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Recent Research Publications and Funding
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February 28, 2014 6:00AM
Incidences of both human papillomavirus (HPV) infection and HPV-related cancers are on the rise in men. However, vaccine uptake is low. Parental consent is required prior to receiving the HPV vaccine. This study examined parental perceptions of the HPV vaccine for boys through survey methods (N = 422) and focus groups (N = 45).
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February 10, 2014 6:00AM
Misclassification of race in medical and mortality records has long been documented as an issue in American Indian/Alaska Native data. Yet, little has been shared in a cohesive narrative which outlines why misclassification of American Indian/Alaska Native identity occurs. The purpose of this paper is to provide a summary of the current state of the science in racial misclassification among American Indians and Alaska Natives. We also provide a historical context on the importance of this problem and describe the ongoing political processes that both affect racial misclassification and contribute to the context of American Indian and Alaska Native identity.
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February 1, 2014 6:00AM
Aim: To determine the relationship between quality of life (QoL) and perceived self reported symptoms in an elderly, ambulatory, urban population living with heart failure (HF).
Background: While arrhythmias in the elderly with HF are well documented, the association between perceived arrhythmia symptoms and QoL is not well defined.
Design: Prospective, cross sectional single center study.
Methods: A single-center, prospective study was conducted with HF patients recruited from an urban outpatient cardiology clinic in the United States. Fifty-seven patients completed a baseline QoL survey with 42 of these completing the 6-month follow-up survey. QoL was evaluated with the SF-36v2™ and frequency of symptoms with the Atrial Fibrillation Severity Scale. Subjects wore an auto triggered cardiac loop monitor (LifeStar AF Express®) for 2-weeks to document arrhythmias. Data analysis utilized Spearman’s rank correlation and logistic regression.
Results: Baseline and 6-month QoL measures did not correlate with recorded arrhythmias. However, perceptions of diminished general health correlated significantly with symptoms of exercise intolerance, lightheadedness/dizziness, palpitations, and chest pain/pressure. By multivariable logistic regression, more severe perceived arrhythmic, symptoms of exercise intolerance, and lightheadedness/dizziness were independently associated with diminished QoL.
Conclusion: QoL was significantly worse in patients with perceptions of severe arrhythmic episodes and in those whose symptoms of dizziness and exercise intolerance.
Relevance to clinical practice: The findings of this study indicate that symptomatic HF patients suffer from poor QoL and that interventions are needed to improve QoL and decrease symptom severity. Nurses who care for HF patients play an essential role in symptom evaluation and management and could significantly improve overall QoL in these patients by carefully evaluating symptomatology and testing interventions and educational programs aimed at improving QoL.
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February 1, 2014 6:00AM
Objectives: Participants will be able to: 1. Identify risk assessment for sexually transmitted infection (STI) exposure. 2. Explore communication skills and their role in preventing STIs. 3. Use Second Life, a virtual environment, as an educational intervention to increase the knowledge of safer sex practices and viral STI risk reduction. Purpose: This study aims to use Second Life, a virtual environment, as an educational intervention to increase the knowledge of safer sex practices and viral STI risk reduction. Methodology: Female college students at two large universities were recruited to complete a cross-sectional questionnaire that assessed the dependent variables of sexual intercourse refusal; ability to question potential sexual partners; condom use; and level of worry concerning contracting various STIs. The participants’ information was correlated with the events collected from the exhibit and contained within Moodle’s primary MySQL Database. Results: Demographic data were obtained from all of the research participants. The study sample was mostly female (60%) and composed of second-year college students (60%). All of the research participants were in school full-time and had never been married. Eighty percent lived off-campus in a house or apartment. Most research participants (60%) had no previous experience with Second Life. Almost half (40%) found the exhibit “very” useful. All participants reported that they learned something new and most (60%) indicated that what they learned would lead to a behavior change. Implications for women’s health: This study enrolled students who had consistent access to computers with updated systems at their respective universities. Another advantage was the excitement associated with a new, stimulating adventure. This explosive tactile experience mentally captivated participants and drew them in. Last, the use of a virtual world exceeded current barriers by increasing the scope of people who could be reached.
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January 30, 2014 6:00AM
The purpose of this study was to explore perceptions of dating relationships and teen dating violence prevention within a predominantly Cuban American community in Miami-Dade County. The information generated from this study can be used to develop culturally tailored teen dating violence prevention programs targeting youth of Hispanic origin.
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January 30, 2014 6:00AM
The purpose of this study was to explore perceptions of dating relationships and teen dating violence prevention within a predominantly Cuban American community in Miami-Dade County. Eight focus groups (n = 74 participants) with adolescents of Hispanic origin (n = 29), their parents (n = 29), and school personnel (n = 16) were conducted and analyzed using content analysis. Four themes characterized the nature and context of dating relationships among adolescents of Hispanic origin: YOLO -You Only Live Once, cultural unity but social division, dating is not going out, and the social environment challenges healthy relationships. The information generated from this study can be used to develop culturally tailored teen dating violence prevention programs targeting youth of Hispanic origin.
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January 22, 2014 6:00AM
Many women experience anxiety during pregnancy with potential negative effects on maternal, birth, and child outcomes. Because of potential risks of fetal exposure to psychotropic medications, efficacious non-pharmacologic approaches are urgently needed. However, no published studies of psychotherapeutic treatments for anxiety in pregnancy exist. Mindfulness-based cognitive therapy (MBCT) may substantially reduce anxiety and co-morbid symptoms in people with anxiety disorders. Coping with Anxiety through Living Mindfully (CALM) Pregnancy is an adaptation of MBCT designed to address anxiety in pregnant women. This study examined the feasibility, acceptability, and clinical outcomes of the CALM Pregnancy intervention in pregnant women anxiety. Twenty-four pregnant women with generalized anxiety disorder (GAD) or prominent symptoms of generalized anxiety participated in an open treatment trial of the CALM Pregnancy group intervention. Psychiatric diagnoses were determined by structured clinical interview, and self-report measures of anxiety, worry, depression, self-compassion, and mindfulness were completed at baseline and post-intervention. Qualitative feedback was elicited via questionnaire. Twenty-three participants completed the intervention with high attendance and good compliance with home practice. Completers showed statistically and clinically significant improvements in anxiety, worry, and depression, and significant increases in self-compassion and mindfulness. Of the 17 participants who met GAD criteria at baseline, only one continued to meet criteria post-intervention. Participants regarded their experience in the intervention to be overwhelmingly positive. MBCT in the form of the CALM Pregnancy intervention holds potential to provide effective, non-pharmacological treatment for pregnant women with anxiety. These promising findings warrant further testing of the intervention with a randomized controlled trial.
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January 19, 2014 6:00AM
OBJECTIVE: The risk for pressure ulcers is rarely identified in the perioperative period, and the influence of this period on risk factors has not been as rigorously studied as the postoperative period. We hypothesized that intraoperative risk factors exist, which increase the likelihood of a postoperative new-onset pressure ulcer.
DESIGN: A retrospective observational study.
SETTING: A large midwestern U.S. quaternary care institution.
PATIENTS: A total of 2,695 adult surgical patients underwent operative procedures and received care in one of three ICUs using an electronic documentation application.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was hospital-acquired pressure ulcer categorized as stages II, III, and IV; deep tissue injury; or unstageable. Univariate analyses comparing patients with and without the outcome of pressure ulcers were conducted for each preoperative characteristic or comorbidity. Patients were matched using the logit of the propensity score based solely on their preoperative comorbidities. Adjusted associations between development of pressure ulcers and intraoperative characteristics were determined in the postmatch cohort. We identified seven independent preoperative patients' characteristics and comorbidities in our adult surgical patient sample: American Society of Anesthesiologists risk classification 4 or 5, underweight body mass index, noncardiac surgery, history of congestive heart failure, renal disease, existing airway present prior to arrival in the operating room, and age. The only significant association in the matched dataset accounting for patient preoperative variability is the use of intraoperative blood products.
CONCLUSION: Postoperative pressure ulcers developed in 10.7% of critically ill patients in our study. Only intraoperative use of blood products, not operative case length, hypotension, or vasopressor use, was associated with postoperative pressure ulcer development on adjusted analysis.
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January 17, 2014 6:00AM
OBJECTIVE: To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life.
DESIGN: Single-blind, randomized controlled trial.
SETTING: General community.
PARTICIPANTS: Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke.
INTERVENTIONS: Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls.
MAIN OUTCOME MEASURES: Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index.
RESULTS: During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%.
CONCLUSIONS: TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended.
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The effect of cardiac genetic testing on psychological well-being and illness perceptions| January 15, 2014 6:00AM
The objective of this study was to assess the effects of positive cardiac genetic diagnoses, ICD discharges, and arrhythmias on measures of psychological well-being.