Mally Ehrenfeld

Childhood obesity: current literature, policy and implications for practice

THE PROBLEM In most of the industrialized world, a childhood obesity epidemic is evident, with the numbers rising each year. PURPOSE To discuss the current literature in relation to childhood obesity and to provide health practitioners, especially nurses, with the fundamental knowledge that is imperative in the recognition of children who are at risk and thereby tailor appropriate interventions. METHOD Databases that were accessed for current literature included CINAHL, Science Direct and ProQuest. Keywords used in the search included obesity, childhood, health, relevant national statistics, policy and health risks. The literature was confined to the past 10 years with emphasis on the past 5 years. The 50 most pertinent papers from a variety of countries were chosen, and 35 papers that represented key areas of relevance were selected as the basis of this article. This selection of papers dictated the key areas of discussion such as the acknowledged factors in childhood obesity. FINDINGS Although childhood obesity may be related to specific cultural and national circumstances, universal themes emerged from the literature review. These include social factors, exercise, advertising, public policy and the importance of partnerships in policy. CONCLUSION Any country that has a high rate or increasing rate of childhood obesity must acknowledge core factors that contribute to this serious health problem. Furthermore, public policy and community partnerships that include all health professionals have a responsibility in the prevention of childhood obesity. This can be implemented through education, research and advocacy of all nurses involved with children and families.

A Psycho-Educational Program for Improving Women's Attitudes and Coping With Menopause Symptoms

OBJECTIVE To examine the impact of participation in a psycho-educational program on womens attitudes toward menopause, the perceived severity of their symptoms, and the association between the two. DESIGN Quasi-experimental. Data were gathered at baseline and 3 months after termination of the program. SETTING Two health maintenance organization clinics. PARTICIPANTS Eighty-two healthy 40- to 60-year-old women who chose to participate in the study. Thirty-six women participated in the program, and 46 women comprised the control group. INTERVENTION Program participants met for 10 weekly sessions to receive information from a professional team on subjects related to menopause and to share and discuss their experiences. MAIN OUTCOME MEASURES Attitudes toward menopause and severity of menopause symptoms. RESULTS The more negative the attitudes, the higher was the severity of symptoms. Participants reported significant improvements in attitudes and reductions in symptom severity compared to their own baseline scores and compared with the control group. CONCLUSIONS Participation in a program that combines delivery of information and processing of experiences on the cognitive, emotional, and social levels may improve womens attitudes toward menopause and ease the perceived severity of their symptoms, thereby increasing quality of life.

Coping with preoperative anxiety in cesarean section: physiological, cognitive, and emotional effects of listening to favorite music.

BACKGROUND Listening to music has a stress-reducing effect in surgical procedures. The effects of listening to music immediately before a cesarean section have not been studied. The objective of this study was to assess the effects of listening to selected music while waiting for a cesarean section on emotional reactions, on cognitive appraisal of the threat of surgery, and on stress-related physiological reactions. METHODS A total of 60 healthy women waiting alone to undergo an elective cesarean section for medical reasons only were randomly assigned either to an experimental or a control group. An hour before surgery they reported mood, and threat perception. Vital signs were assessed by a nurse. The experimental group listened to preselected favorite music for 40 minutes, and the control group waited for the operation without music. At the end of this period, all participants responded to a questionnaire assessing mood and threat perception, and the nurse measured vital signs. RESULTS Women who listened to music before a cesarean section had a significant increase in positive emotions and a significant decline in negative emotions and perceived threat of the situation when compared with women in the control group, who exhibited a decline in positive emotions, an increase in the perceived threat of the situation, and had no change in negative emotions. Women who listened to music also exhibited a significant reduction in systolic blood pressure compared with a significant increase in diastolic blood pressure and respiratory rate in the control group. CONCLUSION Listening to favorite music immediately before a cesarean section may be a cost-effective, emotion-focused coping strategy. (BIRTH 39:2 June 2012).

Nursing in Israel

Nurses in Israel struggle with many of the same problems faced by nurses in other parts of the world, such as increased use of technology, overwhelming amounts of information, and demands for high quality of services to larger numbers of people within tighter budgets. In addition to the aging of the general population, the country has welcomed large numbers of immigrants. The nations expenditures for healthcare and nursing education have, at times, had to take a back seat to the governments efforts to house new immigrants, to relocate groups, and to defend the nation against politically motivated violence and attacks. All of this is in the context of regional conflicts and international debates.

Acculturation among immigrant nurses in Israel and the United States of America.

BACKGROUND Former Soviet Union (FSU) nurses in Israel and Filipino registered nurses (RNs) in the United States of America (USA) play significant roles in the delivery of health-care services in their host countries. However, little is known about how they acculturate in a different culture. OBJECTIVES The purposes of this study were to determine the levels of and the difference in acculturation of FSU nurses in Israel and Filipino RNs in the USA. METHODS Acculturation was assessed using A Short Acculturation Scale for Filipino Americans and t-test was conducted to determine the difference in acculturation between these two groups of immigrant nurses. FINDINGS Results revealed that Filipino RNs have an acculturation level that leaned towards their host culture while FSU nurses have an acculturation level that was closer to their original culture than the Israeli culture and that there was a significant difference in acculturation between these two groups of immigrant nurses. CONCLUSIONS Differences in acculturation between two predominant groups of immigrant nurses in Israel and the USA exist. Understanding the differences and the factors that affect their integration into their host cultures could be used to develop strategies to assist Filipino and FSU immigrant nurses achieve positive personal and work-related outcomes.

Job satisfaction among immigrant nurses in Israel and the United States of America.

AIM The aim of this study is to examine perceptions of job satisfaction among immigrant registered nurses (RNs) in Israel and the USA. BACKGROUND Former Soviet Union (FSU) RNs in Israel and Filipino RNs in the USA make up the majority of the immigrant nursing workforce in their host countries. However, little is known about their perception of job satisfaction. METHODS Data were gathered using the Index of Work Satisfaction Scale among 71 FSU RNs recruited from three different courses in baccalaureate and masters degree programmes at a central Israeli university, and 96 Filipino RNs attending a national convention hosted by the Philippine Nurses Association of America. The required sample size was obtained by means of the WINPEPI COMPARE2 program, used to determine power and sample size for comparisons of two groups in cross-sectional designs. FINDINGS The findings show that FSU RNs perceived pay and professional status as important, although they were least satisfied with pay. For Filipino RNs, organizational policies and interactions were most important and they were least satisfied by task requirements. Although the average length of residence in the host country was similar in the two samples, significant differences were found between FSU and Filipino RNs in selected demographic variables and components of job satisfaction. CONCLUSIONS Different characteristics of immigrant RNs affect their distinct perceptions of job satisfaction. As successful adjustment of international immigrant RNs to their workplace could enhance perceptions of job satisfaction, nursing managers should support professional advancement of immigrant RNs through mentorship and educational programmes. There is a need to conduct longitudinal studies among international immigrant RNs in order to better understand changes in their job satisfaction over time and contributing factors. STUDY LIMITATIONS Generalization of the findings is limited, because a convenience sample was used to recruit FSU and Filipino immigrant RNs.

Nursing and midwifery education, practice, and issues in Israel

Nurses deliver most of Israels healthcare services, yet its nurse per population ratio is only 5.9 per 1000, one of the lowest in the developed world. For several years, the managers of the profession have been pushing to upgrade nursing and to move it into the academic sphere. The semiskilled qualification of the practical nurse has been eliminated and training programs for registered nurses are being transformed from diploma training to academic degree programs. A midwifery license is accessible only to registered nurses who take a further 1 year of advanced training and sit the State Midwifery Licensing Examination. Most deliveries in Israel are carried out by midwives. Alongside the Western-standard hospital system there operates both a well-developed community nursing network and a strong mother-and-child clinic system. The acute shortage of nurses in Israel is now coinciding with a rising number of academic job-seekers, which has encouraged the Ministry of Health to offer university graduates a career-change program. Special scholarships are on offer in return for a 4 year commitment to work in nursing after completing an accelerated training curriculum (2.5 years instead of the usual 3 years), plus a starting monthly wage that is higher than the national average wage.

From diploma to degree: Follow up of R.N.-B.A. graduates of Tel Aviv University

The Tel Aviv University post-basic nursing program, established in 1968, was the first step of nursing academization in Israel. Since then, one-third of the nursing schools in Israel have been academized. The objectives of the present study were to document changes in the worklife of the graduates since completion of the program, to learn about the influence of the program, and to identify factors promoting or impeding study in the program. A mailed questionnaire to 709 graduates produced a 46.8% response. At the time of this study 93% were working, almost half of them in hospital. Data also showed upward mobility, with 38% employed at the institutional to national supervisor level. Recommendations include continuation of the post-basic program, expansion of the clinical content, and enhanced interaction between students, graduates and faculty.

Does the conservation of resources motivate middle-aged women to perform physical activity?

This article aims to examine the factors that motivate middle-aged women to engage in leisure physical activity (LPA) and to explore the relationship between resources loss and gains and engaging in LPA. It is a cross-sectional study based on a self-reported questionnaire (n = 949), using variables of the conservation of resources theory and the theory of planned behavior. Results show that women who engage in physical activity experience lower resources loss than inactive women. The longer they engage in physical activity, the less they experience losses such as youth, attractiveness, optimism, health, and beauty. Conservation of resources, perceived behavioral control, attitudes, and normative beliefs predict 41% (p < .0001) of the variance in the engagement in leisure physical activity. Findings suggest that constructing effective strategies to promote LPA requires also addressing these factors, which are valued by middle-aged women.

Young People Considering Nursing as a Career: Starters vs. Non-starters

This study focused on applicants who were accepted to a nursing education program but did not begin their studies, thus wasting time, effort and money. Of 953 accepted applicants, 27% did not enter the program. Significant variables differentiating starters from non-starters were higher psychometric score, higher paternal education, lower priority for nursing studies, older age, non-Israeli country of birth and not completed army service. The study relating to starters vs. non-starters is one aspect of a large study (Ehrenfeld, Rotenberg, Sharon, & Bergman, 1995). In most nursing education programs the number of applicants exceed the facultys capacity, and suitable candidates must be rejected. It is therefore both wasteful and disappointing when accepted applicants change their mind and do not actually begin in the program. In light of the costs and complexities involved in the student screening process and the continuous efforts extended today all over the world to raise the standards of nursing education and care, the factors differentiating starters from non-starters may have important implications. The aim of the present study was to evaluate the screening process at the Tel Aviv University baccalaureate nursing program and determine which variables were predictive of starters and non-starters among accepted applicants.