Integrative Review of Dietary Choice Revealed by fMRI: Considerations for Obesity Prevention and Weight-Loss Education.

BACKGROUND: Emerging findings from neuroimaging studies investigating brain activity associated with dietary behavior are illuminating the interaction of biological and behavioral mechanisms that have implications for obesity prevention. Globally, A total of 1.9 billion adults are overweight, and 650 million are obese. Obesity and being overweight are major risk factors for chronic illness and death. Behaviorally based health interventions have had limited success in curbing the obesity epidemic. Greater understanding of brain responses to food cues will contribute to new knowledge and shape public health efforts in obesity prevention. However, an integration of this knowledge for obesity prevention education has not been published. AIMS: This study links evidence generated from brain activation studies generated in response to diet and food images and highlights educational recommendations for nurses engaged in obesity prevention and weight-loss education. METHODS: An integrative review of the literature was conducted using the MeSH keywords "magnetic resonance imaging," "diet," and "food images" in PubMed, MEDLINE Complete, CINAHL, and Cochrane databases from their first appearance in 2006 through March 2018. Studies published in English and using functional magnetic resonance imaging to measure brain response to diet, and food images were initially identified. Animal models, those whose primary focus was a specific disease, and intervention studies were excluded. RESULTS: Of 159 studies identified, 26 met inclusion criteria. Findings from neuroimaging studies may help explain the relationship between brain mechanisms and behavioral aspects of dietary choice and inform patient education in obesity prevention. Awareness of this evidence is applicable to nursing education efforts. This review contributes several recommendations that should be considered by nurses providing individualized weight-loss education. LINKING EVIDENCE TO ACTION: Nurses engaged in patient education for obesity prevention should consider personalized interventions that cultivate internal awareness for dietary adherence, self-care, exercise, hydration, and mood state; avoid using caloric deprivation approaches, such as skipping breakfast, for weight-loss interventions; and note the importance of individualized obesity prevention and weight-loss education.

Self-Efficacy: Changing the Tide of Evidence-Based Practice.

AIMS: The specific aim for this study was to describe differences in evidence-based practice (EBP) and self-efficacy in frontline RNs. This project utilized a national study with a convenience selection of acute care agencies to examine the relationship between organizational and unit culture, EBP, and self-efficacy in frontline nurses. METHODS: This national study used descriptive correlational methodology to describe differences in EBP and self-efficacy among RNs. The sample included 245 frontline RNs employed in acute care settings. To measure the study variables, the Nursing Evidence-Based Practice Survey (Titler, Hill, Matthews, & Reed, 1999)  and the Evidence-Based Nursing Practice Self-Efficacy Scale were used (Tucker, Olson, & Frusti, 2009). Each instrument was delivered via the Qualtrics online platform. RESULTS: The correlation of bivariate interval level variables was analyzed using Pearson's r. The correlation between EBP and self-efficacy was strongly correlated: r(170) = .537, p = .01. Sections within the Nursing Evidence-Based Practice Survey were calculated and found to be significant (unit culture r = .241, p = .01; organizational culture r = .570, p = .01; knowledge, skills, attitude r = .538, p = .01). LINKING EVIDENCE TO ACTION: Several implications exist for education, staff development, and nursing management. Nursing school programs incorporate EBP into the curriculum so that nurses have a foundation for EBP. However, staff development professionals in clinical settings must continue to build on the nurses' knowledge and skill, thus increasing self-confidence for EBP. Nursing management can provide the resources for staffing models and policies to reinforce the value of EBP and positive patient outcomes. This combination provides frontline staff with EBP participation and increased self-efficacy in its usage.

Effects of Recording Food Intake Using Cell Phone Camera Pictures on Energy Intake and Food Choice.

BACKGROUND: The well-documented increases in obesity and unhealthy dietary practices substantiate the need for evidence-based tools that can help people improve their dietary habits. The current spread of mobile phone-embedded cameras offers new opportunities for recording food intake. Moreover, the act of taking pictures of food consumed may enhance visual consciousness of food choice and quantity. The present study aimed to assess the effect of using cell phone pictures to record food intake on energy intake and food choice in college students. The effectiveness and acceptability of cell phone picture-based diet recording also was assessed. METHODS: A repeated measures crossover design was used. One group of participants entered their food intake online during 3 days based on their memory, although a second group recorded their food intake using cell phone pictures as their reference. Participants then crossed over to complete 3 more days of diet recording using the alternate method. Focus groups were conducted to obtain feedback on the effectiveness and acceptability of cell phone picture-based diet recording. RESULTS: Intake of meat and vegetable servings were significantly higher in the memory period compared with the cell phone period, regardless of the order. Results from the focus group indicated a positive attitude toward the use of cell phone pictures in recording food intake and an increased awareness of food choice and portion size. LINKING EVIDENCE TO ACTION: Cell phone pictures may be an easy, relevant, and accessible method of diet self-monitoring when aiming at dietary changes. Future trials should combine this technique with healthy eating education.

Students' perceptions of holistic nursing care.

AIM: This qualitative study aimed to investigate the trends and perceptions related to the provision of spiritual care for patients. BACKGROUND: Holistic nursing integrates the body, mind, and spirit into care. However, nursing students from a traditional program, an RN-BSN program, and a graduate nurse practitioner program voiced discomfort with providing such spiritual care. METHOD: The study was a retrospective review of a convenience sample of journal entries about specific questions of how and when three groups of students developed ideas and concepts about spirituality. RESULTS: Students embraced the idea of spirituality connected to their experiences. As students developed as registered nurses, their manner of including spirituality mirrored Benner's model. CONCLUSION: Additional education is needed for professional nurses concerning spirituality and the provision of spiritual care in a holistic manner.

Effectiveness of cell phones and mypyramidtracker.gov to estimate fruit and vegetable intake.

AIM AND BACKGROUND: Inadequate fruit and vegetable intake is linked to leading causes of global mortality and rise in obesity. Measuring fruit and vegetable intake is problematic. Advances in cell phone technologies may improve the accuracy and ease of recording diet. This study tested the effectiveness of using cell phones with digital pictures to prompt memory and mypyramidtracker.gov to estimate self-reported fruit and vegetable intake in 69 college students. METHODS: A repeated measures design was used. Focus groups provided feedback on the acceptability, usability, and feasibility of cell phones for diet recording in this population. RESULTS: A statistically significant difference in fruit and vegetable scores, F(1, 58)=4.64, p=.04, was supported between cell phone use for short-term memory prompt and mypyramidtracker.gov alone. CONCLUSIONS: Cell phone pictures improved memory and accuracy of recall when using an online self-reported interactive diet record and was considered an easy, relevant, and accessible way to record diet.

Capturing the Impact of the Doctor of Nursing Practice Degree on West Texas Health Care.

BACKGROUND: This article describes findings from a Phase 1 investigation exploring the influence of Doctor of Nursing Practice (DNP)-prepared nurses in West Texas. METHOD: Following a focus group session with eight practicing DNPs, the focus group shared how their roles effected safer health care. RESULTS: Final takeaways included their commitment to safer health care and prevention, moving care to the community, and a wish for more variety in projects generated in workplaces. Three themes emerged from the data: DNP leadership practice affects health outcomes through improved quality of care, influence, and innovation; DNP strengths include communication, leadership, and ability to change others' thinking; and the influence of DNP-prepared leaders at all external levels occurs through both increasing awareness of the role and influencing in multiple areas. DNP challenges include lack of understanding by others of the role and the lack of recognition and respect for their educational preparation. CONCLUSION: Leading, innovating, and communicating during constantly changing care models are key skills needed during the current health care crisis. These skills are basic to DNP practice. [J Contin Educ Nurs. 2021;52(4):192-197.].

Evidence review of technology and dietary assessment.

SIGNIFICANCE: Diets high in fruit and vegetable consumption are associated with a decrease in chronic diseases. Dietary factors are linked to 4 of the 10 leading noncommunicable causes of death: cardiovascular disease, some cancers, stroke, and type 2 diabetes. Accurately measuring dietary patterns has many challenges. Dietary intake measurement has traditionally relied on self-report instruments such as 24-hour recall, food record, and food frequency questionnaires to record consumption history. These methods have inherent limitations in detecting small but important changes in fruit and vegetable consumption patterns. Promising advances in technology have made more sophisticated techniques for recording dietary intake possible. Computers and Web-based programs, handheld personal digital assistants with cameras and telephone cards, smart phones, cameras, and video recorders options may reduce the burden of recording what has been consumed. Furthermore, technology-based methods of dietary assessment may provide a higher degree of reliability and validity in visually determining fruit and vegetable consumption, and additional study is warranted. PURPOSE: The purpose of this article is to present a review of the evidence on the effectiveness of technology-based methods for dietary assessment, which included fruit and vegetable consumption. APPROACH: One hundred and eighty-seven articles published between 1998 and 2008 were initially identified. Fifteen met the study inclusion criteria and were evaluated by an interdisciplinary team using the Stetler Strength of Evidence Scale. RESULTS: Six technology-based methods for dietary assessment were identified. Findings from validity and reliability testing of technology-based methods are encouraging and need replication. Clinically important features offered through technology may reduce reporting burden and offer behavioral feedback to users. Methodologically sound, empirical research into using technology-based application for dietary assessment in a variety of populations of sufficient size is needed.

Assessing Stressors for Interns: Using the Casey-Fink Graduate Nurse Experience Survey.

New graduate nurses experience stress when transitioning from the student role to the RN role. The Casey-Fink Graduate Nurse Experience Survey tool (CFGNES) was used to evaluate new graduate nurse stressors. The CFGNES study looked at the effect that a nurse intern program and simulation had on their anxiety. Understanding and identifying stressors can aid transition to practice programs in assisting new graduate transition into the practicing nurse role. [J Contin Educ Nurs. 2020;51(11):516-521.].

Filling gaps in knowledge: educating nurses to provide appropriate patient materials.

Assessing and addressing health literacy is a key issue in providing quality patient education. Often, nurses do not know how to do this. Continuing nursing education provides a venue for filling this gap in knowledge, contributing to better and safer patient care.

Time requirements for implementation of the course facilitator role.

The purpose of this descriptive study was to identify the time requirements to implement the lead position (course facilitator) for nursing courses at a health sciences center school of nursing located in the southwestern United States. Faculty participants completed instruments dividing tasks into pre-course, within-course, and post-course responsibilities. The results of this study revealed that more than 1 hour per week was spent in pre-course and post-course activities and 3.79 hours per week were spent in within-course activities. Recommendations include examining tasks requiring large amounts of time for management alternatives; developing workload expectations that accurately reflect pre-course, within-course and post-course time requirements; and using course facilitators as mentors when preparing novice faculty for the course facilitator role. Although the results of this study are not generalizable, the findings represent formal assessment of a critical component of the faculty role and suggest the need for further investigation into the demands placed on nursing faculty.

Planning and implementing an interdisciplinary diabetes workshop for healthcare professionals.

A diabetes education program for healthcare professionals evolved out of a series of discussions among healthcare providers. This group realized the importance and the necessity of developing a current knowledge base for themselves, their clients, and their clients' families. The target audiences for this program were physicians, nurses, pharmacists, and dietitians who could be eligible to work toward becoming a certified diabetes educator. This article discusses the process used to develop and conduct these workshops. The lessons learned during this project are provided for consideration by others seeking to address common concerns and challenges in other areas of clinical practice.

The need for a community diabetes education curriculum for healthcare professionals.

Healthcare professionals need valuable up-to-date information on diabetes management and skills to treat and educate patients with diabetes mellitus. The Diabetes Education for Healthcare Professionals program was developed to provide healthcare professionals with current diabetes management skills. It was also designed to increase the number of certified diabetes educators in the area in which it was delivered. The program enrolled 147 participants and was delivered on four different occasions. Fifty-five of those participants stated a strong interest in pursuing certified diabetes educator certification, which may significantly increase the number of certified diabetes educators in both rural and urban areas of West Texas.

Exploring Shared Governance for an Academic Nursing Setting.

BACKGROUND: A beneficial work environment influences staff and employee satisfaction and contributes to enhanced organizational execution. METHOD: This article communicates a literature review of the existing knowledge to describe the potential influence of job satisfaction, empowerment, and work engagement on a faculty and staff academic shared governance model and impact on the improvement of a healthy work environment. RESULTS: References from PubMed (from 1975 to 2014) and ERIC (from 2006 to 2016), along with manuscripts included in the reference lists of the selected articles, served as the basis of the review. Definitions and descriptions of shared governance in academic settings suggested the potential influence on the development of a faculty and staff shared governance model within a school of nursing on job satisfaction, empowerment, and work engagement, resulting in the maintenance of a healthy work environment. CONCLUSION: This shift is essential for the resilience of nursing academia and the building of novel, more inclusive approaches to innovation that tap into the talent and skill of all organizational members. [J Nurs Educ. 2017;56(4):197-203.].

Nurses' political involvement: responsibility versus privilege.

Nursing apathy toward participation in the political process is pandemic. Never more so than today has the profession needed a strong united stand within the political arena. Political involvement encompasses being knowledgeable about issues, laws, and health policy. Barriers to political activism are thought to encompass several spectra including heavy workloads, feelings of powerlessness, time constraints, sex issues, and lack of understanding of a complex political process. The implementation of a political role for a nurse is based on three levels of commitment including survival, success, and significance. Survival includes individual involvement within communities. Success accepts challenges in addressing injustices especially within the health-care arena. Significant involvement uses visionary nurses toward the betterment of the nurse profession. Strategies for involvement include political awareness, incorporation of course/program expectations on both undergraduate and graduate levels and teamwork. As patient advocates, nurses cannot continue to be spectators in the political arena.

New horizons for collaborative partnershipss.

The need for partnerships between health care professionals within geographical communities is becoming increasingly important as new health care needs, trends, and issues are identified. Frequently, nurses are key stakeholders within these alliances or partnerships. This article identifies three essential elements associated with successful collaborative partnerships, namely networking, leadership, and vision. It shares examples of various collaborative efforts in which the authors have engaged, illustrating how networking, leadership, and vision have enhanced these collaborative efforts.