Recent Research Publications and Funding

The advent of the Human Genome Project has allowed for increased understanding and sophistication in diagnosis, treatment methods, and overall care planning on the part of healthcare providers for children with genetic disorders. Genetics research dealing with polymorphic changes within a genome has opened the door to awareness of how dormant genetic alleles may become active when coupled with certain environmental insults. Such genetic aberrations may place a child at a higher risk for health disparities when exposed to environmental toxins. It has been posited that such exposure in children with an arylsulfatase-A (ASA) allelic variation is associated with increased risk for neurodevelopmental damage. This initial study contributes to this new field and supports development of finer-tuned methods to prevent ominous outcomes of lead exposure. The purpose of this study was to explore the incidence of children in a representative sample from a Midwest metropolitan city with positive test results for the ASA allelic variation who have been exposed to the environmental toxin lead. In this corollary study of 107 children, part of a parent study on the behavior of African American children prenatally exposed to cocaine, 45% were found to be heterozygous, 11% mutant homozygous, and 44% normal in terms of ASA allele or alleles. Further studies on neurodeficiencies, low-level exposure to environmental toxins, and allelic variations must be conducted before a relation between ASA allelic variance and environmental lead can be determined.  

 PURPOSE/OBJECTIVES: To describe perceived breast cancer risk, identify the percentage of women with inaccurate risk perceptions, and examine the influence of perceived and objective risk on screening behavior.

DESIGN: Descriptive, correlational, cross-sectional.

SETTING: Community settings in a metropolitan area on the western coast of the United States.

SAMPLE: Multicultural sample of 184 English-speaking women (57% non-Caucasian, X age = 47 +/- 12 years) who have never been diagnosed with cancer.

METHODS: Two perceived risk scales (verbal and comparative) and the Gail model were used to assess perceived and objective breast cancer risk, respectively.

MAIN RESEARCH VARIABLES: Perceived breast cancer risk, objective breast cancer risk, screening behavior.

FINDINGS: Participants reported that they "probably will not" get breast cancer and that their risk was "somewhat lower" than average. Family history of breast cancer was a significant predictor of perceived risk. Demographic characteristics and objective risk factors were not associated with perceived risk. Most women at high risk for breast cancer (89%) underestimated their actual risk; fewer women with low to average risk for breast cancer (9%) overestimated their risk. Age, Gail scores, and health insurance status promoted breast cancer screening; underestimation of risk had the opposite effect.

CONCLUSIONS: Inaccurate perceptions of risk do not promote optimal breast cancer screening. The finding has implications for most women at high risk for developing breast cancer who underestimate their risk.

IMPLICATIONS FOR NURSING: Oncology nurses can use risk assessment tools to provide individualized counseling regarding breast cancer risk factors and screening. Women at high risk who underestimate their risk could benefit from additional screening and from advances in cancer chemoprevention.

A shortage of RNs is a problem that has reached crisis levels in the United States and many other countries. The inadequate supply of RNs translates into limited access for individuals who need health care. The U.S. psychiatric-mental health RN (PMH RN) workforce is virtually unstudied. The purposes of this article are to present a nationally representative demographic, education, and employment profile of PMH RNs, analyze issues associated with the supply of PMH RNs, and discuss options for building the PMH RN workforce.  

This is a qualitative study report from a parent study that used a concurrent mixed methods design whose aim was to describe the transition and self-management experiences of patients diagnosed with type 2 diabetes mellitus (T2DM) and stage 3 chronic kidney disease (CKD). Six adult men and women recruited from outpatient clinics completed two focus group interviews. Discerned in the ethnographic analysis of interviews and field notes using ATLAS/ti was a pattern of Health Literacy Self-Management with two major threads: (a) transition experience to self-advocacy characterized as seeking useful resources and difficulties in resource use and (b) partnering with the health care provider (HCP) characterized as helpful messaging and messaging confusion. Self-management support includes a shared responsibility and developmental process by the patient and the HCP to achieve quality care. Description of behavioral factors and self-management processes provides a foundation for future study.