Effect of NGN-Style Case Studies on Nursing Students' Anxiety and Self-Confidence With Clinical Decision-Making.

Background: The Next Generation National Council Licensing Examination (NCLEX) uses the Clinical Judgment Measurement Model in unfolding case studies to assess graduate nurses' clinical judgment.

Purpose: This study explored the impact of Next Generation NCLEX (NGN)-style case studies on baccalaureate nursing students' self-confidence and anxiety with clinical decision-making.

Methods: Seventy-six second-year baccalaureate nursing students participated in this 1-group convergent mixed-methods study.

Elevated Total Serum Immunoglobulin A Levels in Patients with Suspicion for Celiac Disease.

Patients with classic symptoms of celiac disease are often initially tested for serum tissue transglutaminase-immunoglobulin A (tTG-IgA) and total serum immunoglobulin A (IgA) levels concurrently, as IgA deficiency can lead to falsely low tTG-IgA. There are no guidelines for incidental findings of elevated total serum IgA when testing for celiac disease. In our study, we described the proportion of patients with suspicion of celiac disease who had elevated total serum IgA and the factors that may be associated with these findings.

Adolescent and young adult preferences for financial incentives to support adherence to antiretroviral therapy in Kenya: a mixed methods study.

Introduction: To develop a patient-centred financial incentive delivery strategy to improve antiretroviral treatment adherence in adolescents and young adults (AYA) living with HIV in Kisumu, Kenya, we conducted a mixed methods study exploring preferences.

Methods: A discrete choice experiment (DCE) and focus group discussion (FGD) were conducted simultaneously to identify preferences for five incentive delivery strategy features: value, eligibility, recipient, format and disbursement frequency. We used consecutive sampling to recruit AYA (14-24 years) living with HIV attending three health facilities in Kisumu, Kenya.

Mental health and life-course shocks in a low-income country: Evidence from Malawi.

Economic insecurity has been widely hypothesized to be an important determinant of mental health, but this relationship has not been well-documented in low-income countries. Using data from the Mature Adults Cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-MAC), we investigate the association of negative economic shocks with mental health outcomes such as depression and anxiety among adults aged 45+ years living in a low-income country. Using fixed effects estimates that control for time-invariant unobserved individual heterogeneity, we find that increased economic instability caused by events such as death of a family member, yield loss, or income loss is positively associated with worse mental health outcomes as measured by the PHQ-9 and GAD-7 instruments.

Reliability and validity testing of the physical resilience measure.

Objective: The purpose of this study was to test reliability and validity of the Physical Resilience Scale.

Methods: A single-group repeated measure design was used and 130 older adults from three different housing sites participated. Participants completed the Physical Resilience Scale, Hardy-Gill Resilience Scale, 14-item Resilience Scale, 5-item Geriatric Depression Scale, and the Yale Physical Activity Survey at baseline and again 2 weeks later.

Pilot testing of the PRAISEDD intervention among African American and low-income older adults.

Background And Research Objective: The incidence of cardiovascular disease (CVD) is particularly high among African American (AA) older adults, and these individuals are least likely to have access to CVD prevention activities. The purpose of this study was to test the feasibility of People Reducing Risk and Improving Strength through Exercise, Diet and Drug Adherence (PRAISEDD), which is geared at increasing adherence to CVD prevention behaviors among AA and low-income older adults.

Methods: This feasibility study was conducted in a senior housing site, using a single-group repeated-measures design and testing physical activity, diet, medication adherence beliefs and behaviors, and blood pressure at baseline and after a 12-week intervention period.

The Functional Pain Scale: reliability, validity, and responsiveness in an elderly population.

Objectives: Because of difficulty experienced in assessing pain in frail older patients and the lack of pain assessment tools with standardization in the elderly, the Functional Pain Scale (FPS), an instrument incorporating both subjective and objective components to assess pain, was developed and evaluated.

Design, Setting, Participants, And Measures: One hundred subjects more than 65 years old participated in the validity, reliability, and responsiveness (the clinical sensitivity of the instrument to change) testing of the Functional Pain Scale. Subjects were recruited from a geriatrics inpatient setting, a geriatrics outpatient setting, and a local hospice (residing in their homes).

The Frail Elderly Functional Assessment questionnaire: its responsiveness and validity in alternative settings.

Objective: To test the Frail Elderly Functional Assessment (FEFA) questionnaire for responsiveness (sensitivity to change) to low-level functional tasks in a frail elderly cohort and to evaluate its validity over the telephone or when administered to a caregiver proxy.

Subjects: Fifty-eight elderly patients from three urban inpatient rehabilitation settings and an outpatient geriatrics center.

Methods: A prospective, clinical, comparative trial.

The impact of a geriatrics evaluation and management unit compared to standard care in a community teaching hospital.

A prospective, controlled trial was initiated to determine whether an acute inpatient geriatrics unit located in a community-based teaching hospital provides better care for frail elderly patients at less cost than conventional medical-surgical units.

Hepatitis B virus vaccination for older adults.

Objective: To compare in adults more than 50 years old the tolerability and immunogenicity of vaccination with recombinant hepatitis B surface antigen (HBs) compared with vaccination with recombinant hepatitis B protein PreS2 + S, and to investigate the safety and immunogenicity of a fourth vaccine dose in poor and non-responders.

Design: Randomized, double-blind prospective study.

Setting: General clinical research center for outpatient evaluation and vaccination.

The effects of changing prompted voiding schedules in the treatment of incontinence in nursing home residents.

Objective: To determine the effects of different prompted voiding schedules on urinary incontinence on a continence unit (CU) and the maintenance of benefits on normal nursing units.

Design: Multiphase study with both intra- and inter-subject comparisons.

Participants: Subjects were 41 consenting incontinent nursing home residents.

Urinary incontinence: an augmented prompted void approach.

Continence improves from 44.7% dryness at baseline to 54.7% at the end of treatment, an improvement of 22%, or about one incontinent episode per day.

Cost-effectiveness of treating incontinence in severely mobility-impaired long term care residents.

Severely mobility-impaired residents in long term care facilities are usually incontinent. The incontinence and immobility predispose this group to decubitus ulcers and urinary tract infections that have been described as adding to the "consequence costs of incontinence" of $80 million per year. In this quasi-experimental study of ten subjects, a mechanical lift (Clinilift) was used with a two-hour schedule to improve incontinence.

A descriptive analysis of nursing staff behaviors in a teaching nursing home: differences among NAs, LPNs, and RNs.

Various staff behaviors in a nursing home were sampled seven times a day, 5 days a week over 37 months and were coded separately for LPNs, RNs, and NAs. The behavior most frequently observed was patient care, which occurred during 56.9% of the samples.

A staff management system for maintaining improvements in continence with elderly nursing home residents.

We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system included self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities.

Nursing management of urinary incontinence in geriatric inpatients.

The management and treatment of incontinence represent two interrelated areas--providing enough providers of care and describing the types of management and treatment options available to the incontinent patient. This article has stressed that adequate staffing underlies any successful program of continence management and treatment. In addition, many options for the management and treatment of incontinence in the elderly have been presented.

Transiently reduced activity of carbamyl phosphate synthetase and ornithine transcarbamylase in liver of children with Reye's syndrome.

Since Reye's syndrome is associated with hyperammonemia, we measured the urea-cycle enzymes in hepatic tissue of 13 patients. Expressed as nanomoles of citrulline per milligram of hepatic protein per minute, mean activity of carbamyl phosphate synthetase (6.27 +/- 2.