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1.
BMC Public Health ; 24(1): 1830, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38982408

RESUMO

BACKGROUND: Lack of physical activity is a concern for children across diverse backgrounds, particularly affecting those in rural areas who face distinct challenges compared to their urban counterparts. Community-derived interventions are needed that consider the unique context and additional physical activity barriers in under-resourced rural settings. Therefore, a prospective pre-post pilot/feasibility study of Hoosier Sport was conducted over 8-weeks with 6th and 7th grade children in a low-socioeconomic rural middle school setting. The primary objective of the present study was to assess trial- and intervention-related feasibility indicators; and the secondary objective was to collect preliminary assessment data for physical activity levels, fitness, psychological needs satisfaction, and knowledge of physical activity and nutrition among participating youth. METHODS: This prospective 8-week pilot/feasibility study took place in the rural Midwestern United States where twenty-four middle school students participated in a mixed-methods pre-post intervention during physical education classes. The intervention included elements like sport-based youth development, individualized goal setting, physical activity monitoring, pedometer usage, and health education. Data were collected at baseline (T1) and post-intervention (T3), with intermediate measures during the intervention (T2). Qualitative data were integrated through semi-structured interviews. Analytical methods encompassed descriptive statistics, correlations, repeated measures ANOVA, and thematic analysis. RESULTS: Key findings indicate robust feasibility, with intervention-related scores (FIM, AIM, and IAM) consistently surpassing the "good" threshold and 100% retention and recruitment success. Additionally, participants showed significant physical performance improvement, shifting from the 25th to the 50th percentile in the 6-minute walk test (p < 0.05). Autonomy and competence remained high, reflecting positive perceptions of program practicality. Nutrition knowledge, initially low, significantly improved at post-intervention (p < 0.01), highlighting the efficacy of targeted nutritional education in Hoosier Sport. CONCLUSIONS: This study pioneers a community-engaged model for physical activity intervention in under-resourced rural settings. Positive participant feedback, coupled with improvements in physical fitness and psychosocial factors, highlights the potential of the co-design approach. The findings offer valuable insights and a practical template for future community-based research, signaling the promising impact of such interventions on holistic well-being. This research lays the foundation for subsequent phases of the ORBIT model, emphasizing collaborative, community-driven approaches to address the complex issue of declining physical activity levels among adolescents.


Assuntos
Exercício Físico , Estudos de Viabilidade , População Rural , Humanos , Projetos Piloto , Masculino , Exercício Físico/psicologia , Criança , Feminino , Adolescente , Estudos Prospectivos , Promoção da Saúde/métodos , Meio-Oeste dos Estados Unidos , Avaliação de Programas e Projetos de Saúde , Educação Física e Treinamento
2.
J Gerontol Nurs ; 50(7): 35-41, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38959508

RESUMO

PURPOSE: Increasing racial and ethnic diversity in U.S. nursing facilities has necessitated the provision of more culturally competent care. This study explored the cultural challenges in providing palliative care from the perspective of certified nursing assistants (CNAs) and nurses in nursing facilities. METHOD: A thematic analysis approach was used to examine data from semi-structured interviews with 12 CNAs and 11 nurses from six nursing facilities in a U.S. Midwestern state. RESULTS: Four themes emerged from the data: Cultural Needs Expressed by Residents, Cultural Needs Expressed by Family Members, Accommodating Residents' Cultural Needs, and Organizational Responses to Cultural Competency Challenges. CONCLUSION: Results highlighted the training variations on diversity and cultural competency issues and the varying cultural competency levels possessed by staff. To support residents' culture-related needs, staff need education and support. Organizations can provide foundational resources for this diversity of cultural expression, including providing more culturally diverse programming facilities. [Journal of Gerontological Nursing, 50(7), 35-41.].


Assuntos
Competência Cultural , Assistentes de Enfermagem , Cuidados Paliativos , Humanos , Assistentes de Enfermagem/educação , Assistentes de Enfermagem/psicologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Casas de Saúde , Meio-Oeste dos Estados Unidos , Assistência à Saúde Culturalmente Competente
3.
Sci Data ; 11(1): 581, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834712

RESUMO

Conservation agriculture (CA) is a set of principles thought to be able to enhance crop productivity while minimizing impacts on the environment. The evidence base for CA can be challenging to synthesize because it encompasses many different practices and social and agroecological outcomes. To facilitate synthesis of CA evidence we have created a dataset organizing 218 response variables from five common categories of CA: cover crops, tillage management, pest management, nutrient management, and crop diversification. These data cover the Midwestern United States (U.S.) from 1980-2020. The dataset is also summarized and visualized on the AgEvidence website, which enables users to interactively explore, filter, and download data. We hope this dataset will help a wide variety of stakeholders, including researchers, policy makers, advocacy groups, and growers access the evidence needed to make informed and impactful decisions about how to produce food with less negative environmental impact.


Assuntos
Agricultura , Conservação dos Recursos Naturais , Produtos Agrícolas , Meio-Oeste dos Estados Unidos
4.
J Sch Health ; 94(8): 687-696, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38863265

RESUMO

BACKGROUND: The objective of this study is to evaluate the Respect YOU program's impact on students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. A total of 444 (intervention cohort n = 348, control cohort n = 96) underclassmen enrolled in health or physical education courses from 7 high schools in the Midwest participated in the study. METHODS: A repeated measure research design was utilized to assess students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. More specifically, paired t-tests were conducted to compare outcome measurements to evaluate the efficacy of the intervention. RESULTS: Among the students who received the intervention (n = 348), there was a statistically significant change in scores for eating expectancies (Z = -14.403, p < .001), body image satisfaction levels (Z = -14.114, p < .001), social media self-efficacy (Z = 14.868, p < .001), and knowledge scales (Z = -16.100, p < .001) at post-intervention and compared to the control group. CONCLUSIONS: Results indicate that the Respect YOU program was effective in improving body image scores, eating expectancies, self-esteem, and knowledge-related outcomes among students post-intervention. These results can be used to further develop educational programming to address body image concerns and disordered eating among adolescents.


Assuntos
Imagem Corporal , Currículo , Autoeficácia , Humanos , Feminino , Masculino , Projetos Piloto , Adolescente , Imagem Corporal/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Avaliação de Programas e Projetos de Saúde , Meio-Oeste dos Estados Unidos , Estudantes/psicologia , Comportamento Alimentar/psicologia , Satisfação Pessoal , Educação Física e Treinamento
5.
Ther Adv Respir Dis ; 18: 17534666241259373, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38877686

RESUMO

BACKGROUND: Chronic cough (CC) affects about 10% of adults, but opioid use in CC is not well understood. OBJECTIVES: To determine the use of opioid-containing cough suppressant (OCCS) prescriptions in patients with CC using electronic health records. DESIGN: Retrospective cohort study. METHODS: Through retrospective analysis of Midwestern U.S. electronic health records, diagnoses, prescriptions, and natural language processing identified CC - at least three medical encounters with cough, with 56-120 days between first and last encounter - and a 'non-chronic cohort'. Student's t-test, Pearson's chi-square, and zero-inflated Poisson models were used. RESULTS: About 20% of 23,210 patients with CC were prescribed OCCS; odds of an OCCS prescription were twice as great in CC. In CC, OCCS drugs were ordered in 38% with Medicaid insurance and 15% with commercial insurance. CONCLUSION: Findings identify an important role for opioids in CC, and opportunity to learn more about the drugs' effectiveness.


Assuntos
Analgésicos Opioides , Tosse , Registros Eletrônicos de Saúde , Humanos , Estudos Retrospectivos , Analgésicos Opioides/uso terapêutico , Analgésicos Opioides/administração & dosagem , Masculino , Tosse/tratamento farmacológico , Feminino , Pessoa de Meia-Idade , Adulto , Doença Crônica , Estudos de Coortes , Idoso , Antitussígenos/administração & dosagem , Antitussígenos/uso terapêutico , Estados Unidos , Prescrições de Medicamentos/estatística & dados numéricos , Medicaid , Meio-Oeste dos Estados Unidos , Padrões de Prática Médica/estatística & dados numéricos , Adulto Jovem , Adolescente , Tosse Crônica
6.
PLoS One ; 19(6): e0304319, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38900768

RESUMO

Mounting evidence shows overall insect abundances are in decline globally. Habitat loss, climate change, and pesticides have all been implicated, but their relative effects have never been evaluated in a comprehensive large-scale study. We harmonized 17 years of land use, climate, multiple classes of pesticides, and butterfly survey data across 81 counties in five states in the US Midwest. We find community-wide declines in total butterfly abundance and species richness to be most strongly associated with insecticides in general, and for butterfly species richness the use of neonicotinoid-treated seeds in particular. This included the abundance of the migratory monarch (Danaus plexippus), whose decline is the focus of intensive debate and public concern. Insect declines cannot be understood without comprehensive data on all putative drivers, and the 2015 cessation of neonicotinoid data releases in the US will impede future research.


Assuntos
Biodiversidade , Borboletas , Mudança Climática , Inseticidas , Animais , Herbicidas , Meio-Oeste dos Estados Unidos , Ecossistema , Dinâmica Populacional
7.
Soc Work ; 69(3): 231-239, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38697186

RESUMO

This study examines the moderating effects of distant leader's practice of transformational leadership on the relationship between secondary traumatic stress (STS) and burnout among child welfare workers. Caseworkers and supervisors in a Midwest U.S. state (N = 210) rated their regional director's use of transformational leadership skills using a survey. Given the nature of the clustered data, multilevel modeling was employed to examine the main effects of transformational leadership on worker burnout and its cross-level interaction effect on the association between worker STS and burnout. Multilevel modeling demonstrated that worker burnout was positively associated with STS and negatively associated with organizational-level transformational leadership. The cross-level interaction between transformational leadership and STS was significant. Specifically, the positive association between workers' STS and burnout decreased as transformational leadership increased. These findings suggest that organizational approaches such as transformational leadership can influence workforce results. Further research will guide child welfare policymakers to develop more sophisticated training programs in leadership skills and strategies.


Assuntos
Esgotamento Profissional , Liderança , Humanos , Esgotamento Profissional/psicologia , Feminino , Masculino , Adulto , Inquéritos e Questionários , Proteção da Criança/psicologia , Pessoa de Meia-Idade , Criança , Meio-Oeste dos Estados Unidos , Serviços de Proteção Infantil , Serviço Social/métodos
8.
J Trauma Nurs ; 31(3): 136-148, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38742721

RESUMO

BACKGROUND: Experiencing symptoms of traumatic stress may be the cost of caring for trauma patients. Emergency nurses caring for trauma patients are at risk for traumatic stress reactions. OBJECTIVE: This study explored the stress and coping behaviors experienced by emergency nurses who provide trauma care. METHODS: Focus groups were held at three urban trauma centers in the Midwestern United States: a Level I pediatric trauma center, a Level I adult trauma center, and a Level III adult trauma center. Data were collected between December 2009 and March 2010. Data analysis was guided by the principles of grounded theory. Line-by-line coding and constant comparative analysis techniques were used to identify recurring constructs. RESULTS: A total of 48 emergency nurses participated. Recurring constructs emerged in the data analysis and coding, revealing four major themes: care of the trauma patient, professional practice, personal life, and support. CONCLUSIONS: Nurse job engagement, burnout, and professional and personal relationships are influenced by trauma patient care. The study's resulting themes of care of the trauma patient, professional practice, personal life, and support resulted in the development of the "trauma nursing is a continual experience theory" that can be used as a framework to address these effects. Intentional support and timely interventions based on this new theory can help mitigate the effects of traumatic stress experienced by trauma nurses.


Assuntos
Adaptação Psicológica , Enfermagem em Emergência , Grupos Focais , Teoria Fundamentada , Recursos Humanos de Enfermagem Hospitalar , Pesquisa Qualitativa , Centros de Traumatologia , Humanos , Feminino , Adulto , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermagem em Ortopedia e Traumatologia , Esgotamento Profissional/psicologia , Ferimentos e Lesões/enfermagem , Ferimentos e Lesões/psicologia
9.
J Prim Care Community Health ; 15: 21501319241251934, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38726652

RESUMO

INTRODUCTION/OBJECTIVES: Despite U.S. Preventive Services Task Force and American Cancer Society endorsement of primary HPV screening, limited published data shows low uptake. PRIMARY AIM: Assess cervical cancer screening rates over time, particularly primary HPV test uptake, among patients in a midwestern practice. SECONDARY AIM: Evaluate associations between sociodemographics and screening adherence. METHODS: Cross-sectional study. Qualifying subjects and type of screening test used were identified by applying ICD-9, ICD-10, lab test, and CPT codes to the Unified Data Platform. Sociodemographics were found through the electronic health record. RESULTS: Primary HPV uptake represented <1% of annual screening from 1/2017 to 1/2022. On 1/1/2022, only 55% of 21 to 29 year old and 63% of 30 to 65 year old were up to date with screening among the studied population. For 21 to 29 year old, compared with White women, Black women were 28% less likely to be screened [RR = 0.72 (0.66-0.79)]. Compared with never-smokers, current smokers were 9% less likely to be screened [RR = 0.91 (0.87-0.96)], past smokers were 14% more likely [RR = 1.14 (1.09-1.2)]. Among 30 to 65 year old, compared with White women, Black women were 14% less likely to be screened [RR = 0.86 (0.81-0.9)]. Compared with never-smokers, current smokers were 21% less likely to be screened [RR = 0.79 (0.77-0.81)], past smokers were 6% less likely [RR = 0.94 (0.92-0.95)]. Jointly considering race, ethnicity, smoking status, Charlson score, and rurality, findings were similar for 21 to 29 year old; Black women were screened less than White women [RR = 0.73 (0.67-0.79)]; current smokers [RR = 0.9 (0.85-0.94)] and past smokers [RR = 1.12 (1.06-1.17)] were screened less than never smokers. For 30 to 65 year old, Black women were screened less than White women [RR = 0.83 (0.79-0.88)]; current smokers [RR = 0.8 (0.78-0.81)] and past smokers [RR = 0.95 (0.93-0.96)] were screened less than never smokers. CONCLUSIONS: Screening rates remained below the Healthy People 2030 goal of 79.2% over time, particularly for younger Black women and current smokers, with minimal use of primary HPV screening.


Assuntos
Detecção Precoce de Câncer , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Detecção Precoce de Câncer/estatística & dados numéricos , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Idoso , Meio-Oeste dos Estados Unidos/epidemiologia , Adulto Jovem , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Papillomavirus Humano
10.
PLoS One ; 19(5): e0303280, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38768115

RESUMO

BACKGROUND: Access to breast screening mammogram services decreased during the COVID-19 pandemic. Our objectives were to estimate: 1) the COVID-19 affected period, 2) the proportion of pandemic-associated missed or delayed screening encounters, and 3) pandemic-associated patient attrition in screening encounters overall and by sociodemographic subgroup. METHODS: We included screening mammogram encounter EPIC data from 1-1-2019 to 12-31-2022 for females ≥40 years old. We used Bayesian State Space models to describe weekly screening mammogram counts, modeling an interruption that phased in and out between 3-1-2020 and 9-1-2020. We used the posterior predictive distribution to model differences between a predicted, uninterrupted process and the observed screening mammogram counts. We estimated associations between race/ethnicity and age group and return screening mammogram encounters during the pandemic among those with 2019 encounters using logistic regression. RESULTS: Our analysis modeling weekly screening mammogram counts included 231,385 encounters (n = 127,621 women). Model-estimated screening mammograms dropped by >98% between 03-15-2020 and 05-24-2020 followed by a return to pre-pandemic levels or higher with similar results by race/ethnicity and age group. Among 79,257 women, non-Hispanic (NH) Asians, NH Blacks, and Hispanics had significantly (p < .05) lower odds of screening encounter returns during 2020-2022 vs. NH Whites with odds ratios (ORs) from 0.70 to 0.91. Among 79,983 women, those 60-69 had significantly higher odds of any return screening encounter during 2020-2022 (OR = 1.28), while those ≥80 and 40-49 had significantly lower odds (ORs 0.77, 0.45) than those 50-59 years old. A sensitivity analysis suggested a possible pre-existing pattern. CONCLUSIONS: These data suggest a short-term pandemic effect on screening mammograms of ~2 months with no evidence of disparities. However, we observed racial/ethnic disparities in screening mammogram returns during the pandemic that may be at least partially pre-existing. These results may inform future pandemic planning and continued efforts to eliminate mammogram screening disparities.


Assuntos
Neoplasias da Mama , COVID-19 , Detecção Precoce de Câncer , Mamografia , Humanos , COVID-19/epidemiologia , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/diagnóstico por imagem , Mamografia/estatística & dados numéricos , Detecção Precoce de Câncer/estatística & dados numéricos , Idoso , Adulto , Centros Médicos Acadêmicos , Meio-Oeste dos Estados Unidos/epidemiologia , Pandemias , SARS-CoV-2 , Teorema de Bayes , Programas de Rastreamento/estatística & dados numéricos
11.
J Nurs Educ ; 63(5): 277-281, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38729136

RESUMO

BACKGROUND: Enhancing faculty voice and promoting shared governance within academia has long been called for but has not been well-reported. A college of nursing in the midwestern United States identified shortcomings in its organizational structure including lack of faculty voice, communication barriers, lack of faculty participation in decision making, and academic programs operating independently. METHOD: A workgroup was formed to transform the bylaws to promote shared governance, including faculty voice, equality, and engagement. RESULTS: The bylaws were revised and presented to faculty for discussion, further revisions, and vote. The revised bylaws were approved and implemented in August 2021. CONCLUSION: Through transformation of the bylaws, the college's 12-committee structure was reconceptualized to five standing committees and 13 subcommittees. Clear communication lines and cross-committee collaboration was established to break down the former academic program silos. Faculty with primary teaching assignments are equally represented throughout the structure with voice, vote, and responsibility. [J Nurs Educ. 2024;63(5):277-281.].


Assuntos
Docentes de Enfermagem , Escolas de Enfermagem , Humanos , Escolas de Enfermagem/organização & administração , Meio-Oeste dos Estados Unidos
12.
Hosp Pediatr ; 14(6): e249-e253, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38808411

RESUMO

BACKGROUND: Although multiple specialties perform neonatal circumcision (NC), overall NC proceduralist availability is limited. The approach to training new practitioners varies. This study aims to describe NC training experiences, current practices, and make suggestions for future improvements. METHODS: Perinatal physicians across 11 hospitals in a large Midwestern United States city who perform NC or who conduct newborn examinations and provide circumcision counseling were recruited for semistructured interviews about NC care. Interviews were transcribed; training-related comments underwent inductive and deductive qualitative coding. Themes related to circumcision training and recommendations for improving the experience of future circumcision learners were summarized. RESULTS: Twenty-three physicians (10 family medicine, 8 pediatrics, and 5 obstetrics; 78% currently perform circumcision) participated. All participants conducted newborn examinations and provided circumcision counseling, but only 21/23 were trained to perform circumcision. Several themes related to training emerged: (1) personal training experience, (2) training others to perform circumcision, and (3) current training needs and barriers. Most reported learning in residency by a "see one, do one, teach one" approach with minimal formal didactic or structured training. Compared with their personal experience, participants noted a shift toward more direct supervision and preprocedure preparation for current trainees. However, most reported that circumcision learning continues to be "hands-on." Participants desired a more structured approach for future trainees. CONCLUSIONS: Perinatal physicians noted a shift in the current NC training to a more hands-on approach than they experienced personally. Development of a structured NC curriculum was recommended to improve training.


Assuntos
Circuncisão Masculina , Humanos , Circuncisão Masculina/educação , Masculino , Recém-Nascido , Feminino , Competência Clínica/normas , Pediatria/educação , Meio-Oeste dos Estados Unidos , Entrevistas como Assunto
13.
J Trauma Nurs ; 31(3): 158-163, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38742724

RESUMO

BACKGROUND: Early administration of antibiotics in the presence of open fractures is critical in reducing infections and later complications. Current guidelines recommend administering antibiotics within 60 min of patient arrival to the emergency department, yet trauma centers often struggle to meet this metric. OBJECTIVES: This study aims to evaluate the impact of a nurse-initiated evidence-based treatment protocol on the timeliness of antibiotic administration in pediatric patients with open fractures. METHODS: A retrospective pre-post study of patients who met the National Trauma Data Standard registry inclusion criteria for open fractures of long bones, amputations, or lawn mower injuries was performed at a Midwestern United States Level II pediatric trauma center. The time of patient arrival and time of antibiotic administration from preimplementation (2015-2020) to postimplementation (2021-2022) of the protocol were compared. Patients transferred in who received antibiotics at an outside facility were excluded. RESULTS: A total of N = 73 participants met the study inclusion criteria, of which n = 41 were in the preimplementation group and n = 32 were in the postimplementation group. Patients receiving antibiotics within 60 min of arrival increased from n = 24/41 (58.5%) preimplementation to n = 26/32 (84.4%) postimplementation (p< .05). CONCLUSIONS: Our study demonstrates that initiating evidence-based treatment orders from triage helped decrease the time from arrival to time of antibiotic administration in patients with open fractures. We sustained improvement for 24 months after the implementation of our intervention.


Assuntos
Antibacterianos , Fraturas Expostas , Centros de Traumatologia , Humanos , Fraturas Expostas/enfermagem , Fraturas Expostas/tratamento farmacológico , Estudos Retrospectivos , Antibacterianos/administração & dosagem , Masculino , Criança , Feminino , Pré-Escolar , Protocolos Clínicos , Adolescente , Tempo para o Tratamento/normas , Fatores de Tempo , Meio-Oeste dos Estados Unidos
14.
Am J Mens Health ; 18(2): 15579883241241973, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38613210

RESUMO

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer's disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted with a total of 10 cognitively normal Black men aged 55 years and older. Survey data were analyzed using a frequency analysis and qualitative data were analyzed using a six-step thematic analysis process. Most men indicated having hypertension (N = 7, 77.8%) and currently not following a dietary eating pattern (N = 8, 88.9%). Emerging themes identified included (1) knowledge of dementia, (2) perceptions of dietary interventions, (3) barriers impacting participation in dietary interventions, and (4) overcoming barriers to engage Black men in dietary interventions. Findings from this study should inform the design of future dietary interventions for AD prevention to enhance participation among older Black men.


Assuntos
Negro ou Afro-Americano , Homens , Humanos , Masculino , População Negra , Grupos Focais , Percepção , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos
15.
West J Nurs Res ; 46(6): 478-482, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38577819

RESUMO

BACKGROUND: Leadership development, career advancement, and collaboration among scholars are essential to nurturing nursing research excellence and sustainability. The Midwest Nursing Research Society (MNRS) has incorporated several strategies to advance nursing science and to increase the pool of future nurse leaders. In this article, we describe the process, activities, and outcomes of the Leadership Academy (LA), an innovative initiative from MNRS developed to identify, engage, and nurture future generations of leaders. METHODS: For the LA 2022 to 2023 period, the MNRS leaders selected a cohort of 5 nurse scholars and engaged them in activities to develop, enhance, and advance their leadership skills. By following the LA purposes, the cohort participated in monthly meetings with MNRS leaders, received individual mentoring sessions, assessed strengths and areas for further development, attended seminars, participated in a book club, and implemented a cohort project that focused on the promotion and support of early career scholars. RESULTS: Outcomes showed increased knowledge about organizational governance, direction, and resource development; leadership confidence culminating with leadership positions inside and outside MNRS; career development plans; engagement with board members, and enhanced networking. Moreover, the cohort members planned and executed a well-attended conference special session that engaged a large group of scholars to discuss challenges and opportunities for career development at the MNRS Annual Conference. CONCLUSION: The MNRS LA is a thriving organizational initiative that promotes engagement and leadership skills development thereby increasing the pool of candidates confidently prepared to lead the nursing profession.


Assuntos
Liderança , Pesquisa em Enfermagem , Humanos , Sociedades de Enfermagem , Meio-Oeste dos Estados Unidos , Enfermeiros Administradores/tendências , Mobilidade Ocupacional , Academias e Institutos
16.
J Prim Care Community Health ; 15: 21501319241247984, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38682480

RESUMO

BACKGROUND: Arsenic is a well-known toxin which may contaminate household water. It is harmful when ingested over prolonged periods of time. As a result, public health experts recommend that water should be screened and treated to prevent arsenic ingestion. In the United States, the responsibility of testing and treatment of private wells falls on homeowners. Despite recommendations for routine screening, this is rarely done. OBJECTIVES: To assess the prevalence of well water use in a Midwestern patient population, how patients and clinicians perceive the risks of arsenic in well water, and whether additional resources on well water testing are desired. These findings will be used to influence tools for clinicians regarding symptom and examination findings of chronic arsenic exposure and potentiate the distribution of informational resources on well water testing. METHODS: Surveys were sent via email to all actively practicing primary care clinicians at the Mayo Clinic in the United States Midwest, and all active adult patients at the Mayo Clinic in the same region. Our team analyzed survey data to determine whether both patients and clinicians are aware of the health effects of chronic arsenic toxicity from well water, the need for routine well water testing and whether each group wants more information on the associated risks. RESULTS: Both patients and primary care clinicians worry about arsenic exposure. Patients with well water are concerned about their water safety yet feel uninformed about testing options. Clinicians do not know how prevalent well water use is among their patients, feel uninformed about the chronic risks of arsenic exposure and the physical examination associated with it. Both groups unanimously want more information on testing options. CONCLUSIONS: Our findings show a significant reliance on well water use in the American Midwest, and unanimous support for the need for further well water testing information and resources for patients and their clinicians.


Assuntos
Arsênio , Poços de Água , Humanos , Arsênio/análise , Feminino , Adulto , Masculino , Pessoa de Meia-Idade , Exposição Ambiental/efeitos adversos , Inquéritos e Questionários , Meio-Oeste dos Estados Unidos , Poluentes Químicos da Água/análise , Conhecimentos, Atitudes e Prática em Saúde , Água Potável , Abastecimento de Água , Idoso , Intoxicação por Arsênico/epidemiologia
18.
Ecohealth ; 21(1): 56-70, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38478199

RESUMO

Lyme disease (LD) is the most common vector-borne disease in the United States (U.S.). This paper assesses how climate change may influence LD incidence in the eastern and upper Midwestern U.S. and the associated economic burden. We estimated future Ixodes scapularis habitat suitability and LD incidence with a by-degree approach using variables from an ensemble of multiple climate models. We then applied estimates for present-day and projected habitat suitability for I. scapularis, present-day presence of Borrelia burgdorferi, and projected climatological variables to model reported LD incidence at the county level among adults, children, and the total population. Finally, we applied an estimate of healthcare expenses to project economic impacts. We show an overall increase in LD cases with regional variation. We estimate an increase in incidence in New England and the upper Midwestern U.S. and a concurrent decrease in incidence in Virginia and North Carolina. At 3°C of national warming from the 1986-2015 baseline climate, we project approximately 55,000 LD cases, a 38-percent increase from present-day estimates. At 6°C of warming, our most extreme scenario, we project approximately 92,000 LD cases in the region, an increase of 145 percent relative to current levels. Annual LD-related healthcare expenses at 3°C of warming are estimated to be $236 million (2021 dollars), approximately 38 percent greater than present-day. These results may inform decision-makers tasked with addressing climate risks, the public, and healthcare professionals preparing for treatment and prevention of LD.


Assuntos
Borrelia burgdorferi , Mudança Climática , Ixodes , Doença de Lyme , Doença de Lyme/epidemiologia , Doença de Lyme/economia , Humanos , Animais , Ixodes/microbiologia , Meio-Oeste dos Estados Unidos/epidemiologia , Incidência , Estados Unidos/epidemiologia , Ecossistema
19.
J Am Pharm Assoc (2003) ; 64(3): 102067, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38490332

RESUMO

BACKGROUND: Depression is a major source of morbidity but often goes undiagnosed. Broader screening is recommended, and pharmacists could contribute. OBJECTIVES: This study aimed to assess the feasibility of community pharmacy depression and anxiety screening and describe the medication-related problems (MRPs) identified, pharmacist interventions, and provider responses for high-risk patients. METHODS: This pilot was conducted between October 2022 and January 2023 at an independently owned community pharmacy in the Midwest United States. Patients aged 18-45 years with ready prescriptions were identified through weekly reports, and tags were placed on prescription bags. A convenience sample of patients fluent in English were offered the Patient Health Questionnaire (PHQ2) and Generalized Anxiety Disorder (GAD2), with follow-up PHQ9 and GAD7 for at-risk individuals. High-risk individuals met with the pharmacist for consultation and recommendations were discussed. Descriptive statistics were calculated for participant demographics, questionnaire responses, MRPs, and provider responses. Patient profiles were examined 2 months after the workup to identify medication changes. RESULTS: A total of 29 patients volunteered to be screened for anxiety and depression; of these, 41% scored in the high-risk category for depression or anxiety and met with the pharmacist for the consultation. The pharmacist identified multiple MRPs. The most common was the need for additional therapy and inadequate dosages. Patients were reluctant for the pharmacist to follow up with their prescriber and were unreachable for telephone follow-up. Profiles reviewed 2 months after assessment showed half of the at-risk patients had one or more mental health medication changes. CONCLUSION: Community pharmacists may have a role in the screening and management of patient mental health, although there were challenges with screening uptake and follow-up. The pharmacist identified multiple MRPs for this high-risk group for which greater routine monitoring and follow-up may be beneficial. More work seems needed to engage both patients and prescribers.


Assuntos
Ansiedade , Serviços Comunitários de Farmácia , Depressão , Programas de Rastreamento , Farmacêuticos , Papel Profissional , Humanos , Adulto , Feminino , Masculino , Serviços Comunitários de Farmácia/organização & administração , Pessoa de Meia-Idade , Depressão/diagnóstico , Depressão/tratamento farmacológico , Projetos Piloto , Ansiedade/tratamento farmacológico , Ansiedade/diagnóstico , Programas de Rastreamento/métodos , Adulto Jovem , Adolescente , Inquéritos e Questionários , Meio-Oeste dos Estados Unidos , Estudos de Viabilidade
20.
J Agromedicine ; 29(3): 504-507, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38523569

RESUMO

Roadway incidents involving farm equipment is a growing area of concern among agricultural safety and health and public health professionals. The aim of this project was to evaluate the usefulness of the Fatality Analysis Reporting System (FARS) and analyze the number of roadway fatal incidents that involve farm equipment. Data collected from the FARS through the National Highway Traffic Safety Administration was used to summarize roadway incidents involving farm equipment. Cases from five midwestern states were analyzed from January to December 2020 using SPSS. Incidents involving farm equipment resulted in 25 cases with Iowa, Michigan, and Wisconsin all reporting six cases each. The most common manner of incidents were single-vehicle crashes and rear-ending incidents. Most of the events occurred during busy agricultural seasons, most often occurring in June and August with five cases each. The FARS dataset is a useful tool to identify cases, but it faces limitations, such as only reporting fatalities and lack of information on specific farm equipment involved in incidents. The results from the study are helpful to better understand roadway incidents and guide future intervention strategies.


Assuntos
Acidentes de Trânsito , Fazendas , Humanos , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Fazendas/estatística & dados numéricos , Meio-Oeste dos Estados Unidos/epidemiologia , Acidentes de Trabalho/mortalidade , Acidentes de Trabalho/estatística & dados numéricos , Agricultura/estatística & dados numéricos , Wisconsin/epidemiologia , Fazendeiros/estatística & dados numéricos , Iowa/epidemiologia
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