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Recent Research Publications and Funding
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June 1, 2010 4:00AM
National incidence rates of cervical cancer are disproportionately higher in African-American women, and cancers related to human papillomavirus (HPV) infection impose an enormous health burden of over $3.7 billion annually. Current efforts to use Hip Hop culture to address health disparities include disease prevention and health promotion. The use of Hip Hop cultural cues for HPV vaccination uptake and education was developed through an interdisciplinary collaboration. Interventions that incorporate youth values and beliefs are needed to reduce an escalating HPV infection trajectory. Prior research has shown that Hip Hop music has a significant influence on the sexual attitudes and behaviors of African-American emerging young women, providing a context within which to prevent risky behaviors. The current study examines the efficacy of a Hip Hop-based HPV vaccination uptake feasibility project that integrates wireless technology among African-American female college students. Findings suggest that cultural relevance of Hip Hop to the lives of young African-American women increases the acceptability of transmitted health messages. Discussion is centered on implications of wireless technology and Hip Hop as a viable approach to increase HPV vaccination, and a formal randomized control trial is planned.
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May 19, 2010 4:00AM
Purpose/Objectives: To describe the experiences of women who were diagnosed with breast cancer while also encountering intimate partner violence (IPV). IPV was determined by scores on the Women's Experience With Battering Scale and the Abuse Assessment Screen.
Research Approach: Qualitative interviews were conducted with a convenience sample of seven women. Data were analyzed with a hermeneutic phenomenologic approach.
Setting: Community settings in central Virginia and Maryland.
Participants: 7 participants ranging in age from 37-63 years (X = 50 years); age at diagnosis ranged from 36-58 years (X = 46 years). All were in relationships with men, and relationship length ranged from 2-29 years (X = 12 years).
Methodologic Approach: Each participant had one semistructured qualitative interview.
Main Research Variables: Experiences of women simultaneously experiencing breast cancer and IPV.
Findings: A number of themes emerged, including: (a) reassessing life, (b) believing that stress from the relationship caused the cancer, (c) valuing support from others, and (d) the significance of the breast.
Conclusions: For all of the participants, the breast cancer diagnosis changed their intimate relationships in some way. The cancer was an opportunity for the women to engage in life review, focus inward, and, in some cases, change the relationship status.
Interpretation: Increased awareness and screening for IPV are needed in oncology clinical settings. Women with cancer are members of a vulnerable population and use the diagnosis to reassess their intimate relationships.
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May 1, 2010 4:00AM
Social disparities in the receipt of contraceptive services were assessed among a sample of 2,031 sexually experienced adolescent females 15 to 18 years of age using secondary data from the National Longitudinal Study of Adolescent Health (Add Health). Findings revealed no social disparities in receipt of contraceptive services; rather, adolescent females who had a parent with less than a high school degree were more likely to receive contraceptive services. Adolescents' individual characteristics, including perceptions of maternal disapproval of sexual activity and use of contraceptives, barriers in access to and use of birth control, health needs, and enabling resources were significantly associated with their receipt of contraceptive services. Neighborhood characteristics were not significantly associated with adolescents' receipt of services in this study
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May 1, 2010 4:00AM
The purpose of this secondary data analysis was to describe the prevalence and treatment of anemia and test the impact of anemia on physical and psychosocial outcomes at baseline and following restorative care interventions. A total of 451 residents from 12 nursing homes participated in this study. The average age of the participants was 83.74 (SD = 8.24), the majority were female (79%), White (66%), and unmarried (90%). A total of 245 (54%) residents were anemic, and 66% were treated with at least one medication. Physical performance was worse in those with anemia, and those with anemia associated with chronic kidney disease had lower self-efficacy and outcome expectations for functional activities than those without anemia. There was no time by treatment interaction between those with and without anemia. The findings provide some additional support for the prevalence of anemia and suggest that those with anemia associated with chronic kidney disease are less motivated to engage in functional activities.
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May 1, 2010 4:00AM
In the ongoing Interdisciplinary Nursing Quality Research Initiative Program study, we are testing the impact of Function-Focused Care, which is an approach to care in which we work with assisted living (AL) residents and staff to optimize the functional and physical activities of residents during daily activity. The purpose of this article is to evaluate life satisfaction of AL residents with a focus on the impact of physical activity. In a sample of 171 older adults from 4 ALs, it was found that depression, social support from friends and experts, time in caregiving, and fear of falling all had a significant relationship with life satisfaction in AL. Physical activity was not related to life satisfaction in this study. Ongoing research is necessary to explore whether changing attitudes about physical activity among older adults and increasing social support related to physical activity can improve life satisfaction.
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April 9, 2010 4:00AM
CONTEXT: It is unclear whether young adult men who have ever been forced to have sex are at increased risk for sexual risk-taking, and whether their risk differs according to the gender of the perpetrator.
METHODS: Data from 1,400 males aged 18–24 who participated in the 2002 National Survey of Family Growth were used to determine the prevalence of a history of forced sex and the context of each respondent’s most recent experience with such assaults. Logistic regression analyses were conducted to examine the relationship between victimization and having a recent indicator of sexual risk (e.g., having had sex in the past year with five or more female partners, a female injection-drug user or an HIV-positive female). Separate analyses were performed for coercion by females and coercion by males.
RESULTS: Six percent of men reported having been forced by a female perpetrator to have vaginal intercourse, while 1% said they had been forced by a male perpetrator to have oral or anal sex. Men had an elevated likelihood of having had one or more recent sexual risk indicators if they had ever been forced to have sex by a male (odds ratio, 6.9) or female (3.3). Verbal and physical forms of coercion and provision of alcohol and drugs were commonly used by perpetrators of both genders.
CONCLUSIONS: A better understanding of the pathways linking sexual victimization to sexual risk-taking among men is needed. Clinicians working with young men should screen them for victimization and provide STD testing and referrals for counseling if abuse is suspected or disclosed.
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April 1, 2010 4:00AM
This study assesses sociodemographic and health-related factors associated with loneliness and outcome differences between loneliness groups using a sample of 13,812 older adults from the U.S Health and Retirement Study. Descriptive and bivariate analyses were followed by logistic regression to evaluate risks and analysis of covariance testing to determine outcome differences. Overall, prevalence of loneliness was 16.9%. Nonmarried status, poorer self-report of health, lower educational level, functional impairment, increasing number of chronic illnesses, younger age, lower income, and less people living in the household were all associated with loneliness. The chronically lonely group reported less exercise, more tobacco use, less alcohol use, a greater number of chronic illnesses, higher depression scores, and greater average number of nursing home stays. Future research evaluating the effectiveness of both prevention and treatment interventions for loneliness in older adults would provide empirical data to further guide gerontological nursing practice.
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April 1, 2010 4:00AM
e analyzed a statewide survey of individuals with chronic back and neck pain to determine whether prevalence and care use varied by patient race or ethnicity. We conducted a telephone survey of a random sample of 5,357 North Carolina households in 2006. Adults with chronic (>3 months duration or >24 episodes of pain per year), impairing back or neck pain were identified and were asked to complete a survey about their health and care utilization. 837 respondents (620 white, 183 black, 34 Latino) reported chronic back or neck pain. Whites and blacks had similar rates of chronic back pain. Back pain prevalence was lower in Latinos (10.4% [9.3-11.6] vs 6.3% [3.8-8.8]), likely due to their younger age; and the prevalence of chronic, disabling neck pain was lower in blacks (2.5% [1.9-3.1] vs 1.1% [.04-1.9]). Blacks had higher pain scores in the previous 3 months (5.2 vs 5.9 P < .05), and higher Roland disability scores (0-23 point scale): 14.2 vs 16.8, P < .05. Care seeking was similar among races (83% white, 85% black, 72% Latino). Use of opioids was also similar between races, at 49% for whites, 52% for blacks, and trended lower at 35% for Latinos. We found few racial/ethnic differences in care seeking, treatment use, and use of narcotics for the treatment of chronic back and neck pain.
PERSPECTIVE: This article presents new, population-based data on the issue of racial and ethnic disparities in neck- and back-pain prevalence and care. Few disparities were found; care quality issues may affect all ethnic groups similarly. Previous findings of disparities in chronic-pain management may be decreasing, or may perhaps be site specific.
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March 1, 2010 6:00AM
Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments
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March 1, 2010 6:00AM
The United States is facing a severe shortage of well-trained public health workers, and public health nursing is the discipline with the greatest shortage. A local public health agency's (LPHA's) staffing and leadership characteristics are critical in determining its programs, performance, and capacity. A better understanding of the relationship between specific staffing and leadership characteristics and public health programs is needed to address this capacity challenge.
Method: Data from the 2005 National Profile of Local Health Departments, were examined to identify associations between an LPHA's nursing workforce and the specific activities performed by LPHAs.
Results: LPHAs with a nurse as senior executive had a greater breadth of immunization, maternal/child health, and prevention activities than their nonnurse-led counterpart LPHAs, particularly in rural areas. Nurse-led LPHAs were less likely, however, to have a broad level of environmental health and regulation activities or to have recently conducted community assessment and planning activities.
Conclusions: Both LPHA nurse leaders and nursing staff play an important role in the provision of LPHA services, and a shortage of LPHA nursing leaders and staff, particularly in rural areas, will likely have a major impact on certain LPHA programs unless steps are taken to address these challenges.