Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

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Health Behavior And Health Education Theory Research And Practice

Current solutions developed for the purpose of in and on body (IOB) electrical stimulation (ES) lack autonomous qualities necessary for comfortable, practical, and self-dependent use. Consequently, recent focus has been placed on developing self-powered IOB therapeutic devices capable of generating therapeutic ES for human use. With the recent invention of the triboelectric nanogenerator (TENG), harnessing passive human biomechanical energy to develop self-powered systems has allowed for the introduction of novel therapeutic ES solutions. TENGs are especially effective at providing ES for IOB therapeutic systems given their bioconformability, low cost, simple manufacturability, and self-powering capabilities. Due to the key role of naturally induced electrical signals in many physiological functions, TENG-induced ES holds promise to provide a novel paradigm in therapeutic interventions. The aim here is to detail research on IOB TENG devices applied for ES-based therapy in the fields of regenerative medicine, neurology, rehabilitation, and pharmaceutical engineering. Furthermore, considering TENG-produced ES can be measured for sensing applications, this technology is paving the way to provide a fully autonomous personalized healthcare system, capable of IOB energy generation, sensing, and therapeutic intervention. Considering these grounds, it seems highly relevant to review TENG-ES research and applications, as they could constitute the foundation and future of personalized healthcare.

Triboelectric Nanogenerators for Therapeutic Electrical Stimulation.

Background
Urinary incontinence can affect 40% to 60% of people admitted to hospital after a stroke, with 25% still having problems when discharged from hospital and 15% remaining incontinent after one year.

This is an update of a review published in 2005 and updated in 2008.

Objectives
To assess the effects of interventions for treating urinary incontinence after stroke in adults at least one‐month post‐stroke.

Search methods
We searched the Cochrane Incontinence and Cochrane Stroke Specialised Registers (searched 30 October 2017 and 1 November 2017 respectively), which contain trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In‐Process, MEDLINE Epub Ahead of Print, CINAHL, ClinicalTrials.gov, WHO ICTRP and handsearched journals and conference proceedings.

Selection criteria
We included randomised or quasi‐randomised controlled trials.

Data collection and analysis
Two review authors independently undertook data extraction, risk of bias assessment and implemented GRADE.

Main results
We included 20 trials (reporting 21 comparisons) with 1338 participants. Data for prespecified outcomes were not available except where reported below.

Intervention versus no intervention/usual care

Behavioural interventions: Low‐quality evidence suggests behavioural interventions may reduce the mean number of incontinent episodes in 24 hours (mean difference (MD) –1.00, 95% confidence interval (CI) –2.74 to 0.74; 1 trial; 18 participants; P = 0.26). Further, low‐quality evidence from two trials suggests that behavioural interventions may make little or no difference to quality of life (SMD ‐0.99, 95% CI ‐2.83 to 0.86; 55 participants).

Specialised professional input interventions: One trial of moderate‐quality suggested structured assessment and management by continence nurse practitioners probably made little or no difference to the number of people continent three months after treatment (risk ratio (RR) 1.28, 95% CI 0.81 to 2.02; 121 participants; equivalent to an increase from 354 to 453 per 1000, 95% CI 287 to 715).

Complementary therapy: Five trials assessed complementary therapy using traditional acupuncture, electroacupuncture and ginger‐salt‐partitioned moxibustion plus routine acupuncture. Low‐quality evidence from five trials suggested that complementary therapy may increase the number of participants continent after treatment; participants in the treatment group were three times more likely to be continent (RR 2.82, 95% CI 1.57 to 5.07; 524 participants; equivalent to an increase from 193 to 544 per 1000, 95% CI 303 to 978). Adverse events were reported narratively in one study of electroacupuncture, reporting on bruising and postacupuncture abdominal pain in the intervention group.

Physical therapy: Two trials reporting three comparisons suggest that physical therapy using transcutaneous electrical nerve stimulation (TENS) may reduce the mean number of incontinent episodes in 24 hours (MD –4.76, 95% CI –8.10 to –1.41; 142 participants; low‐quality evidence). One trial of TENS reporting two comparisons found that the intervention probably improves overall functional ability (MD 8.97, 95% CI 1.27 to 16.68; 81 participants; moderate‐quality evidence).

Intervention versus placebo

Physical therapy: One trial of physical therapy suggests TPTNS may make little or no difference to the number of participants continent after treatment (RR 0.75, 95% CI 0.19 to 3.04; 54 participants) or number of incontinent episodes (MD –1.10, 95% CI –3.99 to 1.79; 39 participants). One trial suggested improvement in the TPTNS group at 26‐weeks (OR 0.04, 95% CI 0.004 to 0.41) but there was no evidence of a difference in perceived bladder condition at six weeks (OR 2.33, 95% CI 0.63 to 8.65) or 12 weeks (OR 1.22, 95% CI 0.29 to 5.17). Data from one trial provided no evidence that TPTNS made a difference to quality of life measured with the ICIQLUTSqol (MD 3.90, 95% CI –4.25 to 12.05; 30 participants). Minor adverse events, such as minor skin irritation and ankle cramping, were reported in one study.

Pharmacotherapy interventions: There was no evidence from one study that oestrogen therapy made a difference to the mean number of incontinent episodes per week in mild incontinence (paired samples, MD –1.71, 95% CI –3.51 to 0.09) or severe incontinence (paired samples, MD –6.40, 95% CI –9.47 to –3.33). One study reported no adverse events.

Specific intervention versus another intervention

Behavioural interventions: One trial comparing a behavioural intervention (timed voiding) with a pharmacotherapy intervention (oxybutynin) contained no useable data.

Complementary therapy: One trial comparing different acupuncture needles and depth of needle insertion to assess the effect on incontinence reported that, after four courses of treatment, 78.1% participants in the elongated needle group had no incontinent episodes versus 40% in the filiform needle group (57 participants). This trial was assessed as unclear or high for all types of bias apart from incomplete outcome data.

Combined intervention versus single intervention

One trial compared a combined intervention (sensory motor biofeedback plus timed prompted voiding) against a single intervention (timed voiding). The combined intervention may make little or no difference to the number of participants continent after treatment (RR 0.55, 95% CI 0.06 to 5.21; 23 participants; equivalent to a decrease from 167 to 92 per 1000, 95% CI 10 to 868) or to the number of incontinent episodes (MD 2.20, 95% CI 0.12 to 4.28; 23 participants).

Specific intervention versus attention control

Physical therapy interventions: One study found TPTNS may make little or no difference to the number of participants continent after treatment compared to an attention control group undertaking stretching exercises (RR 1.33, 95% CI 0.38 to 4.72; 24 participants; equivalent to an increase from 250 to 333 per 1000, 95% CI 95 to 1000).

Authors' conclusions
There is insufficient evidence to guide continence care of adults in the rehabilitative phase after stroke. As few trials tested the same intervention, conclusions are drawn from few, usually small, trials. CIs were wide, making it difficult to ascertain if there were clinically important differences. Only four trials had adequate allocation concealment and many were limited by poor reporting, making it impossible to judge the extent to which they were prone to bias. More appropriately powered, multicentre trials of interventions are required to provide robust evidence for interventions to improve urinary incontinence after stroke.

/pdf/interventions-for-treating-urinary-incontinence-after-stroke-1enwj29dn5.pdf

Interventions for treating urinary incontinence after stroke in adults

Colorectal cancer (CRC) is prevalent in the developed world. Favourable survival rates highlight the need to better understand CRC survivors’ experiences of long-term impacts of treatment, which can in turn inform decision making. This systematic review aimed to identify and synthesise CRC survivors’ experiences of long-term impacts on health-related quality of life. We searched Medline, Embase and PsychINFO from inception to January 2019. Qualitative studies describing CRC survivors’ experiences at least 1-year post-treatment were included. Study eligibility, quality assessment (COREQ guidelines), and data synthesis was performed independently by two reviewers and discussed with the study team. Of 1363 papers retrieved, 20 reporting 15 studies met eligibility. Thematic synthesis produced 12 themes: symptoms, physical, social, psychological and sexual functioning, impact on relationships, informal care needs provided by family/friend, supportive care needs provided by healthcare professional, health care experiences, health behaviour, financial toxicity and occupational experiences. Stoma problems (e.g. leakage, skin irritation) were common in ostomates. Survivors with no/reversed stoma experienced unexpected, long-term altered and unpredictable bowel functioning. Survivors often regulated timing, amount and foods consumed to manage bowel functioning. Less common symptoms included fatigue, impaired sleep and anal pain. Stoma problems and altered bowel functioning impaired survivors’ physical, social, sexual and psychological functioning. Cognitive functioning and heredity issues were not reported in any paper. CRC survivors experience ongoing symptoms and functioning impairments more than 1-year post-treatment completion. Many survivors find their own ways to manage symptoms rather than seek professional help. Follow-up care for CRC survivors should integrate screening for long-term effects and provide targeted supportive care.

/pdf/patient-reported-outcomes-and-experiences-from-the-1o3l7tdlfz.pdf

Patient-reported outcomes and experiences from the perspective of colorectal cancer survivors: meta-synthesis of qualitative studies.

Objective: The current study aimed to investigate the relationship between nutrition literacy (NL) and food habits (FH) in adolescents, and the factors affecting the relationship. Design:
 The study used a cross-sectional design. The data were collected using socio-demographic information forms, the Adolescent Nutrition Literacy Scale (ANLS) and the Adolescent Food Habit Checklist (AFHC). The socio-demographic characteristics of adolescents were analysed using descriptive statistics, and the factors affecting NL and FH were determined using the t test, Mann–Whitney U test and ANOVA. The correlation between ANLS and AFHC scores was tested with correlation analysis, and linear regression analysis was employed to predict the change in the NL of adolescents at the level of FH. Setting:
 The study was conducted in the city of Izmir in Turkey. Participants:
 The study consisted of a total of 467 adolescents. Results:
 There was a statistically significant relationship between NL of adolescents and their gender, education level of the father, grade, BMI values and daily lifestyle behaviours (DLB), as well as between their FH and DLB. There was a positive and significant relationship between ANLS and AFHC. The ANLS and its subscales were found to have a statistically significant effect on AFHC. According to the linear regression analysis, the nutritional habits of adolescents were found to be significantly affected by NL (β = 0·357). Conclusions:
 As ANLS scores increased, AFHC scores were determined to increase as well. This finding shows that the FH of adolescents have changed positively with increase in their NL.

/pdf/the-relationship-between-adolescents-nutrition-literacy-and-21bxhszdbw.pdf

The relationship between adolescents' nutrition literacy and food habits, and affecting factors.

Introduction: Poststroke urinary incontinence is a common problem, with a prevalence ranging from 32% to 79%. Urinary incontinence after stroke has negative physiological, psychological, and economic effects, which lead to lifestyle changes for both patients and caregivers. Nurses play an im

Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study.

The present study aimed assesses the nursing students' knowledge of skin cancer and sun and their sun protection behaviors. This descriptive cross-sectional study was performed from May to June 2014 with a convenience sample of 376 undergraduate nursing students from one nursing faculty located in Izmir. Mean age of the students was 21.56 ± 1.96 years. The mean score that the females obtained from the level of knowledge and protection behaviors scales was significantly higher than that of the males. Older age group (≥22 years) obtained higher scores on the knowledge and protection behaviors scales than younger group (≤21 years). Nursing students' knowledge of, and behavior regarding, skin cancer and sun health were insufficient. Equipping them with the necessary knowledge and behaviors related to skin cancer and sun health by developing training programs and strategies on the issue is of utmost importance.

Psychometric Testing of the Turkish Version of the Skin Cancer and Sun Knowledge Scale in Nursing Students

Objective: The purpose of this study is to investigate the effects of pelvic floor muscle exercises (PFMEs) done by stroke patients at home in line with the health belief model (HBM) on patient car...

Effects on urinary outcome of patients and caregivers’ burden of pelvic floor muscle exercises based on the health belief model done at home by post-stroke patients

OBJECTIVE This study investigated the effect of the Jennings Disaster Nursing Management Model-based and learning management system-assisted six-module training programme on nursing students' disaster preparedness perceptions and response self-efficacy. DESIGN AND SAMPLE This randomized controlled trial used a two group comparison design, experimental group (n = 127), and control group (n = 108), carried out with third-year nursing students in a city in the west of Turkey. MEASURES Data included a socio-demographic form, the Disaster Preparedness Perception Scale in Nurses (DPPSN) and the Disaster Response Self-Efficacy Scale (DRSES). RESULTS After the training, disaster preparedness perceptions and the response self-efficacy of the EG increased significantly (p < .05). This study had a moderate effect on participants' knowledge and self-efficacy. CONCLUSION Public health nurses are health professionals with important roles and responsibilities in the stages of disaster preparedness, response, and recovery that is all stages of disaster management. This theoretical-based program can be considered for both students and nursing professionals.

Gulcihan Arkan

Papers

The relationship between adolescents' nutrition literacy and food habits, and affecting factors.

Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study.

Psychometric Testing of the Turkish Version of the Skin Cancer and Sun Knowledge Scale in Nursing Students

Effects on urinary outcome of patients and caregivers’ burden of pelvic floor muscle exercises based on the health belief model done at home by post-stroke patients

The effect of the disaster management training program among nursing students.