Physical activity and nutritional weight loss interventions in obese, low-income women: an integrative review.

INTRODUCTION: Obesity is epidemic in the United States and is considered a public health issue that disproportionally affects low-income women. Combating obesity among low-income women presents unique challenges that must be addressed if weight loss interventions are to be successful. The aim of this integrative review was to explore and synthesize the literature that addresses physical activity and nutrition interventions used to combat obesity in obese, low-income women. METHODS: A search for original research published between 2006 and 2011 was conducted in online databases. In addition, a hand search of references was performed, and one author was contacted to clarify outcome data. Articles that met inclusion criteria targeted obese, low-income adult women; focused on physical activity or nutrition behavior as an intervention; and measured change in weight as a primary outcome. Studies that focused on women who were postpartum or breastfeeding and those that used pharmacologic or surgical interventions to augment weight loss were excluded. RESULTS: A total of 7 articles were chosen for critical appraisal. According to a synthesis of the current studies, specific weight loss interventions for physical activity and nutrition behavior change for obese, low-income women produced the desired outcome of weight loss. Participants among these studies voiced a preference for group interventions led by peers or medical professionals. Interventions led by peer educators were successful and had the advantage of lowering cost and increasing sustainability. Pragmatic nutrition education worked best, especially when cognizant of cost, food preferences, and culture. Even small increases in physical activity augmented weight loss; however, safety concerns prevented some low-income women from engaging in exercise. DISCUSSION: According to this synthesis of the best-available evidence, customized weight loss interventions are effective in obese, low-income women. By incorporating these evidence-based interventions, clinicians can be instrumental in decreasing the burden of obesity in obese, low-income women.

Engaging students through the use of classroom response systems.

Nursing faculty strive to stimulate learning and actively engage students in the classroom. Developing new approaches to student engagement in large classrooms can be a challenging task. The use of a classroom response system encourages students to actively participate while learning essential nursing knowledge in a way that adheres to principles of adult learning.

Decompressive hemicraniectomy with duraplasty: a treatment for large-volume ischemic stroke.

Increased intracranial pressure (ICP) is a cause of death and disability in neurological patients. Patients experiencing malignant stroke of the middle cerebral artery (MCA) have a high mortality related to cerebral edema, increased ICP, and subsequent cerebral herniation. Decompressive hemicraniectomy with duraplasty is a surgical option for those experiencing large volume MCA stroke. When decompressive hemicraniectomy with duraplasty is performed, functional outcomes improve if the MCA stroke candidate is younger, the onset of increased ICP occurred less than 24 hours before surgery, and surgery is performed before clinical signs of herniation syndrome occur. The level of care required for these patients makes nursing care challenging.