Recent Research Publications and Funding

Background: Stroke survivors fall up to seven times more annually than healthy adults of a similar age. The inability to recover balance from slipping, tripping, or rapid ambulation accounts for the majority of falls, while balance control can prevent falls. An examination of the triggers for falls and balance recovery strategies for near falls is crucial for fall prevention in stroke survivors.

Purpose: To examine the self-reported triggers for falls and balance recovery strategies for near falls among community-dwelling stroke survivors.

Methods: Descriptive study examining fall-related data from stroke survivors (n=89) aged ≥ 50 years, at ≥ 3 months post-stroke, participating in a 12-week exercise intervention study. All subjects were interviewed weekly to ascertain fall/near fall data over the 12 weeks. Falls were defined as: “events in which subjects end up on the floor or ground when they did not expect to.” Near falls were defined as: “events in which subjects recovered their balance without falling.”

Results: Subjects (46% women) were on average 70±10 years old. The majority reported an ischemic stroke (80%), were White/European-American (79%), married/partnered (60%), college-educated (79%), and retired/unemployed (93%). Over the 12-week trial, there were a total of 124 fall-related events (n=34 falls, n=90 near falls); all events happened at home. Most falls happened due to slipping or tripping (21%) or rapid ambulation (18%). Other reported fall triggers included: legs or knees giving way (12%), bathroom related incidents such as incontinence (12%), reaching or leaning (6%), and vertigo or syncope (3%). Subjects most commonly recovered their balance without falling by grabbing onto or leaning against something (62%). A total of 29 (23%) fall-related events resulted in an injury, though only 8% of those events were evaluated by a healthcare provider.

Conclusion: Our data suggests that stroke survivors fall most frequently as a result of slipping, tripping or rapid ambulation. Future studies investigating the effects of fall prevention strategies on these fall triggers are recommended. Since balance recovery was aided by grabbing onto or leaning against something, post-stroke home safety evaluation is essential in preventing falls.

HIV-related fatigue continues to be the most common complaint of infected people. No physiological factors have been consistent predictors for fatigue; psychosocial factors, particularly depression, have emerged more consistently in studies. While clinicians would want to rule out common causes of fatigue such as hypothyroidism, hypogonadism, or anemia, there is scant research for most interventions, which makes it difficult to make definitive recommendations for their use. Modafinil has the strongest research evidence to date, with multiple studies finding it effective in relieving fatigue. However, researchers must continue to pursue ways to ameliorate fatigue in HIV infection, given the high financial, personal, and social costs suffered by people experiencing it.

DNA methylation is an epigenomic modification that is essential to normal human development and biological processes. DNA methylation patterns are heritable and dynamic throughout the life span. Environmental exposures can alter DNA methylation patterns, contributing to the development of complex disease. Identification and modulation of environmental factors influencing disease susceptibility through alterations in DNA methylation are amenable to nursing intervention and form the basis for individualized patient care. Here we describe the evidence supporting the translation of DNA methylation analyses as a tool for screening, diagnosis, and treatment of complex disease in nursing research and practice. The ethical, legal, social, and economic considerations of advances in genomics are considered as a model for epigenomic policy. We conclude that contemporary and informed nurse scientists and clinicians are uniquely poised to apply innovations in epigenomic research to clinical populations and develop appropriate policies that guide equitable and ethical use of new strategies to improve patient care.

The prevalence of loneliness is reported to be as high as 20% for school-age children. The purpose of this paper is to present an integrative review of quantitative studies of loneliness in samples of school age children. Thirty-six articles are included. Three different scales were used to assess loneliness. Loneliness related to negative psychological problems such as anxiety and depression, and to poor academic achievement. The school environment and both peer and family relationships contributed to loneliness. Only one school-based intervention was identified as potentially successful for alleviating loneliness.