Low-Sodium Dietary Perceptions and Experiences of African-American Women with Hypertension.

African-Americans are disproportionately affected by hypertension with lower rates of blood pressure control in comparison to the general population (Brennan et al., 2010). Low-sodium dietary intake is one of the most important lifestyle changes that can help control hypertension (Zhang et al., 2013). This qualitative study aimed to explore and describe the perceptions and experiences of low-sodium dietary practices among African-American women with hypertension. The study used a single-category focus group design. The findings suggest that African-American women are attempting to follow a low-sodium diet; however, they are influenced by personal and environmental factors and lack a clear understanding of what a low-sodium diet entails. Therefore, nurses must understand the factors that influence African-American women's ability to follow a low-sodium diet so that effective interventions can be implemented to improve adherence in this population.

Addressing Food Insecurity and Overweight/Obesity in Hospitalized Low-Income Latino Patients.

Food insecurity (FI), the limited or unreliable availability of safe and nutritious food, is a pressing public health concern affecting millions of U.S. citizens. Unfortunately, FI tends to impact those who are most vulnerable (e.g., low-income minorities) and potentially increases obesity risks, diet-sensitive disease risks (e.g., hypertension and type 2 diabetes), and hospital utilization. Low-income Latino patients may be particularly sensitive to adverse outcomes based on unaddressed socioeconomic needs. Nurses are in a prime position to assess and address FI in these patients. Our article will discuss how nurses can be advocates in combating FI in Latino patients with overweight/obesity.

Hospitalists' Needs Assessment and Perceived Barriers in Wound Care Management: A Quality Improvement Project.

The purpose of this quality improvement project was to determine hospitalists' knowledge, practices, and perspectives related to management of pressure injuries and neuropathic/diabetic foot complications (having a foot ulcer or subsequent development of a foot infection because of a foot ulcer). We also sought to identify resources for and knowledge-based barriers to management of these wounds. This quality improvement effort targeted an interdisciplinary group of 55 hospitalists in internal medicine that consisted of 8 nurse practitioners, 10 physician assistants, and 38 physicians. The site of this initiative was the Johns Hopkins Bayview Medical Center, a 342-bed academic hospital located in the mid-Atlantic United States (Baltimore Maryland). The first phase of our quality improvement project comprised an online survey to identify hospitalists' knowledge, practices, and opinions on inpatient management of pressure injuries and diabetic foot complications. The second phase involved semistructured focus groups attended by hospitalists to identify resource gaps and barriers inferred by survey results. Twenty-nine of 55 (52%) hospitalists responded to the survey; 72% indicated no formal training in wound care. Over 90% had little to no confidence in management of pressure injuries and diabetic foot complications. In a separate ranking section of the survey, respondents selected lack of knowledge/confidence 12 of 29 (41.3%) and resources 9 of 29 (31.0%) as number 1 barriers to wound care. Managing patients with obesity was identified as a second major barrier from 10 of 29 selected options (34.5%). Eighteen of 55 (33%) hospitalists attended focus group sessions acknowledging barriers to wound care that included provider education, information technology, system factors, and interprofessional engagement. Attendees welcomed additional educational and ancillary resource support.

Food Security Status and Overweight/Obesity Among 2- to 5-Year-Old Boys and Girls in a Community-Based Clinic.

The purpose of this study was to examine relationships between food security, parental health behaviors, and overweight/obesity among 2- to 5-year-old children in West Tennessee (N = 264). Results from logistic regression models indicate that the association between parental characteristics and child weight status varies by child sex and household food security. These findings highlight the need for more nuanced analysis that can produce results that inform and shape the development of precise health promotion and intervention strategies designed for diverse low-resource populations.

Linking care of patients with obesity to outpatient weight control clinics following acute hospitalizations.

Despite obesity impacting over one-third of US adults, guideline recommendations have not been effectively utilized by health care providers in hospital settings. Initiation of weight loss plans for obese patients during hospitalizations followed by linkage of care to weight control centers may improve compliance with the guidelines. Provider recognition and awareness that obesity is a chronic condition that warrants inpatient counsel and management with appropriate arrangement of postdischarge follow-up care will be critical to guideline implementation.

A Different Class of Care: the Benefits Crisis and Low-Wage Workers.

When compared to other developed nations, the United States fares poorly with regard to benefits for workers. While the situation is grim for most U.S. workers, it is worse for low-wage workers. Data show a significant benefits gap between low-wage and high-wage in terms of flexible work arrangements (FWAs), paid leave, pensions, and employer-sponsored health-care insurance, among other things. This gap exists notwithstanding the fact that FWAs and employment benefits produce positive returns for employees, employers, and society in general. Despite these returns, this Article contends that employers will be loath to extend FWAs and greater employment benefits to low-wage workers due to (1) concerns about costs, (2) a surplus of low-wage workers in the labor market, (3) negative perceptions of the skill of low-wage workers and the value of low-wage work, (4) other class-based stereotypes and biases, and (5) structural impediments in some low-wage jobs. Given the decline of unions and limited legislative action to date, the Article maintains that low-wage workers are in a "different class of care" with little hope for meaningful change on the horizon.

Exercise deficit disorder in youth: an emergent health concern for school nurses.

Although the benefits of regular physical activity are widely acknowledged, recent findings indicate that a growing number of youth are not as active as they should be. The impact of a sedentary lifestyle during childhood on lifelong pathological processes and associated health care costs have created a need for immediate action to manage, if not prevent, unhealthy behaviors during this vulnerable period of life. The concept of identifying children with exercise deficit disorder early in life and prescribing effective interventions to prevent the cascade of adverse health outcomes later in life is needed to raise public awareness, focus on primary prevention, and impact the collective behaviors of health care providers and public health agencies. School nurses are in a unique position to take advantage of well-child visits as an ideal opportunity to assess physical activity habits and encourage daily participation in play, recess, sports, planned exercise, and physical education.

Perceived work and family conflict among African American nurses in college.

PURPOSE: This article describes the perceptions of African American nurses regarding the interaction between work-family conflict, job satisfaction, and psychological well-being. DESIGN: A qualitative descriptive design was employed to conduct six focus group sessions with 23 nurses at three universities in the southeastern United States. FINDINGS: Stressors such as racism or lack of teamwork and supervisor support caused the nurses to contemplate leaving a workplace or the profession. Family stressors, such as an ill family member, also influenced any decision regarding career longevity. IMPLICATIONS: Future studies examining work-family interface, especially positive spillover and psychological well-being are warranted.

Patient-provider race-concordance: does it matter in improving minority patients' health outcomes?

OBJECTIVE: To understand if patient-provider race-concordance is associated with improved health outcomes for minorities. DESIGN: A comprehensive review of published research literature (1980-2008) using MEDLINE, HealthSTAR, and CINAHL databases were conducted. Studies were included if they had at least one research question examining the effect of patient-provider race-concordance on minority patients' health outcomes and pertained to minorities in the USA. The database search and data analysis were each independently conducted by two authors. The review was limited to data analysis in tabular and text format. A meta-analysis was not possible due to the discrepancy in methods and outcomes across studies. RESULTS: Twenty-seven studies met the inclusion criteria. Combined, the studies were based on data from 56,276 patients and only 1,756 providers. Whites/Caucasians (37.6%) and Blacks/African Americans (31.5%), followed by Hispanics/Latinos (13.3%), and Asians/Pacific Islanders (4.3%) comprised the majority of the patient sample. The median sample of providers was only 16 for African Americans, 10 for Asians and two for Hispanics. The review presented mixed results. Of the 27 studies, patient-provider race-concordance was associated with positive health outcomes for minorities in only nine studies (33%), while eight studies (30%) found no association of race-concordance with the outcomes studied and 10 (37%) presented mixed findings. Analysis suggested that having a provider of same race did not improve 'receipt of services' for minorities. No clear pattern of findings emerged in the domains of healthcare utilization, patient-provider communication, preference, satisfaction, or perception of respect. CONCLUSIONS: There is inconclusive evidence to support that patient-provider race-concordance is associated with positive health outcomes for minorities. Studies were limited to four racial/ethnic groups and generally employed small samples of minorities. Further research is needed to understand what health outcomes may be more sensitive to cultural proximity between patients and providers, and what patient, provider and setting-level variables may moderate or mediate these outcomes.

Factors that shape mental health treatment-seeking behaviors of HIV-positive African-American women with depressive symptoms: a review of the literature.

Acquired immune deficiency syndrome (AIDS) remains a leading cause of death for African-American women from 25 to 34 years of age. Depressive symptoms are commonly associated with the diagnosis of AIDS. Highly active antiretroviral therapy (HAART) is needed for optimal treatment; however, African-American women who are infected with the human immunodeficiency virus (HIV) and who experience depressive symptoms have low and/or inconsistent use of HAART. Additionally, behaviors associated with untreated depressive symptoms increase the chances for HIV transmission. Clinicians, therefore, need to recognize both the individual and the contextual factors that influence those seeking treatment for depressive symptoms. The purpose of this article is to gain a better understanding of the factors that shape treatment seeking for depressive symptoms among HIV-positive African-American women, an important variable in secondary HIV prevention. Multi-contextual underpinnings shape this phenomenon; therefore, Bronfenbrenner's ecological framework was used to organize this literature review. Knowledge gained from this paper can support the promotion of health and can prevent or manage depressive symptoms among this vulnerable group.