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- Go to article: Measuring Quality of Medical Care for Dying Persons and Their Families: Preliminary Suggestions for Accountability
- Go to article: Intervention Strategies to Assist Caregivers of Frail Elders: Current Research Status and Future Research Directions
- Go to article: Female Troubles: An Analysis of Menstrual Cycle Research in the NINR Portfolio As a Model for Science Development in Women’s Health
Female Troubles: An Analysis of Menstrual Cycle Research in the NINR Portfolio As a Model for Science Development in Women’s Health
The National Institute for Nursing Research (NINR) has been active in developing a research portfolio of investigator-initiated studies in addressing the cause and consequences of menstrual cycle and menopause-related health problems, This chapter provides an overview of the nature and level of research activity funded by NINR since its inception in 1986, major findings generated by the most successful award recipients, the impact on the broader field of women’s reproductive health and directions for future research. Presented here is an analysis of research designs and methodologies framed within the context of 4 stages of scientific development in the field: exploratory, descriptive studies in well women; illness as a biobehavioral phenomenon; knowledge generation in understudied populations; and the development and testing of clinical therapeutics for symptom management and health promotion strategies. Nursing science contributions to the NINR portfolio of women’s health research has been focused primarily on the definition and management of the symptoms of premenstrual syndrome and menopause. The increasing numbers of intervention studies suggests a coming-of-age in nursing science with respect to the development of evidence-based outcome data for the management of menstrual cycle and menopause-related symptoms. Clearly, the range and diversity of NINR grant-funded activity suggest that menstrual cycle research is a strong area of interest in nursing science.
Ideal and effective communication consists of a clear, audible, and focused message from a transmitter that is delivered to an attentive, undistracted receiver, and consists of both verbal and nonverbal types. Communication in the health care setting is highly complex and dynamic, involving multiple settings, participants, and unique challenges. Effective communication in the perioperative environment is a requirement for safe patient care delivery and an important element of teamwork. A message must be accurately delivered in a uniquely high-risk and time-sensitive location, beset with numerous distractions, barriers, and challenges. Surgical checklists and time-out procedures have promoted a standardized, "all-hands" approach to addressing some of the challenges to effective communication in the perioperative environment. Postoperative debriefing sessions have demonstrated effectiveness in improving team functioning in the simulated learning environment and hold promise as another strategy to address these challenges, but require further research and development. Other promising strategies to improve effective perioperative communication are focused on team building activities and minimizing distractions at critical time points within patient care delivery, but to date are not substantiated by evidence. Future research is necessary to examine these novel approaches to improving communication in the perioperative environment to influence the safety of patient care delivery in this highly challenging health care setting.
Increasing urbanization coupled with population aging suggests that the neighborhood context in which people grow old may shape their health, longevity, and well-being. In this chapter, we examine the neighborhood–health relationship within the context of age and aging. We summarize the literature on neighborhoods and health, lay out a set of theories that inform the study of neighborhood structural and social process factors, and suggest two promising new directions in research on neighborhoods, aging, and health: (1) study of neighborhoods and households as nested contexts and (2) the examination of biomarkers in large-scale social surveys that include a geographic component. These two pursuits illustrate the additional potential of neighborhood-based research in gerontology and geriatric research.
- Go to article: Genetic and Environmental Contributions to Cognitive Decline in Aging and Alzheimer's Disease
Inheritance appears to play a strong role in terms of human longevity and also in risk for chronic neurodegenerative diseases of late life such as Alzheimer's disease (AD). Understanding the role of genes in normal biological aging of the nervous system and in the expression of AD pathological changes is important for developing useful disease targets for clinical intervention and treatment. The extent to which gene expression can be altered through environmental exposures may also provide important clues for disease prevention. In this chapter, we consider the role of genetic and environmental factors in AD risk and in age-related cognitive decline. We focus, in particular, on targets that are potentially modifiable with respect to exerting positive effects on cognition and AD risk. In this context, we conclude the chapter by considering lifestyle approaches to disease prevention and enhancement of successful cognitive aging that extend from the current state of evidence and discuss areas for future research development.