Exploring the meaning of excess child weight and health: shared viewpoints of Mexican parents of preschool children.

In the United States, the prevalence of childhood overweight and obesity has reached epidemic levels, with U.S. Hispanic children, a sub-group mainly composed of children of Mexican decent, disproportionately affected.

Translating the evidence-based NICU COPE program for parents of premature infants into clinical practice: impact on nurses' evidence-based practice and lessons learned.

Background And Purpose: Many interventions that have been supported as efficacious through research never make it to clinical practice to improve care and patient outcomes. Therefore, the purposes of this dissemination-implementation study were to determine (a) the impact of translating the evidence-based Creating Opportunities for Personal Empowerment (COPE) program for parents of premature infants into clinical practice on nurses' EBP (evidence-based practice) beliefs and implementation; (b) the best strategy for disseminating COPE into the neonatal intensive care unit (NICU), including evaluating the use of a COPE EBP mentor; and (c) barriers and facilitators to successful implementation of the COPE program.

Subjects And Methods: The subjects for this study were 81 (45%) out of 180 nurses from a 55-bed NICU of a large children's hospital located in the Southwest region of the United States.

Differential effects of a nurse home-visiting intervention on physically aggressive behavior in children.

Objective: The objective of this study is to examine the differential effects of nurse home visiting (NV) on physical aggression (PA) among children aged 2-12 years.

Methods: This study used secondary data analysis from a randomized trial of NV intervention.

Results: There were significant reductions in PA observed among NV girls at 2 years old and NV children of high-psychological-resource mothers at 6 and 12 years old.

Keeping an eye on patient safety using human factors engineering (HFE): a family affair for the hospitalized child.

Barbara L. Wilson Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building.

Creating a culture of innovation in nursing education through shared vision, leadership, interdisciplinary partnerships, and positive deviance.

Although innovation is typically viewed by healthcare and academic institutions, business leaders, entrepreneurs, and private corporations as necessary for continuous improvement, high-quality care, and scientific advancement, barriers in creating and sustaining innovative academic environments abound and require effective leadership to overcome them. Therefore, the purpose of this article is to describe the major barriers and facilitators to innovation in colleges of nursing and healthcare professions along with recommendations for creating a culture of innovation in these academic environments. In addition, key strategies for educational innovation are discussed.

Patterns of antecedents of catastrophic reactions in nursing home residents with dementia in the United States.

Purpose: The purpose of this study was to describe the patterns of antecedents of catastrophic reactions (CRs) in nursing home residents with dementia in the United States.

Methods: A total of 229 catastrophic reaction events were the sample for this study. Ten antecedent variables were selected and analyzed using cluster analysis to address the patterns of antecedents of CRs in dementia.

The teaching-coaching role of the APN.

The demand for well-educated and skilled healthcare providers has never been greater. As a result, enrollment is expanding in academic settings that prepare advanced practice nurses for primary care and acute care roles. The growth in programs has led to a corresponding increased demand for clinical mentors and preceptors.

Pediatric nurse practitioners' assessment and management of childhood overweight/obesity: results from 1999 and 2005 cohort surveys.

Introduction: Recently, public and professional emphasis has been placed on addressing the increasing prevalence of childhood overweight.

Method: This survey study was conducted with two cohorts of pediatric nurse practitioners (N = 413) to explore differences in self-reported practice skills over time.

Results: Significant improvements in assessment, screening, and laboratory evaluations were reported, although reduced adherence to recommended psychosocial assessments was noted.

Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children.

The evidence-based practice beliefs and implementation scales: psychometric properties of two new instruments.

Background: Implementation of evidence-based practice (EBP) by health professionals is a key strategy for improving health care quality and patient outcomes as well as increasing professional role satisfaction. However, it is estimated that only a small percentage of nurses and other health care providers are consistently using this approach to clinical practice.

Aim: The aim of this study was to report on the development and psychometric properties of two new scales: (1) the 16-item EBP Beliefs Scale that allows measurement of a person's beliefs about the value of EBP and the ability to implement it, and (2) the 18-item EBP Implementation Scale that allows measurement of the extent to which EBP is implemented.

Systematic review of multicomponent interventions with overweight middle adolescents: implications for clinical practice and research.

Background: Being overweight is a global epidemic that occurs in more than 10% of school-aged children (age 5-17) worldwide. The rate of adolescents being overweight continues to rise despite numerous public health campaigns and programs to increase awareness and modify unhealthy lifestyle patterns.

Aims: The purpose of this systematic review was to determine the most efficacious intervention for treating overweight adolescents.

Lessons Learned in Clinical Research: Using the MMSE With Older Mexican American Nursing Home Residents.

This authors examined the utility of the Mini-Mental State Examination (MMSE) in a pilot study to measure cognitive function in older Mexican American nursing home residents. Many of the lessons learned are transferable to the community: Cognitive screening instruments must be carefully examined for validity and utility, they may need to be administered in Spanish, certain items may need alteration in the questions or expected responses, phrases to be repeated must be culturally appropriate, cutoff scores may need adjustment, "serial sevens" must be used, and education and socioeconomic status must be considered in interpretation of results. Consequently, the MMSE may not be an appropriate measure to use to assess cognitive functioning in older Hispanic populations whose educational levels or literacy is low or unknown.

Influence of intestinal stoma on spiritual quality of life of U.S. veterans.

Purpose: To examine spiritual quality of life (QOL) of veterans with intestinal ostomies.

Design: Mixed-method cross-sectional.

Methods: Male veterans with total scores in the upper (n = 59) and lower (n = 61) quartiles of the City of Hope Quality-of-Life-Ostomy survey provided spiritual QOL data.

"Attached at the umbilicus": barriers to educational success for Hispanic/Latino and American Indian nursing students.

Hispanic/Latino and American Indian students receiving services from a 3-year Nursing Workforce Diversity Grant called ALCANCE responded every semester to a semistructured interview protocol about their program experiences. Eighteen Anglo student volunteers also participated in one such interview. Comparison of the transcribed interview sets using methods outlined by (Miles, M.

The importance of educational and social backgrounds of diverse students to nursing program success.

This article compares the educational and social backgrounds of Anglo students with those of Hispanic/Latino and American Indian students receiving stipends and other services from a Nursing Workforce Diversity Grant to determine the possible effects of such backgrounds on success in a baccalaureate nursing program. Stipend recipients provided baseline background data by interview on admission, and the results were compared with corresponding data from a volunteer sample of Anglo students to enhance understanding of the educational and social circumstances of the stipend recipients and to identify a need for individualized, tailored grant approaches. The Hispanic/Latino and American Indian students demonstrated less adequate educational backgrounds and lower social class as gauged by parental occupation, than did the Anglo students.

Don't ask, don't tell: parental nondisclosure of complementary and alternative medicine and over-the-counter medication use in children's asthma management.

Introduction: Parent-health care provider (HCP) communication is an important component of pediatric asthma management. Given the high prevalence of complementary and alternative medicine (CAM) and over-the-counter (OTC) medication use among this population, it is important to examine parental nondisclosure of these asthma management strategies.

Method: One-time interview and 1-year retrospective medical record review with 228 parents of 5- to 12-year-old children with asthma enrolled from six pediatric primary care practices examining parental nondisclosure of CAM and OTC medication use, reasons for nondisclosure, medical record documentation of CAM usage, and association between parent-HCP relationship and nondisclosure.

Overweight and obesity in postpartum Hispanic women.

Overweight and obesity vary in prevalence among particular groups, and are especially problematic for childbearing Hispanic women. The complex interaction between physical changes associated with pregnancy, role changes accompanying birth, and family and cultural values related to childbearing are superimposed upon the underlying mechanisms that create or perpetuate obesity. In this article we review biological and behavioral research on obesity in postpartum Hispanic women to identify critical components for intervention studies focused on weight management.

Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.

Nurse practitioner educators' perceived knowledge, beliefs, and teaching strategies regarding evidence-based practice: implications for accelerating the integration of evidence-based practice into graduate programs.

Unlabelled: The paradigm shift to evidence-based practice (EBP) in the United States has been slow. Evidence has supported that one barrier to accelerating this paradigm shift is that many nurses have negative attitudes toward research, in large part due to the manner in which they were taught research in their educational programs. The primary aims of this study were to (a) describe nurse educators' knowledge, beliefs, and teaching practices regarding EBP; (b) determine whether relationships exist among these variables; and (c) describe major barriers and facilitators to the teaching of EBP in nurse practitioner curriculums.

Improving healthcare and outcomes for high-risk children and teens: formation of the National Consortium for Pediatric and Adolescent Evidence-Based Practice.

Although major healthcare and professional organizations as well as key leaders have long emphasized the importance of evidence-based practice (EBP) in improving patient care and outcomes, the majority of healthcare professionals do not implement EBP. There is a huge gap in time that exists between the generation of research findings and the translation of those findings into clinical practice. Many efficacious interventions are not being used in clinical practice even though research findings suggest that they improve child and adolescent health and development.

The COPE Healthy Lifestyles TEEN program: feasibility, preliminary efficacy, & lessons learned from an after school group intervention with overweight adolescents.

Introduction: There has been a paucity of theory-based interventions to improve health outcomes in overweight adolescents. Therefore, two intervention studies were conducted to: (a) determine the feasibility of implementing the Creating Opportunities for Personal Empowerment (COPE) Healthy Lifestyles Thinking, Emotions, Exercise, and Nutrition (TEEN) program with overweight adolescents; (b) obtain feedback that could be used to refine the program; and (c) examine the preliminary efficacy of the COPE program on the adolescents' weight and body mass index (BMI).

Method: Phase I and Phase II clinical trials were conducted with 23 overweight teens.

Differences in Mexican American and Non-Hispanic White veterans' homocysteine levels.

Purpose: To compare homocysteine (Hcy) levels and possible modulatory factors, such as nutrient or supplement intake, between Mexican American and Non-Hispanic White (NHW) male military veterans scoring at high- versus low-risk for stroke.

Design: A cross-sectional survey with a high and low stroke risk biomarkers substudy.

Methods: Voluntary participants were Mexican American (n=109) and NHW (n=120) veteran outpatients 54 to 85 years of age at a Southwestern Veterans Administration (VA) medical center.