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Recent Research Publications and Funding
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March 1, 2010 6:00AM
As part of a larger randomized controlled trial examining the efficacy of an HIV/AIDS symptom management manual (n = 775), this study examined the prevalence of peripheral neuropathy in HIV-infected individuals at 12 sites in the USA, Puerto Rico, and Africa. Neuropathy was reported by 44% of the sample; however, only 29.4% reported initiating self-care behaviors to address the neuropathy symptoms. Antiretroviral therapy was found to increase the frequency of neuropathy symptoms, with an increased mean intensity of 28%. A principal axis factor analysis with Promax rotation was used to assess the relationships in the frequency of use of the 18 self-care activities for neuropathy, revealing three distinct factors: (i) an interactive self-care factor; (ii) a complementary medicine factor; and (iii) a third factor consisting of the negative health items of smoking, alcohol, and street drugs. The study's results suggest that peripheral neuropathy is a common symptom and the presence of neuropathy is associated with self-care behaviors to ameliorate HIV symptoms. The implications for nursing practice include the assessment and evaluation of nursing interventions related to management strategies for neuropathy.
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March 1, 2010 6:00AM
OBJECTIVES: To describe the environmental health (EH) demands placed on public health nurses (PHNs) as well as the barriers and facilitators to incorporating EH into PHN practice.
DESIGN AND SAMPLE: A cross-sectional multimode (Web and pencil/paper) survey was used to collect data from PHNs in 1 rural western state. Research participants included 141 PHNs from a total of 228 survey invitations (61% response).
MEASURES: A 39-item questionnaire was developed to measure the frequency of EH demands experienced by PHNs as well as the barriers and facilitators to the incorporation of EH into PHN practice and standard demographics.
RESULTS: Significant numbers of PHNs reported less than baccalaureate preparation (29%), suggesting that EH competencies cannot be assumed. PHNs are often asked for basic EH information and cite lack of time and lack of interest on the part of the populations being cared for as barriers to incorporating EH into their practice. Facilitators included free or inexpensive continuing education programs offered via the Internet and additional Internet resources or staff resource people.
CONCLUSION: PHNs represent a significant portion of the public health workforce and have implied and explicit mandates to address EH issues in their practice. Resources should be directed toward helping PHNs become better prepared to address the current and future EH needs of populations.
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February 22, 2010 6:00AM
Little is known about the consequences of maternal copper (Cu) deficiency on the vascular function of offspring or on perpetuation of vascular effects to a second generation. We examined vascular functional responses in mesenteric arteries from Cu-deficient Sprague-Dawley rat dams and from offspring directly exposed to maternal Cu deficiency during development and lactation and perpetuation of the effects in a second generation of offspring. Dams were fed a diet with marginal (1 mg Cu/kg) or adequate (6 mg Cu/kg) Cu for 3 weeks before conception and throughout pregnancy and lactation periods. Half of the first generation (F1) litters were cross-fostered. At reproductive maturity, F1 pairs were bred within groups resulting in second generation (F2) offspring. At 9 weeks of age, mesenteric artery (200 μm) isometric tension was determined in response to vasoconstrictors and vasorelaxants using a small artery wire myograph. Cu deficiency did not alter the vascular function in dams. In F1 offspring, increased responsiveness to potassium chloride in male offspring was due to direct exposure to maternal Cu deficiency in the birth mother, while enhanced endothelium-dependent relaxation responses in female offspring resulted from postnatal exposure to maternal Cu deficiency. Increased endothelium independent and decreased endothelium-dependent relaxation responses were identified in F2 Cu-deficient male offspring. These data indicate that exposure to maternal Cu deficiency during critical windows of development alter the vascular function across two generations of offspring.
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February 1, 2010 6:00AM
Latino immigrants have unique stressors that can influence mental health. The challenges of adapting to a new society include language barriers, separation from family, and feelings of loss, which can lead to depression. Low health literacy may make it difficult to obtain health care services, and depression may then go untreated. This secondary data analysis examined the relationships of immigration demands, health literacy, and depression in a sample of recent Latino immigrants. Depressive symptoms were a significant problem; 26% of the participants reported symptoms that were suggestive of depression. Furthermore, low health literacy and greater immigration demands predicted higher depression scores. The study suggests that recent Latino immigrants would benefit from health literacy training, education on depressive symptoms, and better access to mental health services. Latinos who do access health care services need to be screened for depression; furthermore, home health care nurses can promote access to support and health care services.
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January 7, 2010 6:00AM
Objective: To explore body temperature in relationship to heart rate in extremely low birth weight (ELBW) infants during their first 12 hours to help identify the ideal set point for incubator control of body temperature. Design: Within subject, multiple-case design. Setting: A tertiary neonatal intensive care unit (NICU) in North Carolina. Participants: Ten infants born at fewer than 29 weeks gestation and weighing 400 to 1,000 g. Methods: Heart rate and abdominal body temperature were measured at 1-minute intervals for 12 hours. Heart rates were considered normal if they were between the 25th and 75th percentile for each infant. Results: Abdominal temperatures were low throughout the 12-hour study period (mean 35.17-36.68 1C). Seven of 10 infants had significant correlations between abdominal temperature and heart rate. Heart rates above the 75th percentile were associated with low and high abdominal temperatures; heart rates less than the 25th percentile were associated with very low abdominal temperatures. The extent to which abdominal temperature was abnormally low was related to the extent to which the heart rate trended away from normal in 6 of the 10 infants. Optimal temperature control point that maximized normal heart rate observations for each infant was between 36.8 1C and 37 1C. Conclusions: Hypothermia was associated with abnormal heart rates in transitional ELBW infants. We suggest nurses set incubator servo between 36.8 1C and 36.9 1C to optimally control body temperature for ELBW infants.
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January 7, 2010 6:00AM
Methylmercury is a known neurotoxin especially harmful to the fetus, infant, and child. Preventing exposure to this environmental toxin is best accomplished through consumer messages specifically adapted for local populations. Health care providers play an important role in the dissemination of information. The purpose of this article is to review the benefits and risks of fish consumption and identify strategies for presenting effective risk communication messages to vulnerable groups, particularly women of childbearing age.
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January 4, 2010 6:00AM
Purpose: To provide the advanced practice nurse (APN) information on the prevalence and causes of anemia in elderly nursing home (NH) residents, in order to affect diagnostic and management strategies that may help improve physical function and mobility outcomes.
Data Sources: Literature review of current peer-reviewed research articles.Conclusions: In the United States, the prevalence of anemia increases with advancing age, and are reported to be much higher among older NH residents than among community-dwelling older adults. Causes of anemia among the elderly are often multifactorial. Older individuals with anemia, including mild anemia and even low normal level, have demonstrated lower muscle strength, physical function, mobility, and increased morbidity and mortality outcomes.Implications for Practice: Given the potentially significant relationship between anemia and physical performance outcomes among NH residents, gaining a better understanding will help guide future evidence-based care by allowing the APN an opportunity to tailor both medical and restorative care interventions. Because anemia is a potentially modifiable condition, intervention may preserve, limit, or reverse functional impairment and/or disablement, and allow for maximal functional independence. -
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January 1, 2010 6:00AM
Stalking is a serious public health and societal concern affecting the college population. Although numerous studies illustrate the physical and mental effects of stalking, literature addressing how individuals cope with this phenomenon is lacking. The purpose of this study was to describe stalking experiences of college students and the coping strategies used to manage stalking. In this descriptive study, 262 college students completed an online survey that included a stalking questionnaire and coping survey. Slightly more than one-fourth of the sample (n = 69) reported experiencing stalking victimization. Results indicated that the most common coping strategies employed were: ignoring the problem, minimizing the problem, distancing, detaching or depersonalizing, using verbal escape tactics, attempting to end the relationship, controlling the interaction, and restricting accessibility. Implications for refining current practice and research on coping strategies and stalking are suggested.
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An Evidence-Based Review on Guided Imagery Utilization in Adult Cardiac Surgery| January 1, 2010 6:00AM
This article illustrates a comprehensive review, synthesis, and critical appraisal of the research evidence surrounding guided imagery utilization in cardiac surgery. By adding guided imagery in the "usual care" of adult cardiac surgery patients, pre- and postoperative anxiety and pain, as well as hospital length of stay may be reduced. However, in spite of fairly strong "level" of evidence, the limited number of studies and low research quality deter the full acceptance of guided imagery as a standard therapeutic modality in this population. Acute and critical care nurses can offer guided imagery to their patients based on the documented safety of its use and clinically significant findings that it may have a direct impact on patients' recovery outcomes. Higher quality, methodologically rigorous, and larger-scale studies are warranted to establish the efficacy and standard utilization of guided imagery during perioperative and rehabilitative periods. Future studies should also address long-term outcomes, specifically on physical and psychological health, well-being, and overall quality of life after cardiac surgery.
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January 1, 2010 6:00AM
Previous research on legacy making includes Chochi- nov et al.’s (2005) work on dignity therapy, during which older adults with end-stage malignancies dis- cussed issues that mattered most to them or that they most wanted remembered about themselves. Coyle (2006) reported that adults living with ad- vanced cancer were concerned about how they would be remembered, and the creation of a legacy was uni- versal to all participants. Bereaved parents and sib- lings reported that children living with cancer created legacies that were both intentional and ser- endipitous in nature (Foster et al., 2009). These studies suggest that it is important for many dying individuals to create a legacy and know they will be remembered. As a nursing scientist studying continuing bonds and legacy making at the end-of-life since 2004, I found that this phenomenon appeared very different to me after it recently and suddenly became a very personal part of my own life. A 33-year-old loved one was diagnosed with squamous cell oral cancer, quickly deteriorated, and died just 6 months later. I was suddenly living within my own research phenomenon of interest and observing legacy making through a different lens. During the last few weeks of Henry’s life (real name not used to maintain privacy), it struck me that I should write about my obser- vations, and he agreed for me to write and share this small part of his life and death. This article reflects what I wrote in the waiting room just weeks before his death.