Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching.

The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study's priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions.

Breastfeeding and Growth of Children in the Peri/postnatal Epigenetic Twins Study (PETS): Theoretical Epigenetic Mechanisms.

Background: The prevalence of overweight infants and toddlers has increased by 60% in the past 30 years and is a significant contributor to diabetes, cardiovascular disease, and early morbidity and mortality. The World Health Organization's updated meta-analysis in 2013 observed an association between breastfeeding and a lower prevalence of obesity later in life. The purpose of this study was to assess the growth of children in a cohort of Australian twins to examine associations between duration of breastfeeding and growth at 18 months of age.

Examining the benefit of vaccinating adults against pertussis.

Purpose: To examine recent evidence concerning the health benefits and cost effectiveness of replacing a single dose of adult tetanus/diphtheria vaccine with a single dose of tetanus/diphtheria/pertussis (TDaP).

Methods: A review of the literature was conducted utilizing the databases CINAHL and Medline with the keywords pertussis, adult immunization, vaccination, TDaP, DTaP, and healthcare workers.

Conclusions: Recent outbreaks of pertussis have shown that preventing such outbreaks through immunization of adults with a single TDaP vaccine is a cost-effective measure.

Preventing type 2 diabetes after gestational diabetes.

Purpose: The purposes of this article are to examine the epidemiology of gestational diabetes mellitus (GDM) and subsequent type 2 diabetes, identify risk factors for the development of GDM and subsequent type 2 diabetes, discuss protocols for postpartum screening, and recommend evidence-based interventions to delay or prevent type 2 diabetes after GDM.

Methods: A review of the research literature from 1995 to 2005 concerning gestational diabetes was done using MEDLINE, CINAHL, National Institutes of Health, and American Diabetes Association internet resources. The criteria set for selection included the following: the research explored risk factors for and epidemiology of gestational diabetes, the relationship of gestational diabetes and the subsequent development of type 2 diabetes, and/or the prevention of type 2 diabetes after GDM.

Acculturation and adherence: issues for health care providers working with clients of Mexican origin.

Providing care to clients who come from different countries is a challenge for the American health care providers as they traverse the issues of cultural health beliefs and practices and language and knowledge deficits. It is just as difficult for the clients as they face new cultural customs, language barriers, and unfamiliar health care systems and medical management plans. Both parties face acculturation and adherence challenges.

Warfarin therapy in older adults: managing treatment in the primary care setting.

Oral anticoagulant therapy with war farin is commonly used to prevent thromboembolic events in patients at risk. The degree of anticoagulation is variable among individuals and is influenced by many factors; therefore, patients must be monitored frequently to assess for potential adverse effects related to treatment. Individuals older than age 65 are at particular risk for thromboembolic events as well as anticoag ulant-related complications.

Insights from older adults with type 2 diabetes: making dietary and exercise changes.

Purpose: The purpose of this research was to identify factors that affect the nutrition and exercise behaviors of persons over the age of 55 with type 2 diabetes.

Methods: Focus groups were conducted using a validated focus group interview guide to determine primary health concerns and health behaviors, favored learning modalities, barriers to learning, food preferences, and exercise preferences.

Results: The following major themes and subthemes were identified: some risk factors for diabetes and heart disease seem more salient than others; perceived susceptibility for serious outcomes of diabetes can occur through vicarious learning; willpower, often obtained through a belief in God, is necessary for successful behavior change; effective modification of behavior and building self-efficacy starts with small steps; and intrinsic reinforcement is necessary for behavior change.