Nursing students' attitudes toward video games and related new media technologies.

Little is known about Millennial nursing students' attitudes toward computer games and new media in nursing education and whether these attitudes differ between undergraduates and graduates. This study elicited nursing students' experience with computer games and new media, their attitudes toward various instructional styles and methods, and the role of computer games and new media technologies in nursing education. We e-mailed all nursing students enrolled in two universities to invite their participation in an anonymous cross-sectional online survey. The survey collected demographic data and participants' experience with and attitudes toward video gaming and multi-player online health care simulations. We used descriptive statistics and logistic regression to compare the differences between undergraduates and graduates. Two hundred eighteen nursing students participated. Many of the nursing students support using new media technologies in nursing education. Nurse educators should identify areas suitable for new media integration and further evaluate the effectiveness of these technologies.

The lived experience of middle-aged women with New York Heart Association class III heart failure: a pilot study.

Although heart failure (HF) is equally prevalent in men and women, women with HF are more likely to report decreased quality of life and are more likely to die of the disease compared with men. Moreover, HF has been studied less extensively in women and no study has specifically addressed women with New York Heart Association (NYHA) class III HF using a qualitative method. This pilot study sought to gain insight into the lived experience of women with NYHA class III HF. Using a phenomenological approach, interviews obtained from 4 middle-aged women with NYHA class III HF were analyzed using the Giorgi method of data analysis. Five themes emerged: (1) developing a new conception of self, (2) conceding physical limitations, (3) enduring emotional heartache, (4) accepting support, and (5) rejuvenating through rest. This study provides a beginning to our understanding of the lived experience of women with NYHA class III HF. However, further exploration is needed to increase our knowledge of HF in women, particularly among diverse populations.

Staff's attitudes toward the delivery of tobacco cessation services in a primarily psychiatric Veterans Affairs hospital.

To prepare for improving the delivery of cessation services in a primarily psychiatric Veterans Affairs (VA) hospital, the investigators surveyed (n = 150) and interviewed (n = 8) clinical and nonclinical staff to determine staff's characteristics associated with attitudes about providing cessation services and to seek suggestions about what would be important to include in a tobacco cessation program. Almost one third reported that they currently use tobacco products. Almost three quarters said that they felt that the VA should be doing more to assist patients to quit smoking, yet only approximately one quarter said that they personally provide cessation services. Over half felt moderately, very, or extremely confident in providing cessation services. Multivariate analyses showed that higher education and, surprisingly, not being a nurse were associated with feeling that it was important to provide cessation services.

Preparedness for taking care of elderly parents:"first, you get ready to cry".

The results reported in this article are from a larger, mixed-methods study of the factors influencing the preparedness of adult daughters for taking care of elderly parents. This article focuses on findings surfacing in unstructured interviews with daughters revealing an area of caregiving not addressed in survey items, that of daughters' emotional reactions to multiple losses. Actual and anticipatory losses clustered into two categories: loss of the parent and loss of one's own youth. Implications for health care providers are detailed, including: recognizing each daughter's unique life situation; providing anticipatory and long-term emotional support and counseling; and assisting with problem solving, grief work, and making meaning of losses.

Determination of ventricular diameters in multiple sclerosis patients with transcranial sonography (TCS)--a two year follow-up study.

CONTEXT: Brain atrophy is an indicator of diffuse brain pathology that appears even in the early stages of multiple sclerosis (MS). Magnetic resonance imaging (MRI) techniques used in clinical trials suggest a correlation between ventricular enlargement and axonal pathology and clinical disability in MS. OBJECTIVE: To evaluate by transcranial sonography (TCS) and MRI ventricular diameters in order to assess prospectively the development of brain atrophy in MS. SETTING: MS outpatient clinic of a university hospital. PATIENTS AND METHODS: 38 MS patients (27 females, 11 males) were followed up for 2 years. Ventricular diameters (third ventricle, right and left lateral ventricle) were determined by TCS at baseline, 12 and 24 months and correlated with clinical disability (Expanded Disability Status Scale, EDSS), and the Multiple Sclerosis Functional Composite Score (MSFC). MRI was performed at study entry and after two years. MAIN OUTCOME MEASURE: Correlation of ventricular diameters measured by TCS and MRI with assessment of clinical disability in MS patients at baseline and after two years. RESULTS: TCS and MRI measurements especially of third ventricle diameter matched closely at study entry and after two years (r = 0.9; p < 0.0001). At all time points the width of the third ventricle was significantly correlated with clinical disability (EDSS: r = 0.6, p < 0.01; MSFC: r = -0.6, p < 0.02). In the follow-up over 2 years there was an increase of the width of the third ventricle in comparison with study entry (p < 0.002). Increase of third ventricular width at study entry was associated with higher EDSS levels after 2 years (p = 0.01). CONCLUSION: Assessment of ventricular diameters by TCS is a reliable tool with which to monitor brain atrophy in the longitudinal follow-up of MS patients. Because TCS is a simple, inexpensive, non-invasive and generally available bedside-test it may be used in clinical practice as well as in therapeutic trials to assess brain atrophy.