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1.
Res Nurs Health ; 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38994689

RESUMO

The purpose of this manuscript is to describe the protocol for an Alzheimer's Association-funded cluster randomized trial that focuses on engaging assisted living residents with dementia in meaningful activity to help address their behavioral symptoms of distress using a theoretically based approach, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD). The development of MAC-4-BSD was based on the Social Ecological Model and Social Cognitive Theory. The MAC-4-BSD intervention includes the following four steps: (1) Assessment of the assisted living physical environment and policies to facilitate meaningful activity; (2) Education of staff about implementation of meaningful activity; (3) Assessment of resident preferences and goals for meaningful activity; (4) Mentoring and motivating staff and residents to facilitate engagement in meaningful activity. The overall aim of this study will be to determine the feasibility and preliminary efficacy of implementing the MAC-4-BSD intervention and test whether it will improve residents' engagement in meaningful activity, behavioral symptoms of distress, and quality of life as well as the environment and policies to promote meaningful activity in assisted living.

2.
J Adv Nurs ; 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-39031572

RESUMO

AIM: This study aimed to examine the psychological symptoms of distress among nurses in relation to their intention to leave. DESIGN: This study was a secondary data analysis of a cross-sectional survey collected between November 2020 and March 2021. METHODS: Chi-square was used to examine the associations between the demographic characteristics and intention to leave and psychological distress symptoms-feeling depressed, anxious and worried. Multiple linear regression analyses were performed to examine if work settings, position (staff, charge, administrators, educators/researchers and advanced practice registered nurses) and years of experience were associated with psychological distress and intention to leave. A mediation analysis examined if psychological distress mediated the relationship between years of experience and intention to leave. RESULTS: Overall, psychological distress was significantly positively associated with intention to leave and negatively associated with years of experience. Nurses with less than 2 years of experience had increased psychological distress, while nurses with >25 years of experience had decreased psychological distress. Both groups of nurses had increased intention to leave compared to those with 16-25 years of experience. Psychological distress partially mediated intention to leave in nurses with less than 2 years of experience and more so among nurses with >25 years of experience. CONCLUSIONS: This study suggests that nurses encounter psychological distress symptoms, such as feeling anxious, depressed and worried, that contribute to an increased intention to leave. Among the workplace locations, nurses practicing in nursing homes had the highest intention to leave. IMPACT: The study emphasizes that organizations need to focus on mitigating distress across all levels of nurses to promote retention efforts and intention to stay. REPORTING METHOD: The authors adhered to the STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient contribution. Completion of the survey in the original study (NWWS) implied consent from the participating nurses.

3.
Rehabil Nurs ; 49(4): 115-124, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38904657

RESUMO

ABSTRACT: The purpose of this secondary data analysis was to describe physical activity and the factors associated with physical activity among older adults living with dementia on medical units in acute care settings. Measures included accelerometry data from the MotionWatch 8, behavioral and psychological symptoms associated with dementia, use of psychotropic medications, subjective reports of activities of daily living and other types of physical activity (e.g., walking to the bathroom, participating in therapy), delirium severity, and medications. The majority of the 204 participants were White (70%) and female (62%), with a mean age of 83 years. Over 24 hours of assessment, participants engaged in 15 ( SD = 46) minutes of vigorous activity, 43 ( SD = 54) minutes of moderate activity, 2 hours 50 ( SD = 2) minutes of low-level activity, and 20 ( SD = 3) hours of sedentary activity. Subjective walking activities, toileting, evidence of disinhibition, delirium severity, agitation, and use of psychotropic medications were associated with increased physical activity based on the MotionWatch 8. The findings provide information for rehabilitation nurses regarding factors associated with physical activity among patients with dementia admitted to acute care settings as well as some of the challenges associated with measurement of physical activity. Future research needs to continue to explore the impact of behavioral symptoms associated with dementia on physical activity and increase participation in activities that are functionally relevant.


Assuntos
Acelerometria , Demência , Exercício Físico , Humanos , Feminino , Masculino , Idoso de 80 Anos ou mais , Demência/psicologia , Demência/complicações , Idoso , Exercício Físico/psicologia , Acelerometria/métodos , Hospitalização/estatística & dados numéricos , Atividades Cotidianas/psicologia
4.
Geriatr Nurs ; 57: 117-122, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38640645

RESUMO

Effective staff-patient communication is critical in acute care settings, particularly for patients with dementia. Limited work has examined the impact of quality of staff-patient care interactions on patient engagement. The purpose of this study was to determine whether the quality of staff-patient care interactions were associated with active patient engagement during the interaction after controlling for relevant covariates. The study was a secondary data analysis using baseline data from the Function Focused Care for Acute Care intervention study, with a total sample of 286 patients. Descriptive statistics and a generalized linear mixed model were used. The findings indicated that there was a significant relationship between the quality of care interactions and patient engagement such that receiving positive care interactions resulted in higher odds of active patient engagement. These findings can inform future interventions and training for acute care staff to improve quality of care interactions and patient engagement.


Assuntos
Demência , Participação do Paciente , Qualidade da Assistência à Saúde , Humanos , Demência/enfermagem , Masculino , Feminino , Idoso , Comunicação , Idoso de 80 Anos ou mais , Relações Profissional-Paciente
5.
J Environ Manage ; 354: 120368, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38394874

RESUMO

Hydrodynamic conditions play a crucial role in governing the fate, transport, and risks of metal elements. However, the contribution of hydrodynamic conditions to the fate and transport of heavy metals among water, sediment, and biofilm phases is poorly understood. In our study, we conducted experiments in controlled hydrodynamic conditions using a total of 6 two-phase and 9 three-phase mesocosms consisting of water, biofilm, and sediment. We also measured Cd (cadmium) specification in different phases to assess how hydrodynamic forces control Cd bioavailability. We found that turbulent flow destroyed the surface morphology of the biofilm and significantly decreased the content of extracellular polymeric substances (p < 0.05). This led to a decrease in the biofilm's adsorption capacity for Cd, with the maximum adsorption capacity (0.124 mg/g) being one-tenth of that under static conditions (1.256 mg/g). The Cd chemical forms in the biofilm and sediment were significantly different, with the highest amount of Cd in the biofilm being acid-exchangeable, accounting for up to 95.1% of the total Cd content. Cd was more easily released in the biofilm due to its weak binding state, while Cd in the sediment existed in more stable chemical forms. Hydrodynamic conditions altered the migration behavior and distribution characteristics of Cd in the system by changing the adsorption capacity of the biofilm and sediment for Cd. Cd mobility increased in laminar flow but decreased in turbulent flow. These results enhance our understanding of the underlying mechanisms that control the mobility and bioavailability of metals in aquatic environments with varying hydrodynamic conditions.


Assuntos
Metais Pesados , Poluentes Químicos da Água , Cádmio/química , Água , Hidrodinâmica , Metais Pesados/química , Biofilmes , Poluentes Químicos da Água/análise , Sedimentos Geológicos
6.
Environ Pollut ; 344: 123305, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38195022

RESUMO

Iron sludge, produced during the drinking water treatment process, can be recycled as potential iron resource to create environmental functional material. In this study, sulfur-iron composites derived from iron sludge (S-Fe composites) was synthesized through sulfidation and carbonization, and used for the tetracycline (TC) removal under aerobic and anoxic conditions. The reactivities of these as-prepared products were strongly depended on pyrolysis temperatures. In particular, sulfidated nanoscale zero-valent iron loaded on carbon (S-nFe0@CIS) carbonized at 800 °C exhibited the highest TC removal efficiency with 86.6% within 30 min at circumneutral pH compared with other S-Fe composites. The crystalline structure of α-Fe0, FeSx and S0 as main active sites in S-nFe0@CIS promoted the degradation of TC. Moreover, the Fe/S molar ratios significantly affected the TC removal rates, which reached the best value as the optimal S/Fe of 0.27. The results illustrated that the optimized extent of sulfidation could facilitate electron transfer from nFe0 towards contaminants and accelerate Fe(III)/Fe(II) cycle in reaction system compared to bared nFe0@CIS. We revealed that removal of TC by S-nFe0@CIS in the presence of dissolved oxygen (DO) is mainly attributed to oxidation, adsorption and reduction pathways. Their contribution to TC removal were 31.6%, 25.2% and 28.8%, respectively. Furthermore, this adsorption-oxygenation with the formation of S-nFe0@CIS-TC* complexes was a surface-mediated process, in which DO was transformed by the structural FeSx on complex surface to •OH with the generation of H2O2 intermediate. The intermediates of TC and toxicity analysis indicate that less toxicity products generated through degradation process. This study provides a new reclamation of iron sludge and offers a new insight into the TC removal by S-nFe0@CIS under aerobic conditions.


Assuntos
Esgotos , Poluentes Químicos da Água , Ferro/química , Peróxido de Hidrogênio , Tetraciclina/química , Antibacterianos/química , Oxigênio , Poluentes Químicos da Água/análise
7.
J Aging Health ; 36(3-4): 220-229, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37311566

RESUMO

Objectives: The purpose of this study was to evaluate the psychometric properties of the modified 25-item Resilience Scale (RS-25) in older adults post-hip fracture using Rasch analysis. Methods: This was a descriptive study using baseline data from the Seventh Baltimore Hip Studies (BHS-7). There were 339 hip fracture patients included in this analysis. Results: Findings suggest there was support for reliability of the measure based on person and item separation index. The INFIT and OUTFIT statistics for testing validity were all in the acceptable range indicating that each item on the modified RS-25 fits the appropriate concept. There was no evidence of Differential Item Functioning (DIF) between genders. Conclusions: This study demonstrated evidence that the modified RS-25 is a reliable and valid measure to evaluate resilience among older adults post-hip fracture and therefore can be used in this population in clinical practice and research.


Assuntos
Fraturas do Quadril , Resiliência Psicológica , Humanos , Masculino , Feminino , Idoso , Psicometria , Reprodutibilidade dos Testes , Testes Psicológicos , Inquéritos e Questionários
8.
Behav Brain Res ; 460: 114803, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38070689

RESUMO

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, sometimes dose-limiting side effect of neurotoxic chemotherapy. Treatment is limited because its pathophysiology is poorly understood. Compared to research on peripheral mechanisms, the role of the brain in CIPN is understudied and it may be important to develop better treatments. We propose a novel task that assesses brain activation associated with attention to bodily sensations (interoception), without the use of painful stimulation, to understand how CIPN symptoms may be processed in the brain. The goals of this preliminary study were to assess, 1) feasibility of the task, 2) sensitivity to changes in brain activity, and 3) suitability for assessing relationships between brain activation and CIPN severity. Eleven participants with varying types of cancer completed a brain fMRI scan and rated CIPN severity (CIPN-20) before and/or 12 weeks after starting neurotoxic chemotherapy. The Bodily Attention Task is a 7.5-min long fMRI task involving attentional focus on the left fingertips, the heart, or a flashing word "target" for visual attention (reference condition). Feasibility was confirmed, as 73% of all data collected were usable and participants reported feeling or focus during 75% of the trials. Regarding brain activity, finger attention increased activation in somatosensory regions (primary sensory cortex, insula) and sensory integration regions (precuneus, dorsolateral prefrontal cortex). Exploratory analyses suggested that brain activation may be associated with CIPN severity. A larger sample size and accounting of confounding factors is needed to test for replication and to identify brain and interoceptive biomarkers to help improve the prediction, prevention, and treatment of CIPN.


Assuntos
Antineoplásicos , Síndromes Neurotóxicas , Doenças do Sistema Nervoso Periférico , Humanos , Antineoplásicos/efeitos adversos , Síndromes Neurotóxicas/diagnóstico por imagem , Síndromes Neurotóxicas/etiologia , Encéfalo/diagnóstico por imagem , Qualidade de Vida
9.
Nurs Res ; 73(2): 118-125, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37916845

RESUMO

BACKGROUND: Painful, treatment-resistant wounds are prevalent among diabetic patients and significantly affect health-related quality of life (HRQOL). Topical treatments may help alleviate pain without risk of dependence or side effects. However, there is a lack of topical wound compounds targeting pain-specific receptors. One possible target is proinflammatory angiotensin 1 receptor (AT1R), which is upregulated in diabetic skin and has been implicated in nociception. OBJECTIVES: We investigated the effects of topical valsartan, an AT1R antagonist, on pain (nociceptive thresholds) and gene expression changes (transcriptomics) in a swine model of diabetic wounds. METHODS: Eight wounds were surgically induced in diabetic, hyperglycemic Yucatan miniature swine ( n = 4). Topical AT1R antagonist was applied to wounds on one side and vehicle on the other side. Nocifensive testing was conducted at baseline and then weekly, beginning 7 days after wound induction. Mechanical and thermal stimuli were applied to the wound margins until a nocifensive reaction was elicited or a predetermined cutoff was reached. After 7 weeks of testing, tissue from the dorsal horn, dorsal root ganglion, and wounds were sequenced and analyzed with DESeq2. Unbiased pathway analyses using Metascape were conducted on differentially expressed genes. RESULTS: There was no significant difference in mechanical tolerance threshold between AT1R antagonist-treated and vehicle-treated wounds ( p = .106). Thermal tolerance was significantly higher in AT1R antagonist-treated wounds compared to vehicle-treated ( p = .015). Analysis of differentially expressed genes revealed enriched pathways of interest: interleukin-18 signaling in dorsal horn laminae IV-V and sensory perception of mechanical stimulus in wound tissue. DISCUSSION: In this study, wounds modeling diabetic ulcers were created in hyperglycemic swine and treated with a topical AT1R antagonist. AT1R-antagonist-treated wounds had a higher tolerance threshold than vehicle-treated wounds for thermal hyperalgesia, but not mechanical allodynia. Pathway analyses of differentially expressed genes revealed several pathways of interest for future pain research. Although further studies are needed to confirm the findings, this study can improve nursing care by providing information about a potential future treatment that may be used to decrease pain and improve HRQOL in patients with diabetic wounds.


Assuntos
Diabetes Mellitus , Nociceptividade , Humanos , Animais , Suínos , Qualidade de Vida , Dor , Perfilação da Expressão Gênica , Angiotensinas
10.
J Appl Gerontol ; 43(6): 627-637, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38105620

RESUMO

This study aimed to test a model of factors associated with resilience and physical activity post-hip fracture and compare model fit between men and women. We used data from the seventh Baltimore Hip Study that included 339 participants. Model testing indicated that health status (men: ß = .237, p = .002; women: ß = .265, p = <.001), depression (men: ß = -.245, p = .001; women: ß = -.241, p = <.001), and optimism (men: ß = .320, p = <.001; women: ß = .282, p = <.001) were associated with resilience in men and women, but resilience was only associated with physical activity in men (ß = .203, p = .038) and not in women. Social interaction was related to physical activity only among women (ß = .206, p = .044). This study provides support for the relationship between resilience and physical activity at least among men.


Assuntos
Depressão , Exercício Físico , Nível de Saúde , Fraturas do Quadril , Resiliência Psicológica , Humanos , Feminino , Masculino , Idoso , Fraturas do Quadril/psicologia , Exercício Físico/psicologia , Depressão/psicologia , Idoso de 80 Anos ou mais , Fatores Sexuais , Baltimore , Interação Social , Otimismo/psicologia
11.
Palliat Support Care ; 22(3): 470-481, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38131143

RESUMO

OBJECTIVES: Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers' burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer. METHODS: This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates. RESULTS: Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers' spirituality on the relationship between depression and caregiver burden over time (b = -1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support. SIGNIFICANCE OF RESULTS: Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients' health.


Assuntos
Cuidadores , Depressão , Neoplasias , Espiritualidade , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias/psicologia , Neoplasias/complicações , Depressão/psicologia , Depressão/etiologia , Cuidadores/psicologia , Idoso , Estudos Longitudinais , Adulto , Inquéritos e Questionários , Adaptação Psicológica , Sobrecarga do Cuidador/psicologia , Efeitos Psicossociais da Doença
12.
Cancer Nurs ; 2023 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-38032743

RESUMO

BACKGROUND: Cancer-related fatigue is difficult to treat, and dietary interventions are promising yet underused. OBJECTIVE: We explored associations between dietary patterns and fatigue, and the effect of a dietary intervention versus control on fatigue using Women's Healthy Eating and Living study data, plus mediators and moderators of the intervention effect. METHODS: The Women's Healthy Eating and Living study was a randomized controlled trial among early-stage breast cancer survivors. The 4-year intervention encouraged fruits, vegetables, fiber, and 15% to 20% calories from fat. Fatigue outcomes included a 9-item energy scale and a single-item tiredness question. Dietary quality was estimated using a modified Healthy Eating Index (24-hour dietary recall) and serum carotenoid concentrations. Nutrient timing was obtained from 4-day food logs. RESULTS: Among 2914 total participants, lower body mass index was associated with less tiredness and more energy at baseline (P < .001 for both). Earlier start and end times for daily eating windows were associated with less tiredness (P = .014 and P = .027, respectively) and greater energy (P = .006 and P = .102, respectively). The intervention did not lead to improvements in fatigue on average (P > .125). However, the intervention was more effective for participants who were younger, had fewer comorbidities, and did not have radiation treatment. Mediators included increases in serum carotenoids, increases in the modified Healthy Eating Index, and weight loss/maintenance. CONCLUSION: Diet quality and earlier eating windows were associated with less fatigue. IMPLICATIONS FOR PRACTICE: Programs that encourage high diet quality and a morning meal and discourage nighttime eating should be tested for efficacy in reducing cancer-related fatigue in survivorship.

13.
Geriatr Nurs ; 54: 229-236, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37844539

RESUMO

BACKGROUND: This study aimed to: 1) determine the feasibility of a virtual reality physical activity intervention among older adults and 2) test the preliminary effectiveness of the intervention at increasing physical activity and 3) decreasing depressive symptoms. METHODS: We included 10 older adults randomized into the Motivating Older Adults Through Immersive Virtual Exercise (MOTIVE) intervention group and 10 randomized into the physical activity education only control group. We analyzed the data using descriptive statistics and linear mixed models, testing the interaction of time and the treatment condition. RESULTS: Participants in the intervention group attended an average of 15 out of the 16 sessions. A total of 90% of MOTIVE intervention group participants "completely agreed" that the intervention was acceptable, (compared to 30% of education control group participants). CONCLUSION: This study supports testing the effectiveness of the intervention at improving physical activity and depressive symptoms in a larger sample of older adults.


Assuntos
Terapia por Exercício , Exercício Físico , Humanos , Idoso , Projetos Piloto
14.
Artigo em Inglês | MEDLINE | ID: mdl-37580439

RESUMO

The purpose of this study was to describe differences in treatment of White versus Black older adults, males versus females, and those living at home, assisted living, or nursing home communities with regard to the use of psychotropic, pain, and cardiovascular medications. Baseline data from the first 352 participants in the study, implementation of Function-Focused Care for Acute Care Using the Evidence Integration Triangle, were used. Data included age, gender, race, comorbidities, admission diagnosis, and living location prior to hospitalization, the Saint Louis University Mental Status exam, the modified Charlson Comorbidity Index, the Pain Assessment in Advanced Dementia scale, the Confusion Assessment Method, and medications prescribed. Generalized linear mixed model analyses were done, controlling for race or gender (depending on which comparison analysis was being done), age, cognitive status, hospital, delirium, and comorbidities. Medication use was significantly higher for White older adults, compared to Black older adults, for antidepressants, anxiolytics, non-opioid pain medications, and opioids and lower for antihypertensives. Females received more anxiolytics than their male counterparts. There were differences in medication use by living location with regard to non-opioid pain medication, antipsychotics, statins, and anticoagulants. The findings provide some current information about differences in medication use across groups of individuals and can help guide future research and hypothesis testing for approaches to minimizing these differences in treatment.

15.
Sci Total Environ ; 894: 164847, 2023 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-37331403

RESUMO

This study systematically compared the degradation kinetics, conversion pathways, formation of disinfection by-products (DBPs), and changes in toxicity for sulfamethazine and carbamazepine in UV/nitrate system. Additionally, the study simulated the generation of DBPs in the post-chlorination process after the introduction of bromine ions (Br-). The contributions of UV irradiation, hydroxyl radicals (•OH), and reactive nitrogen species (RNS) to SMT degradation were determined to be 28.70 %, 11.70 %, and 59.60 %, respectively. The contributions of UV irradiation, •OH, and RNS to CBZ degradation were found to be 0.00 %, 96.90 %, and 3.10 %, respectively. A higher dosage of NO3- facilitated the degradation of both SMT and CBZ. Solution pH posed almost no effect on SMT degradation, while acidic conditions favored CBZ removal. The degradation of SMT was found to be slightly promoted at low concentrations of Cl-, while the presence of HCO3- significantly accelerated the degradation. Cl-, as well as HCO3-, retarded the CBZ degradation. Natural organic matter (NOM) as a free radical scavenger and UV irradiation filter posed a substantial inhibitory effect on the degradation of SMT and CBZ. The degradation intermediates and transformation pathways of SMT and CBZ by UV/NO3- system were further elucidated. The results showed that the main reaction pathways were bond-breaking reaction, hydroxylation, and nitration/nitrosation reaction. The acute toxicity of most of the intermediates generated during SMT and CBZ degradation was reduced after UV/NO3- treatment. After treatment of SMT and CBZ in UV/nitrate system, the DBPs generated in subsequent chlorination were mainly trichloromethane and a small amount of nitrogen-containing DBPs. After bromine ions were introduced in UV/NO3- system, a large amount of the originally generated trichloromethane was converted to tribromomethane.


Assuntos
Poluentes Químicos da Água , Purificação da Água , Desinfecção/métodos , Nitratos , Sulfametazina , Cloro , Clorofórmio , Bromo , Carbamazepina , Benzodiazepinas , Halogenação , Raios Ultravioleta , Poluentes Químicos da Água/toxicidade , Poluentes Químicos da Água/análise , Purificação da Água/métodos , Cinética
16.
Clin Nurs Res ; 32(5): 865-872, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37129107

RESUMO

To describe the use of psychotropic medications among older hospitalized patients. This was a descriptive study using baseline data from the first 308 older patients in a function focused care intervention study. Age, gender, race, comorbidities, admitting diagnosis, and medications (antidepressants, antianxiety medications, anticonvulsants, dementia drugs, antipsychotics, sedative-hypnotics, and opioids) were obtained at baseline and discharge. To compare change over time, generalized estimating equations were used. Participants were mostly female (63%) and White (69%) and were 83.1 years old on average. Antidepressant, antianxiety, anticonvulsant, dementia medication, sedative-hypnotic, and opioid use remained essentially unchanged between admission and discharge. Antipsychotic medication use increased significantly from 16% to 21% at discharge. There was persistent use of psychotropic medication among hospitalized older adults living with dementia and little evidence of deprescribing. There was some indication of changes made during hospitalization that may be appropriate, even without a focused deprescribing initiative.


Assuntos
Demência , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Demência/tratamento farmacológico , Psicotrópicos/uso terapêutico , Hospitalização , Alta do Paciente , Hipnóticos e Sedativos/uso terapêutico
17.
West J Nurs Res ; 45(7): 653-664, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37114849

RESUMO

Fatigue in chronic obstructive pulmonary disease (COPD) is debilitating and associated with considerable morbidity. The aim of this study is to present a model based on the Theory of Unpleasant Symptoms of physiologic, psychologic, and situational factors with COPD-related fatigue and the relationship with physical functioning. This study used data collected from Wave 2 (2010-2011) of the National Social, Health, and Aging Project (NSHAP). A total of 518 adults with self-reported COPD were included in this study. Path analysis was used for hypothesis testing. Depression was the only psychologic factor found to have a direct relation to both fatigue (ß = 0.158, p < .001) and physical function (ß = -0.131, p = .001). Factors related to physical function included fatigue, depression, sleep, loneliness, and pain. Additionally, fatigue was indirectly associated with physical function via depression (ß = -0.064, p = .012). These findings suggest avenues for future research on predictors of COPD-related fatigue in relation to physical functioning.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Adulto , Humanos , Doença Pulmonar Obstrutiva Crônica/psicologia , Autorrelato , Dor/complicações , Fadiga/etiologia , Envelhecimento , Qualidade de Vida
18.
ANS Adv Nurs Sci ; 46(4): 349-362, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37102714

RESUMO

Real-word data (RWD) refer to data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources, including electronic health records, medical claims data, and patient-generated data. Data sets that combine personal health data stored in different sources can provide a more complete picture of an individual's health and can be used to improve population health through research and practice. The 2-tiered aim of this article is to provide a brief introduction to using RWD in health care research and to present a case study that demonstrates data curation and data merge from different sources while highlighting the benefits and limitations of using RWD. The current digital health ecosystem and value-based care approach highlight the need to use RWD to catalyze the advancement of health care research and practice. This is an excellent field that nurse researchers can lead, as they have an innate understanding of such data and data sources.


Assuntos
Atenção à Saúde , Ecossistema , Humanos , Pesquisa sobre Serviços de Saúde
19.
J Pain ; 24(9): 1617-1632, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37121497

RESUMO

Pain catastrophization (PC), involving rumination, magnification, and helplessness, can be viewed as a coping strategy associated with chronic pain. PC is considered a driving force in mediating pain-related outcomes, but it is still unclear whether PC mediates the relationship between psychological and sociodemographic factors with chronic pain when considered in a single model. Using baseline data from a parent study, this study examined the effect of positive and negative psychological and sociodemographic factors on pain severity, interference, and jaw limitation mediated by the PC dimensions in a sample of 397 temporomandibular disorder (TMD) participants using structural equation modeling (SEM). SEM revealed that pain severity regressed on age, sex, education, and income; interference regressed on positive and negative psychological factors, education, and income; and jaw limitation regressed on age. The PC dimensions did not individually mediate these relationships. Although they jointly mediated the relationships between negative psychological factors and pain severity and between age and pain interference, the effect size was small, suggesting that PC is not a critical factor in mediating TMD pain outcomes. Reducing negative cognitions, not just PC, may be of greatest benefit to the most vulnerable TMD populations. PERSPECTIVE: This study examines sociodemographic and psychological factors that affect orofacial pain, finding that the pain catastrophizing dimensions do not mediate these relationships. Understanding which factors most strongly affect pain outcomes will help identify targets for intervention to produce the greatest benefit for the most vulnerable persons suffering from pain.


Assuntos
Dor Crônica , Transtornos da Articulação Temporomandibular , Humanos , Dor Crônica/psicologia , Análise de Classes Latentes , Dor Facial , Catastrofização/psicologia , Ansiedade , Transtornos da Articulação Temporomandibular/complicações
20.
Antioxidants (Basel) ; 12(3)2023 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-36978985

RESUMO

As an indispensable element in the morphology and phytochemical profile of plants, UV-A has proved to help promote the growth and quality of kale. In this study, UV-A supplementation in different photoperiods (light period supplemental UVA = LS, dark period supplemental UVA = DS, and light-dark period supplemental UVA = LDS) contributed to yielding greater biomass production (fresh weight, dry weight, and plant moisture content), thus improving morphology (plant height, stem diameter, etc.) and promoting higher phytochemicals content (flavonoids, vitamin c, etc.), especially glucosinolates. To fathom its mechanisms, this study, using RNA-seq, verified that UV-A supplementation treatments signally generated related DEGs of plant hormone signal pathway, circadian rhythm plant pathway, glucosinolate pathway, etc. Moreover, 2047 DEGs were obtained in WGCNA, illustrating the correlations between genes, treatments, and pathways. Additionally, DS remarkedly up-regulated related DEGs of the key pathways and ultimately contributed to promoting the stem diameter, plant height, etc., thus increasing the pigment, biomass, vitamin c, etc., enhancing the antioxidant capacity, and most importantly, boosting the accumulations of glucosinolates in kale. In short, this study displayed new insights into UV-A supplementation affected the pathways related to the morphology and phytochemical profile of kale in plant factories.

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