Annual review of nursing research最新文献

The health of skeletal muscle is promoted by optimal nutrition and activity/exercise through the activation of molecular signaling pathways. Reactive oxygen species (ROS) or reactive nitrogen species (RNS) have been shown to modulate numerous biochemical processes including glucose uptake, gene expression, calcium signaling, and contractility. In pathological conditions, ROS/RNS signaling excess or dysfunction contributes to contractile dysfunction and myopathy in skeletal muscle. Here we provide a brief review of ROS/RNS chemistry and discuss concepts of ROS/RNS signaling and its role in physiological and pathophysiological processes within striated muscle.

Hispanics/Latinos represent the largest, fastest growing, and youngest minority group in the United States. Although data suggest that most Hispanics/Latinos in the United States tend to be in better health than non-Hispanic Whites (the so-called "Hispanic Paradox"), these relative advantages in health status decrease markedly with the number of years of residence in the United States. Hispanic women or Latinas, in general, report less than recommended levels of physical activity (PA), putting them at greater risk for the development of cardiovascular disease (CVD) and other chronic illnesses associated with sedentary lifestyles.

Animal models have been invaluable in the conduct of nursing research for the past 40 years. This review will focus on specific animal models that can be used in nursing research to study the physiologic phenomena of exercise and obesity when the use of human subjects is either scientifically premature or inappropriate because of the need for sampling tissue or the conduct of longitudinal studies of aging. There exists an extensive body of literature reporting the experimental use of various animal models, in both exercise science and the study of the mechanisms of obesity. Many of these studies are focused on the molecular and genetic mechanisms of organ system adaptation and plasticity in response to exercise, obesity, or both. However, this review will narrowly focus on the models useful to nursing research in the study of exercise in the clinical context of increasing performance and mobility, atrophy and bedrest, fatigue, and aging. Animal models of obesity focus on those that best approximate clinical pathology.

The beginning of the 21st century has been marked by an increase in attention to the quality of emergency and disaster response, particularly the preparedness of health workers of all kinds. The increase in natural disasters, civil unrest, and dislocation of populations has seen health workers mobilized. These workers are moving, both within countries and across borders, as members of long- organized teams such as the National Disaster Medical System (NDMS), volunteers joining through a nongovernmental organization (NGO) such as a Red Cross/Red Crescent unit, or individuals self-deploying to the scene of the emergency. Postevent evaluations have consistently identified the need for those responding to be able to join in an organized response that includes taking on assigned roles, communication through established channels and minimization of the number of "SUVs" or "spontaneous unrequested volunteers." Although bystanders and self-deployed helpers (some with professional qualifications) are the first at any disastrous event, the subsequent response efforts are expected to be organized, efficient, and effective. This requires advance training of the responders.

Health care workers (HCWs) are a critical component of the emergency management cycle (prevention, mitigation, preparation, response, and recovery). The potential for large numbers of injured from either a man-made or natural disaster has resulted in the development of surge capacity plans and attempts to predict how many HCWs will be available to respond. Since 1991 (with the majority of the research published in 2002 and later), researchers have been conducting studies to learn about the willingness, ability, and intentions of HCWs to respond to disasters. Potential and real barriers to disaster response are being explored as well. This chapter focuses on research authored or coauthored by nurses. Nurse-authored research is just a portion of the growing body of knowledge in this area; however, the findings are consistent with other published works. HCWs are more likely to be willing and able to respond to natural disasters and less likely to be willing and able during infectious outbreaks or incidents with potential exposure to harmful agents (biological, chemical, nuclear, or radiological). HCW concerns include safety of self and family, availability of protective equipment, medicines and vaccines, and caretaking responsibilities (children, elders, and pets).

The potential for man-made or natural disasters is a reality that exists within the confines of the global setting. Man-made and/or natural disasters, although devastating to the human population, offers researchers the ability to explore and advance current preparedness, response, and recovery practices. When conducting research, consideration must be given to the ethical treatment of vulnerable populations and the protection of privacy for those affected by the disaster.

During disasters, health care providers are faced with limited resources, harsh environments, and an increased amount of sick and injured patients. These conditions sometimes require health care providers to deviate from existing treatment protocols. Deviating from these protocols results in a perception of increased legal risk for health care providers. This has led to a national debate regarding the necessity of establishing altered standards of care for health care providers during crisis events. This chapter explores the development of disaster preparedness, the issue of health care provider liability, and national and local efforts to protect providers in disaster situations.

Health care professionals have always faced the threat of catastrophic disaster and pandemic infectious illness but have continued to practice without adequately considering the ethical consequences of many of the decision-making tools we currently have in place. Lack of research on these ethical decisions in the face of disasters regarding the 3Rs-rationing (triage and allocating scarce resources), restrictions (quarantine and the denial of care based on some criteria or the magnitude of the disaster), and responsibility (duty to treat and duty to report for work)-will leave nurses to make decisions in the throws of disaster rather than before the crisis occurs. This chapter focuses on conducting ethically sound nursing research in disasters. A survey of the literature on the topic to include current research on the 3Rs, frameworks, and methodological problems will be examined. This chapter concludes with a call to action for the nursing profession to accept their role as patient advocates and drive the research necessary to avoid the ethical pitfalls seen in recent disaster decisions and scenarios.

It is clear that technology and informatics are becoming increasingly important in disasters and humanitarian response. Technology is a critical tool to recording, analyzing, and predicting trends in data that could not be achieved prior to its implementation. Informatics is the translation of this data into information, knowledge, and wisdom. Combining technology and informatics applications with response efforts has resulted in various enhanced biosurveillance efforts, advanced communications, and information management during disasters. Although these efforts have been well described in the literature, research on the impact of technology and informatics during these efforts has been limited. As a result, this chapter will provide an overview of these technology and informatics solutions and present suggestions for further research in an era when disaster and humanitarian response efforts continue to increase as well. A literature search was performed using PubMed search tools with the National Library of Medicine Medical Subject Headings (MeSH) terms of "disasters," "disaster planning," "disaster medicine," "technology," "informatics," and "research." Search limitations were set for 5 years and in English. Because of the limited number of research articles in this field, the MeSH term research was deleted.

Meeting the "special needs" of at-risk populations affected by disasters is of the utmost importance. In the United States, there are 54 million people who fit into the special needs category who are defined as handicapped, disabled, vulnerable, challenged, or having special needs. The paramount importance for the special needs population is maintaining human dignity throughout the disaster management cycle. Government agencies, nongovernmental organizations, and advocacy organizations have all worked together to attempt to address and ensure that the needs of all individuals are addressed throughout the disaster cycle. Each provider and emergency responder should be familiar with the Americans with Disabilities Act requirements, but this alone does not begin to address the needs of children, the elderly, or other individuals and their special needs. There are multiple theoretical frameworks that may be useful, but the most human approach may be to consider needs based on Maslow's hierarchy of needs.