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The Person-centred Nursing Framework: A Mid-range Theory for Nursing Practice
Get PDFBackground:Person-centredness is a global movement in healthcare that prioritises the human experience. Person-centred care has a long association with nursing; however, the implementation of person-centredness as a philosophy of practice remains challenging and requires a sustained focus on the development of healthful workplace cultures.Aim:This is a discussion paper that focuses on the theoretical development of person-centred nursing, drawing out the uniqueness of the Person-centred Nursing Framework (PCNF) to the discipline of nursing and its relevance as a middle-range theory for nursing practice.Discussion:The PCNF highlights the complexity of person-centred nursing, and through the articulation of the key constructs, emphasises the contextual, attitudinal and moral dimensions of humanistic caring practices. The development of the framework as a means of operationalising person-centredness in practice has been integral to the establishment of a research programme spanning over two decades. The programme has privileged research that focuses on the implementation of person-centred nursing in a variety of healthcare contexts, illustrating outcomes that focus on enhanced care experience for both patients and nurses.Conclusions:The theoretical development of nursing through the lens of the PCNF highlights the uniqueness of person-centredness to the discipline of nursing
Language proficiency across tasks in sequential bilingual and monolingual children
Get PDFA number of different language measures are used in child language acquisition studies. This raises the issue of comparability across tasks, and whether this comparability diverges depending on the specific language domain or the language population (e.g., monolinguals versus bilinguals). The current study investigates the comparability across tasks in the domains of vocabulary, morphology, and syntax in primary-school-aged sequential bilingual children with L1 Arabic/L2 English (N = 40, 5;7–12;2) and age-matched monolinguals (N = 40). We collected narrated speech samples to produce measures across language domains, and additional measures from separate vocabulary, morphology, and syntax assessments. Using a logistic regression analysis, we find a correspondence between syntax measures in monolinguals; however, we find no further correspondences in the other domains for monolinguals, and no correspondences at all in bilinguals. This suggests that assessment measures are highly task-dependent, and that a given assessment measure is not necessarily indicative of language as a whole, or even of language within a domain. We also find selective effects of age for monolinguals and both age and length of exposure (LOE) for bilinguals; in particular, while LOE predicts variation between the first and second language, age effects reflect underlying similarity across languages. We consider the implications of these effects for language assessments across populations
Implementing an AI That Automatically Extracts Standardized Functional Patterns From Wearable Sensor Data
Get PDFStandardized functional tests (SFTs) are frequently used to quantify a person's ability to perform activities of daily living (ADLs) against expected values. SFTs provide valuable information to aid a clinician's understanding of a patient's status and direction of improvement. Such information may support clinicians when assessing a wide range of conditions such as musculoskeletal or neurological diseases or age-related frailty. If these SFTs could be performed reliably by patients in their own home without supervision, they could track and help to guide rehabilitation. Wearable devices have the potential to collect reliable data from the wearer when performing SFTs. However, the data generated from sensors for long-term recordings of movement can become very large, making it difficult to manually extract movement information with any level of accuracy. Hence, it is important to evaluate whether it is possible to implement an automated system capable of extracting SFT patterns from long-term sensor data without manual data processing. This article describes an artificial neural network (ANN) system that was trained to extract specific SFTs such as the 30-s chair stand test (CST) (30s-CST) and the 40-m fast-paced walk test (40m-FPWT). The resultant model obtained 99.7% accuracy in 30s-CST pattern recognition, 99.3% accuracy in 40m-FPWT pattern recognition, and 97.3% accuracy in detecting false patterns. The system provided an overall accuracy of 98.76% with supervised clinical trial data. The ambulatory data testing phase obtained an overall accuracy of 90.18%. Specifically, it achieved 92.73% accuracy in detecting 30s-CST patterns and 86.67% accuracy in recognizing 40m-FPWT patterns.</p
Capturing food insecurity data and implications for business and policy
Get PDFFood insecurity (also known as food poverty) is the inability to afford or access a healthy diet. It has become recognised as a public health emergency and is a priority in the context of the environmental, geopolitical and socio-economic implications on businesses, households and civic society. This review paper aims to discuss the merits of collecting food insecurity data and its importance in informing cross-sectoral government and others’ understanding, policymaking and action on hunger. The review paper’s key findings are that concerted action on measuring and mapping food insecurity with the aim of eliminating or reducing its prevalence represents a triple win for government, business and citizens. However, measurement does not provide solutions to food insecurity but contributes importantly to understanding its extent and severity to inform and evaluate proffered solutions. Government, business and food insecurity researchers and commentators cannot merely continue to simply describe food poverty - but must effect meaningful change amidst our communities to improve life quality in a timely way for those experiencing acute and chronic hunger. This is best done by addressing the structural causes of food insecurity through economically, socially and culturally fair and appropriate policy levers, requiring cross-sectoral collaboration. Ultimately, food insecurity requires a long-term, sustainable solution that addresses the policy issues under focus: low income, under/unemployment, rising food prices and Welfare Reform, informed by routine, Government-supported monitoring and reporting of the extent of food poverty among our citizens
Associations between maternal fish intake and polyunsaturated fatty acid status with childhood asthma in a high fish‐eating population
Get PDFBackground: Studies investigating associations between prenatal polyunsaturated fatty acid status (PUFAs), in particular the anti-inflammatory n-3 PUFAs, and the development of childhood asthma have yielded conflicting results. Objective: To determine the associations between maternal fish intake (a rich source of the n-3 PUFAs), maternal or cord PUFAs with the prevalence of childhood asthma in a high fish-eating population. Methods: We examined these associations between fish intake and PUFA concentrations with childhood asthma prevalence in the Seychelles Child Development Study Nutrition Cohort 2, a large observational study in a high fish-eating population. Maternal fish intake during pregnancy and child's fish intake at 7 years were assessed by questionnaire, with frequency reported as meals/week. Serum concentrations of PUFAs were quantified in maternal blood collected at 28 weeks' gestation (n = 1448) and in cord blood (n = 1088). Asthma in children at 7 years was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire (n = 1098). Results: A total of 97 children (10.5%) were reported to have asthma. In regression analysis, the odds of childhood asthma were not associated with maternal fish intake or maternal PUFA status. Cord DHA concentrations were associated with increased asthma prevalence when the highest quartile (≥0.123 mg/mL) was compared with the lowest (<0.061 mg/mL). Conclusion: The results from this current study add to the growing body of evidence that fish consumption during pregnancy is not associated with asthma development in offspring. The associations between cord blood DHA and asthma prevalence are unexpected and warrant further investigation.</p
Assessing the supportive care needs of parents of children with rare diseases in Ireland
Get PDFPURPOSE: Rare diseases are individually uncommon yet collectively prevalent. They affect over 300,000 people in Ireland, with 50-70 % impacting children. This study explores the supportive care needs of parents caring for children with rare diseases in Ireland, utilising a validated Parental Needs Scale for Rare Diseases (PNS-RD).DESIGN AND METHODS: This descriptive quantitative study employed survey techniques to assess parental support needs. An online survey was administered to parents across Ireland from August 2021 to December 2021 using the Qualtrics™ platform.RESULTS: Out of 107 consented participants, 89 provided data suitable for analysis. Findings revealed significant challenges, with children averaging six hospital visits per year; 77 % of families indicated special education needs, and 42 % required medically complex care. The PNS-RD scale mean was M = 48.62 (95 % CI: 44.5-52.7), comprising four dimensions (each scored out of 25): i) Understanding the disease (M = 9.01, 95 % CI: 7.5-10.5), ii) Working with health professionals (M = 13.68, 95 % CI: 12.0-15.4), iii) Emotional issues (M = 13.22, 95 % CI: 12.0-14.5), and iv) Financial needs (M = 12.94, 95 % CI: 11.2-14.6). Parents demonstrated confidence in managing their child's care but reported considerable emotional strain and financial challenges.CONCLUSION: While parents generally felt confident in handling their child's rare disease and were moderately satisfied with the care and support received, the emotional, psychological, and financial toll remained high.IMPLICATIONS FOR PRACTICE: This study underscores the urgent need for comprehensive support systems to alleviate these burdens, advocating for tailored healthcare and social support interventions to meet the diverse needs of these families.</p
Measuring differences in the ERG in myopia using the RETeval device with Skin Electrodes
Get PDFIntroductionPrevious research suggests that the electroretinogram (ERG) is reduced and delayed in non-pathological myopia. However, the invasive nature of the electrode and cumbersome equipment required has prevented the widescale uptake of ERG measures. This study investigated whether previously reported changes to the ERG response in myopia are also observable when measured using non-invasive skin electrodes and a hand-held ERG device.MethodMonocular flash ERGs were measured using the RETeval® device according to the ‘ISCEV 6 Step Dark First cd’ protocol in 46 participants with non-pathological myopia (spherical equivalent refraction [SER] −0.50 to −11.25 D, median −3.75 D, median axial length [AL] 25.4 mm) and 47 non-myopic controls (SER +2.00 to −0.25 D, median +1.00 D, median AL 23.6 mm). Measures were performed under pupil mydriasis with Sensor Strip skin electrodes.ResultsThe median implicit time for all dark-adapted (DA) components was longer among myopes. Following Holm-Bonferroni correction, this difference reached statistical significance (p < 0.05) for the DA 3.0 A-wave, DA 10.0 A-wave and B-waves, and DA Oscillatory potentials 1 and 2. There were no significant differences between median light-adapted (LA) implicit times nor response amplitudes between refractive groups. For all DA components, there was a significant, positive correlation between AL and implicit time (all p < 0.05).ConclusionsThe RETeval®, used with skin electrodes, did not detect the reduction in ERG amplitude reported in myopic eyes using traditional ERG setups, potentially due to high inter-subject variability and/or anatomical confounders associated with the use of a skin electrode. The RETeval® with skin electrodes did detect subtle delays to DA implicit times previously reported in myopia, with a positive relationship observed between AL and implicit time for all DA components. In contrast, no significant differences were observed for LA implicit times, which may indicate underlying differences in the dark-adaptation process and/or scotopic visual pathways in myopia
Depression and anxiety in patients with type 2 diabetes in Indonesia and Malaysia: do age, diabetes duration, foot ulcers, and prescribed medication play a role?
Get PDFPatients with type 2 diabetes mellitus (T2DM) are susceptible to mental health issues, impacting medication adherence and diabetes control. This study aimed to evaluate factors associated with depression and anxiety among T2DM patients in Indonesia and Malaysia. A cross-sectional study was conducted in Indonesia and Malaysia from October 2022 to April 2023 among T2DM patients. The study utilised an instrument with patient and disease data and three validated tools to assess depression, anxiety, and medication adherence. Statistical analysis, including binary logistic regression, was performed using SPSS® version 28 software. A study of 606 T2DM patients revealed that 56.5% were at risk of depression, while 41.6% were at risk of anxiety. Older patients with T2DM had lower rates of depression (AOR = 0.41, 0.25–0.68) and anxiety than younger patients. Normal-weight patients were less likely to experience depression and anxiety (AOR = 0.44, 0.27–0.72) than overweight patients. Patients without diabetic foot ulcers had a lower risk of depression (AOR = 0.34, 0.21–0.55) and anxiety than those with foot ulcers. Patients with a shorter duration of diabetes had a higher risk of depression (AOR = 3.27, 1.70–6.30) and anxiety than those with a longer duration. Patients on insulin-based regimens had higher rates of depression and anxiety (AOR = 2.28, 1.20–4.30) than those on metformin-based regimens. Nonadherent patients were more likely to experience depression and anxiety (AOR = 4.30, 2.22–8.32) than patients who adhered to their medication. The prevalence of depression and anxiety is concerning and influenced by factors such as age, diabetes duration, the presence of diabetic foot ulcers, and the prescribed medication regimen. Further efforts are necessary to enhance the mental health of T2DM patients and improve management outcomes
