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1.
J Nurs Adm ; 49(11): 538-542, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31651613

RESUMEN

A strong culture rooted in excellent nursing practice is essential to the future success of healthcare organizations. Nursing leaders face the challenge of establishing and retaining this culture with the exodus of nursing knowledge and clinical reasoning expertise from retirements of experienced nurses. This article presents a novel plan to mitigate this looming problem by rehiring and reengaging recently retired nurses to return to practice for an emeritus RN program.


Asunto(s)
Empleo/estadística & datos numéricos , Atención de Enfermería/organización & administración , Personal de Enfermería/estadística & datos numéricos , Admisión y Programación de Personal/organización & administración , Jubilación , Centros de Atención Terciaria/organización & administración , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medio Oeste de Estados Unidos
2.
S D Med ; 72(9): 419-423, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31581377

RESUMEN

BACKGROUND: A disparity in overweight/obesity prevalence exists between rural and urban youth; however, definitions of 'rural' vary widely and the degree to which rurality impacts overweight/obesity prevalence is unclear. Therefore, the purpose of this study was to examine the school height and weight data in a rural Midwest state to determine differences in overweight and obesity prevalence among youth by using Rural-Urban Continuum (RUC) codes to define county-level degree of urbanization. METHODS: De-identified statewide data were obtained in electronic format from the state Department of Health. Height, weight, sex and age were used to calculate body mass index (BMI) z-scores, which were used to determine BMI percentile and categories. The county variable was used to assign a RUC code to each individual. Logistic regression was used to examine binary weight classifications by rural status while controlling for age, sex and race/ethnicity. RESULTS: Odds of obesity and of overweight/obesity were higher among rural youth compared to non-rural. Odds of overweight/obesity increased with increasing rurality. Compared to youth who lived in counties with a RUC code of 3, youth who lived in counties with RUC codes of 5, 7, 8 and 9 had greater odds of overweight/obesity. The number of youth classified as 'rural' ranged from 11-48 percent, depending on how 'rural' was defined. Likewise, overweight/obesity prevalence differed by 4.6 percent depending on how 'rural' was defined. CONCLUSIONS: Consistently defining 'rural' and determining degree of rurality is important in understanding how geographic location plays a role in overweight/obesity among youth. Future research should work to assess the physical and social environments of these different types of rural areas to better understand the role that rurality plays in contributing to overweight/obesity among youth. Assessing social determinants of health and its impact on health in rural youth is essential for designing effective public health interventions that can be implemented to address the issue.


Asunto(s)
Obesidad , Sobrepeso , Población Rural , Población Urbana , Adolescente , Índice de Masa Corporal , Niño , Humanos , Medio Oeste de Estados Unidos/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , Prevalencia
3.
Bull Environ Contam Toxicol ; 103(5): 663-669, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31473775

RESUMEN

Climate change is expected to alter hydrological cycles on global and regional scales, impacting groundwater and surface water inputs to stream habitats. In the midwestern United States, the volume and frequency of inputs are expected to become increasingly variable. This region has a high incidence of agriculture, creating enormous potential for transport of pesticides and herbicides into aquatic ecosystems. Metolachlor, an herbicide for corn and soybean crops, has been demonstrated to contaminate surface water and groundwater in the region. This study examines the impact of variable flow conditions on the toxicity of environmentally relevant concentrations of metolachlor in a macroinvertebrate found in midwestern streams, the rusty crayfish (Faxonius rusticus). Changes in crayfish foraging behavior were analyzed using a Mixed Model ANCOVA. Under toxicant exposure, crayfish significantly increased their consumption of macrophytes, but only under the variable flow regime. Thus, the increased variability in toxicant exposure impacted crayfish foraging behavior more than other flow regimes. This significant interaction between flow regime and metolachlor exposure suggests that the greater variability in toxicant inputs to streams may lead to more severe changes in behavior for exposed organisms.


Asunto(s)
Acetamidas/toxicidad , Astacoidea/efectos de los fármacos , Conducta Alimentaria/efectos de los fármacos , Herbicidas/toxicidad , Ciclo Hidrológico , Contaminantes Químicos del Agua/toxicidad , Animales , Astacoidea/fisiología , Ecosistema , Agua Subterránea/química , Medio Oeste de Estados Unidos , Ríos/química
4.
J Natl Black Nurses Assoc ; 30(1): 29-33, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31465682

RESUMEN

This paper reports the methodological challenges encountered while performing a descriptive, qualitative study examining the perspectives of African-American women who successfully maintained long-term physical activity. The socioecological model was used to expand on the dynamics pertaining to the long-term physical activity of 14 African-American women between 35 and 65 years of age. These women were recruited in 2 Midwestern American states and had been physically active for more than 6 months at the time of the study. Content analysis of themes revealed factors influencing physical activity at the individual, social, environmental, and political levels. Methodological challenges the student researcher encountered were choosing the appropriate framework to guide the study, recruiting participants who met the inclusion criteria, and proficiently transcribing and organizing the responses for data analysis using qualitative analysis software. The reflections described in this paper may provide insight to challenges and possible solutions for new researchers to consider when developing a research project.


Asunto(s)
Afroamericanos/psicología , Ejercicio , Proyectos de Investigación , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Femenino , Humanos , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Investigación Cualitativa , Factores de Tiempo
5.
J Neurosci Nurs ; 51(5): 217-220, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31469703

RESUMEN

BACKGROUND: Myelomeningoceles are routinely closed surgically within 24 to 48 hours after birth; the defect and exposed placode must be protected from further damage from excoriation and contamination until surgery. PURPOSE: Two methods to keep the defect moist and clean are used at our large Midwestern children's hospital: the occlusive and the drip. There was no agreement between the neonatal and neurosurgical teams as to which technique was superior, hence the need for a formal evaluation. METHODS: A prospective, randomized trial was conducted to compare the ease of nursing care, cost of supplies, neonatal temperature, and moisture of the placode at the time of closure in neonates with a myelomeningocele. RESULTS: Nurses categorized the occlusive group as easy care (100%) compared with 60% for the drip group, although the difference was not statistically significant (P = .18). The mean temperatures of the 2 groups before surgery were identical (36.9°C) in both groups. The cost of the drip was 6 times higher than that of the occlusive technique. The placode was assessed as moist in all 13 cases (100%). CONCLUSION: The occlusive technique was easier to care for by all the nurses and was 6 times more cost effective. Both methods kept the placode moist and did not affect the temperature of the baby.


Asunto(s)
Meningomielocele/cirugía , Enfermería Neonatal/normas , Apósitos Oclusivos/economía , Apósitos Oclusivos/normas , Femenino , Hospitales Pediátricos , Humanos , Recién Nacido , Masculino , Medio Oeste de Estados Unidos , Estudios Prospectivos
6.
Ecology ; 100(12): e02856, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31381148

RESUMEN

Forest ecosystems in eastern North America have been in flux for the last several thousand years, well before Euro-American land clearance and the 20th-century onset of anthropogenic climate change. However, the magnitude and uncertainty of prehistoric vegetation change have been difficult to quantify because of the multiple ecological, dispersal, and sedimentary processes that govern the relationship between forest composition and fossil pollen assemblages. Here we extend STEPPS, a Bayesian hierarchical spatiotemporal pollen-vegetation model, to estimate changes in forest composition in the upper Midwestern United States from about 2,100 to 300 yr ago. Using this approach, we find evidence for large changes in the relative abundance of some species, and significant changes in community composition. However, these changes took place against a regional background of changes that were small in magnitude or not statistically significant, suggesting complexity in the spatiotemporal patterns of forest dynamics. The single largest change is the infilling of Tsuga canadensis in northern Wisconsin over the past 2,000 yr. Despite range infilling, the range limit of T. canadensis was largely stable, with modest expansion westward. The regional ecotone between temperate hardwood forests and northern mixed hardwood/conifer forests shifted southwestward by 15-20 km in Minnesota and northwestern Wisconsin. Fraxinus, Ulmus, and other mesic hardwoods expanded in the Big Woods region of southern Minnesota. The increasing density of paleoecological data networks and advances in statistical modeling approaches now enables the confident detection of subtle but significant changes in forest composition over the last 2,000 yr.


Asunto(s)
Ecosistema , Bosques , Teorema de Bayes , Cambio Climático , Medio Oeste de Estados Unidos , Minnesota , Incertidumbre , Estados Unidos , Wisconsin
7.
Artículo en Inglés | MEDLINE | ID: mdl-31337001

RESUMEN

Acute bouts of uninterrupted sitting has been associated with discomfort and fatigue in adult populations. However, little is known regarding the impact of uninterrupted sitting on such outcomes among college students. Understanding these relations would be useful for informing best practice and future interventions. The present study explored the relation between uninterrupted sitting and perceived levels of physical discomfort and sleepiness among college students in a real classroom setting. We recruited 54 undergraduate students enrolled in a single class at a Midwestern university. Participants remained seated throughout a 2.5 h lecture while completing the Stanford Sleepiness Scale (SSS) and General Comfort Scale (GCS) every 15 min. Linear mixed effect model analyses were used to determine the relations between the independent and dependent variables and the duration at which students reported significant impairments in discomfort and/or sleepiness. Classroom sitting time was associated with increases in discomfort (r = 0.28, p < 0.01) and sleepiness (r = 0.30, p < 0.01). Students reported significant impairments in discomfort and sleepiness after 75 and 15 min, respectively. These findings support further research into the acceptability, feasibility and efficacy of interventions designed to interrupt classroom sitting on discomfort, sleepiness and measures of academic performance.


Asunto(s)
Fatiga , Sedestación , Estudiantes , Rendimiento Académico , Adolescente , Adulto , Femenino , Humanos , Masculino , Medio Oeste de Estados Unidos , Universidades , Adulto Joven
8.
J Community Health Nurs ; 36(3): 105-114, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31291770

RESUMEN

Older adults manage multiple medications for chronic disease and those living in rural areas are impacted by health care disparities due to health provider shortages and fewer pharmacies. The use of downloadable medication reminder apps on smartphones may serve as a strategy for medication self-management of chronic diseases. In this feasibility study, thirteen rural older adult participants downloaded Medisafe® and used the app to manage their daily medications. The community-dwelling aging adults in this pilot perceived the Medisafe® as not difficult to use, useful for medication tracking and providing reminders for the self-management of multiple medications.


Asunto(s)
Cumplimiento de la Medicación , Aplicaciones Móviles , Sistemas Recordatorios , Población Rural , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Cumplimiento de la Medicación/psicología , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Teléfono Inteligente
9.
J Behav Addict ; 8(2): 335-342, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31257917

RESUMEN

BACKGROUND: This study sought to examine the occurrence of the problematic use of smartphones in a university sample and associated physical and mental health correlates, including potential relationships with risky sexual practices. METHODS: A 156-item anonymous online survey was distributed via e-mail to a sample of 9,449 university students. In addition to problematic smartphone usage, current use of alcohol and drugs, psychological and physical status, and academic performance were assessed. RESULTS: A total of 31,425 participants were included in the analysis, of whom 20.1% reported problematic smartphone use. Problematic use of smartphones was associated with lower grade point averages and with alcohol use disorder symptoms. It was also significantly associated with impulsivity (Barratt scale and ADHD) and elevated occurrence of PTSD, anxiety, and depression. Finally, those with current problems with smartphone use were significantly more sexually active. CONCLUSIONS: Problematic use of smartphones is common and has public health importance due to these demonstrable associations with alcohol use, certain mental health diagnoses (especially ADHD, anxiety, depression, and PTSD), and worse scholastic performance. Clinicians should enquire about excessive smartphone use as it may be associated with a range of mental health issues. Research is needed to address longitudinal associations.


Asunto(s)
Rendimiento Académico/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Conducta Adictiva/epidemiología , Conducta Impulsiva , Trastornos Mentales/epidemiología , Teléfono Inteligente/estadística & datos numéricos , Rendimiento Académico/estadística & datos numéricos , Adulto , Consumo de Bebidas Alcohólicas/psicología , Conducta Adictiva/psicología , Comorbilidad , Femenino , Humanos , Masculino , Trastornos Mentales/psicología , Medio Oeste de Estados Unidos/epidemiología , Factores de Riesgo , Asunción de Riesgos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Universidades , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricos , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-31288463

RESUMEN

The goal of this three-year longitudinal study was to examine the buffering effect of parental mediation of adolescents' technology use (i.e., restrictive, co-viewing, and instructive) on the relationships among cyber aggression involvement and substance use (i.e., alcohol use, marijuana use, cigarette smoking, and non-marijuana illicit drug use). Overall, 867 (Mage = 13.67, age range from 13-15 years, 51% female, 49% White) 8th grade adolescents from the Midwestern United States participated in this study during the 6th grade (Wave 1), 7th grade (Wave 2), and 8th grade (Wave 3). Results revealed that higher levels of Wave 2 instructive mediation weakened the association between Wave 1 cyber victimization and Wave 3 alcohol use and Wave 3 non-marijuana illicit drug use. The relationship was stronger between Wave 1 cyber victimization and Wave 3 alcohol use and Wave 3 non-marijuana illicit drug use when adolescents reported lower levels of Wave 2 instructive mediation. At lower levels of Wave 2 instructive mediation, the association between Wave 1 cyber aggression perpetration and Wave 3 non-marijuana illicit drug use was stronger. Implications of these findings are discussed in the context of parents recognizing their role in helping to mitigate the negative consequences associated with adolescents' cyber aggression involvement.


Asunto(s)
Agresión , Ciberacoso , Padres , Trastornos Relacionados con Sustancias/psicología , Adolescente , Confidencialidad , Víctimas de Crimen , Femenino , Humanos , Estudios Longitudinales , Masculino , Medio Oeste de Estados Unidos
12.
J Allied Health ; 48(2): 119-126, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31167014

RESUMEN

BACKGROUND: The significance of evidence-based practice (EBP) cannot be overstated. However, literature on the perception of occupational and physical therapists toward EBP is scarce. METHODS: This survey study was intended to examine occupational and physical therapists' perceptions of EBP. A total of 47 of 261 practicing therapists in a health care system in the Midwest U.S. responded to the questionnaire previously developed by Rubin et al. RESULTS: The results of the study showed that therapists reported familiarity with the EBP process and maintained an overall positive attitude toward EBP. Of the five subscale measures of EBP, familiarity with EBP process had the greatest average score (3.82±0.48) followed by attitude about EBP process (3.73±0.37). The smallest mean subscale score was found on the measure of current engagement in EBP process (2.93±0.55). Therapists reported intent to engage in the EBP process but were less favorable to engage in EBP and only reported engagement in EBP a little less than "some of the time." Barriers to engaging in EBP included time, access, and the constraints of the responders' practice setting. Implications of this study resulted in recommendations for clinical practice and educational programs.


Asunto(s)
Actitud del Personal de Salud , Práctica Clínica Basada en la Evidencia/organización & administración , Terapeutas Ocupacionales/psicología , Fisioterapeutas/psicología , Adulto , Práctica Clínica Basada en la Evidencia/normas , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Percepción
13.
Pediatrics ; 144(1)2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31164439

RESUMEN

BACKGROUND: Available evidence supports ovary-sparing surgery for benign ovarian neoplasms; however, preoperative risk stratification of pediatric ovarian masses can be difficult. Our objective of this study was to characterize the surgical management of pediatric ovarian neoplasms across 10 children's hospitals and to identify factors that could potentially aid in the preoperative risk stratification of these lesions. METHODS: A retrospective review of girls and women aged 2 to 21 years who underwent surgery for an ovarian neoplasm between 2010 and 2016 at 10 children's hospitals was performed. Multivariable logistic regression was used to examine the relationships between the preoperative cohort characteristics, procedure performed, and risk of malignancy. RESULTS: Among 819 girls and women undergoing surgery for an ovarian neoplasm, malignant lesions were identified in 11%. The overall oophorectomy rate for benign disease was 33% (range: 15%-49%) across institutions. Oophorectomy for benign lesions was independently associated with provider specialty (P = .002: adult gynecologist, 45%; pediatric surgeon, 32%; pediatric gynecologist, 18%), premenarchal status (P = .02), preoperative suspicion for malignancy (P < .0001), larger lesion size (P < .0001), and presence of solid components (P < .0001). Preoperative findings independently associated with malignancy included increasing size (P < .0001), solid components (P = .003), and age (P < .0001). CONCLUSIONS: The rate of oophorectomy for benign ovarian disease remains high within the pediatric population. Identification of factors associated with the choice of procedure and the risk of malignancy may allow for improved preoperative risk stratification and fewer unnecessary oophorectomies. These results have been used to develop and validate a multidisciplinary preoperative risk stratification algorithm that is currently being studied prospectively across 10 institutions.


Asunto(s)
Tratamientos Conservadores del Órgano , Neoplasias Ováricas/cirugía , Ovariectomía/estadística & datos numéricos , Medición de Riesgo , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Hospitales Pediátricos , Humanos , Medicina , Medio Oeste de Estados Unidos , Neoplasias Ováricas/patología , Estudios Retrospectivos , Procedimientos Innecesarios , Adulto Joven
14.
Public Health Rep ; 134(4): 432-440, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31170033

RESUMEN

OBJECTIVE: The objective of this study was to determine the number, risk factors, and demographic characteristics of potential human trafficking victims from tips reported to a social services agency in a major Midwest metropolitan area from 2008 through 2017. METHODS: The agency, comprising 90 employees serving more than 10 000 persons annually, received federal funding to raise awareness about trafficking and to identify and support persons who are at risk for trafficking through training, coalition building, direct outreach and service, and case management. We, the authors, counted the numbers of tips and potential victims reported to the agency by year, type of trafficking, economic sector, sex, region of origin, and age and looked for new risk factors for trafficking. RESULTS: Data were available for 213 tips received from September 1, 2008, through June 30, 2017, and for 82 potential victims identified from July 1, 2011, through June 30, 2017. Labor trafficking (126 tips, 57 potential victims) was more common than sex trafficking (59 tips, 17 potential victims). The number of tips varied during the study period. Tips and potential victims were diverse and included male and female children and adults. Most victims were from Mexico (n = 68), the United States (n = 47), Asia (n = 31), and Central and South America (n = 23). Potential victims were exploited in several industries including agriculture, construction, commercial sex, and landscaping. New risk factors for trafficking were exploitation within marriage and work in the sales industry. CONCLUSIONS: Domestic and foreign-born men, women, and children are all at risk for labor and sex trafficking. Direct outreach to foreign-born victims should be a priority. The new risk factors should be explored.


Asunto(s)
Abuso Sexual Infantil/estadística & datos numéricos , Trabajo Infantil/estadística & datos numéricos , Trata de Personas/estadística & datos numéricos , Trabajo Sexual/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
15.
Biol Res Nurs ; 21(5): 571-577, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31185732

RESUMEN

PURPOSE: This study was designed to identify underlying cardiovascular risk factors among college students including lifestyle characteristics, health behaviors and knowledge, and perception of the risk factors. METHOD: College students (N = 293), aged 19-36 years, enrolled at either a Midwestern or a Southwestern University in the United States, responded to three questionnaires: sociodemographic, knowledge of cardiovascular risk factors, and perception of cardiovascular risk factors. Anthropometric measures collected included blood pressure (BP), glucose, lipid panel, height, weight, and body mass index (BMI). RESULTS: There were significant regional and gender differences in cardiovascular disease (CVD) risk among Southwestern and Midwestern college students. Students from the Southwest had a higher risk of developing CVD in 30 years compared to those in the Midwest; they also had a higher perceived risk. Males were more at risk of developing CVD than females but had a lower perceived risk than females. Dietary habits were similar between the two populations, and we found no significant differences in BMI. The two regions varied in BP levels, but the Midwestern students had significantly higher prevalence of elevated BP and Stage 2 hypertension. CONCLUSION: Our data suggest that college students are a high-risk population and tend to underestimate and misperceive their risk for developing CVD.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Conductas Relacionadas con la Salud , Estado de Salud , Estudiantes/estadística & datos numéricos , Adulto , Índice de Masa Corporal , Conducta Alimentaria , Femenino , Humanos , Hipertensión/epidemiología , Masculino , Medio Oeste de Estados Unidos , Prevalencia , Factores de Riesgo , Factores Sexuales , Sudoeste de Estados Unidos , Encuestas y Cuestionarios , Adulto Joven
16.
Res Nurs Health ; 42(5): 392-409, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31241204

RESUMEN

The purpose of this study was to test hypothesized relationships of the health promotion model (HPM) as a means of predicting moderate-to-vigorous physical activity (MVPA) among urban, adolescent girls. A secondary analysis of baseline data from a group randomized controlled trial was conducted. The study involved eight urban schools in the Midwestern United States. The sample included girls (N = 517) in the 5th-8th grades. Data were collected on age, body mass index, pubertal status, enjoyment, self-efficacy, social support, options for physical activity (PA), and commitment to PA. MVPA was measured via accelerometers worn by the girls for 7 days. Structural equation modeling was used to analyze study aims. Mean age of the sample was 11.8 years (standard deviation [SD] = 1.0). Girls attained an average of 3.0 (SD = 1.2) minutes per hour of MVPA. Self-efficacy had a positive direct (ß = .337; p < .001) and total effect (ß = .310; p < .001) on MVPA. Social support and options for PA were not significant predictors of commitment to PA or MVPA. Commitment to PA had a negative but nonsignificant effect (ß = -.056; p = .357) on MVPA. The model predicted 10.1% of the variance in MVPA with 9.6% of the variance predicted by self-efficacy. Limitations include lack of longitudinal analysis and inability to generalize the results to other populations such as boys. PA self-efficacy continues to emerge as a significant predictor of MVPA in the HPM. Continued theory testing is needed to better understand the correlates and determinants of PA among adolescent girls before designing theory-based interventions to promote PA.


Asunto(s)
Conducta del Adolescente/psicología , Actitud Frente a la Salud , Ejercicio/psicología , Estilo de Vida Saludable , Población Urbana/estadística & datos numéricos , Adolescente , Niño , Femenino , Promoción de la Salud , Humanos , Medio Oeste de Estados Unidos
17.
Health Serv Res ; 54(5): 994-1006, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31215029

RESUMEN

OBJECTIVE: To evaluate the implementation and outcomes of evidence-based fall-risk-reduction processes when those processes are implemented using a multiteam system (MTS) structure. DATA SOURCES/STUDY SETTING: Fall-risk-reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall-event reporting system to drive improvement. STUDY DESIGN: A one-group pretest-posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall-event reporting system. DATA COLLECTION: Hospitals used gap analyses to assess the presence of fall-risk-reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall-event data throughout the study. PRINCIPAL FINDINGS: The extent to which hospitals implemented 21 processes to coordinate the fall-risk-reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end-of-study period (January 2014-July 2014). Bedside fall-risk-reduction processes were not significant predictors of these outcomes. CONCLUSIONS: Multiteam systems that effectively coordinate fall-risk-reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.


Asunto(s)
Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Enfermería Basada en la Evidencia/organización & administración , Hospitales Rurales/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Grupo de Atención al Paciente/organización & administración , Adulto , Anciano , Anciano de 80 o más Años , Conducta Cooperativa , Enfermería Basada en la Evidencia/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Factores de Riesgo
18.
J Fam Psychol ; 33(7): 753-763, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31045402

RESUMEN

This study examined the prospective associations among maternal substance use, depressive symptoms, and children's behavioral problems in a family systems therapy (ecologically based family therapy [EBFT]) condition and an individual treatment condition. Participants included 183 mothers with a substance use disorder who had at least 1 biological child in their care. Mothers were randomly assigned to the EBFT condition (n = 123) or an individual treatment condition (n = 60). Maternal substance use, depressive symptoms, and child behavioral problems were assessed at baseline and at 3, 6, and 12 months postbaseline. Autoregressive cross-lagged models were estimated to compare whether the cross-lagged paths among the 3 variables differed from zero in each treatment condition. Findings revealed that for individual treatment, strong reciprocal relationships were observed between maternal substance use and maternal depressive symptoms, and between maternal substance use and child behavioral problems. Conversely, in the EBFT group, fewer reciprocal relationships were observed, and instead, maternal depressive symptoms predicted more future child behavioral problems. These findings suggest an interruption in the dysfunctional reciprocal transmission of problem behaviors between mothers and children over time in the family therapy condition. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in interrupting the dysfunctional family dynamics that contribute to maternal substance using behaviors and child behavioral problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Trastornos de la Conducta Infantil/terapia , Trastorno Depresivo/terapia , Terapia Familiar/métodos , Relaciones Madre-Hijo/psicología , Trastornos Relacionados con Sustancias/terapia , Adolescente , Adulto , Niño , Trastornos de la Conducta Infantil/complicaciones , Trastornos de la Conducta Infantil/psicología , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Madres/psicología , Estudios Prospectivos , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicología , Resultado del Tratamiento , Adulto Joven
19.
BMC Public Health ; 19(1): 515, 2019 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-31060527

RESUMEN

BACKGROUND: Among cervical cancer patients in the U.S., a disproportionate number are Hispanics/Latinos. Also, about a third of patients diagnosed with cervical cancer annually in Mexico die of the disease. Vaccines are available to protect against HPV, the cause of cervical cancer. METHODS: A cross-sectional study was conducted with 200 mothers of Mexican origin in the U.S. Midwest and Xalapa, Veracruz, Mexico. Based on a validated bilingual questionnaire, this study elicited information about knowledge and attitudes regarding HPV vaccination and cervical cancer. RESULTS: Mothers living in Mexico showed better knowledge about HPV and HPV vaccine (77.8%) than participants living in the U.S. (48%) p < .0001. Logistic regression revealed that receiving information about the HPV vaccine from medical providers was a significant predictor of mothers' willingness to vaccinate their children. CONCLUSIONS: A need for increasing public health education of Mexican mothers in the Midwest on HPV/HPV vaccination, may lead to improving utilization of the vaccination and eventually a reduction of cervical cancer. HPV vaccination for boys is critical for reducing the risk of transmission to sexual partners and decreasing the risk of HPV- related diseases in the population. Therefore, we recommend increasing efforts to vaccine boys and increasing knowledge that boys must also be vaccinated, especially in Mexico.


Asunto(s)
Personal de Salud/psicología , Americanos Mexicanos/psicología , Madres/psicología , Vacunas contra Papillomavirus/administración & dosificación , Relaciones Médico-Paciente , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Masculino , Americanos Mexicanos/estadística & datos numéricos , México , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Madres/estadística & datos numéricos , Infecciones por Papillomavirus/prevención & control , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/etnología , Neoplasias del Cuello Uterino/prevención & control
20.
Nurs Womens Health ; 23(3): 224-233, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31077639

RESUMEN

OBJECTIVE: To design and implement group prenatal care (GPC) for Somali women and to evaluate participants' satisfaction, knowledge, and care engagement. DESIGN: Quality improvement project. SETTING/LOCAL PROBLEM: A federally qualified health center in an urban Midwestern setting, which serves a largely East African immigrant and refugee population. PARTICIPANTS: Pregnant Somali women at more than 20 weeks gestation receiving prenatal care at the project site. Many participants were non-English speaking. INTERVENTION/MEASUREMENTS: While honoring the 13 essential elements of CenteringPregnancy, the model was adapted to the East African population at the project site and offered to all eligible women receiving individual prenatal care at the clinic. Women attended biweekly sessions, including individual assessment and education, exposure to integrative health therapies, and group discussion. Pre- and postintervention data were collected in surveys and in-depth interviews from March through August 2017. RESULTS: Seventeen Somali women attended a median of two sessions (range = 1-7). Self-reported results for knowledge of safe exercise in pregnancy (p = .02), exclusive breastfeeding (p = .04), what happens in the hospital (p = .02), and stress management (p = .03) increased after GPC participation. Ninety-three percent of women preferred GPC to individual care. CONCLUSION: When adapted to meet the needs of Somali women, GPC has the potential to improve care satisfaction, increase knowledge, and reduce stress during pregnancy and the postpartum period. This model may interest women and care providers in similar community health care settings.


Asunto(s)
Instituciones de Atención Ambulatoria/tendencias , Atención Prenatal/métodos , Desarrollo de Programa/métodos , Adulto , Instituciones de Atención Ambulatoria/organización & administración , Emigrantes e Inmigrantes/psicología , Femenino , Humanos , Medio Oeste de Estados Unidos , Áreas de Pobreza , Embarazo , Mejoramiento de la Calidad , Somalia/etnología , Encuestas y Cuestionarios
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