Sarcopenia is the age-related loss of muscle mass. Sarcopenic obesity, which describes the process of muscle loss combined with increased body fat as people age, is associated with loss of strength and function, reduced quality of life, and early death. This article describes the clinical significance of sarcopenia and sarcopenic obesity, their pathophysiology, and management strategies for healthy older adults. Both diet and exercise are essential for preventing and reversing loss of muscle and gains in fat. Dietary approaches include protein supplementation and a high protein diet. Exercise strategies promote resistance training in order to maintain muscle mass and maximize energy expenditure. Nurses should be knowledgeable about this condition and its management and routinely educate older patients on the benefits of resistance training and dietary protein to prevent or reverse sarcopenia and sarcopenic obesity.
The phenomenon of down low sex, wherein men involved in monogamous relationships with women seek extrarelationship sexual relations with men, has gained recognition in recent years. This study addressed the issue of down low sex in a group of African American women whose long-term sexual partners had become infected with HIV during extramarital sexual encounters with men. A grounded theory methodology was used to explore the experiences of 11 women in individual interviews that were sensitive to the intimate nature of their experiences. Themes shown in the data focused on (a) being betrayed and losing trust; (b) reflecting upon the features of the past relationship; (c) seeking the positive aspects of the past relationship; (d) being ashamed before God, community, and family; and (e) assuming the caregiver role and sharing the burden of illness. The study identified the strong influence of positive long-term relationships on life decisions of women following a diagnosis of HIV, despite the extrarelationship sexual activities of their partners.
Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in cases where African migrants enter the UK legally, they often face considerable difficulty in their quest to gain legal employment due to barriers inherent to the system that grants work permits. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority.
This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787.
There are a dearth of studies that quantitatively measure nurses' appreciation of stimuli and the subsequent generation of options in practice environments. The purpose of this paper was to provide an examination of nurses' ability to solve problems while quantifying the stimuli upon which they focus during patient care activities. The study used a quantitative descriptive method that gathered performance data from a simulated task environment using multi-angle video and audio. These videos were coded and transcripts of all of the actions that occurred in the scenario and the verbal reports of the participants were compiled. The results revealed a pattern of superiority of the experienced exemplar group. Novice actions were characterized by difficulty in following common protocols, inconsistencies in their evaluative approaches, and a pattern of omissions of key actions. The study provides support for the deliberate practice-based programs designed to facilitate higher-level performance in novices.
While current research on the factors affecting the HIV epidemic within the general population has considered the role of HIV case managers, much remains to be known about case management effectiveness and how it might be enhanced. This article presents the data from a statewide survey of case management professionals in Florida. The study focused on case managers' preparation for practice and barriers to successful practice. The study results reflect a very broad educational preparation in multiple disciplines with highly varied means of case manager training and orientation at entry to practice. Further, the results highlighted the existence of multiple barriers that challenge the ability of case managers to cope with the demands of case management practice in sites serving people living with HIV/AIDS who are socially and economically challenged. The article concludes with recommendations for changes in the system that would enhance the preparation of case management professionals for entry to practice.
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