Catherine G. Ling

Caring for military children in the 21st century

Purpose Civilian healthcare professionals provide approximately 2/3 of the healthcare for the 2 million U.S. military children. The President of the United States has made their care and support a top national security priority. The purpose of this article is to arm NPs with information necessary to care for the 21st century military child by providing current data on military family life, deployments, and the impact on children and their health‐seeking behaviors. Data sources Literature collected from sources identified through searches of PubMed, CINAHL, and PsycInfo covering the periods from 2003 to 2012. Conclusions Military children are both resilient and vulnerable. While frequent moves build resilience, combat deployments increase the risk for abuse, neglect, attachment problems, and inadequate coping. The risk is highest right after the service member leaves for deployment and immediately upon return. Childrens reactions to deployment differ by age, gender, and individual temperament. There is an 11% increase in outpatient visits for mental or behavioral health issues during deployment. Implications for practice Healthcare professionals can support the physical and mental health of children by normalizing expectations and using the I CARE (Identify, Correlate, Ask, Ready Resources, Encourage) strategy to facilitate prevention and encourage early engagement with available resources.

Gait and Function in Class III Obesity

Walking, more specifically gait, is an essential component of daily living. Walking is a very different activity for individuals with a Body Mass Index (BMI) of 40 or more (Class III obesity) compared with those who are overweight or obese with a BMI between 26–35. Yet all obesity weight classes receive the same physical activity guidelines and recommendations. This observational study examined the components of function and disability in a group with Class III obesity and a group that is overweight or has Class I obesity. Significant differences were found between the groups in the areas of gait, body size, health condition, and activity capacity and participation. The Timed Up and Go test, gait velocity, hip circumference, and stance width appear to be most predictive of activity capacity as observed during gait assessment. The findings indicate that Class III-related gait is pathologic and not a normal adaptation.

Effective weight-loss using an e-health delivered physical activity and dietary intervention: A federal credit union pilot study

BACKGROUND/OBJECTIVE This pilot study investigated the effectiveness of a distance-based e-health program delivered across multiple rural Federal Credit Union worksites that focused on physical activity and dietary education. Program design and implementation were based on the premises of Social Impact Theory (SIT). METHODS A sample of fifty-four participants (47 white. 7 black) aged 24 to 58 across different worksite locations completed 10 weeks of e-health delivered physical activity and dietary intervention. Pre to post weight changes were examined as a primary outcome. RESULTS The findings showed that regardless of worksite location, participants on average reduced their weight by 10.13 lbs if they completed both the exercise and lunch and learn components of the study compared to a decrease of 2.73 lbs for participants who chose not to engage in the exercise related activities. Participant dropout from either group was less than four percent. CONCLUSIONS The results of this study show the beneficial influence of physical activity integration using SIT upon distance programs targeting weight loss. In addition, the high adherence and weight loss success show promise and demonstrates the potential for e-health delivered exercise and lifestyle interventions. Further replication of results via additional randomized controlled trials is needed.

Alternative placements for women wearing pedometers

Purpose: The purpose of this pilot study was to determine if pedometer placement sites in women, other than the waist, provide the same results. Data sources: Three pedometers were given to 12 women to wear on a bra strap, waist, and shoe for a week and then rotated through each site. The participants recorded their daily step counts in a log, turned in weekly, and were instructed not to change their daily routine. Body mass index (BMI), placement preference, and waist and hip measures were collected at enrollment and the concluding sessions. Conclusions: Womens adiposity distribution patterns and clothing provide potential barriers to pedometer use at the waist. Daily walking is an affordable option for physical activity counseling by nurse practitioners (NPs). The bra and shoe placements were not found to be equitable alternative sites compared with waist placement of pedometers. However, 75% of participants had improvement in BMI and waist‐to‐hip measures with no lifestyle intervention. The participants preferred a placement perceived as comfortable and consistent. Implications for practice: The results inform NPs that women need to consistently wear pedometers in a daily walking program, which can lead to beneficial changes in BMI. NPs should encourage walking as a form of daily physical activity, which may be monitored by a pedometer worn consistently.

Multi-disciplinary Care for the Elderly in Disasters: An Integrative Review

INTRODUCTION Older adults are disproportionately affected by disaster. Frail elders, individuals with chronic diseases, conditions, or disabilities, and those who live in long-term care facilities are especially vulnerable. Purpose The purpose of this integrative review of the literature was to describe the system-wide knowledge and skills that multi-disciplinary health care providers need to provide appropriate care for the elderly during domestic-humanitarian and disaster-relief efforts. Data sources A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed, CINAHL, and PsycINFO were conducted using terms such as Disaster, Geological Processes, Aged, Disaster Planning, and Vulnerable Populations. Forty-six articles met criteria for inclusion in the review. CONCLUSIONS Policies and guidance regarding evacuating versus sheltering in place are lacking. Tenets of elderly-focused disaster planning/preparation and clarification of legal and ethical standards of care and liability issues are needed. Functional capacity, capabilities, or impairments, rather than age, should be considered in disaster preparation. Older adults should be included in disaster planning as population-specific experts. Implications for Practice A multifaceted approach to population-specific disaster planning and curriculum development should include consideration of the biophysical and psychosocial aspects of care, ethical and legal issues, logistics, and resources.

Caring for Military Children in the Emergency Department: The Essentials

The life of a military child has several challenges that can provide opportunities for resilience or risk for vulnerability. Nurses in emergent/urgent care may encounter military children when they are in a stressful transition such as during a move or deployment. Understanding the unique lifestyle of military children and implementing some key suggestions for practice can improve outcomes for this population. This article highlights the exceptional context of military children, military transitions, and opportunities to recognize families who are at risk and strategies to reach out using the I CARE (identify, correlate, ask, ready resources, and encourage) framework.