Reading Wharton with Pain: On Rest, Practices, and Care.

Critics have widely regarded Edith Wharton's Twilight Sleep (1927) as an ironic novel about pain: a satire of modern life's supposed promise that pain can be avoided. This essay argues that Wharton's novel is as much about managing pain as it is about avoiding it. I consider the novel in light of experiences of chronic pain and illness, both Wharton's and my own. My analysis finds that while the novel's satire targets the fleeing of pain, the text also engages aspects of life lived with pain. The characters demonstrate constant fatigue, a symptom of pain's presence; they undertake mental, physical, and care practices as modes of pain management; and the text's formal structures suggest chronic pain's duration. By focusing not on direct representations of pain but on how pain can condition a life (and a narrative), I elucidate the ongoing value of making a distinction between managing pain and avoiding it.

A qualitative study of LoveYourBrain Yoga: a group-based yoga with psychoeducation intervention to facilitate community integration for people with traumatic brain injury and their caregivers.

Purpose: To explore participants' experiences in a group-based yoga with psychoeducation intervention designed to facilitate community integration for people with traumatic brain injury and their caregivers.Materials and methods: We conducted semi-structured interviews with 13 people with traumatic brain injury and three caregivers who had completed LoveYourBrain Yoga, a 6-session, manualized, group-based yoga intervention that incorporates breathing exercises, yoga, meditation, and psychoeducation. Interviews were analyzed using content analysis.Results: We identified seven themes: ease of participation, belonging, sustaining community connection, physical health, self-regulation, self-efficacy, and resilience. All participants valued the community-based yoga studio environment and multifaceted structure of the program. Participants reported improvements in strength, balance, flexibility, and attention control, and a greater sense of belonging, community connection, and ability to move forward with their lives. Participants reported ongoing use of tools (e.g., breathing exercises) to cope with negative emotions and stress. About half of participants sustained relationships built during LoveYourBrain Yoga and felt more capable of accessing other activities in their community.Conclusions: LoveYourBrain Yoga successfully promoted community integration for people with traumatic brain injury. It also facilitated diverse and meaningful physical, psychological, and social health benefits, which suggest that it may be an effective mode of community-based rehabilitation.Implications for rehabilitationTraumatic brain injury survivors often struggle to participate in their community, the ultimate goal of rehabilitationYoga is a holistic therapy with many benefits, yet is not accessible to the traumatic brain injury population at the community levelParticipants in a community-based yoga with psychoeducation intervention in six states experienced diverse and meaningful physical, psychological, and social health benefitsGroup-based yoga with psychoeducation may be an effective mode of community integration and community-based rehabilitation for traumatic brain injury survivors.

Predictors of Food Insecurity among Older Adults in the United States.

OBJECTIVE: Food insecurity among U.S. households is a national concern. Since 2010, the U.S. Healthy People goal has been to reduce food insecurity to 6%. Despite this goal, 14.5% of households remained food insecure in 2013 (U.S. Department of Agriculture). The purpose of this study was to examine the antecedents of food insecurity among older adults through the lens of the social ecological model. DESIGN AND SAMPLE: This retrospective cross-sectional study utilized secondary data from the National Health and Nutrition Examination Survey (NHANES) from the years 2007 and 2008 from a sample that included 2,045 adults 60 years of age and older. MEASURES: Variables related to the constructs of the social ecological model were examined using descriptive, chi-square, and logistic regression analyses. RESULTS: Analyses of the model indicated that the severity of depression, reports of financial support, and having ever received household food stamp benefits had statistically significant main effects on food insecurity among older adults. CONCLUSIONS: The study findings have implications for nursing practice, education, and research and could facilitate the development of screening methods, interventions, and policy evaluation that focus on food insecurity at multiple spheres of influence among the targeted population.

Trends in the nursing doctoral comprehensive examination process: a national survey.

The doctoral comprehensive or qualifying examination (CE/QE) is a traditional rite of passage into the community of scholars for the nursing profession. This exploratory, descriptive cross-sectional study examined trends in the process, timing, and methodology of comprehensive and qualifying examinations in nursing doctoral programs in the United States. Administrators from 45 schools responded to an online survey from 27 states across the country (37% response rate). Participants reported wide variations in the process. The most common method of implementation was the written take-home test (47%), two thirds of which had a subsequent oral examination. Eleven survey respondents (24%) reported using a form of the traditional written, timed, on-site examination; however, only 4 of these also followed up with an oral defense. Nine schools (20%) moved to a requirement for a written publishable paper; three schools consider the written proposal and its defense as the CE/QE. Approximately half had changed their policy in the past 5 years. With the increase in nursing doctor of philosophy programs over the past decade, information is needed to facilitate the development of methods to achieve program outcomes. An understanding of national CE/QE trends can provide a starting point for discussion and allow innovative ideas to meet the need of individual programs.