A review of the impact of exercise on fall rates among community-dwelling older adults.

Background: The physical decrements of aging predispose older adults to falls and fall-related injuries. Consequences of falling place financial and logistical burdens on the health care system. With an aging population, mitigation of risk and reduction of harm are important objectives.

Open education resources to support the WHO nurse educator core competencies.

Aim: This paper describes an innovative approach to tackling the shortage of qualified nurse educators, which is a major constraining factor or 'bottle-neck' to improve the global supply of nurses, especially in low- and middle-income countries.

Background: The World Health Organization commissioned experts to develop Nurse Educator Core Competencies that describe expectations for this cadre of workers. In their deliberations, the WHO experts cited the challenges affecting the adoption of these competencies, particularly the lack of resources available for implementation.

Race, Ethnicity, and Other Risks for Live Discharge Among Hospice Patients with Dementia.

Objectives: The end-of-life trajectory for persons with dementia is often protracted and difficult to predict, placing these individuals at heightened risk of live discharge from hospice. Risks for live discharge due to condition stabilization or failure to decline among patients with dementia are not well established. Our aim was to identify demographic, health, and hospice service factors associated with live discharge due to condition stabilization or failure to decline among hospice patients with dementia.

Aging gay male veterans: a community-based study on their health and psychosocial needs.

Lesbian, gay, and bisexual persons have served in the military throughout history despite military policies that necessitated concealment of their sexual orientation. This secondary data analysis of research from a community-based study of sexual and gender minority (SGM) older adults sought to explore the unique needs of this growing "out" population and identify the future program, policy, and research goals. The sampling population for this study was drawn from a community-based study conducted initially by researchers from the ACRIA center.

That was a game changer: clinical impact of an emergency department-based palliative care communication skills training workshop.

Objective: To explore the impact of an adapted goals-of-care communications skills workshop created for ED physicians from the physicians' perspective.

Methods: Semi-structured, one-on-one audio-recorded interviews lasting 30-60 min were conducted with twelve physicians who had completed the training workshop. Interviews explored the experience of undertaking the workshop, its impact on their clinical practice and their ability to teach new skills to other clinicians using learnt techniques.

Perceived Risk of Heroin in Relation to Other Drug Use in a Representative US Sample.

Low perception of risk is a risk factor for heroin use. Research is needed to determine whether this risk factor for heroin use is affected by the use of other drugs. Data were analyzed from participants in the 2015/2016 National Surveys on Drug Use and Health who denied lifetime heroin use (= 110,102).

Navigating virginities: enactment of sexual agency among Arab women in the USA.

People interpret virginity in a variety of ways with different implications for sexual identity and behaviour. In Arab societies, heterosexuality and compulsory virginity before marriage are traditionally understood as ideals for a 'good' Arab girl, a 'good' Arab family and, consequently, a 'good' Arab society. In this study, our goal was to gain an in-depth understanding of the enactment of sexual agency and decision-making around virginity from the perspectives of Arab women living in the USA.

Complex Patterns Across the Migration Process and Associated HIV Testing and Risk Behaviors among Latino Immigrants.

Background: Migrants are at elevated risk for adverse HIV-related outcomes. Yet, there is limited understanding about the complexity of the migration process and the different migration experiences that may influence HIV testing and risk behaviors. This study examined whether patterns in immigrants' migration experience were associated with HIV risk and preventive behaviors.

Genomics of Reproductive Traits and Cardiometabolic Disease Risk in African American Women.

Background: Age at menarche and age at natural menopause occur significantly earlier in African American women than in other ethnic groups. African American women also have twice the prevalence of cardiometabolic disorders related to the timing of these reproductive traits.

Objectives: The objectives of this integrative review were to (a) summarize the genome-wide association studies of reproductive traits in African American women, (b) identify genes that overlap with reproductive traits and cardiometabolic risk factors in African American women, and (c) propose biological mechanisms explaining the link between reproductive traits and cardiometabolic risk factors.

Detection of Fentanyl Analogs and Synthetic Opioids in Real Hair Samples.

Novel synthetic opioids include various analogs of fentanyl and emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45 and U-47700. In recent years, these drugs have rapidly emerged on the drug market, and their abuse has been increasing worldwide. The motivations for use of these new compounds include their legal status, ready availability, low cost, users' curiosity or preference for their particular pharmacological properties and the intention to avoid detection.

Change and variability in drug treatment coverage among people who inject drugs in 90 large metropolitan areas in the USA, 1993-2007.

Background: Our previous research has found low and stable mean drug treatment coverage among people who inject drugs (PWID) across 90 large US metropolitan statistical areas (MSAs) during 1993-2002. This manuscript updates previous estimates of change in drug treatment coverage for PWID in 90 MSAs during 1993-2007.

Methods: Our drug treatment sample for calculating treatment coverage includes clients enrolled in residential or ambulatory inpatient/outpatient care, detoxification services, and methadone maintenance therapy at publicly- and privately-funded substance abuse agencies receiving public funds.

Correlates of Subjective Cognitive Decline in Lesbian, Gay, Bisexual, and Transgender Older Adults.

Background: Little is known about subjective cognitive decline (SCD) in lesbian, gay, bisexual, and transgender (LGBT) older adults.

Objectives: To examine SCD and its association with dementia risk factors, other physical and psychosocial health factors in LGBT older adults.

Methods: A cross-sectional study of SCD was conducted with LGBT older adults, aged 50 and older (n = 210).

Does Level of Numeracy and Graph Literacy Impact Comprehension of Quality Targets? Findings from a Survey of Home Care Nurses.

Clinical dashboards that display targets compared to performance metrics are increasingly used by healthcare organizations in their quality improvement efforts. However, few studies have evaluated the extent to which healthcare professionals can readily understand and interpret these data. This study explored associations between measures of graph literacy and numeracy in home care nurses from two agencies (N=195) with comprehension of quality targets presented in a graphical dashboard format.

How gender- and violence-related norms affect self-esteem among adolescent refugee girls living in Ethiopia.

Background: Evidence suggests adolescent self-esteem is influenced by beliefs of how individuals in their reference group perceive them. However, few studies examine how gender- and violence-related social norms affect self-esteem among refugee populations. This paper explores relationships between gender inequitable and victim-blaming social norms, personal attitudes, and self-esteem among adolescent girls participating in a life skills program in three Ethiopian refugee camps.

A National Study Links Nurses' Physical and Mental Health to Medical Errors and Perceived Worksite Wellness.

Objective: The aim of this study was to describe (1) nurses' physical and mental health; (2) the relationship between health and medical errors; and (3) the association between nurses' perceptions of wellness support and their health.

Methods: A cross-sectional descriptive survey was conducted with 1790 nurses across the U.S.

Association between Hospice Spending on Patient Care and Rates of Hospitalization and Medicare Expenditures of Hospice Enrollees.

Background: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice.

Objective: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees.

Design: Longitudinal, observational cohort study (2008-2010).

Staff Perspectives on a Tablet-Based Intervention to Increase HIV Testing in a High Volume, Urban Emergency Department.

Emergency departments (EDs) frequently serve people who have limited, if any, additional interactions with health care, yet many ED patients are not offered HIV testing, and those who are frequently decline. ED staff ( = 13) at a high volume urban ED (technicians, nurses, physicians, and administrators) were interviewed to elicit their perspectives on the feasibility and acceptability of a tablet-based intervention designed to increase HIV test rates among patients who initially decline testing. Content-based thematic analysis of semi-structured interviews indicated overall support for interventions to increase HIV testing, but a lack of available staff resources emerged as a potential barrier to widespread implementation.

Comparison of the Substance Use Brief Screen (SUBS) to the AUDIT-C and ASSIST for detecting unhealthy alcohol and drug use in a population of hospitalized smokers.

Hospitalized patients have high rates of unhealthy substance use, which has important impacts on health both during and after hospitalization, but is infrequently identified in the absence of screening. The Substance Use Brief Screen (SUBS) was developed as a brief, self-administered instrument to identify use of tobacco, alcohol, illicit drugs, and non-medical use of prescription drugs, and was previously validated in primary care patients. This study assessed the diagnostic accuracy of the SUBS in comparison to longer screening instruments to identify unhealthy and high-risk alcohol and drug use in hospitalized current smokers.

Prevalence and associated risk factors of violence against conflict-affected female adolescents: a multi-country, cross-sectional study.

Background: Over half of displaced civilians in humanitarian emergencies are children, and these settings pose unique threats to children's safety with long-lasting consequences. Our study broadens the limited evidence on violence against adolescent girls in emergencies by estimating prevalence and predictors of violence among adolescent girls aged 13-14 in South Kivu, Democratic Republic of the Congo (DRC), and aged 13-19 in refugee camps in the Benishangul-Gumuz region of Ethiopia.

Methods: Survey data were collected from a sample of 1296 adolescent girls using Computer-Assisted Personal Interview and Audio Computer-Assisted Self-Interview programming.

The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo.

Background: Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls' hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced girls.

Methods: Secondary analysis, using multivariable regression of cross-sectional data from girls ages 10-14 in South Kivu, Democratic Republic of the Congo.

The Effective Use of Psychiatric Mental Health Nurses in Integrated Care: Policy Implications for Increasing Quality and Access to Care.

In the last ten years primary care providers have been encouraged to implement integrated models of care where individuals' medical and mental health needs are addressed holistically. Many integrated models use Psychiatric Mental Health (PMH) nurses as case managers and select exemplars use PMH Advanced Practice Nurses (APNs) as providers. However, the potential value of PMH nurses in integrated health care remains unrealized by health care planners and payers, limiting access to services for the populations most in need of comprehensive care approaches.

Diversity dynamics: The experience of male Robert Wood Johnson Foundation nurse faculty scholars.

Background: Managing diversity dynamics in academic or clinical settings for men in nursing has unique challenges resulting from their minority status within the profession.

Purpose: The purpose of this study was to share challenges and lessons learned identified by male scholars in the Robert Wood Johnson Foundation Nurse Faculty Scholars program and suggest strategies for creating positive organizations promoting inclusive excellence.

Methods: Multiple strategies including informal mentored discussions and peer-to-peer dialogue throughout the program, formal online surveys of scholars and National Advisory Committee members, and review of scholar progress reports were analyzed as part of the comprehensive evaluation plan of the program.