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1.
J Pediatr Nurs ; 52: 76-81, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32213455

RESUMO

PROBLEM: Asthma affects almost 15% of children in the United States. Despite the availability of treatments and educational methods, children with asthma continue to report an impaired quality of life, including symptoms of anxiety and inability to participate in physical activity. As complementary health approaches are becoming more popular and show promise in the management of many chronic diseases, the purpose of this integrative review is to examine the state of the science regarding popular complementary health approaches- yoga and mindfulness- for children and adolescents with asthma. ELIGIBILITY CRITERIA: A comprehensive search of five databases for peer reviewed articles was performed to identify experimental and non-experimental studies. The search for each database was performed from the inception of each to January 2020 and limited to the English language. The search included terminology that addressed the concepts of "asthma", "yoga" and "mindfulness". SAMPLE: A total of eleven articles met the criteria for review from the years 1991 to 2019. RESULTS: Nine publications focused on the use of yoga in children and adolescents with asthma and two publications focused on mindfulness in adolescents with asthma. CONCLUSIONS: Interventions involving either mindfulness or yoga may be effective in reducing stress and anxiety and improving quality of life and lung function in this population. IMPLICATIONS: Mindfulness intervention studies in the pediatric and adolescent asthma population are warranted as are additional studies that include the use of yoga with skills in mindfulness in order to evaluate their physiological and psychological effects.

2.
Nurs Res ; 69(1): 82-88, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31373995

RESUMO

BACKGROUND: Pregnant women with depressive symptoms face significant treatment challenges and are in great need of safe, effective, accessible, inexpensive, and nonpharmacological self-management therapies to enhance well-being, reduce the burden of symptoms both during their pregnancy and postpartum, and prevent chronic sequelae. OBJECTIVES: In this article, we describe the protocol for our pilot study testing a self-management intervention entitled, "Mindful Moms," designed to foster women's ability to address current depressive symptoms and enhance resilience to prevent recurrence. METHODS: We will conduct a longitudinal pilot trial of the 12-week intervention with pregnant women with depressive symptoms (n = 40); the primary aim is to determine the feasibility and acceptability of the intervention. The secondary aim is to examine preliminary effects of the intervention on maternal psychobehavioral outcomes in pregnancy and 6 weeks postpartum. The third aim will quantify genome-wide and gene-specific DNA methylation patterns associated with depressive symptoms during pregnancy and investigate whether intervention participation influences these patterns. RESULTS: This study is currently ongoing. DISCUSSION: Findings from this study will inform future research addressing the need for nonpharmacological self-management interventions for pregnant women with depressive symptoms.

3.
Clin Epigenetics ; 11(1): 169, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31779682

RESUMO

BACKGROUND: Perinatal depressive symptoms have been linked to adverse maternal and infant health outcomes. The etiology associated with perinatal depressive psychopathology is poorly understood, but accumulating evidence suggests that understanding inter-individual differences in DNA methylation (DNAm) patterning may provide insight regarding the genomic regions salient to the risk liability of perinatal depressive psychopathology. RESULTS: Genome-wide DNAm was measured in maternal peripheral blood using the Infinium MethylationEPIC microarray. Ninety-two participants (46% African-American) had DNAm samples that passed all quality control metrics, and all participants were within 7 months of delivery. Linear models were constructed to identify differentially methylated sites and regions, and permutation testing was utilized to assess significance. Differentially methylated regions (DMRs) were defined as genomic regions of consistent DNAm change with at least two probes within 1 kb of each other. Maternal age, current smoking status, estimated cell-type proportions, ancestry-relevant principal components, days since delivery, and chip position served as covariates to adjust for technical and biological factors. Current postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Ninety-eight DMRs were significant (false discovery rate < 5%) and overlapped 92 genes. Three of the regions overlap loci from the latest Psychiatric Genomics Consortium meta-analysis of depression. CONCLUSIONS: Many of the genes identified in this analysis corroborate previous allelic, transcriptomic, and DNAm association results related to depressive phenotypes. Future work should integrate data from multi-omic platforms to understand the functional relevance of these DMRs and refine DNAm association results by limiting phenotypic heterogeneity and clarifying if DNAm differences relate to the timing of onset, severity, duration of perinatal mental health outcomes of the current pregnancy or to previous history of depressive psychopathology.

4.
J Spec Pediatr Nurs ; : e12280, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31749322

RESUMO

PURPOSE: Severe asthma is an inflammatory illness associated with adverse health outcomes and behaviors in children, such as decreased quality of life, impaired sleep, and increased medical costs and morbidity. CONCLUSIONS: Children with severe asthma frequently exhibit a cycle of health and behaviors which contribute to these adverse health outcomes, consisting of decreased physical activity, increased stress, and increased airway inflammation and asthma exacerbations. School-age children, in particular, are a vulnerable population because they not only rely on others for their care but also suffer from a chronic illness and are at risk for unequal healthcare access and health outcomes. PRACTICE IMPLICATIONS: Currently, there is no one nursing theory that adequately addresses the vulnerability, cycle of health and behaviors, and adverse health outcomes of children with severe asthma. By integrating key concepts from three vulnerability theories and presenting a modified conceptual framework, this paper aims to demonstrate how the use of this new conceptual framework may assist nurses in evaluating the unique needs of school-age children with severe asthma to provide best practices and develop appropriate interventions.

5.
J Evid Based Integr Med ; 24: 2515690X19855303, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31204485

RESUMO

The present study investigated whether a brief yoga intervention would be feasible and acceptable for dental students. Based on empirical evidence about state mindfulness (SM), change in self-reported SM was assessed as a measure of the intervention's feasibility and acceptability. A repeated-measures within-subjects design was used. Participants were third- and fourth-year dental and dental hygiene students (76% female). The State Mindfulness Scale (SMS), a validated self-report measure of SM with 2 subscales, Mind and Body, was used. Students (n = 132) completed the SMS immediately prior to and following a 1-hour yoga intervention. Dispositional mindfulness, burnout, perceived stress, and depressive symptoms were also investigated as moderators of changes in state mindfulness to determine whether psychological variables had an effect on feasibility in this sample. Total SM significantly increased from pre- to post-intervention, t(46) = 10.26, P < .001. An analysis of covariance showed a significant interaction effect in the relationship between pre-/post-intervention SM of Mind (ß = 0.51, P = .048), such that higher levels of stress saw greater increases in SM of Mind. No other psychological variables were significant moderators. A brief yoga intervention for dental students significantly increased SM, suggesting that yoga interventions may be feasible and acceptable in this population. The results of moderation analyses suggest that a brief yoga intervention may be especially effective at increasing SM for those with high levels of stress. Future research should use a randomized control group to test group differences in SM after a brief yoga intervention for dental students.

6.
Behav Neurol ; 2019: 8459579, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31191740

RESUMO

Anxiety in Parkinson's disease (aPD) is underdiagnosed, undertreated, and understudied. As many as 50% of persons diagnosed with Parkinson's disease (PD) are reported to suffer from anxiety. Current treatment is largely pharmacologic, which can result in a myriad of undesirable and unsafe side effects. The aim of this paper is to examine intervention studies of self-managed nonpharmacological strategies for the treatment of anxiety. A comprehensive review was conducted on experimental or quasi-experimental trials that included self-management approaches for the nonpharmacologic treatment of anxiety as a primary or secondary aim or outcome measure. Thirteen studies were identified from four databases. Study quality demonstrated variability in design and delivery of self-managed interventions; sample sizes were small; anxiety was most commonly a secondary aim; and the use of anxiety measures varied widely. Statistical significance was evident in slightly more than 50% of the anxiety intervention studies. A common element in the interventions in all studies was the focused use of breath. Further research is needed to determine the feasibility of using focused breathing, alone, as an intervention for the self-management of anxiety in Parkinson's disease.


Assuntos
Ansiedade/terapia , Doença de Parkinson/psicologia , Autogestão/métodos , Humanos , Doença de Parkinson/complicações , Respiração , Autocuidado/métodos , Autocuidado/psicologia , Autogestão/psicologia
7.
Neurosci Biobehav Rev ; 102: 106-122, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30981737

RESUMO

OBJECTIVE: Major depression with peripartum onset (MDP) has been associated with multiple adverse offspring health outcomes. The biological mechanisms underlying this relationship remain unclear, but DNA methylation (DNAm) represents a plausible mechanism for mediating MDP exposures and changes in offspring development, behavior, and health. Advances in DNAm research necessitate reevaluating the MDP-DNAm literature to determine how well past studies conform with current best practices. METHOD: Five databases were searched to identify studies of prenatal-onset MDP and DNAm. Quality scores were assigned to each article independently by two raters using a novel scale specific for MDP-DNAm research. RESULTS: Nineteen studies met inclusion criteria. Quality scores ranged from 10 to 17 out of 24 points (M = 12.8; SD = 1.9), with higher scores indicating increased study rigor. Poor covariate reporting was the most significant contributor to lower scores. CONCLUSION: No longitudinal MDP-DNAm studies exist. Earlier MDP-DNAm studies should be interpreted with caution, and future research must commit to sharing methodology and data to facilitate cross-study comparisons and maximize dataset utility.

8.
Nurs Outlook ; 67(3): 252-258, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30975493

RESUMO

Mid-career nurse scientists in academia are at risk for burnout and departing scientific careers, particularly those in research-intensive academic settings. With the shortage of nursing faculty and the public health need for high-quality nursing research, it is critical to retain current research-focused individuals in nursing. In this paper, we discuss definitions and expectations of mid-career scientists, challenges and barriers faced by mid-career scientists, and opportunities for mid-career scientists, informed by both nursing and non-nursing literature. Finally, we focus on definitions and expectations, challenges, and opportunities specifically related to mid-career nurse scientists in research-intensive academic settings.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Esgotamento Profissional/prevenção & controle , Docentes de Enfermagem/organização & administração , Enfermeiras e Enfermeiros/organização & administração , Pesquisa em Enfermagem/organização & administração , Pesquisadores/organização & administração , Apoio Social , Adulto , Escolha da Profissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
J Holist Nurs ; 37(2): 189-199, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30227765

RESUMO

PURPOSE: To contribute to the treatment fidelity literature by providing real-world examples and suggestion for future research and potential clinical application, this article reports on implementation, assessment, and evaluation of treatment fidelity in mind-body self-care approaches in at-risk women. METHOD: Aligning with best practices, treatment fidelity was integrated into three randomized clinical trials. The first examined the effects of a tai chi intervention designed to decrease cardiometabolic risk factors in women; the second examined the effects of a tailored guided imagery intervention on pregnancy outcomes in African American women; and the third explored effects of a mindful physical activity intervention (yoga) on psychological outcomes in women with moderate to severe depressive symptoms. FINDINGS: Each of the studies successfully designed, implemented, and evaluated strategies to address recommended treatment fidelity components. These strategies provided qualitative and quantitative data that informed intervention refinement, directions for future research, and application in clinical practice. CONCLUSIONS: The treatment fidelity framework used here is based on best practices and was a feasible and reliable approach for ensuring and reporting on treatment fidelity, which is contributing to future research to foster translation of potentially effective mind-body self-care approaches into practice.


Assuntos
Terapias Mente-Corpo/normas , Resultado do Tratamento , Adolescente , Adulto , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/terapia , Feminino , Humanos , /normas , Terapias Mente-Corpo/métodos , Fatores de Risco , Tai Ji/métodos , Tai Ji/normas
10.
BMJ Open ; 8(5): e019721, 2018 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-29743320

RESUMO

PURPOSE: The goal of the Pregnancy, Race, Environment, Genes study was to understand how social and environmental determinants of health (SEDH), pregnancy-specific environments (PSE) and biological processes influence the timing of birth and account for the racial disparity in preterm birth. The study followed a racially diverse longitudinal cohort throughout pregnancy and included repeated measures of PSE and DNA methylation (DNAm) over the course of gestation and up to 1 year into the postpartum period. PARTICIPANTS: All women were between 18 and 40 years of age with singleton pregnancies and no diagnosis of diabetes or indication of assisted reproductive technology. Both mother and father had to self-identify as either African-American (AA) or European-American (EA). Maternal peripheral blood samples along with self-report questionnaires measuring SEDH and PSE factors were collected at four pregnancy visits, and umbilical cord blood was obtained at birth. A subset of participants returned for two additional postpartum visits, during which additional questionnaires and maternal blood samples were collected. The pregnancy and postpartum extension included n=240 (AA=126; EA=114) and n=104 (AA=50; EA=54), respectively. FINDINGS TO DATE: One hundred seventy-seven women (AA=89, EA=88) met full inclusion criteria out of a total of 240 who were initially enrolled. Of the 63 participants who met exclusion criteria after enrolment, 44 (69.8%) were associated with a medical reason. Mean gestational age at birth was significantly shorter for the AA participants by 5.1 days (M=272.5 (SD=10.5) days vs M=277.6 (SD=8.3)). FUTURE PLANS: Future studies will focus on identifying key environmental factors that influence DNAm change across pregnancy and account for racial differences in preterm birth.


Assuntos
Afro-Americanos/estatística & dados numéricos , Metilação de DNA , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Genômica/métodos , Nascimento Prematuro/epidemiologia , Características de Residência , Adolescente , Adulto , Afro-Americanos/genética , Estudos de Coortes , Grupos de Populações Continentais , Meio Ambiente , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Disparidades nos Níveis de Saúde , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Estudos Prospectivos , Estados Unidos , Virginia/epidemiologia , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-27672398

RESUMO

Health disparities (HD) continue to persist in the United States which underscores the importance of using low-cost, accessible, evidence-based strategies that can improve health outcomes, especially for chronic conditions that are prevalent among underserved minority populations. Complementary/integrative health modalities, particularly self-administered mind-body practices (MBP), can be extremely useful in reducing HD because they are intrinsically patient-centered and they empower patients to actively engage in self-care of health and self-management of symptoms. Interprofessional healthcare providers and patients can engage in powerful partnerships that encompass self-administered MBP to improve health. This is a call to action for interprofessional researchers to engage in high-quality research regarding efficacy and cost-effectiveness of self-administered MBP, for practitioners to engage patients in self-administered MBP for health promotion, disease prevention, and symptom management, and for healthcare institutions to integrate self-administered MBP into conventional health practices to reduce HD in their communities.

12.
Brain Behav ; 4(5): 665-74, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25328843

RESUMO

BACKGROUND: Depression is a chronic mental health condition that affects millions of individuals worldwide. It is well-established that psychological stress plays an integral role in depression and that depression has numerous negative health outcomes. However, a closer look at components of stress vulnerabilities and depression is required to allow for the development and testing of appropriate interventions. AIMS AND DISCUSSION: This article describes a conceptual framework about the complex and bidirectional relationship between stress vulnerability, depression, and health outcomes in women. The authors elucidate how the framework can be applied in clinical research about cellular aging and on the mechanisms of complementary and alternative medicine (CAM) for depression, using yoga as an example of a CAM modality. CONCLUSION: The proposed conceptual framework may be helpful for adding depth to the body of knowledge about the use of mind-body therapies for individuals at high risk of stress vulnerability and/or depression.


Assuntos
Terapias Complementares , Transtorno Depressivo/psicologia , Nível de Saúde , Estresse Psicológico/psicologia , Saúde da Mulher , Feminino , Humanos , Pesquisa , Ioga
13.
Pain Manag Nurs ; 14(4): 327-335, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24315255

RESUMO

To investigate the effects of microcurrent cranial electrical stimulation (CES) therapy on reducing pain and its associated symptoms in fibromyalgia (FM), we conducted a randomized, controlled, three-group (active CES device, sham device, and usual care alone [UC]), double-blind study to determine the potential benefit of CES therapy for symptom management in FM. Those individuals using the active CES device had a greater decrease in average pain (p = .023), fatigue (p = .071), and sleep disturbance (p = .001) than individuals using the sham device or those receiving usual care alone over time. Additionally, individuals using the active CES device had improved functional status versus the sham device and UC groups over time (p = .028).


Assuntos
Dor Crônica/terapia , Terapia por Estimulação Elétrica/métodos , Terapia por Estimulação Elétrica/enfermagem , Fibromialgia/terapia , Adulto , Pressão Sanguínea , Dor Crônica/enfermagem , Fadiga/enfermagem , Fadiga/terapia , Feminino , Fibromialgia/enfermagem , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Transtornos do Sono-Vigília/enfermagem , Transtornos do Sono-Vigília/terapia , Resultado do Tratamento
14.
Health Care Women Int ; 26(5): 422-9, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-16020007

RESUMO

An understanding of imposed cultural norms allows the scientist, researcher, and health care practitioner to move beyond the social construction of gender and illness. From Aristotle's theory of reproduction to neurological and psychological research asserting sex as destiny to present-day attitudes toward intersexuality, we can trace the conceptualization of women in terms of biological inferiority. These theories elucidate the ways in which the cultural assumptions influence the institution of scientific inquiry and vice versa. To assure equal and fair health care practices, a paradigm shift is called for that actively accepts feminist research practices and rejects culturally dominant methods of research in medicine and science.


Assuntos
Identidade de Gênero , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa sobre Serviços de Saúde/normas , Direitos da Mulher , Mulheres Trabalhadoras , Feminino , Humanos , Médicas/normas , Projetos de Pesquisa/normas , Percepção Social , Estereotipagem , Serviços de Saúde da Mulher/normas
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