Moving Beyond Mean Levels: Associations Between Subject-Level Variability in Psychological Determinants and Physical Activity in Older Adults.

Background: Research investigating the psychological determinants of physical activity (PA) tends to conceptualize determinants as stable, trait-like factors. Growing evidence suggests that people and the processes that regulate people's behavior fluctuate over short timescales (eg, hours and days). This study explores the extent to which subject-level variability (vs stability) in determinants of PA, as well as the interaction between subject-level mean and variability in those determinants, is associated with moderate- to vigorous-intensity PA (MVPA) in older adults.

Self-Care of Diabetes and Diabetes Distress in Non-Hispanic Black Adults With Type 2 Diabetes.

Purpose: The purpose of the study was to describe the level of self-care of diabetes and diabetes distress and examine their relationship in non-Hispanic Black adults living with type 2 diabetes.

Methods: This cross-sectional, correlational study was conducted with 275 non-Hispanic Black adults with type 2 diabetes in North Carolina over 10 weeks, July 2022 to September 2022. An online survey collected sociodemographic and clinical characteristics, self-care measures of diabetes, and diabetes distress.

Establishing and Affirming Social Connections: Recruiting Non-Hispanic Black Adults with Type 2 Diabetes.

The underrepresentation of non-Hispanic Black adults in clinical research impacts the generalizability and usefulness of research findings. The purpose of this article is to discuss recruitment strategies used in a research study examining the self-care of diabetes and diabetes distress in non-Hispanic Black adults with type 2 diabetes. In this cross-sectional correlation study, the participants were non-Hispanic Black adults with type 2 diabetes living in North Carolina.

Identifying barriers and facilitators to seeking care for symptoms of bacterial sepsis: A qualitative study.

Aim: Research suggests that early access to quality care is essential to improving bacteraemia outcomes and reducing the risk of developing sepsis because it allows for early intervention. Currently, there are limited data regarding the facilitators and barriers that alter the trajectory of arrival at the hospital when patients in the United States experience symptoms of bacteraemia and sepsis. This study sought to explore and describe the facilitators and barriers to seeking care for suspected bacteraemia and sepsis symptoms.

Studying Movement-Related Behavioral Maintenance and Adoption in Real Time: Protocol for an Intensive Ecological Momentary Assessment Study Among Older Adults.

Background: Older adults struggle to maintain newly initiated levels of physical activity (PA) or sedentary behavior (SB) and often regress to baseline levels over time. This is partly because health behavior theories that inform interventions rarely address how the changing contexts of daily life influence the processes regulating PA and SB or how those processes differ across the behavior change continuum. Few studies have focused on motivational processes that regulate the dynamic nature of PA and SB adoption and maintenance on microtimescales (ie, across minutes, hours, or days).

Perceived Effectiveness of Nursing Faculty of Clinical Video Simulation for Use in Nurse Practitioner Education.

Quality clinical placements for nurse practitioner students are increasingly challenging to locate and sustain, restricting faculty opportunities to assess student clinical competency. With the additional impact of COVID-19 restricting access to in-person clinicals and simulations, faculty began to incorporate virtual clinical simulation experiences. This cross-sectional design study examined nurse practitioner faculty's perception that by including videos with the accompanying faculty guides found at the University of North Carolina at Greensboro School of Nursing Clinical Video Simulation Series site, students' clinical decision making could be enhanced and that video simulation can be used to assess clinical competency.

Characteristics of Hospitalized Adults 55 and Older With Clostridioides difficile Infection.

Clostridioides difficile infection in older adults can result in severe infection, difficulty in treating, and complicated disease process, yet few studies have examined the characteristics of hospitalized older adults and recurrent Clostridioides difficile infection. A retrospective cohort study was conducted to explore the characteristics of hospitalized adults 55 years and older with initial Clostridioides difficile infection and recurrences by extracting routinely documented data in the electronic health record. A sample of 1,199 admissions on 871 patients was included, with a recurrence rate of 23.

Exploration of pre-hospital patient delays in seeking care for symptoms of bacteremia and sepsis: A qualitative study.

Aim: We explored patient pre-hospital delays in seeking care for symptoms of bacteremia and sepsis.

Design: A qualitative descriptive study.

Methods: In January 2021, we recruited a convenience sample of four men and six women who were former patients diagnosed with bacteremia.

The Experiences of African American Male Caregivers.

Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S.

Low-Income, Older African Americans' Engagement in and Perceptions of a Smartphone-Based Ecological Momentary Assessment Study of Physical Activity and Sedentary Behavior.

Background And Objectives: Smartphone-based ecological momentary assessment (EMA) methods can provide novel insights into modeling and predicting activity-related behaviors, yet many racial and ethnic minority groups report barriers to participating in mobile health research. We aim to (a) report on strategies used to successfully recruit and retain minority older adults in a smartphone-based physical activity and sedentary behavior EMA study and (b) report on participants' perceptions of study acceptability.

Research Design And Methods: Researchers partnered with trusted individuals and community organizations serving older adults to facilitate recruitment for an 8-day EMA study of minority older adults' physical activity and sedentary behavior.

The effect of an exergame on physical activity among older adults residing in a long-term care facility: A pilot study.

Background: Older adults who engage in arranged residential video games have the potential to gain health benefits such as increase in physical activity beyond purposeful movement with movement-based games.

Methods: A Nintendo Wii video gaming system was implemented for six-weeks as a physical activity intervention with long-term care residents to determine the impact on exercise benefits/barriers, self-efficacy for exercise, and physical activity levels.

Results: Paired t-tests revealed improvement in exercise benefits/barriers, self-efficacy for exercise, and physical activity levels, albeit none with statistical significance (all p > .

A Quality Improvement Project Comparing Two Treatments for Deep-Tissue Pressure Injuries to Feet and Lower Legs of Long-term Care Residents.

Objective: To retrospectively examine clinical outcomes from a feasibility study that compared two treatment options for deep-tissue pressure injuries (DTPIs), including the clinical indicators increasing the risk of deteriorating DTPIs among long-term care residents.

Methods: A retrospective chart audit of 40 DTPIs from 33 long-term care residents in two long-term care facilities was conducted to compare (1) polymeric membrane dressings (PMDs) with offloading and (2) a skin barrier film with offloading.

Results: Of the 13 DTPIs treated with PMDs, only 23% deteriorated to a stage 3 or 4 pressure injury (PI), whereas of the 27 DTPIs treated with skin barrier film, 41% deteriorated to a stage 3 or 4 PI.

Creating a Gerontological Nursing Digital Repository Within a Learning Management System.

Background: Faculty who teach gerontological nursing are challenged to deliver competency-based baccalaureate nursing education. Because our courses are divided into multiple sections and taught by a variety of faculty, the need for a peer-reviewed, curated repository of gerontological learning materials was conceived.

Method: Syllabi for prelicensure and RN-to-baccalaureate nursing (BSN) degree gerontological courses were reviewed.

Recognition and management of Clostridium difficile in older adults.

Clostridium difficile infection (CDI) is increasing in the outpatient setting, and older adults are at a higher risk for contracting CDI and experiencing poor outcomes. NPs may see this infection in the primary care setting. This article focuses on the presentation, treatment, and clinical practice implications for CDI in community-dwelling older adults.

Frailty in the older adult: will you recognize the signs?

With the rapid aging of the oldest old, it is inevitable that nurse practitioners will encounter frail patients across care settings. Presented through a case study, this article addresses the clinical characteristics of frailty, strategies to prevent this geriatric syndrome, and recommendations for care.

Teaching while learning while practicing: reframing faculty development for the patient-centered medical home.

Soaring costs of health care, patients living longer with chronic illnesses, and continued attrition of interest in primary care contribute to the urgency of developing an improved model of health care delivery. Out of this need, the concept of the team-based, patient-centered medical home (PCMH) has developed. Amidst implementation in academic settings, clinical teachers face complex challenges not previously encountered: teaching while simultaneously learning about the PCMH model, redesigning clinical delivery systems while simultaneously delivering care within them, and working more closely in expanded interprofessional teams.

Older adults with bipolar disorder: guidelines for primary care providers.

The purpose of this article is to present evidence-based guidelines to facilitate early diagnosis and appropriate treatment of older adults with symptoms of bipolar disorder. Assessment criteria, diagnostic tools, and interventions to optimize care of older adults with bipolar disorder--with a focus on implications for primary care providers--are described.

Prescribing patterns of gerontological nurse practitioners in the United States.

Purpose: To identify the prescribing patterns of gerontological nurse practitioners (GNPs) as reported on the Gerontological Nurse Practitioner Practice Profile. Specifically, the study examined (a) GNPs' frequency of prescribing certain categories of medications for older adults; (b) the influence of practice, education, and experience variables on prescribing practices of GNPs; and (c) the rate of prescribing inappropriate medications for older adults based on the list of medications on the modified Beers Criteria.

Data Sources: The study was part of a larger descriptive survey that examined the practice characteristics of GNPs using the Gerontological Nurse Practitioner Practice Profile.

Clinical practice characteristics of gerontological nurse practitioners: a national study.

Purpose: To determine the clinical practice characteristics of gerontological nurse practitioners (GNPs) in the United States and ascertain whether length of employment, geographic region of practice, work setting, and educational preparation influence GNPs' delivery of advanced clinical services and clinical procedures.

Data Sources: The Gerontological Nurse Practitioner Practice Profile was mailed to a stratified random sample of 1000 GNPs certified by the American Nurses Credentialing Center.

Conclusions: Despite the growing demands for GNPs, of the 472 GNPs who responded to the survey, only half were working full-time as a GNP.

Infusing gerontological nursing content into advanced practice nursing education.

The inclusion of gerontology content in the nursing curriculum is paramount as our population of older adults grows. As one of 10 recipients of the John A. Hartford Foundation/AACN awards for Enhancing Gerontological and Geriatric Nursing Education for Advanced Practice Nursing Programs, we successfully integrated gerontological/ geriatric content throughout core courses for all concentrations taught at the master's level.

Beta-blocker medication usage in older women after myocardial infarction.

Purpose: The purpose of this study was to assess demographic characteristics of women prescribed beta-blocker (beta-blocker) medication and compare to those not using beta-blocker medication, and to determine if there are differences in depression and fatigue among women who used beta-blockers compared to nonusers 6-12 months after myocardial infarction (MI).

Data Sources: This was a descriptive cross-sectional study of 84 women (61 using beta-blockers and 23 not using beta-blockers) aged 65 and older who were 6-12 months post-MI. Women had their height and weight measured and completed a Demographic Health Form, the Geriatric Depression Scale, and the Revised Piper Fatigue Scale (RPFS).

Integrating gerontology competencies into graduate nursing programs.

Current demographic and health care utilization trends strongly indicate a rapidly increasing demand for nurses who are well qualified to care for older adults. Advanced practice nurses are positioned to assume leadership roles in geriatric nursing care; however, they must first acquire adequate preparatory education. This article describes two graduate nursing schools' curricular innovations that were funded by The John A.