Cognitive decline increasingly plague older adults. Although various studies have correlated aerobic exercises with decreased incidence of the development and progression of cognitive deterioration in older adults, there is no evidence as to whether or not the Wii Fit Plus Rhythm Kung-Fu, Hula-Hoop and the Wii Just Dance can improve the cognitive function of older adults as measured by the Standardized Mini Mental State Examination (SMMSE) instrument. A descriptive study design was used to explore the feasibility of implementing an aerobic exercise program for older adults in an assisted living facility using these Wii games, and evaluating whether or not older adults enjoyed playing the games. A sample of N =5 participants in the East Tennessee region of Appalachia completed the study in an assisted living facility. The games lasted from 5-20 minutes per session, twice a week for four weeks. Pre/post descriptive analysis of survey questions suggested that the sample enjoyed playing the games and these games may be feasible to implement in future studies. However, a larger, randomized, controlled research study is needed to further investigate the effect of these games on the cognitive status of this population.

With healthcare reform on the rise and the population of Baby Boomers increasing exponentially, nurses are in higher demand than ever before. Students in nursing school are under a great deal of stress as they balance a heavy academic load with outside responsibilities to jobs and families. These stressors often carry into professional practice, resulting in nurses that are constantly stressed. This study asks nursing students about their perceived stress and about the specific ways they cope with their stress. The study’s results show that most students wish they had more time to engage in stress relieving activities. When students and nurses do not have time to adequately relieve their stress, their patients may be adversely affected. Stressed nurses are more prone to making careless mistakes, which can negatively impact the quality of patient care. This problem is compounded by the projected shortage of registered nurses. Nursing students need to be educated early on about constructive stress coping mechanisms that will carry into their practice. Nursing programs and employers can help promote effective coping by establishing policies that create positive, lower-stress learning and work environments. Implications of such policies and specific results of this study will also be discussed.

In the United States, cardiovascular disease is the number one cause of death for both men and women. Heart attacks and strokes can happen because of atherosclerosis, or plaque build-up inside arteries, which obstruct blood flow to the heart and brain. One common site of atherosclerosis is the carotid artery bifurcation. This study looks at how the angle between the branching arteries of the bifurcation affects the potential for atherosclerosis by running flow simulations through virtual models of the bifurcation. The higher the wall shear stress, turbulence intensity, and turbulence kinetic energy at the bifurcation, the lower the chance of atherosclerosis. There is an optimal angle at which this occurs.

Aims. To determining the effect of asthma, cystic fibrosis (CF), and both on healthcare utilization, absences from school, and rate of progress in school. Background. Previous studies on academic progression and health care utilization in children with the respiratory diseases of asthma and CF have been limited or conflicting. Design. Non experimental, cross-sectional, secondary data analysis using a multilevel probability sample. Methods. The response of all persons under 18 years of age in the U.S. 1997-2012 National Health Interview Survey to interviewer questions on demographic, educational, and health care utilization items were analyzed. The mean and 95% confidence intervals for these variables were compared for children with asthma, CF, and controls. Results/Findings. Children with asthma, CF, or both had a higher utilization of all major types of healthcare services than children with neither of these conditions. Children with asthma or CF were more likely to have not only poor health, but more rapid declines in recent health with the greatest decline in those with both conditions. The number of missed school days was also higher, and highest in children with both CF and asthma. Despite the many missed school days, children with asthma paradoxically had a greater rate of progression in school than those without asthma. Those with CF or CF with asthma had a slower rate. Conclusion. Asthma in CF has a negative impact on attendance and progress in school largely opposite that of asthma alone.

Dysmenorrhea is one of the most reported symptoms by women in OB/GYN departments with an effect on up to 95% of women. Because pain experienced during menstrual cycles influences the mental and physical health of women, it is important to find practical and effective relief. Complementary and alternative medicine (CAM) is a new clinical and scientific field in the practice of Western medicine. The use of CAM by the public has increased dramatically in recent years and among the practiced modalities lies a fairly new massage technique aimed at treatment of uterine abnormalities attributed to misplacement. The Arvigo Techniques of Maya Abdominal Therapy™ (ATMAT) is rooted in traditional practices by the Maya people of Belize. It is a non-invasive, slow, penetrating external massage of the abdomen that repositions the uterus in women. This study is aimed to measure the patient’s perception of menstrual pain before and after therapy with completion and return of a Short-Form McGill Pain Questionnaire. Each type of data represents a quantitative index of pain quality and intensity as a result of ATMAT. Percent change calculated through paired t-test analysis will provide data on the effectiveness of the therapy.

According to Bandura (1994), self-efficacy is defined as "the belief in one’s capabilities to organize and execute the courses of action required in managing prospective situations" (quoted by Pajaras, 1996, p. 543). Self-efficacy has long been theorized to increase job retention and success after graduation from a nursing program. In this study, the researchers explored whether high fidelity simulation during the senior semester of nursing school increases perceived self-efficacy among nursing students. We also evaluated the impact of stress levels on perceived self-efficacy. The study surveyed 135 senior BSN students from both traditional and accelerated programs a Southeastern Tennessee University using 15 items modified from pre-validated general self-efficacy and stress scales in a 7-point Likert-like scale format. Results showed that high-fidelity simulation-based training increase perceived self-efficacy over time, with significant increases from pre-simulation scores to post capstone simulation experience scores. Stress levels were not correlated with self-efficacy in the study. The information gleaned from this study has implications for nursing education and post-graduation job retention. The results suggest that high-fidelity simulation-based education is an effective way to increase self-efficacy in senior nursing students. Significance and limitations of the results are discussed, along with suggestions for future research.

Current literature overwhelmingly supports the benefits of breastfeeding for mothers and infants. Numerous studies significantly correlate specific demographics and background factors of breastfeeding and non-breastfeeding mothers. However, little research has focused on the intendedness of the pregnancy and its association with breastfeeding. The goal of this study was to examine the association between pregnancy intendedness and breastfeeding plans and behavior. The first question of interest examined was whether pregnancy intent was associated with a woman’s intent to exclusively breastfeed when asked during the third trimester, after control for potentially confounding differences between the two groups. The second question of interest was whether pregnancy intendedness predicted exclusive breastfeeding initiation after control for potentially confounding background variables. Data analysis was completed on a group of women who were part of the Tennessee Intervention for Pregnant Smokers (TIPS) program. The participants were recruited from six prenatal provider offices in Northeast Tennessee. There were 509 women who participated but only 379 women were used in this study due to lack of data on the variables of interest. The study showed that pregnancy intendedness was significantly associated with intent and initiation of breastfeeding after controlling for background factors. Women who planned their pregnancies were two thirds more likely than those who did not to indicate intent to exclusively breastfeed. Also, women who planned their pregnancies were one third more likely to initiate breastfeeding in the postpartum period than women who did not plan their pregnancies. This association is important in the clinical setting because usually women decide whether or not they will breastfeed before delivery. Therefore, healthcare providers can intervene by providing patients with education on the benefits of breastfeeding early in the prenatal period to support increased rates of breastfeeding initiation.

Diabetes mellitus is a major health concern and the number of Americans diagnosed with the disease is quickly increasing, affecting all aspects of an individual’s life and requiring significant self-involvement. Little is known about how low-income Appalachian women with Type 2 Diabetes Mellitus (T2DM) manage their diabetes from day-to-day. This population struggles to effectively manage the illness as they desire for many reasons. The purpose of this study is to better understand the experiences of Appalachian women in self-managing diabetes so that health care providers can better meet the social and cultural needs of this unique population. This study used a qualitative descriptive design. Data were collected by means of in-depth, semi structured interviews. The sample consisted of 5 low-income Appalachian women with T2DM who seek care at the Johnson City Community Health Center. The data analysis was completed by generating a set of themes from the narrative data. Three themes emerged from the interview data: Achieving Care with Limited Resources; Consistent and Involved Health Care Providers; and Family Support. Life situations unique to this population can influence the self-management of T2DM. Financial difficulties hinder the overall care that they need and desire, but through consistent and involved care givers and family support, successful self-management can occur in spite of significant barriers.

Compliance with hand hygiene is widely recognized as the most important factor in preventing transmission of infection to patients in healthcare settings (Haas and Larson, 2007). Hand hygiene dramatically decreases the potential pathogens on hands and is considered the first measure for decreasing the risk of transmitting organisms to patients, healthcare professionals, and family members. Noncompliance with hand hygiene practices has been shown to increase healthcare-associated infections, costing hospitals $35.7-$45 billion each year (Centers for Disease Control and Prevention [CDC], 2012). Education about hand hygiene starts in school and should transfer into the real world of nursing. The purpose of this research is to determine how student nurses in a baccalaureate nursing program in northeastern Tennessee perceive hand hygiene and the importance of conducting the act of hand washing. Students who do not perceive it as important, or do not have the correct information, are unlikely to use principles of good hand hygiene in their practice. Few studies were found assessing nursing school students’ perception of the importance of hand hygiene.

The intensive care unit is an extreme environment which houses the most critically ill patients in a hospital. As a result, an array of equipment, IV lines, medications, and sounds that are unfamiliar to the general public can be found. These factors, added to the fragile emotional state of families and friends who have recently admitted a loved one, can be overwhelming. This rush of unforeseen stimuli often leads to feelings of fear and powerlessness (Farrell, Joseph, & Schwartz-Barcott, 2005). The patients in Intensive Care Units (ICU) are the primary focus of staff; some need virtually continuous care. As a result, the needs of family and friends often go unnoticed. Reasons for this include the supposition that family is bothersome, disruptive, and a distraction from the patient’s care (Farell et al., 2005). Factors such as high patient acuity or limited staffing contribute to this phenomenon as well (Farell et al., 2005). This lack of attention to family members is often overlooked in the health care environment as families are not given high priority. However, families are expected to make essential decisions regarding their loved one’s care, as well as provide the patient with continuous love and support. The family’s ability to provide love and support for the patient, as well as make decisions about the patient’s care is hindered during periods of emotional distress, especially in situations where patients cannot speak for themselves (Bailey, Sabbagh, Loiselle, Boileau, McVey, 2009). When arriving on the unit for the first time, family and friends are exposed to a high acuity environment as well as circumstances foreign to them, with little education by the nursing staff. For nurses who work in this type of environment daily, it is easy to become desensitized. Desensitization results in a lack of sensitivity to patients and their families, causing increased anxiety due to fear of the unknown. Without effective orientation to the unit, family and friends may assume the worst (Azoulay et al. 2002). Previous research has shown that family satisfaction and understanding of patients’ treatment leads to a better experience for the family, encouraging them to be present and supportive of the patient (Azoulay et al., 2002).