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Introduction.: Hispanic/Latino students often underachieve in higher education programs in the health professions and have shown lower first-time pass rates on the National Physical Therapy Examination than their White peers. A plausible explanation for this difference is the lack of English proficiency. The purpose of this study was to determine predictive academic variables for passing licensure examination on the first attempt for Hispanic/Latino Doctor of Physical Therapy (DPT) students. Review of the Literature.: Numerous studies have been conducted to determine the factors that predict success on the National Physical Therapy Examination; however, there is a scarcity of literature on the predictors of success for Hispanic/Latino DPT students, particularly on the influence of English proficiency. Subjects.: A nonprobability convenience sample of 67 Hispanic students from a single DPT program was used. Methods.: A retrospective, predictive, correlational study was conducted. Data collection was performed by secondary analysis of student academic profiles. Predictor variables included proficiency in the English language; undergraduate grade point average; verbal, quantitative, and written skills; and first-year and third-year grade point average while enrolled in the physical therapist education program. Results.: The first-time pass rate was 59.7% (n = 40). Results showed that students who passed and those who did not pass on their first attempt differed in first-year and third-year program grade point average with large effect sizes of d = 1.13 and d = 1.48, respectively; however, third-year grade point average was the only significant independent predictor of success. English proficiency and preadmission variables did not predict first-time success. Discussion and Conclusion.: The results suggest first-year and third-year grade point average may be used to identify at-risk students. Use of these variables is encouraged to monitor the progression of students. The study highlighted the need to identify additional predictors of performance. [ABSTRACT FROM AUTHOR]

Introduction. Physical therapists (PTs) from various educational and clinical backgrounds are being hired to address the faculty shortage issue. Little is known about how junior PT faculty feel about their experiences in academia. the purpose of this study was to 1) explore current demographic and self-perceived experiences of junior faculty in PT education programs across the United States, 2) compare beliefs and experiences based on the highest academic degree held and the type of faculty line held, and 3) explore the relationships between job satisfaction and experiences in academia with the likelihood to remain in academia. Full-time junior faculty employed 5 years or less at accredited PT education programs. Methods: Descriptive correlational study using a 63-item, self-report, electronic, job satisfaction survey was sent to faculty employed at 223 accredited PT education programs in the United States. Results: Two hundred twenty-four fulltime junior faculty completed the survey. Respondents with clinical degrees were more satisfied in their position and more likely to stay in academia than those with terminal academic degrees. Similarly, respondents in nontenure-track positions were more satisfied and more likely to stay in academia than those in tenure-track positions. Social support, teaching, and scholarly activity mentorship were found to contribute to job satisfaction. Also, an association was found between job satisfaction and intention to remain in academia for all cohorts (rs ≥ 0.72; P = .001). Discussion and Conclusions: Junior PT faculty who received support and mentorship were more satisfied with their jobs and more likely to remain in academia. PT education programs should consider new or expanded mentorship programs for junior faculty, regardless of academic background, to promote professional progress, positive role-modeling, and faculty retention. [ABSTRACT FROM AUTHOR]

Background: Different cultural context results in variability in health professionals' attitude toward family presence in the emergency department (ED) during resuscitation. Knowledge about emergency department health professionals' (EDHPs') attitude toward family presence during resuscitation (FPDR) in Greece can contribute to the understanding of cultural and value-related obstacles and opportunities to implement this practice. It would be useful for Greek health professionals when they have to care for citizens from other countries in which guidelines for FPDR exist to understand their difference in behavior and reaction and be more tolerant. Objectives: To explore Greek EDHPs' experiences, concerns, and benefits regarding FPDR and determine the contributing factors that are associated with their positive or negative attitude about the process. Methods: A convenience sample of 305 health professionals working in the ED of 9 general hospitals of the National Healthcare System in northern Greece participated in a cross-sectional study (response rate, 87.6%). Results: Positive experience of FPDR was encountered in 65.9% of EDHPs. Only 2.3% reported that they work in EDs where FPDR is allowed. Hospital regional location, previous positive experience of FPDR, and competency in supporting family members during FPDR were independently associated with a positive attitude toward FPDR. Conclusions: Greek EDHPs are not ready to accept FPDR practice. The establishment of formal policy similarly to resuscitation guidelines and family-centered training courses are needed to mitigate negative beliefs. Attempts to enhance positive attitude should include educational interventions providing knowledge on the benefits of FPDR. [ABSTRACT FROM AUTHOR]

Background: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. Objectives: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. Methods: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. Results: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. Discussion: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of a 12-week chair yoga program on functional fi tness and well-being in community-dwelling older women with low physical activities. Methods: A total of 31 community-dwelling older women with low physical activity participated in this quasi-experimental study. Two communities of the elderly were allocated to 2 groups through lot drawing. Subjects were randomly assigned to control or intervention groups by community to avoid contamination--the experimental group of 16 people and the control group of 15 people. The participants in the experimental group trained chair yoga exercise for 12 weeks with 2 sessions per week, 110 minutes per session, whereas the control group maintained its regular daily activities. Data collection from multiple variables was conducted using questionnaire (well-being ) and examination on functional fi tness (handgrip strength, lower limb muscle strength, upper limb muscle strength, static balance, agility and dynamic balance, lower limb fl exibility, upper limb fl exibility). Results: The results showed a signifi cant improvement for the experimental group in the handgrip strength ( P = .001), upper limb muscle strength ( P = .047), lower limb muscle strength ( P = .007), static balance ( P = .016), agility and dynamic balance ( P = .009), and in the well-being ( P = .003) after the intervention. The control group reveals deteriorated result in upper limb muscle strength ( P = .016). Among other functional fi tness and well-being variables, there is no signifi cant difference. Conclusion: The chair yoga training provides a simple and inexpensive exercise program that improves the functional fi tness and well-being effectively. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether a 1-month physical therapy (PT) program that includes a balance component improves balance impairments and fear of falling in individuals with chronic obstructive pulmonary disease (COPD), and to evaluate the utility of the Four Square Step Test (FSST) and Functional Reach Test (FRT) in this population. Methods: A retrospective analysis of participants with COPD in a PT program between May 2015 and December 2015. Assessments performed before and after therapywere the Berg Balance Scale (BBS), FRT, FSST, and Activities Balance Confidence Scale (ABC) questionnaire. Statistical analysis used Pearson product-moment coefficient of correlation, 1-tailed T test, and Independent T test. Results: Twenty-five individuals with COPD completed the PT program. Individuals at high risk of falls experienced significant improvements on the BBS (6.6 points, P 5 .0097), FSST (6.75 seconds, P5.001), and FRT (5.63 cm, P5.01333). The BBS and FSSTwere correlatedwith each other (r5 0.70) at baseline. Improvements in the ABC were not statistically significant (P5.071). Use of supplemental oxygen was not correlated with any assessment tool. Conclusions: People with greater balance deficits had significant improvements in balance after a 1-month PT program. The FSST should be investigated further in patients with COPD. [ABSTRACT FROM AUTHOR]

Background and Purpose: We sought to evaluate the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in community-dwelling women 65 years and older with vertebral fracture and to describe score distributions and potential ceiling and floor effects. Methods: This was a secondary data analysis of baseline data from the Build Better Bones with Exercise randomized controlled trial using the BOOMER. A total of 141 women with osteoporosis and radiographically confirmed vertebral fracture were included. Concurrent validity and internal consistency were assessed in comparison to the Short Physical Performance Battery (SPPB). Normality and ceiling/floor effects of total BOOMER scores and component test items were also assessed. Exploratory analyses of assistive aid use and falls history were performed. Results and Discussion: Tests for concurrent validity demonstrated moderate correlation between total BOOMER and SPPB scores. The BOOMER component tests showed modest internal consistency. Substantial ceiling effect and nonnormal score distributions were present among overall sample and those not using assistive aids for total BOOMER scores, although scores were normally distributed for those using assistive aids. The static standing with eyes closed test demonstrated the greatest ceiling effects of the component tests, with 92% of participants achieving a maximal score. Conclusions: While the BOOMER compares well with the SPPB in community-dwelling women with vertebral fractures, researchers or clinicians considering using the BOOMER in similar or higher-functioning populations should be aware of the potential for ceiling effects. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study determined whether 1 health system's frontline nursing model redesign to integrate clinical nurse leaders (CNLs) improved care quality and outcome score consistency. METHODS: Interrupted time-series design was used to measure patient satisfaction with 7 metrics before and after formally integrating CNLs into a Michigan healthcare system. Analysis generated estimates of quality outcome: a) change point; b) level change; and c) variance, pre-post implementation. RESULTS: The lowest-performing unit showed significant increases in quality scores, but there were no significant increases at the hospital level. Quality metric consistency increased significantly for every indicator at the hospital and unit level. CONCLUSIONS: To our knowledge, this is the 1st study quantifying quality outcome consistency before and after nursing care delivery redesign with CNLs. The significant improvement suggests the CNL care model is associated with production of stable clinical microsystem practices that help to reduce clinical variability, thus improving care quality. [ABSTRACT FROM AUTHOR]

Pain control is an important concern in limb trauma. The most ideal agent for this purpose varies among different hospitals. The objective of this study was to compare the analgesic effect of oral diclofenac potassium versus intravenous acetaminophen in patients with limb trauma. This was a double-blind randomized clinical trial conducted on 60 adult patients. Oral diclofenac potassium (50 mg) was given in Group D, and intravenous acetaminophen (1 g in 500 ml normal saline over 20 min) was administered in Group A. Patients' pain scores (visual analogue scale) were recorded and compared at baseline, 5, 15, 30, 60 min, and 4 hr after drug administration. The mean age was 42.62 ± 15.42 and 38.04 ± 17.48 years in Group A and Group D, respectively. No significant change was observed between the 2 groups ( p= 0.11). In this study, both drugs could decrease the pain score effectively and safely in isolated limb trauma. [ABSTRACT FROM AUTHOR]

We assessed overall job satisfaction and factors of job satisfaction among physician assistants (PAs) practicing cardiovascular medicine in the United States. Job satisfaction among health care providers is associated with provider satisfaction and retention, reduced health care costs, increased patient satisfaction, and improved health care. Research regarding job satisfaction among physicians and nurse practitioners has been conducted, but knowledge of job satisfaction among PAs is limited, dated, and inadequate. Job satisfaction among PAs in cardiology, a specialty with a disparity between provider supply and demand, has not been investigated. A quantitative, correlational, descriptive study was conducted using participants from the Association of Physician Assistants in Cardiology database. Overall job satisfaction, 45 factors of job satisfaction, and 6 composite factors were calculated. Correlational analysis was performed for factors most associated with overall job satisfaction. Overall job satisfaction was high. Most PAs (87.3%) were satisfied or very satisfied. Physician assistants were most satisfied with job factors related to challenge and autonomy, and these factors had the greatest correlation to overall job satisfaction. Findings can guide employers, health care administrators, and policy makers to promote job satisfaction among PAs in cardiology and provide insights into job satisfaction among PAs in general. [ABSTRACT FROM AUTHOR]

Background and Objective: The health behaviors of hypertensive stroke patients in China are not satisfactory. In this study, we tested the effect of a Health Belief Model Comprehensive Reminder System on health behaviors and blood pressure control in hypertensive ischemic stroke patients after occurrence and hospital discharge. Methods: A randomized, parallel-group, assessor-blinded experimental design yielded participation of 174 hospitalized hypertensive ischemic stroke patients. The intervention consisted of face-to-face and telephone health belief education, a patient calendar handbook, and weekly automated short-message services. Data were collected at baseline and 3 months after discharge. Results: Three months after discharge, the intervention group showed statistically, significantly better health behaviors for physical activity, nutrition, low-salt diet, and medication adherence. The intervention group also had statistically, significantly decreased systolic blood pressure and increased blood pressure control rate. Smoking and alcohol use behaviors were not affected. Conclusion: At 3 months, use of the Comprehensive Reminder System based on the Health Belief Model, yielded improvement in most health behaviors and blood pressure control in hypertensive ischemic stroke patients. Continued implementation of this intervention protocol is warranted to determine the long-term effect. Smoking and alcohol use behaviors need to be targeted with a different intervention. [ABSTRACT FROM AUTHOR]

Effective health education programs for adolescent substance use prevention need to be developed. However, the evidence supporting the use of specific instructional strategies for youth substance use prevention programs is insufficient. The purpose of this study was to develop and implement a community-based program aiming for smoking, alcohol, and substance use prevention based on multiple disciplinary literacy strategies. A one-group pretest-and-posttest comparison design was used to test the feasibility of the new substance use prevention program. Thirty-two adolescents, most from families with minority and low-socioeconomic status backgrounds, participated. The group met for a 1-hour session once a week for 10 weeks. The program was implemented in a suburban setting in a southeastern state in the United States. Pretests and posttests were administered to assess the program's effectiveness in improving participants' knowledge, skills, and assets regarding substance use. Overall, the participants were satisfied with the program and reported significant growth in their knowledge, skills, assets, and perceptions of benefits. These findings suggest that disciplinary literacy strategies may promote adolescents' perceptions of and knowledge regarding substance use. [ABSTRACT FROM AUTHOR]

Background: Depression is known to adversely affect coronary heart disease patients in western countries; however, no study of social support and depression has been conducted in the Chinese population. Objective: The aim of this study was to investigate the predictors of depression in patients with coronary heart disease. Methods: Between January and December 2015, a cross-sectional sample of 105 Taiwanese patients from cardiology units completed a demographic and clinical characteristics questionnaire, Enhancing Recovery in Coronary Heart Disease Social Support Inventory, and Patient Health Questionnaire-9. Results: Thirty-nine percent of the participants reported low social support, and 61.0% had depression symptoms. Eight factors predicted depression. Social support was significantly and adversely correlated with depression (r = -.481, P < .01). The other 7 factors were positively correlated with depression: age (r = .212, P < .05), reported monthly income of less than US $600 (F = 4.98, P =.001), lack of exercise (F = 3.75, P = .027), history of stroke (f = -2.45, P =.016) and kidney disease (f = -2.41, P = .018), unstable angina (F = 3.56, P = .031), and groin puncture (F = 3.27, P = .042). A hierarchical regression model explained 43.7% of the variance in depression. Conclusion: Social support, unstable angina, and stroke may be important predictors of depression in patients with coronary heart disease. These findings help clinical staff to understand physical and mental health problems in cardiovascular patients. Thus, we suggest that early depression prediction and sufficient social support can help patients to face their disease and thus improve depression and health care quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients undergoing orthopaedic surgery experience severe postoperative pain that is frequently undertreated. No study was found that examined the predictors of nurses' intentions to administer as needed (PRN) opioid analgesics for postoperative pain relief. PURPOSE: The purpose of this study was to determine what constructs from the Integrated Behavioral Model (IBM) can predict nurses' intentions to administer PRN opioid analgesics for pain relief to hospitalized postoperative orthopaedic patients. METHODS: A nonexperimental, cross-sectional quantitative format was used. The sample consisted of 800 nurses. Data collection was done by survey. RESULTS: Path analysis revealed the significant predictors of nurses' intention to administer opioid analgesics to be self-efficacy (β = 0.15), normative beliefs (β = 0.21), and salience (importance) of the behavior (β = 0.25). CONCLUSION: The study showed that the IBM constructs are useful for predicting intentions toward performance of a professional behavior. The inclusion of self-efficacy, underlying beliefs, and salience of the behavior was new and unique contributions to the existing body of knowledge. [ABSTRACT FROM AUTHOR]

Background and purpose Hospital-acquired pressure injuries (HAPIs) continue to be a persistent problem in the acute care arena. The purpose of this retrospective quality improvement study was to examine if the introduction of nurse practitioners (NPs), as wound care consultants (WCCs), without other interventions, impacted the HAPI rates in a community hospital. Methods A retrospective, comparison design was used; 48 months of HAPI data (May 2010-2014) reported on the monthly National Database for Nursing Quality Indicators (NDNQI) survey was abstracted from hospital records. Data included the assessment of 10,752 patients and were divided into two groups for comparison: 24 months before and 24 months after NP hiring. Conclusions There was a strong, inverse correlation between the presence of NPs and number of patients with HAPIs ( r = −0.73, p < .01), indicating that HAPI rates were significantly lower after NPs took on the role of WCCs. The odds of a HAPI occurring following introduction of the NP WCCs were 20% of the odds in the previous years. Implications for practice Study findings suggest that NPs assuming a leadership role as WCCs may be instrumental in decreasing HAPI rates. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purposes of this study are to determine the level of emotional intelligence (EI) among nurse managers (NMs) in an academic medical center and determine the relationship of EI and demographic variables. BACKGROUND: Emotional intelligence is a concept that warrants further research in nursing because there is a huge gap in knowledge about nurse leaders' EI. METHODS: Data were collected from 38 NMs recruited from a large academic medical center in the Northeast. RESULTS: Mean EI scores among NMs were average. Nurse managers with less than 2 years of experience had statistically significant lower "using emotions" branch score and strategic EI. Nurse managers with a masters' degree in nursing scored significantly higher in using emotions branch score than did those with a masters' degree in a related field. CONCLUSION: Opportunities exist to enhance the EI of NMs. [ABSTRACT FROM AUTHOR]

Background: The Readiness for Hospital Discharge Scale (RHDS) was designed to assess the readiness of patients for discharge. The original English-language instrument has shown high degrees of reliability and validity, but no Chinese version of the scale has been verified. Purpose: The purpose of this study was to translate the RHDS into Chinese and assess the psychometric properties of this scale on laryngectomy patients in China. Methods: The RHDS was translated into Chinese using forward and back translation, semantic equivalence assessment, and pilot testing. The content and construct validity, internal consistency, and internal reliability of the translated scale were assessed using exploratory factor analysis and Pearson correlation analysis. Results: The content validity index of the developed Chinese version of the RHDS was .97, with the content validity indexes of RHDS items ranging between .75 and 1.00. The Cronbach's α coefficient for internal consistency was .97. Exploratory factor analysis revealed a three-factor structural model. All correlations among the three factor subscales were significant. Pearson's correlation coefficients between subscale factors and the total scale ranged from .81 to .97. Conclusions: The Chinese version of the RHDS is a valid and reliable instrument for assessing the discharge readiness of laryngectomy patients in China. [ABSTRACT FROM AUTHOR]

This article compares the aggressiveness of nursing behavioral intentions in the care of the end-of-life patient between 1989 and 2014. Using a comparison design, the effects of patient age, presence of a do-not-resuscitate order, and nursing unit norms on the aggressiveness of nursing behavioral intentions were documented in 1989 and again in 2014. The results were compared for significant changes over time. Based on the results of this study, it appears that there has been a significant increase in aggressiveness of nursing behavioral intentions in the care of the end-of-life patient, even if the patient has a do-not-resuscitate order and is attempting to refuse certain nursing or medical procedures. This study has implications for increased teaching on end-of-life care, quality of life, and rights of patients to self-determination during the end of life. [ABSTRACT FROM AUTHOR]

The article discusses a project to establish a new code of conduct in an associate degree of nursing (ADN) program to address incivility as of 2016. Topics covered include the increase in uncivil student behavior experienced by the nursing program, the undesirable behaviors covered by incivility in nursing education (INE) such as tardiness, bullying and cheating, and the organizational impact of the new code of conduct.

Background: Deliberate screening allows detection of health risks that are otherwise not noticeable and allows expedient intervention to minimize complications and optimize outcomes, especially during critical events like hospitalization. Little research has evaluated the usefulness of screening performance and outcome indicators as measures to differentiate nursing quality, although policymakers are using them to benchmark hospitals. Objectives: The aims of this study were to examine hospital performance based on nursing-sensitive screening indicators and to assess associations with hospital characteristics and nursing-sensitive outcomes for patients. Methods: A secondary use of nursing-sensitive data from the Dutch Health Care Inspectorate was performed, including the mandatory screening and outcome indicators related to delirium, malnutrition, pain and pressure ulcers. The sample consisted of all 93 hospitals in the Netherlands in 2011. High- and low-performing hospitals were determined based on the overall proportion of screened patients. Descriptive statistics and analysis of variance were used to examine screening performances in relation to hospital characteristics and nursing-sensitive outcomes. Results:Over all hospitals, the average screening rates ranged from 59% (delirium) to 94% (pain). Organizational characteristics were not different in high- and low-performing hospitals. The hospitals with the best overall screening performances had significantly better results regarding protein intake within malnourished patients (p < .01). For mortality, marginal significant effects did not remain after controlling for organizational structures. No associations were found with prevalence of pressure ulcers and patient self-reported pain scores. Discussion: The screening for patient risks is an important nursing task. Our findings suggest that nursing-sensitive screening indicators may be relevant measures for benchmarking nursing quality in hospitals. Time-trend studies are required to support our findings and to further investigate relations with nursing-sensitive outcomes. [ABSTRACT FROM AUTHOR]

Background. This article discusses problems associated with incivility in nursing education and a proposed implementation strategy designed to decrease uncivil acts of student behavior. Problem description. Like most colleges across the nation, this nursing program was experiencing an increase in acts of student incivility . Operational definitions. Incivility, also called bullying, may include behaviors such as name calling, side conversations, and condescending language. Method. The sample consisted of 94 third-semester nursing students and 6 faculty members. The Incivility in Nursing Education survey was used as a tool to measure student and faculty perceptions. Data analysis. Data from pre- and postimplementation surveys demonstrated scientific evidence of both faculty and student perception and a significant decrease in acts of uncivil behavior in the nursing program. Limitations. Because the study was limited to one nursing program and included only third-semester nursing students, the results of the study may not be transferable to all nursing programs. Conclusions. The study revealed a reduction in perceived uncivil acts of behavior in the nursing program by faculty and students. [ABSTRACT FROM AUTHOR]

Introduction: Individuals of South Asian (SA) origin have a greater risk for type 2 diabetes and cardiovascular disease than other ethnic populations. This increased risk is in part explained by the unique obesity phenotype of elevated visceral adipose tissue (VAT) among this population. Aerobic exercise in Europeans is effective at reducing VAT, but this has not been studied in SA, who have some of the lowest levels of physical activity in the world. Therefore, the purpose of this study was to determine whether exercise can reduce VAT given the unique obesity phenotype and associated disease risk in the SA population. Methods: A total of 75 physically inactive, postmenopausal SA women were randomized to either culturally based (Bhangra dance), standard (gym-based), or control (nonexercise) program for 12-wk. The primary outcome was change in VAT. Results: The average attendance in the culturally based and standard program was 78% ± 33% and 67% ± 25%, respectively. After an intention-to-treat analysis, VAT was not significantly reduced in culturally based (-60 cm³,95% confidence interval [CI] = -172 to 54, P = 0.300) or standard (-98 cm³, 95% CI = -216 to 21, P = 0.106) exercise compared with control after adjustment for baseline physical activity and age. In those participants who attended more than two-thirds of the exercise classes, VAT was significantly reduced compared with control (-109 cm³, 95% CI = -204 to -13, P = 0.026). Conclusion: In intention-to-treat analysis VAT was not significantly reduced after 12 wk of either standard or culturally based exercise. However, attendance in both standard and culturally based exercise was high, and VAT was significantly reduced among SA women who adhered to these programs. [ABSTRACT FROM AUTHOR]

Introduction: Data evaluating mortality benefit from replacing sedentary time with physical activity are sparse. We explored reallocating time spent in sedentary behavior to physical activity of different intensities in relation to mortality risk. Methods: Women and men age 50-85 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006 cycles with follow-up through December 31, 2011, were included. Sedentary time and physical activity were assessed using an ActiGraph accelerometer. Isotemporal substitution models were used to estimate the effect of replacing one activity behavior with another activity behavior for the same amount of time while holding total accelerometer wear time constant. Results: During a mean follow-up of 6.35 yr, 697 deaths from any cause occurred. Replacing 30 min of sedentary time with an equal amount of light activity was associated with 14% reduced risk of mortality (multivariable-adjusted hazard ratio (HR), 0.86; 95% confidence interval (CI), 0.83-0.90). Replacement of sedentary time with moderate to vigorous activity was related to 50% mortality risk reduction (HR, 0.50; 95% CI, 0.31-0.80). We also noted a 42% reduced risk of mortality when light physical activity was replaced by moderate to vigorous activity (HR, 0.58; 95% CI, 0.36-0.93). Conclusion: Replacing sedentary time with an equal amount of physical activity may protect against preterm mortality. Replacement of light physical activity with moderate to vigorous activity is also associated with protection from premature mortality. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to determine the effectiveness of an evidence-based practice (EBP) learning module within a nursing residency program (NRP). BACKGROUND: Utilization of EBP has been shown to improve patient outcomes; however, new-graduate nurses lack the practice application ability, attitudes, knowledge, and skills to incorporate EBP into their personal practice. METHODS: New-graduate nurses in a hospital NRP participated in this nonexperimental, descriptive, correlational, study. The Evidence-Based Practice Questionnaire was utilized in a prestudy-poststudy format to collect data for analysis. RESULTS: Statistically significant changes occurred throughout the EBP module in regard to new-graduate nurse practice and knowledge of EBP. CONCLUSION: Enabling novice nurses to foster a spirit of inquiry through EBP literacy is essential to patient outcomes; nonetheless, new-graduate nurse readiness must be further assessed in order to determine appropriate timing of EBP education within NRPs in an effort to improve the application of evidence at the bedside. [ABSTRACT FROM AUTHOR]

Background: Most previously reported literature on diabetes self-care is either solely quantitative or qualitative research conducted in developed countries; findings may not be generalizable to developing countries with different sociodemographic and cultural factors. Purpose: The study aims to develop an explanatory mediation model for self-care and enhance model interpretation through qualitative input. Methods: A quantitatively driven, sequential, mixed method design was used. Structured questionnaires were used to collect data for the quantitative component from 230 participants. Participants for the qualitative interview were selected using maximum variation sampling (n = 13), and interviewing was guided by semistructured questions. Results: Diabetes management self-efficacy had the strongest influence on diabetes self-care (standardized path coefficient = .42, p < .001), followed by perceived social support (standardized path coefficient = .26, p < .001), and educational status (standardized path coefficient = -.22, p < .001). Diabetes management self-efficacy significantly and partially mediated the relationship between diabetes duration and diabetes self-care (Sobel's z= 2.65, p < .001) and between expectation regarding aging and diabetes self-care (Sobel's z= 3.03, p < .001). Perceived social support significantly and partially mediated the relation between educational status and diabetes self-care (Sobel's z= -2.81, p < .001). The qualitative component elucidated nine themes interwoven in Nepalese culture, social structure, and religious belief. Responsibilities toward family and belief in God acted as boosters for self-care in the case of Nepalese adults, which differed by age, gender, and literacy status. Discussion: The results from this study suggest that tailored psychosocial interventions to promote diabetes management self-efficacy may be beneficial in promoting self-care among Nepalese adults with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: The shortage of professional nurses is a global issue of critical importance. Improving the retention and recruitment of nurses is necessary to reduce this shortage. The ability to measure the quality of work life (QWL) of nurses is important to understand the current QWL status among nurses and to develop appropriate improvement strategies. The two instruments that are currently used in Taiwan both require excessive amounts of time to complete. Furthermore, the results that these two instruments generate are not easily interdisciplinary and international comparisons. Purpose: The aims of this study were to translate into Chinese the English version of the Work-Related Quality of Life Scale (WRQoL) that was developed by Van Laar, Edwards, and Easton (2007) and then to determine the reliability and validity of this Chinese-version scale in terms of measuring the QWL of nurses in Taiwan. Methods: The WRQoL was translated from English into Chinese using forward-translation with group discussions, back-translation, and verification of conceptual equivalence. Concurrent validity, test-retest reliability, and internal consistency reliability were determined in two samples of nurses (n = 30 and n = 213 for Phases 1 and 2, respectively) from a medical center in Taiwan during September 2009. Results: The 23-item Taiwanese version of the WRQoL showed satisfactory concurrent validity with a Taiwanese QWL scale (correlation = .75). The 3-week test-retest reliability was .89, and the Cronbach's alpha was .88, indicating high internal consistency reliability. Conclusions/Implications for Practice: The Taiwanese version of the WRQoL is acceptable for measuring the QWL of nurses in Taiwan. Larger scale studies are recommended for confirmatory factor analysis. This tool may be used for human resources management and policy-making applications, providing the potential to help retain and recruit nurses in Taiwan. Furthermore, the Taiwanese-version scale may be used to compare work-related quality of life between Taiwanese nurses and their counterparts overseas. [ABSTRACT FROM AUTHOR]

A descriptive, retrospective design was used to explore the relationship between employee engagement and culture of safety in ICUs within a large Midwestern healthcare system. Results demonstrated a strong positive relationship between total engagement score and total patient safety score ( r =0.645, P G .01) and positive relationships between total engagement score and the 12 safety culture dimensions. These findings have implications for improving managerial strategies relative to employee engagement that may ultimately impact perceptions of a safety culture. [ABSTRACT FROM AUTHOR]

The article cites a study which determined the relationship between isometric strength and performance during the squat jump (SJ) and countermovement jump (CMJ). The study results demonstrates that absolute isometric peak force (IPF) and IMP are related to vertical jump (VJ) peak force (PF) and peak power (PP), but not VJ height.

The article cites the findings of a study which analyzed the effect of supplementing normal in-season training by a 10-week lower limb plyometric training program (hurdle and depth jumping), examining measures of competitive potential. The study concluded that adding plyometric training improved important components of athletic performance relative to standard in-season training in young runners.

Background: Anxiety and depression are associated with recurrent cardiac events after percutaneous coronary interventions (PCIs). However, few investigators have evaluated the impact of depression and anxiety on recurrent cardiac events in Korea. Objective: The aim of this study was to examine the relationship among depression, anxiety, and recurrent cardiac events in Korean patients with coronary artery disease (CAD) after PCI. Methods: A prospective longitudinal study was undertaken with a sample of 133 CAD patients with PCI. Data were collected between August 2009 and September 2010, and patients were followed after discharge through 2011 with self-report questionnaires on anxiety and depression using the Hospital Anxiety and Depression Scale and with patient medical records on sociodemographic and clinical characteristics. Recurrent cardiac events were collected for 12 months after discharge and were assessed by patient interviews and medical records. Results: There were 18 recurrent cardiac events (13.5%) among the 133 participants. After adjustment for sociodemographic and clinical characteristics, a hierarchical Cox proportional hazards regression model found that a moderate or severe level of anxiety (hazard ratio, 6.21; 95%confidence interval, 1.64Y23.54) and amoderate or severe level of depression (hazard ratio, 4.32; 95% confidence interval, 1.35Y13.88) were independent predictors of recurrent cardiac events. Conclusions: Patients with CAD who have a high level of anxiety and depression are at increased risk for recurrent cardiac events after PCI. Screening should be focused on patients who experience anxious and depressive feelings in addition to traditional risk factors. Furthermore, psychoeducational support interventions to reduce anxiety and depression after PCI may improve health outcomes. [ABSTRACT FROM AUTHOR]

Mindfulness-based stress reduction is a mindfulness-based intervention that is an effective treatment modality for many conditions including stress, anxiety, and depression. Using data from 23 patients who completed a short-form mindfulness-based stress reduction course at a federally qualified health center, a quasi-experimental design was used to assess the impact of participation on self-reported anxiety, stress, mindfulness, and quality of life. Mindfulness and stress showed improvements from pre- to posttests, but neither difference achieved statistical significance. Participants showed statistically significant decreases in anxiety (7-item Generalized Anxiety Disorder scale score: 7.8-4.4; P = .005) and improvements in health-related quality of life including the 36-item Medical Outcomes Study Short Form Health Survey Mental Component Summary (+9.1; P = .001), Physical Functioning (+6.6; P = .039), Vitality (+16.1; P = .001), Social Functioning (+16.9; P = .003), Role Physical (+16.8; P= .016), and Mental Health (+15.6; P < .001) subscales. These findings suggest that an abbreviated mindfulness-based stress reduction course can serve to reduce anxiety and improve quality of life in an underserved population. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated the association between short-term exposure to outdoor air pollution and out-of-hospital cardiac arrest in Japan. Methods: We studied 558 residents of Okayama, Japan, who visited hospital emergency departments between January 2006 and December 2010 for out-of-hospital cardiac arrest using a time-stratified case-crossover design. We calculated city-representative average concentrations of different air pollutants and examined the association between air pollution and cardiac arrest. Results: Exposure to air pollution was associated with an elevated risk of cardiac arrest; for example, odds ratios was 1.17 (95% confidence interval, 1.02 to 1.33) per interquartile-range increase in suspended particulate matter concentrations in the previous 48 to 72 hours. We also observed different susceptibilities to suspended particulate matter and ozone exposures by age category. Conclusions: Short-term exposure to outdoor air pollution was associated with increased risk of cardiac arrest. [ABSTRACT FROM AUTHOR]

This article focuses on a study which looked into the prevalence and impact of shoulder symptoms and dysfunction in an older adult veteran population in Milwaukee, Wisconsin, referencing the research "Shoulder Symptoms and Function in Geriatric Patients," published in the October-December 2014 issue of the "Journal of Geriatric Physical Therapy." Topics discussed include the methods used in recruiting study participants aged 60 years or older and the results and conclusion of the study.

Objective: To assess whether working in an industrial harbor where an oil tank exploded was associated with more airway symptoms and lower lung function in men 1.5 years later. Methods: Tn a cross-sectional study of 180 men, 18 to 67 years old, airway symptoms and lung function among men who worked in the industrial harbor at the time of the explosion was compared with those of working men with residence more than 20 km away. Regression analyses are adjusted for smoking, occupational exposure, atopy recent infection, and age. Results: Exposed men had significantly more upper (ORjrrjtate(j nose = 2-89 [95% confidence interval = 1.31 to 6.37]) and lower (ORjyspnea Upi,iii = 3.79 [95% confidence interval = 1.69 to 8.46]) airway symptoms, and some indication of more reversible airway obstruction than unexposed workers. Conclusions: Men working in an area with an oil tank explosion had more airway symptoms and indication of more airway obstruction 1.5 years after the event. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to investigate and compare the internal and external training loads during basketball training. Researchers evaluated eight male semiprofessional players.They found that significant relationships were found between internal and external training and that internal training load models measured different constructs of the training process than the accelerometer training load model in basketball settings. They concluded that coaches should use both types of training.

This retrospective observational quality improvement study was conducted to determine whether an evidence-based protocol for the treatment of diabetic ketoacidosis improved patient outcomes in our academic medical center. This study evaluated fidelity of providers to the protocol, as well as time to resolution of diabetic ketoacidosis as measured by closure of the anion gap (AG). Other secondary outcomes included time to intravenous fluids, time to potassium replacement, and rates of hypoglycemia and hypokalemia. Two cohorts including historical (A/ = 41) and current (N = 37) were compared to evaluate the effectiveness of the protocol. There were no differences between group demographics at baseline. After implementation of the protocol, 43.2% of patients were treated using full protocol fidelity, 21.6% were treated with partial fidelity, and 35.1% were not treated using the protocol. Although none of the outcomes reached statistical significance, patients in the current group who were treated with full protocol fidelity had an average time to AG closure that was 3 hr less than those who were not treated according to the protocol, and an average time to potassium replacement that was 2 hr less. When comparing the historical cohort with the patients treated with full protocol fidelity, there was improvement in protocol-treated patients in time to AG closure (2 hr), time to dextrose replacement (1.7 hr), and time to potassium replacement (2 hr). The rates of hypokalemia were improved with protocol treatment; 37.5% of protocol-treated patients had hypokalemia as opposed to 63.4% of those not treated according to protocol. Overall, despite the low fidelity in our institution, the protocol promoted evidence-based practice and patients treated according to the protocol had decreased time to treatment outcomes including quicker AG closure, improved intravenous fluids resuscitation, and more accurate and timely electrolyte correction. [ABSTRACT FROM AUTHOR]

Violence in hospitals complicates patient care. Emergency department settings (ED) pose significant risk for caregivers. Nonviolent crisis intervention (NCI) training was initiated to reduce the incidence of violence in an acute care hospital ED with more than 75,000 annual visitors. Training intended to build skills to defuse potentially violent situations and significantly decrease incidents in the ED requiring emergency security team involvement (manifested as code purples). A quantitative quality improvement study evaluated the training investment. The study collected ED code purple and staff training data from November 2012 to October 2013. Correlations were derived using Pearson's r. A regression model determined incremental training impact. There was a negative correlation between violence and NCI training in the previous 90-150 days; regression determined a 23% decrease in code purples, pursuant to training. Risk mitigation justified the facility's investment to continue NCI training. Training reinforcement at 6-month intervals shall be implemented for continued benefit. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to examine the relationship between lactate threshold (LT) as a percentage of maximal oxygen consumption (Vo2max) and power output of LT (LTw) and also to investigate to what extent Vo2max, oxygen cost of cycling (Cc), and maximal aerobic power (MAP) determine LTw in cycling. Researchers evaluated 108 male cyclists. After evaluating the cyclists, researchers found that they were able to develop a new time-saving method for calculating LTw in well-trained cyclists.

The article discusses a study of peak oxygen uptake in cyclists, focusing on methods of assessing power output and suggesting that methods involving minimal power outputs and individual peak oxygen uptake rates are compatible. Topics include the measurement of times to exhaustion during continuous cycling exercises.

Purpose Men with prostate cancer receiving androgen deprivation therapy (ADT) are at increased risk for decreased bone mineral density (BMD). This study evaluates the relationship between self-reported daily activity, endurance and resistance exercise, and BMD measured by dual-energy x-ray absorptiometry (DEXA) in prostate cancer patients receiving ADT. Data sources We recruited 96 men treated with ADT for ≥9 months from urology and cancer practices. The Canadian Fitness Survey assessed daily activity and exercise. Data on demographic and lifestyle characteristics and calcium and vitamin D supplementation were collected. Blood was collected for analysis of 25-OH vitamin D. A DEXA scan was performed. Conclusions A positive association between endurance exercise and DEXA T-scores of the hip was shown. Regression analysis showed endurance exercise of medium to heavy intensity (measured as energy expenditure in MET-hours/week) was associated with T-scores of the hip ( β = 0.048; 95% CI 0.003, 0.112; p = .040) but not with spinal T-scores after controlling for age, body mass index, and alcohol use. Implications for practice Findings are cross-sectional, but if confirmed in prospective studies suggest that increased endurance exercise is a practical measure nurse practitioners can institute to prevent low bone density in the hip of men treated with ADT. [ABSTRACT FROM AUTHOR]

The article presents information on the improvement of maximal aerobic fitness and body composition through crossfit training. Topics discussed include high-intensity interval training (HIIT), and high-intensity power training (HIPT). Also discussed are the differences between these two types of training programs.

Background: Female smokers with coronary heart disease (CHD) are at an increased risk for negative health effects. The time of invasive cardiovascular (CV) interventions is a critical opportunity to make lifestyle changes to reduce future CV interventions. Objective: The purpose of this study guided by the Health Belief Model was to determine which factors predict smoking cessation (SC) in women after an invasive CV procedure. Methods: A correlational, prospective design was used. Data were collected from female smokers at the time of an invasive CV intervention (baseline) and 3 months later. Instruments measured commitment to stop smoking, perceived threat of CHD and future interventions, cessation self-efficacy, barriers to SC, benefits of SC, cues to action, and motivation. Analyses included χ² and t tests and multiple, hierarchical, and logistic regression. Results: On average, women (N = 76) were middle aged (mean [SD] age, 55.9 [8.0] years), smoked 15.3 (9.8) cigarettes per day, and on average smoked for 33.6 (10.2) years. At baseline, fewer perceived barriers to SC, high cessation self-efficacy, and being more autonomously motivated to quit smoking explained 67% of variance in commitment to stop smoking (P < .001). At 3 months, of 54 women responding, only 8 had quit smoking. Women reported smoking fewer cigarettes per day at 3 months compared with baseline (paired tS1 = 3.43, P < .01). Higher baseline cessation self-efficacy and lower CHD threat were predictors of SC at 3 months χ²4 = 18.67, n = 54; P = .001). Conclusions: Although commitment, motivation, and self-efficacy to stop smoking were high, perceived threat of CHD and future invasive CV interventions were high, and perceived barriers to SC were low, most women continued to smoke after their heart catheterization. Referrals for assistance from healthcare providers to decrease anxiety and nicotine dependence and to address ongoing challenges to SC are needed. [ABSTRACT FROM AUTHOR]

Background: A healthy work environment can improve patient outcomes and registered nurse (RN) turnover. Creating cultures of retention and fostering healthy work environments are 2 major challenges facing nurse leaders today. Specific aims: Examine the effects of the healthy work environment (communication, collaboration, and leadership) on RN turnover from data collected from a research study. Methods: Descriptive, cross-sectional, correlational design. Pediatric critical care RNs from 10 pediatric intensive care units (PICU) completed the Practice Environment Scale of the Nursing Work Index Revised and a subscale of the Intensive Care Unit Nurse-Physician Communication Questionnaire. These staff nurses were asked whether they intend to leave their current job in the next 6 months. Statistical analysis included correlations, multiple linear regression, t tests (2-tailed), and 1-way analysis of variance. Results: A total of 415 RNs completed the survey. There was a statistically significant relationship between leadership and the intent to leave (P < .05). There was also an inverse relationship between years of experience and intent to leave. None of the communication variables between RNs and among RNs and MDs or collaboration were significantly associated with PICU nurses’ intention to leave. Conclusion: Effective leadership in the PICU is important to PICU RNs and significantly influences their decisions about staying in their current job. [ABSTRACT FROM AUTHOR]

Background: Several studies have demonstrated that oral care with chlorhexidine gluconate (CHG) 0.12% solution reduces the incidence of ventilator-associated pneumonia (VAP) in mechanically ventilated patients with endotracheal tubes in the ICU. Minimal evidence shows the effectiveness of any oral care protocols in preventing VAP in mechanically ventilated patients with tracheostomies in a step-down or progressive care unit (PCU). Objective: To determine the effectiveness of an oral care protocol in reducing the VAP rate in mechanically ventilated patients with tracheostomies in the PCU. Methods: A 12-month prospective study was conducted on 75 mechanically ventilated patients who had tracheostomies. The oral care protocol consisted of tooth brushing with toothpaste and applying CHG 0.12% solution every 12 hours. At the conclusion of the study, the VAP rate in the study population was compared with the National Health and Safety Network (NHSN) report for 2009 benchmark of 1.5 per 1,000 ventilator days. Results: After the oral care protocol was implemented in the PCU, the VAP rate was 1.1 per 1,000 ventilator days over 12 months, compared with the NHSN report for 2009 of 1.5 per 1,000 ventilator days. Conclusions: Tooth brushing with toothpaste and applying CHG 0.12% solution may be an effective oral care protocol to reduce the VAP rate in patients in PCUs with tracheostomies who are being mechanically ventilated. INSET: Glossary of research terms. [ABSTRACT FROM AUTHOR]

Background: Valid assessment of family functioning can play a vital role in optimizing client outcomes. Because family functioning is influenced by family structure, socioeconomic context, and culture, existing measures of family functioning- primarily developed with nuclear, middle-class European American families-may not be valid assessments of families in diverse populations. The Family Effectiveness Measure was developed to address this limitation. Objectives: The aim of this study was to test the Family Effectiveness Measure with data from a primarily low-income African American convenience sample using the Rasch measurement model. Methods: A sample of 607 adult women completed the measure. Rasch analysis was used to assess unidimensionality, response category functioning, Item fit, person reliability, differential item functioning by race and parental status, and item hierarchy. Criterion-related validity was tested using correlations with five other variables related to family functioning. Results: The Family Effectiveness Measure measures two separate constructs: The Effective Family Functioning construct was a psychometrically sound measure of the target construct that was more efficient because of the deletion of 22 items. The Ineffective Family Functioning construct consisted of 16 of those deleted Items but was not as strong psychometrically. Items in both constructs evidenced no differential item functioning by race. Criterion-related validity was supported for both. Discussion: In contrast to the prevailing conceptualization that family functioning is a single construct, assessed by positively and negatively worded items, use of the Rasch analysis suggested the existence of two constructs. Whereas the Effective Family Functioning scale is a strong and efficient measure of family functioning, the Ineffective Family Functioning scale will require additional item development and psychometric testing. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted at Vanderbilt University, Tennessee to assess the effect of risk factor modification of type 2 diabetes in a working population. It analyzed data collected from the annual health risk assessment (HRA) program over a duration of eight years. The results suggest that weight loss can lower the incidence of diabetes and that workplace wellness programs can prevent the onset of diabetes.

Nurse-parent relationships are a key aspect of high-quality family-centered care in the neonatal intensive care unit. Few studies have examined nursing continuity of care that includes (a) chronological continuity, that is, the number of nurses caring for an infant over time, (b) the consistency of information transferred to the parent and colleagues, and (c) the consistency of interactions between parent and nurse as an important factor in the nurse-parent relationship. The aims of this pilot study were to develop and test a scale of parental perceptions of nursing continuity of care in the newborn intensive care setting and to characterize the association between parents' perceptions and chronological nursing continuity. Fifty-four parents completed the Parents' Perceptions of Continuity Scale and a demographic questionnaire. Also, medical record and a count of the number of nurses caring for infant in past 7 days were collected. The Parents' Perceptions of Continuity Scale demonstrated good internal consistency (Cronbachcα, 0.81). Parents' Perceptions of Continuity Scale scores were significantly associated with chronological nursing continuity, suggesting that the number of nurses caring for an infant plays a role in parents' perceptions of overall nursing continuity. [ABSTRACT FROM AUTHOR]

The article presents a study of the effects of the medicinal herb Rhodiola rosea on endurance exercise performance, including perceived rate of exertion, mood, and cognition. Subjects performed a 6-mile time trial on a bicycle ergometer following acute dose of Rhodiola or placebo and were evaluated for blood lactate and salivary cortisol and alpha-amylase before and after exercise. The results indicate that R. rosea decreased heart rate and perceived exertion, which produced faster trial times.

The article discusses the study to investigate how nurses perceived the risk of musculoskeletal (MSK) injury from work and identify factors associated with their risk perception. Details related to the methods applied during study including sample, data collection, and data analysis are provided. Results showed that perceptions MSK injury risks were affected by physical work exposures, psychosocial job stressors, and experience with MSK symptoms, but not by perceived workplace safety climate.