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Recent Research Publications and Funding
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August 30, 2008 4:00AM
The primal face of pain (PFP) is postulated to be a common and universal facial expression to pain, hardwired and present at birth. We evaluated its presence by applying a computer-based methodology consisting of "point-pair" comparisons captured from video to measure facial movement in the pain expression by way of change across two images: one image before and one image after a painful stimulus (heel-stick). Similarity of facial expression was analyzed in a sample of 57 neonates representing both sexes and 3 ethnic backgrounds (African American, Caucasian and Hispanic/Latino) while controlling for these extraneous and potentially modulating factors: feeding type (bottle, breast, or both), behavioral state (awake or asleep), and use of epidural and/or other perinatal anesthesia. The PFP is consistent with previous reports of expression of pain in neonates and is characterized by opening of the mouth, drawing in of the brows, and closing of the eyes. Although facial expression was not identical across or among groups, our analyses showed no particular clustering or unique display by sex, or ethnicity. The clinical significance of this commonality of pain display, and of the origin of its potential individual variation begs further evaluation.
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August 1, 2008 4:00AM
Collective traumas can negatively affect large numbers of people who ostensibly did not experience events directly, making it particularly important to identify which people are most vulnerable to developing mental and physical health problems as a result of such events. It is commonly believed that successful coping with a traumatic event requires expressing one's thoughts and feelings about the experience, suggesting that people who choose not to do so would be at high risk for poor adjustment. To test this idea in the context of collective trauma, 2,138 members of a nationally representative Web-enabled survey panel were given the opportunity to express their reactions to the terrorist attacks of September 11, 2001, on that day and those following. Follow-up surveys assessing mental and physical health outcomes were completed over the next 2 years. Contrary to common belief, participants who chose not to express any initial reaction reported better outcomes over time than did those who expressed an initial reaction. Among those who chose to express their immediate reactions, longer responses predicted worse outcomes over time. Implications for myths of coping, posttrauma interventions, and psychology in the media are discussed.
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July 31, 2008 12:00AM
Comparing Psychiatric and Nonpsychiatric Nurse Reports on the Quality of Care in General Hospitals
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July 30, 2008 12:00AM
The Abuse Assessment Screen has been used since 1987 to identify and assess for intimate partner violence in a wide variety of clinical and research settings. It has been translated and successfully used in at least 7 languages in addition to English. Meanwhile, a growing body of research indicates that nonlethal strangulation (commonly called "choking") is a significant form of intimate partner violence and that choking has substantial consequences for the health of the woman. This paper describes the modification of the Abuse Assessment Screen to include "choking."
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July 15, 2008 12:00AM
It has been reported previously that the offspring of rat dams consuming low dietary copper (Cu) during pregnancy and lactation experience a deficiency in cardiac cytochrome c oxidase (CCO) characterized by reduced catalytic activity and mitochondrial and nuclear subunit content after postnatal d 10. The present study was undertaken to determine whether the cardiac CCO deficiency was caused directly by low postnatal Cu intake or whether it was a prenatal effect of low Cu intake by the dams that became manifest postnatally. Dams were fed either a Cu-adequate diet (6 mg Cu/kg) or Cu-deficient diet (1 mg Cu/kg) beginning 3 wk before conception and throughout gestation and lactation. One day following parturition, several litters from Cu-adequate dams were cross fostered to Cu-deficient dams and several litters from Cu-deficient dams were cross fostered to Cu-adequate dams. Litters that remained with their birth dams served as controls. CCO activity, the content of the mitochondrial-encoded CCO subunit 1 (COX1), and the content of the nuclear-encoded subunit COX4 in cardiac mitochondria were reduced in the 21-d-old offspring of Cu-deficient dams. COX1 content was normal in the 21-d-old cross-fostered offspring of Cu-deficient dams, but CCO activity and COX4 were reduced. Cross fostering the offspring of Cu-adequate dams to Cu-deficient dams did not significantly affect CCO activity, COX1 content, or COX4 content in cardiac mitochondria of 21-d-old offspring. These data indicate that low prenatal Cu intake by dams was the determinant of CCO activity in cardiac mitochondria of the 21-d-old offspring and may have led to the assembly of a less-than-fully active holoenzyme.
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July 10, 2008 4:00AM
Objective
In this pilot study, we evaluated the impact of providing patients with a literacy-appropriate diabetes education guide accompanied by brief counseling designed for use in primary care.
Methods
We provided the Living with Diabetes guide and brief behavior change counseling to 250 English and Spanish speaking patients with type 2 diabetes. Counseling sessions using collaborative goal setting occurred at baseline and by telephone at 2 and 4 weeks. We measured patients’ activation, self-efficacy, diabetes distress, knowledge, and self-care at baseline and 3-month follow-up.
Results
Statistically significant (p≤0.001) and clinically important (effect sizes=0.29–0.42) improvements were observed in participants’ activation, self-efficacy, diabetes-related distress, self-reported behaviors, and knowledge. Improvements were similar across literacy levels. Spanish speakers experienced both greater improvement in diabetes-related distress and less improvement in self-efficacy levels than English speakers.
Conclusion
A diabetes self-management support package combining literacy-appropriate patient education materials with brief counseling suitable for use in primary care resulted in important short-term health-related psychological and behavioral changes across literacy levels.
Practice implications
Coupling literacy-appropriate education materials with brief counseling in primary care settings may be an effective and efficient strategy for imparting skills necessary for diabetes self-management.
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July 1, 2008 4:00AM
Background: ELBW infants are vulnerable to cold stress during the transition from delivery room to intensive care. Infants produce heat by non-shivering thermogenesis (NST) and should exhibit peripheral vasoconstriction when cold, but little empirical evidence confirms that ELBW infants are capable of peripheral vasoconstriction.
Objective: This study evaluated the ability of ELBW infants weighing 400–1000 grams to exhibit peripheral vasoconstriction when body temperatures decreased.
Design/Methods: A within subject, multiple case design was used to explore the relationships between body temperature and peripheral vasoconstriction in 10 ELBW infants over their first 12 hours in the NICU. Abdominal temperature (AT) and peripheral temperature (PT) were measured in 1-min. intervals. Peripheral vasoconstriction is defined as AT 2°C above PT as established by Lyon et al. Each infant was evaluated for length of time spent with peripheral vasoconstriction.
Results: PT and AT were significantly correlated in each infant. One infant (BW: 880 gms) exhibited peripheral vasoconstriction and one infant (BW 960 gms) had AT 1°C greater than PT. Eight infants (BW: 510–720 gms) did not exhibit peripheral vasoconstriction. Seven infants spent at least 15% of their observations with PT > AT and these infants were most likely to have PT 1–2°C>AT. The peripheral-abdominal temperature difference increased during stressful procedures in some infants.
Conclusions: ELBW infants have little ability to vasoconstrict in response to NST. PT were more often > AT and this difference often increased during stressful clinical events. Vasomotor control appears immature at birth in infants <800 grams.
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June 14, 2008 4:00AM
The child sample of the National Longitudinal Survey of Youth (n.d.) was analyzed to examine the relation of undesirable personality change in early childhood to neighborhood economic deprivation. Participants in the survey who had complete data at Time 1 (3-4 years of age) and Time 2 (5-6 years of age) and who remained in the same neighborhood during both time periods were included in the analyses. The results indicated that neighborhood economic disadvantage was associated with undesirable personality change even after controlling for family-level variables such as maternal education, family income, and cognitive and emotional support in the home environment for children. The association of personality change with neighborhood economic deprivation was not mediated by maternal depression, Head Start participation, cognitive and emotional support in the home, or maternal trust in the neighborhood. The authors discuss recommendations for future investigations. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
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June 1, 2008 4:00AM
The primary aims of this study were to determine the reliability and validity of 2 measures: the Nursing Assistant Self-efficacy for Restorative Care Scale and the Nursing Assistant Outcome Expectations for Restorative Care Scale. This study included 386 nursing assistants from 8 nursing homes. The findings provide some support for the reliability and validity of these measures on the basis of Rasch analysis, confirmatory factor analysis, and convergent validity.
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June 1, 2008 4:00AM
We examined the availability of fast food restaurants and convenience stores within walking distance (0.5 miles or 805 m) of US public secondary schools. We found that one-third of schools nationwide have at least one fast food restaurant or convenience store within walking distance. In multivariate analyses, schools in the lowest-income versus the highest-income neighborhoods have more fast food restaurants and convenience stores, while schools in African-American versus White neighborhoods generally have fewer food outlets. Furthermore, urban neighborhoods with a high school versus no secondary school have more food outlets. Curbing the obesity epidemic among adolescents requires addressing the food environment surrounding schools.