Background: Maternal diet quality during pregnancy is an important modifiable, yet often overlooked, factor in pregnancy outcomes for both the pregnant individual and their baby. Dietary patterns in the United States are often linked to sociodemographic factors and include a significant proportion of highly processed foods (HPF), known contributors to adverse health outcomes. However, these relationships are poorly understood in pregnant populations. Objectives: The objectives of this retrospective observational study were to use Dietary Screener Questionnaire (DSQ) data to (a) explore the consumption of common HPFs during pregnancy, and (b) examine the relationships between HPF consumption and sociodemographic factors and maternal pregnancy outcomes. Methods: We collected sociodemographic information, pregnancy outcomes, and DSQs capturing dietary intake during the previous 30 days from women who delivered their infants at a large metropolitan hospital in Boston, Massachusetts, between January 2019 and August 2021. We calculated descriptive statistics for sociodemographic, pregnancy outcome, and HPF intake data. We used separate linear regression models to examine associations between total HPF consumption and sociodemographic and pregnancy outcome variables; we further examined significant relationships with multivariable regression. Results: Ninety-six women participated (most were White), privately insured, and not Hispanic/Latina. Women in this cohort consumed HPFs an average of 1.91 times each day. There was a trend towards lower total HPF consumption among Black/African American and Asian participants compared to White participants. Total HPF consumption was significantly lower among former smokers compared to those without a history of smoking and among participants diagnosed with gestational diabetes compared to those without diabetes. Conversely, participants with chronic hypertension consumed more HPFs than those without a hypertensive disorder. No other significant interactions were noted. Discussion: Future research is needed to assess the relationships between HPF consumption, sociodemographic factors, and health outcomes across diverse populations of pregnant individuals. Obstetric clinicians, particularly nurses, should consider expanding pregnancy nutrition counseling to include methods such as a DSQ to reduce HPF intake.
BACKGROUND Vitamin K2 (K2) research has demonstrated that with sufficient K2 intake, vitamin K-dependent proteins are activated to regulate bone diseases and inflammation-related diseases, offering an innovative strategy to address ongoing musculoskeletal injury (MSKi) and high adiposity challenges that threaten health promotion, performance, and readiness in service members (SMs). OBJECTIVE This study aimed to characterize K2 status in a military sample and explore the relationship between dietary K2 intake and bone health, metabolic health, and inflammation status in the context of SM health and operational readiness or deployability. METHODS At baseline and 12 months, Army and Air Force units provided data from demographic and food frequency questionnaires, body composition, bone density, cardiometabolic, and biomarker measurements. Activity trackers monitored physical activity and sleep duration continuously. RESULTS Between August 2023 and July 2024, we enrolled 47 active duty SMs. The sample was predominantly male, racially and ethnically diverse, averaged 27 years of age, and had an average of 6.5 years of service. At baseline, 45% met the criteria for stage I hypertension and 45% exceeded military body fat standards. Participants reported insufficient baseline dietary intake of vitamin K1+K2 and vitamin D. Over the 12 months, fermented food consumption slightly increased, activity behaviors remained unchanged, and participants self-reported 10 noncombat MSKis. Participants reported no significant changes in body composition, body fat specifically, or dietary intake of vitamin D or vitamin K2. Exploratory proteomics analysis identified links between K2 and inflammation, bone architecture, glucose homeostasis, and insulin receptors. DISCUSSION MSKi, high body fat, and meeting optimal nutrition goals remain readiness challenges for SMs. Exploring K2 identified meaningful metrics and actionable strategies to address these challenges. Highlighting data-informed interventions adds to nursing's nutritional and cardiometabolic knowledge base and clinical interventions, as the nursing workforce is positioned to influence every step of patient care: conducting research, generating data to inform clinical practice and interventions, and ensuring evidence-based patient education and counseling to optimize SM health and readiness.
Background: The late 1970s represented a period of rapid growth and organizational transition within nursing research and scholarly publishing. During this period, Nursing Research , the first refereed nursing research journal in the United States, underwent substantial editorial and administrative reorganization amid broader changes in nursing science, research infrastructure, and scholarly communication. Objective: To examine how editorials published in Nursing Research during 1978–1979 reflected and shaped emerging ideas about nursing scholarly publishing, research infrastructure, editorial governance, and scientific communication during a pivotal period in the development of nursing science. Methods: This qualitative document analysis examined editorials, guest editorials, and publisher statements published in Nursing Research between January 1978 and December 1979. Archival documents were converted to searchable text using optical character recognition software and reviewed against original page images for accuracy. Structured editorial summaries were created using generative artificial intelligence with investigator review and revision. Documents were analyzed iteratively to identify recurring themes related to research development, scholarly communication, peer review, ethics, methodological rigor, journal governance, and scientific infrastructure. Results: Four interrelated themes were identified: 1) a discipline in expansion; 2) infrastructure under strain; 3) reorganization and the university model; and 4) the journal as scientific infrastructure. The editorials documented rapid growth in doctoral education, research centers, clinical inquiry, and nurse-led investigation while simultaneously revealing mounting concern regarding journal finances, editorial labor, peer review, and publication sustainability. Following organizational restructuring in 1978–1979, Florence Downs reconceptualized Nursing Research as an active component of scientific infrastructure supporting communication, methodological rigor, ethical oversight, and cumulative inquiry. The editorials also demonstrated early engagement with computerized information retrieval systems, statistical reporting standards, and formalized peer review processes. Discussion: The editorials published in Nursing Research during 1978–1979 reveal nursing scholarship at a formative moment in the development of modern scientific publishing. The findings suggest that many concerns associated with contemporary scholarly publishing, including sustainability, editorial labor, peer review, methodological transparency, and information management, were already evident in nursing publishing nearly 50 years ago.
Background: Digital technology is increasingly used in heart failure (HF) management. Deficiencies in digital health literacy (DHL) may hinder the delivery of digitally mediated nursing care. Investigating sociodemographic and clinical factors associated with DHL in middle-income countries could inform targeted interventions to reduce disparities in HF management. Objective: To examine associations between DHL and sociodemographic and clinical factors in adults with HF. Methods: Descriptive, cross-sectional, and correlational study. The sample consisted of adult outpatients with HF from a cardiology clinic in João Pessoa, Brazil. Individuals with a clinical diagnosis of HF confirmed in the medical record, regardless of left ventricular ejection fraction, aged ≥18 years, were included. We obtained sociodemographic and clinical data through self-report. We assessed DHL using the eHealth Literacy Scale . We examined associations between sociodemographic and clinical variables and the digital literacy score using the Mann–Whitney or Kruskal–Wallis test and Spearman’s correlation. Results: The study included 109 participants (mean age, 59.1 years; 60% female). DHL was predominantly low. Age, education, and number of comorbidities were significantly associated with DHL. Discussion: Age, education, and comorbidity burden may affect patients’ ability to engage with digital technologies used in HF management in middle-income countries. Supporting patients’ technological competencies may expand opportunities for digitally mediated caring relationships, enabling nurses to better understand and support individuals with HF in increasingly digital health care environments.
Background: Patients with limited English proficiency (LEP) experience poorer health outcomes and face persistent barriers to interpreter use. Although language access is essential to high-quality care, little is known about how home health care (HHC) managers operationalize language services in this setting. Objectives: To explore HHC managers’ perspectives on delivering care to patients with LEP and identify organizational challenges and strategies related to language access. Methods: We conducted a qualitative secondary analysis of semistructured interviews collected between 2016 and 2017 as part of a parent study examining language barriers in HHC. Participants included 14 managers from a large U.S. home health agency serving a high volume of patients with LEP. Interviews explored experiences managing care delivery, including communication strategies, staffing decisions, and system-level constraints. Results: Five themes and several subthemes emerged from the data. Major themes included strategies for ensuring language-concordant care; structural factors impeding language-concordant care; staff using ad hoc strategies to “get by”; perceived impacts on outcomes; and interventions to address structural factors impeding language-concordant care. Managers described multiple strategies to address language barriers with patients. However, these approaches were constrained by shortages of bilingual clinicians, competing demands that prioritized clinical expertise over language concordance, and variability in language needs across patient populations. Interpreter services, particularly telephone-based language lines, were often perceived as inefficient or unreliable, leading some clinicians to rely on ad hoc communication strategies or “getting by.” These and other barriers were perceived to contribute to communication breakdowns, reduced care quality, patient confusion, and potentially avoidable health care utilization, including emergency department visits and readmissions. Discussion: Improving language access in HHC requires system-level interventions, including investment in a linguistically diverse workforce, clearer protocols for interpreter use, improved communication across care transitions, and organizational support for culturally and linguistically appropriate care. Addressing these challenges is essential to advancing equity, patient safety, and quality of care for patients with LEP.
