Precision health refers to personalized healthcare based on a person's unique genetic,genomic,or omic composition within the context of lifestyle,social,economic,cultural and environmental influences to help indiv...Precision health refers to personalized healthcare based on a person's unique genetic,genomic,or omic composition within the context of lifestyle,social,economic,cultural and environmental influences to help individuals achieve well-being and optimal health.Precision health utilizes big data sets that combine omics(i.e.genomic sequence,protein,metabolite,and microbiome information)with clinical information and health outcomes to optimize disease diagnosis,treatment and prevention specific to each patient.Successful implementation of precision health requires interprofessional collaboration,community outreach efforts,and coordination of care,a mission that nurses are well-positioned to lead.Despite the surge of interest and attention to precision health,most nurses are not well-versed in precision health or its implications for the nursing profession.Based on a critical analysis of literature and expert opinions,this paper provides an overview of precision health and the importance of engaging the nursing profession for its implementation.Other topics reviewed in this paper include big data and omics,information science,integration of family health history in precision health,and nursing omics research in symptom science.The paper concludes with recommendations for nurse leaders in research,education,clinical practice,nursing administration and policy settings for which to develop strategic plans to implement precision health.展开更多
Background:Stroke is the leading cause of mortality.This study aimed to investigate the association between stroke,comorbidities,and activity of daily living(ADL)among older adults in the United States.Methods:Partici...Background:Stroke is the leading cause of mortality.This study aimed to investigate the association between stroke,comorbidities,and activity of daily living(ADL)among older adults in the United States.Methods:Participants were 1165 older adults aged 60 and older from two waves(2016 and 2018)of the Health and Retirement Study who had a stroke.Descriptive statistics were used to describe demographic information and comorbidities.Logistic regressions and multiple regression analyses were used to determine associations between stroke,comorbidities,and ADL.Results:The mean age was 75.32±9.5 years,and 55.6%were female.An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing,walking,bedding,and toileting.Moreover,depression was significantly associated with difficulty in dressing,walking,bathing,eating,and bedding.At the same time,heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL.After adjusting for age and sex,heart condition and depression are significantly associated with seeing a doctor for stroke(odds ratio[OR]:0.66;95%confidence interval[CI]:0.49-0.91;p=0.01)and stroke therapy(OR:0.46;95%CI:0.25-0.84;p=0.01).Finally,stroke problem(unstandardizedβ[B]=0.58,p=0.017)and stroke therapy(B=1.42,p<0.001)significantly predict a lower level of independence.Conclusion:This study could benefit healthcare professionals in developing further interventions to improve older stroke adults'lives,especially those with a high level of dependence.展开更多
基金Emma Kurnat-Thoma,PhD,MS,RN is supported by an NIH/NINR Clinical and Translational Postdoctoral Intramural Research Training Award.
文摘Precision health refers to personalized healthcare based on a person's unique genetic,genomic,or omic composition within the context of lifestyle,social,economic,cultural and environmental influences to help individuals achieve well-being and optimal health.Precision health utilizes big data sets that combine omics(i.e.genomic sequence,protein,metabolite,and microbiome information)with clinical information and health outcomes to optimize disease diagnosis,treatment and prevention specific to each patient.Successful implementation of precision health requires interprofessional collaboration,community outreach efforts,and coordination of care,a mission that nurses are well-positioned to lead.Despite the surge of interest and attention to precision health,most nurses are not well-versed in precision health or its implications for the nursing profession.Based on a critical analysis of literature and expert opinions,this paper provides an overview of precision health and the importance of engaging the nursing profession for its implementation.Other topics reviewed in this paper include big data and omics,information science,integration of family health history in precision health,and nursing omics research in symptom science.The paper concludes with recommendations for nurse leaders in research,education,clinical practice,nursing administration and policy settings for which to develop strategic plans to implement precision health.
基金National Institute on Aging,Grant/Award Number:NIA U01AG009740。
文摘Background:Stroke is the leading cause of mortality.This study aimed to investigate the association between stroke,comorbidities,and activity of daily living(ADL)among older adults in the United States.Methods:Participants were 1165 older adults aged 60 and older from two waves(2016 and 2018)of the Health and Retirement Study who had a stroke.Descriptive statistics were used to describe demographic information and comorbidities.Logistic regressions and multiple regression analyses were used to determine associations between stroke,comorbidities,and ADL.Results:The mean age was 75.32±9.5 years,and 55.6%were female.An adjusted analysis shows that older stroke adults living with diabetes as comorbidity are significantly associated with difficulty in dressing,walking,bedding,and toileting.Moreover,depression was significantly associated with difficulty in dressing,walking,bathing,eating,and bedding.At the same time,heart conditions and hypertension as comorbidity were rarely associated with difficulty in ADL.After adjusting for age and sex,heart condition and depression are significantly associated with seeing a doctor for stroke(odds ratio[OR]:0.66;95%confidence interval[CI]:0.49-0.91;p=0.01)and stroke therapy(OR:0.46;95%CI:0.25-0.84;p=0.01).Finally,stroke problem(unstandardizedβ[B]=0.58,p=0.017)and stroke therapy(B=1.42,p<0.001)significantly predict a lower level of independence.Conclusion:This study could benefit healthcare professionals in developing further interventions to improve older stroke adults'lives,especially those with a high level of dependence.
