

Teacher time spent on student health issues and school nurse presence.

Elementary school teacher time spent on student health issues and the relationship to school nurse services was the focus of this 2-year study. A cross-sectional design was used to survey traditional and exceptional (special needs) classroom teachers about the time they spent on health issues and their perception of school nurse presence. The school nurses were surveyed regarding the impact of their presence on early releases due to illness. Study findings related to teacher perceptions indicate with school nurse presence there are fewer early releases, increased communication, less time spent on health issues, students with chronic illnesses are safer, and there is a resource available for health information. The data provide the groundwork for discussions to improve the communication of the nurses' schedules, increase teacher confidence in consistent nurse hours at their school and aid the nurse in protecting valuable on-site school hours from other interferences or commitments.