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Recent Research Publications and Funding
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November 30, 2007 6:00AM
The purpose of this study was to determine the factors that are associated with the use of prescription medication to control asthma in California's African-American, Latino, and White children from 1 to 11 years of age. This was a secondary analysis of parental reports of the use of prescription medication by children with current asthma symptoms (defined as MD diagnosis of asthma). These children were identified from a cross-sectional survey called the California Health Interview Survey (CHIS), 2001. An overall sample of 1,313 children with current asthma was used in the study. It was found that African-American children were 1.85 times (95% CI: 1.82, 1.88) more likely than White children were and 1.87 times (95% CI: 1.86, 1.90) more likely than Latino children to use prescription medication to control their asthma. Multivariate analysis showed an association with severity (mild, moderate, and severe symptoms), two childhood disability factors, and medication use. Asthma severity and disability (defined as affects to social role function) predicts the use of medications for African-American, Latino, and White children with asthma in California.
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November 29, 2007 6:00AM
The influences of high school community service participation, extracurricular involvement, and civic knowledge on voting and volunteering in early adulthood were examined using the National Educational Longitudinal Study. The major finding in this study is that both voluntary and school-required community service in high school were strong predictors of adult voting and volunteering. In addition, involvement in high school extracurricular activities was predictive of voting and volunteering. Civic knowledge was related only to voting. The authors consider the findings for their policy relevance and their contributions to theoretical debates.
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November 1, 2007 4:00AM
Respecting and understanding religious and cultural influences of gender-based violence inproves the care provided by forensic nurses.
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November 1, 2007 4:00AM
Leveraging funds to sustain the efforts of a grant-funded initiative is often an explicit, or implicit, expectation in philanthropy. However, the magnitude of funds leveraged and the factors that facilitate success in leveraging are rarely researched. An example of one of these grant-funded initiatives is the National Turning Point Initiative. Twenty-one states received funding from The Robert Wood Johnson Foundation as part of this initiative to establish and implement strategic goals for achieving significant statewide public health system improvement through diverse, cross-sector partnerships. Leaders from 17 of these 21 states participated in a two-phased study regarding the leveraging of additional funds for their public health infrastructure improvement activities. This article reports on the second phase of the study. In this phase, key informant interviews were conducted to examine how leveraging of resources occurred as part of this large national initiative. Findings indicate that the combination of a comprehensive planning process and a broad-based partnership was crucial in securing resources to expand their efforts. The ability to strategically respond to unexpected events and opportunities also helped states use their plans and partnerships to make the case for additional resources to improve their public health infrastructure.
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November 1, 2007 12:00AM
The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with antiretroviral therapy. Unhealthy behaviours, particularly substance-use behaviours, are utilized by many HIV-positive individuals to manage neuropathic symptoms. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of unhealthy behaviours to self-manage peripheral neuropathy in HIV disease. Sociodemographic and disease-related correlates and unhealthy behaviours were examined in a convenience sample of 1,217 respondents who were recruited from data collection sites in several US cities, Puerto Rico, Colombia, and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified a variety of unhealthy self-care behaviours including injection drug use, oral drug use, smoking cigarettes and alcohol ingestion. Specific unhealthy behaviours that participants reported to alleviate peripheral neuropathy included use of marijuana (n=67), smoking cigarettes (n=139), drinking alcohol (n=81) and street drugs (n=30). A subset of those individuals (n=160), who identified high levels of neuropathy (greater than five on a scale of 1-10), indicated significantly higher use of amphetamines and injection drug use in addition to alcohol use and cigarette smoking. For participants from Norway, substance use (using alcohol: 56%) was one of the most frequent self-management strategies. Implications for clinical practice include assessment and education of persons with HIV for self-care management of the complex symptom of peripheral neuropathy.
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October 31, 2007 4:00AM
OBJECTIVE: To provide information on the characteristics of eating disorders based on nationally representative samples of African American and Caribbean Black adults and adolescents. METHOD: Conducted between 2001 and 2003 the National Survey of American Life (NSAL) interviewed adults (n = 5,191) and adolescents (n = 1,170) in their homes. Professionally trained interviewers used the WMH Composite International Diagnostic Interview (WMH-CIDI-WHO Organization 2004-modified) to assess DSM-IV TR eating disorders. RESULTS: Anorexia was the rarest eating disorder among African American adults and adolescents, with age of onset for adults in mid adolescence. No 12-month case of anorexia was found among Caribbean Black adults. Binge eating was the most prevalent eating disorder among adults and adolescents. Persistence of disorders was lowest for anorexia and highest for binge eating disorder among adults. CONCLUSION: Prevalence of eating disorders within the U.S. Black population varies by type of disorder, age cohort, gender, and ethnic group among adults, and by type of disorder among adolescents. Clinicians need preparation and training to recognize and treat eating disorders in ethnically-diverse patient populations. (c) 2007 by Wiley Periodicals, Inc.
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October 14, 2007 4:00AM
OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.
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Pain Attitudes and Knowledge Among RNs, Pharmacists, and Physicians on an Inpatient Oncology Service| October 1, 2007 12:00AM
Patients with cancer often experience pain, yet studies continue to document inadequate and inappropriate assessment and management of cancer-related pain. This study aimed to evaluate the attitudes and knowledge of inpatient oncology healthcare providers toward pain management by surveying nurses, pharmacists, and physicians working on the inpatient oncology units at an academic medical center. Healthcare providers generally reported positive attitudes toward pain management but were deficient in their knowledge of pain management. The authors suggest that pharmacists become more integral members of palliative care teams and actively participate in rounds. A need exists for educational programs in pain management for healthcare providers, especially for those who do not routinely care for patients with cancer.
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September 10, 2007 4:00AM
Stalking is a significant public health and criminal justice issue. Lack of clarity exists about which behaviors constitute stalking or harassment. This study sought to understand behaviors that college women identify as stalking. Using a cor-relational design, 841 college women responded to stalking items from the National Violence Against Women Survey. Although 32% (n = 259) self-identified the experience as stalking, when a legal definition was applied, the rate of stalking identification dropped to 26% (n = 117). Specific stalking behaviors most predictive of an experience's being labeled as stalking were identified. Psychiatric nurses interact with individuals who experience stalking, which necessitates the importance of familiarity with stalking definitions.
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September 1, 2007 4:00AM
The quality of the maternal-child feeding interaction has been proposed to be an important contributor to a child's being overweight, yet assessment of this proposition has been hindered by a lack of age-appropriate instrumentation. The primary aim of this study was to examine the reliability of the Nursing Child Assessment of Feeding Scale (NCAFS) if extended to use during toddlerhood. A longitudinal design was used to assess NCAFS reliability at 12, 24, and 36 months. The NCAFS was used to code videotaped feeding observations of 116 mother-toddler dyads collected as part of a larger study examining mother-child interactions and adaptations of toddlers. Reliability was explored through the assessment of interrater reliability, internal consistency of the various subscales and the scale as a whole, and stability of the scale measurements over time. At each age, interrater reliability was generally quite good whereas the NCAFS' internal consistency was low. Maternal contributions to feeding interaction quality were stable over time but dyadic and child contributions were not. The lower internal consistency estimates were likely due to relatively low levels of variance among the dyads within each age. Another probable contributor to diminished internal consistency was the attrition of several behavior items due to zero variance. Possible explanations for this restriction of variance and several approaches for improving the NCAFS internal consistency during toddlerhood are considered. With revision, the NCAFS could be useful in assessment of feeding interaction quality during the transition to toddlerhood when issues of control and autonomy become increasingly prominent.