Evaluation of the Behavioral Risk Factor Surveillance System as a potential index model for Total Force Fitness.

This article reports the results of an evaluation of the Behavioral Risk Factor Surveillance System (BRFSS) as a potential "index model" for the assessment of Total Force Fitness (TFF) in military personnel. The evaluation was conducted using descriptive categories developed by Firth and Smith for appraisal of potential TFF index models, and documents and publications related to BRFSS survey measures and methodology. Secondary analysis of data from military personnel responding to the 2010 BRFSS was used as "sample" data to assess relationships between the domains of TFF. Findings from this evaluation support that the BRFSS is a potential index model for TFF. Additional research is needed to determine the usefulness of BRFSS survey measures and resulting data in assessing TFF in military personnel.

Moderators of access and utilization of clinical preventive services in older adults.

AIM: This paper reports a study exploring the relationships between potential moderators of access and utilization of clinical preventive services in a homogeneous sample of older adults with near universal health coverage. BACKGROUND: Advancements have occurred in eliminating financial and structural barriers to utilization of clinical preventive services (primary, secondary and tertiary prevention) in most developed countries, but variations in utilization continue. These variations may be attributed to non-social determinants of health moderators that impact utilization in older adults. METHODS: Theorized relationships were explored using questions from the United States Behavioral Risk Factor Surveillance System Survey and a homogenous convenience sample of 202 older adults (mean age 84; sd 5·23) with near universal health coverage. Data collected across a 2 year period (2007-2009) were analysed using Chi-square, Mann-Whitney U and Hierarchical Logistic Regression. FINDINGS: Several logistic regression models of personal access (advised to lose weight, high blood pressure, high cholesterol); moderators (gender, perceived health status, BMI ≥ 30 kg/m(2)); and clinical preventive services utilization (check-up in last 12 months; ever had colonoscopy/sigmoidoscopy) showed statistically significant (P < 0·05) improvement in model fit by adding interaction terms (access X moderator). CONCLUSION: Exploring the impact of moderators on utilization may yield more insight into variations than could be explained by measurement of the direct affect of having near universal health coverage alone.

Concept analysis: malpractice and modern-day nursing practice.

TOPIC: The concept of malpractice can mean different things depending upon the context in which the term is used. This can lead to confusion about the standard of care required for nurses engaged in modern-day nursing practice. PURPOSE: This paper examines the attributes and characteristics of the concept of malpractice using Walker and Avant's (2005) eight-step methodology. SOURCES OF INFORMATION: CINAHL, PubMed, and PsychINFO. CONCLUSIONS: Exposure to malpractice liability is an unfortunate consequence of modern-day nursing practice. An understanding of malpractice will assist nurses in identifying situations that may expose them to legal liability and hopefully lead to improved patient care.

A framework for guiding health literacy research in populations with universal access to healthcare.

At least one third of the US population suffers from limited health literacy, which has been linked to poorer health status, higher costs, and individuals who are socioeconomically disadvantaged. However, research and the development of theoretical frameworks to study health literacy have only recently begun to occur. The purpose of this article is to describe theoretical frameworks that have either been used or may be used to guide health literacy research and to identify implications for nursing research and practice related to an adaptation of a health literacy framework developed specifically for conducting research in populations with universal access to healthcare.

Issues associated with secondary analysis of population health data.

Analysis of population health data is crucial for the success of population health. Secondary analysis of data contained in publicly available clinical, administrative, and national health survey databases is a cost-effective and scientific method for generating data to support population health. There are several issues associated with secondary analysis of population health data that must be addressed if analyses are to be expedient, economical, and reliable. This article outlines the value of using secondary analysis to generate population health data, discusses issues associated with secondary analysis of population health data, and offers suggestions for addressing these issues.

Research issues in preparedness for mass casualty events, disaster, war, and terrorism.

This article provides a perspective on the types of research questions that might be explored and strategies used in relation to disaster,terrorism, and mass casualty events. Research is addressed in the context of three areas of focus: issues related to the health care provider; issues affecting the patient, individual, family, and community; and issues related to the health care system.