Ezra C. Holston

Nursing Genomics: Practice Implications Every Nurse Should Know

Twenty-first century nurse clinicians, scientists, and educators must be informed of and become proficient in genetic competencies to provide the best available evidenced-based patient care. This article presents a historical context and basic applications of genetics, along with the attendant legal and ethical issues, to provide a framework for understanding genetics and the genomics applications used in clinical nursing practice. The implications of genomics are relevant to all areas of nursing practice, including risk assessment, education, clinical management, and future research.

Broadening Definitions of Family for Older Lesbians: Modifying the Lubben Social Network Scale

Lesbian seniors have triple vulnerability (gender, sexual orientation, and age), necessitating inquiry into their social support needs, yet research about that is scare. Investigators identify relationships between social support and senior health. The Lubben Social Network Scale, Revised (LSNS-R), has provided such evidence and has been used to study many diverse senior groups. We modified it to include a Family of Choice category and qualitative questions to give context to responses among a sample of older lesbians. Our pilot demonstrated that the modification made a difference in accurately measuring social support among the sample, yet further investigation is warranted.

Are They Family or Friends? Social Support Instrument Reliability in Studying Older Lesbians

We know little about the support needs and health of older lesbians because participant sexual identity has typically not been identified in aging studies. The Lubben Social Network Scale, Revised (LSNS-R) is found widely reliable for testing perceived social support among elders but has never been tested with an exclusively lesbian population. This pilot tested the instrument with an exclusively lesbian population in the Midwest. Our analysis suggests it may not be reliable with this population, even with minor modifications that were made. Further examination adding a category for “family of choice” is warranted and supported by the originator of the tool.

Participant Satisfaction with Wellness Recovery Action Plan (WRAP)

Outpatient programs are often promoted as vehicles for mental health recovery. Yet, few programs include patients’ perspectives about their satisfaction with these programs. This descriptive, cross-sectional survey investigated patients’ satisfaction with Wellness Recovery Action Plan (WRAP). Participants completed the Mental Health Statistics Improvement Program instrument (n = 26) and qualitative interviews (n = 18). Data were analyzed using multivariate statistics (α = .05) and content analysis. Three composite variables explained 48% of the variance (p = .00) in patient satisfaction. Four themes emerged: Retrospective Desire for Early WRAP Introduction, Pay It Forward, Unconditional Relational Support, and It Takes Time. Future research is warranted to promote WRAPs use in broader settings.

Describing Brain Activity of Persons With AD and Depressive Symptoms

The purpose of this retrospective pilot study was to characterize depression of AD using electrophysiological changes in the brain activity of persons with AD and depressive symptoms. Participants had a mean age of 70.12±12.68. Participants manifested an increase in absolute/relative theta activity (p=.000) over entire brain when compared to normative population-based database. Electrophysiological changes did not differ by age or gender except for increased absolute theta activity in the right lateral frontal areas (t-test=-2.31 to -2.39, p=.04) in females. An increased theta activity suggests that depressive symptoms may be part of AD symptomatology, not a co-morbid feature.

Conceptualizing the CHOICE of Driving Retirement by Older Adults

Driving retirement for older adults represents a daily process that influences geriatric rehabilitation. It defines a highly subjective, emotional process that impacts older adults, their family, and society. Yet, it remains unclear if this process involves a decision or a choice since these terms are often used interchangeably. However, conceptually they are not. This systematic literature review examines the conceptual difference between choice and decision, discusses factors related to choice, and applies a CHOICE Framework (Capabilities of Healthy Older-adults Integrating Cognition and Emotions) within the context of driving retirement. Understanding choice may provide insight about rehabilitative issues related to older adults.

The Electrophysiological Phenomenon of Alzheimer's Disease: A Psychopathology Theory

The current understanding of Alzheimers disease (AD) is based on the Aβ and tau pathology and the resulting neuropathological changes, which are associated with manifested clinical symptoms. However, electrophysiological brain changes may provide a more expansive understanding of AD. Hence, the objective of this systematic review is to propose a theory about the electrophysiological phenomenon of Alzheimers disease (EPAD). The review of literature resulted from an extensive search of PubMed and MEDLINE databases. One-hundred articles were purposively selected. They provided an understanding of the concepts establishing the theory of EPAD (neuropathological changes, neurochemical changes, metabolic changes, and electrophysiological brain changes). Changes in the electrophysiology of the brain are foundational to the association or interaction of the concepts. Building on Bergers Psychophysical Model, it is evident that electrophysiological brain changes occur and affect cortical areas to generate or manifest symptoms from onset and across the stages of AD, which may be prior to pathological changes. Therefore, the interaction of the concepts demonstrates how the psychopathology results from affected electrophysiology of the brain. The theory of the EPAD provides a theoretical foundation for appropriate measurements of AD without dependence on neuropathological changes. Future research is warranted to further test this theory. Ultimately, this theory contributes to existing knowledge because it shows how electrophysiological changes are useful in understanding the risk and progression of AD across the stages.

MAMBRA's Impact on IPV Symptoms of Incarcerated and Formerly Incarcerated Women

This repeated measures, descriptive study investigated the effect of Music and Account-Making for Behavioral-Related Adaptation (MAMBRA), a group psychoeducation music intervention, on symptoms reported by 41 incarcerated and community women survivors of intimate partner violence (IPV). Psychosocial measurements included: the Center for Epidemiologic Studies Depression Scale; Speilberger State Anxiety Inventory; Rosenbergs Self Esteem Scale; the UCLA Loneliness Scale, version 3; and the Index of Spouse Abuse. MAMBRA was administered over four sessions for five groups of women. Through descriptive and univariate statistics, psychosocial measures positively changed across the MAMBRA sessions. These findings suggest MAMBRA impacted IPV symptoms and may be an efficacious intervention. Future longitudinal studies with diverse samples are warranted.