Laura Burton Faina Kurdziel

Although antiretroviral therapy (ART) has extended the lifespan of people living with HIV (PWH), many experience complex age-related comorbidities and functional decline. Nurses are increasingly caring for PWH navigating cardiometabolic disease, neurocognitive changes, frailty, and mental health challenges. This narrative review provides a multidimensional overview of aging with HIV and highlights the role of exercise as an accessible, evidence-based strategy to support healthy aging. Chronic immune activation and long-term ART use contribute to inflammation, mitochondrial dysfunction, cardiometabolic risk, and neurocognitive impairment. Evidence demonstrates that aerobic and resistance training can improve immune markers, cardiometabolic health, cognitive function, mood, and quality of life without adversely affecting HIV progression. Practical, adaptable exercise protocols suitable for clinical, home-based, and community-based settings are provided to support integration into routine HIV care. Regular exercise represents a safe and scalable strategy nurses can incorporate into comprehensive, patient-centered care for aging PWH.

Insufficient sleep is highly prevalent among adolescents and young adults and has well-documented effects on neural systems underlying decision-making and risk-taking behavior. While prior research has linked sleep deprivation to poorer decision-making broadly, less is known about how specific features of sleep architecture contribute to risk-taking behavior, or whether the cortisol awakening response (CAR), shaped in part by the preceding night’s sleep, represents an independent hormonal pathway linking sleep physiology to morning behavioral outcomes. The present study used a cross-sectional design to examine associations among objective sleep architecture, the CAR, and next-morning risk-taking behavior in a community sample of adolescents and young adults. We predicted that (1) greater rapid eye movement (REM) sleep percentage would be associated with better overall task performance, and (2) greater N2-N3 sigma power would be associated with reduced risk-taking under uncertainty. The role of the CAR was examined exploratorily. Fifty-five adolescents and young adults (aged 15–34; mean age = 18.9 years, SD = 3.08 years, 86% female) completed overnight sleep monitoring using a wearable EEG device, provided morning saliva samples to index the CAR (n = 28), and completed the Balloon Emotional Learning Task (BELT) to assess risk-taking behavior. Primary sleep variables of interest included REM sleep percentage and Non-REM sleep (N2-N3) sigma power. Behavioral outcomes included overall task performance and risk-taking under uncertainty. Linear regression models with age as a covariate were used for all primary analyses. Higher REM sleep percentage was associated with greater overall task performance, while higher N2-N3 sigma power was associated with reduced risk-taking under uncertainty, consistent with predictions. Greater CAR was independently associated with poorer task performance but did not moderate sleep-behavior associations, nor was it significantly associated with objective sleep measures. These findings highlight the stage-specific contributions of sleep architecture to next-morning risk-taking behavior in adolescents and young adults, with sleep physiology and cortisol responsivity emerging as distinct physiological contributors to behavioral outcomes.

Introduction: Sleep plays a crucial role in memory consolidation, not only stabilizing newly encoded information but also potentially supporting forgetting. Yet it remains unclear how sleep prioritizes what is retained or discarded when multiple salience cues, such as emotional valence and top-down instructional goals, compete for consolidation.Methods: In two studies, we examined how emotional content and intentional memory instruction interact to shape memory performance across a 12 h interval that included either nocturnal sleep or wakefulness. Participants completed a directed forgetting paradigm with neutral and negatively valenced words, followed by immediate recognition and delayed free recall.Results: In both Study 1 (online) and Study 2 (in-lab), behavioral results showed that instruction to remember significantly enhanced recognition and recall, whereas emotion alone did not produce consistent benefits; however, sleep condition did not impact memory performance. In Study 2 (in-lab), which included overnight EEG monitoring, physiological markers of sleep revealed meaningful correlates of memory performance. Specifically, sleep spindle activity predicted recall for negative remember-cued words, while Slow Wave Sleep (SWS) and delta power were negatively correlated with total recall, suggesting a trade-off between deep sleep and memory accessibility. REM theta power was associated with increased false recall of emotionally negative foils, consistent with emotional memory generalization.Discussion: Importantly, these findings extend prior nap-based research by demonstrating that full-night sleep physiology reflects selective consolidation mechanisms even in the absence of overt behavioral effects. Overall, results underscore the primacy of top-down instruction over emotional salience in shaping memory, and highlight the utility of sleep physiology for understanding selective memory consolidation.

Being able to regulate emotions is critical to coping with stress. Stress has also been shown to reduce emotion regulation ability; specifically, stress-based HPA axis activation reduces top-down control of emotion regulation. Reducing HPA axis activation could therefore allow a person to better utilize emotion regulation strategies. Slow-paced breathing can activate the parasympathetic nervous system through increasing vagal tone. In this study, we examined whether a short bout of slow-paced breathing could acutely improve emotion regulation in young adults. Participants were asked to regulate their emotional reactions to negatively valenced images using cognitive reappraisal to either increase, decrease, or maintain the emotional intensity. In the experimental condition, participants completed a 3-minute voluntary breath control exercise prior to the experimental trials. In the control condition, participants completed the experimental trials without a breathing exercise. This was a within-subjects design. An acute bout of slow-paced breathing prior to the emotional experience reduced negative valence and arousal ratings in response to negative images. Participants also reported greater success at emotion regulation following the breathing compared to the control condition. Therefore, slow-paced breathing may be an effective tool to acutely enhance emotion regulation abilities, possibly through the increase in parasympathetic nervous system activation.

This study explored the effects of an 8-week peer coaching program on physical activity (PA), diet, sleep, social isolation, and mental health among college students in the United States. A total of 52 college students were recruited and randomized to the coaching (n = 28) or the control group (n = 24). The coaching group met with a trained peer health coach once a week for 8 weeks focusing on self-selected wellness domains. Coaching techniques included reflective listening, motivational interviews, and goal setting. The control group received a wellness handbook. PA, self-efficacy for eating healthy foods, quality of sleep, social isolation, positive affect and well-being, anxiety, and cognitive function were measured. No interaction effects between time and group were significant for the overall intervention group (all p > 0.05), while the main effects of group difference on moderate PA and total PA were significant (p < 0.05). Goal-specific analysis showed that, compared to the control group, those who had a PA goal significantly increased vigorous PA Metabolic Equivalent of Task (METs) (p < 0.05). The vigorous METs for the PA goal group increased from 1013.33 (SD = 1055.12) to 1578.67 (SD = 1354.09); the control group decreased from 1012.94 (SD = 1322.943) to 682.11 (SD = 754.89); having a stress goal significantly predicted a higher post-coaching positive affect and well-being, controlling the pre-score and other demographic factors: B = 0.37 and p < 0.05. Peer coaching showed a promising effect on improving PA and positive affect and well-being among college students.

Brain development continues throughout childhood and requires micronutrients for optimal maturation, but studies have typically examined only a limited number of micronutrients and there has been inconsistent use of validated cognitive measures. This study evaluated the impact of providing low-income children with a daily fortified meal (570 kcal) in the form of a bar and shake containing >75% of the FDA Daily Values for all essential vitamins and minerals, as well as macronutrients (e.g., omega-3 and omega-6 fatty acids and protein), in an afterschool care setting (instead of the usual meal provided) on cognitive functioning. Students aged 8–12 were randomly assigned to intervention (n = 19) or control (n = 16) meals. Students completed the Stroop Color Word Task, Trail Making Test, and Conner’s Continuous Performance Task (CPT) at baseline and 3 months post-intervention. Differences in cognitive scores were examined using 2 × 2 mixed model ANOVAs (Stroop and CPT) and ANCOVAs (Trail Making Test). Significant main effects of time indicated improvements in both intervention and control groups, but there were no significant main effects of group or group*time interactions. When the amount of meal consumed was examined, most results became non-significant, suggesting that overall meal consumption significantly impacted the observed results. Overall, this pilot study suggests that there may be limited additional benefits to short-term consumption of micronutrient fortified meals among low-income children in an afterschool care setting, and potential benefits observed may be directly related to the amount of food consumed.