Physical activity and postural balance in rural community dwelling older adults

AimThe purpose of this study was two-fold: 1) identify the types of physical activity being done among rural community dwelling older adults; and 2) determine the relationship between amount of physical activity and postural balance in that population.BackgroundBalance impairment coupled with other fall risk factors pose a formidable challenge for aging adults. This study identified types of physical activity rural-community dwelling older adults do and explored the relationship between amount (in minutes) of physical activity and balance.MethodsA cross sectional, correlational design was used to recruit rural community-dwelling older adults. Data were collected using the Jackson Heart Study Physical Activity Survey, Berg Balance Scale, and Timed Up and Go Test; ActiGraph accelerometers were worn to objectively measure physical activity.ResultsOne hundred and one participants enrolled. Most were female (78%), White (74%), and between 65 and 91 years old. Berg Balance Scale scores positively correlated with average minutes of light (r = 0.262) and moderate (r = 0.276) physical activity; and the Jackson Heart Study Physical Activity Survey active living index (r = 0.320) and home and garden index (r = 0.324). In regression models, age and sex were the strongest predictors of Berg Balance Scale (adjusted r² = 0.313, F(6, 89) = 8.203, P ≤ 0.001). Physical activity was not associated.ConclusionsMinutes of light or moderate physical activity were not associated with balance. However, investigating factors such as physical activity that influence health functional status and balance deserve continuous attention.     

The association among demographic factors,health behaviors and sleep quality in youth with Autism Spectrum Disorder

BackgroundA majority of youth with Autism Spectrum Disorder (ASD) have disrupted sleep patterns, but there has been limited research examining factors associated with sleep in this population. Objective: The objective of this study was to compare demographic and lifestyle behaviors with sleep quality in youth with ASD. Methods: A total of 49 children (12.44 years; 78% male) with ASD wore the Actigraph GT9X accelerometer over seven days and nights to assess moderate to vigorous physical activity (MVPA), sedentary behavior (SB), total sleep duration, and sleep efficiency. Parents reported their child’s weekly amount of screen time and demographic information. Participants were classified according to whether they met sleep criteria for duration and efficiency (8–9 h of sleep duration and ≥85% sleep efficiency). T-tests and ANOVA were used to compare demographic and lifestyle factors between the groups. Results: Participants who meet both sleep duration and efficiency criteria had greater minutes of MVPA per day (113.65 min/day) than participants who only met sleep efficiency criteria (40.27 min/day) and participants who did not meet either sleep criteria (67.5 min/day; p < 0.0001). Additionally, participants who met both sleep criteria had fewer minutes of SB compared to those who only met sleep efficiency criteria (384.79 vs 526.05 min/day; p = 0.02). Conclusions: Youth who had indicators of good sleep quality had greater amounts of MVPA and lower amounts of SB. Studies should further examine the relationship between sleep and health behaviors in youth with ASD to determine causal mechanisms, leading to more effective sleep interventions.     

Leadership,health systems and policy: Doctoral education and integrated clinical application

Scientifically rigorous and readily transferable nursing research as a foundation for development of sound local and national policy can be further delivered into the policy arena by PhD prepared nurse leaders. Core curricular elements in the preparation of nurse scientists to advance the profession must therefore include competencies in leadership, health care systems, health economics, and policy. We present a curriculum model from a university in the southern United States that includes both a theoretical and application approach to incorporate a Leadership in Health Care Systems Course and Field Experience. Implementation of this approach is thought to result in a nurse scientist to have better preparation to engage in and with the broader health care system, policy, and interprofessional collaboration more quickly. We then present a student exemplar of a doctoral student's leadership field experience in a national advocacy and legislative process and discuss educational and professional gains from this lived experience.     

安宁疗护对社区临终患者生活质量影响的Meta分析

目的通过Meta分析评价安宁疗护对社区临终患者生活质量的影响。方法计算机检索PubMed、CINAHL、ScienceDirect、MEDLINE、Cochrane Library、SAGE数据库、中国知网、维普中文科技期刊数据库、万方数据库和中国生物医学文献数据库中安宁疗护对社区临终患者的随机对照试验,由2名研究人员独立筛选文献并提取资料,对符合质量标准的随机对照试验进行Meta分析。结果共纳入7篇文献,包括1095名社区临终患者。Meta分析结果显示,安宁疗护可以改善社区临终患者的总体生活质量(SMD=0.48,95%CI0.07~0.88,P=0.02)和情绪功能(SMD=1.27,95%CI0.59~1.95,P<0.001),在改善生活质量的躯体功能、角色功能、认知功能和社会功能水平上差异无统计学意义(P>0.05)。结论安宁疗护能改善社区临终患者的总体生活质量和情绪功能,但对生活质量其他功能的改善情况还需要设计更加规范、多中心、大样本的随机对照试验进一步证实。     

组织气氛在护士知识与行为间的中介效应:以脑卒中吞咽障碍护理为例

目的探究组织气氛在护士吞咽障碍知识水平与护理行为之间的中介效应。方法2019年6-7月,便利抽样法选取15个省市33所医院及医疗机构神经科、康复科具有吞咽障碍护理经验的231名护士为研究对象采用脑卒中吞咽障碍知识水平问卷、脑卒中吞咽障碍护理行为问卷及团队创新气氛量表对其进行调查。结果护士吞咽障碍知识水平总分为(56.69±13.50)分、护理行为得分为(140.65土32.02)分、组织气氛得分为(157.63±26.56)分。组织气氛与吞咽障碍知识水平(r=0.49,P<0.01)、护理行为(r=0.50,P<0.01)均呈正相关。组织气氛在知识水平和护理行为之间起中介作用,中介效应占总效应的83.18%。结论组织气氛在护士吞咽障碍知识水平与护理行为之间起中介作用,临床管理者可在提升护士吞咽障碍知识水平的基础上,通过提高组织气氛水平推进其护理行为。