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Jennifer Doering, Ph.D., R.N.
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August 9, 2009
The purpose of this study was to identify whether severe postpartum fatigue at 1 and 3 months postpartum was associated with depressive symptomatology at 6 months in lower-income urban women. A convenience sample of 43 lower-income postpartum women completed the Modified Fatigue Symptoms Checklist and Edinburgh Postpartum Depression scale at 1, 3, and 6 months postpartum. Participants who were severely fatigued at both 1 and 3 months postpartum were significantly more likely to exhibit depressive symptomatology at 6 months. Fatigue and depressive symptoms were moderately to strongly correlated at 1 (r = .68), 3 (r = .74), and 6 (r = .70) months postpartum (p = .001). Severe fatigue and depressive symptomatology often co-exist for months after childbirth. Future research should examine whether interventions to targeting severe postpartum fatigue in lower-income urban women may also effectively reduce depressive symptoms.
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Evaluating the Role of Serotonin in Hot Flashes after Breast Cancer using Acute Tryptophan DepletionDiane Von Ah, Ph.D., R.N. | June 30, 2009
OBJECTIVE: Among women with breast cancer, hot flashes are frequent, severe, and bothersome symptoms that can negatively impact quality of life and compromise compliance with life-saving medications (eg, tamoxifen and aromatase inhibitors). Clinicians' abilities to treat hot flashes are limited due to inadequate understanding of physiological mechanisms involved in hot flashes. Using an acute tryptophan depletion paradigm, we tested whether alterations in central serotonin levels were involved in the induction of hot flashes in women with breast cancer. METHODS: This was a within-participant, double-blind, controlled, balanced, crossover study. Twenty-seven women completed two 9-hour test days. On one test day, women ingested a concentrated amino acid drink and encapsulated amino acids (no tryptophan) according to published procedures that have been shown to have specific effects on serotonin within 4.5 to 7 hours. On the other test day, women ingested a control drink. Serial venous blood sampling and objective hot flash monitoring were used to evaluate response to each condition. RESULTS: Response to acute tryptophan depletion was variable and unexplained by use of selective serotonin reuptake inhibitors, antiestrogens, breast cancer disease and treatment variables, or genetic polymorphisms in serotonin receptor and transporter genes. Contrary to our hypothesis, hot flashes were not worsened with acute tryptophan depletion. CONCLUSIONS: Physiologically documented and self-reported hot flashes were not exacerbated by tryptophan depletion. Additional mechanistic research is needed to better understand the etiology of hot flashes.
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Genetic and Environmental Risks for High Blood Pressure Among African American Mothers and DaughtersJacquelyn Taylor, Ph.D., PNP-BC, R.N. | June 30, 2009
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.
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Nancy Hanrahan, Ph.D., R.N.
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April 30, 2009
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.
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Diane Von Ah, Ph.D., R.N.
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April 30, 2009
Purpose/Objectives: To examine relationships between capacity to direct attention and the quality-of-life (QOL) domains of psychological and physical well-being in breast cancer survivors.Design: Descriptive, correlational.Setting: National Cancer Institute-designated oncology and county hospital outpatient clinics in the midwestern region of the United States.Sample: 134 breast cancer survivors aged 32-79 years (X = 56.3, SD = 9.4) with a mean of 6.4 years since diagnosis (SD = 2.8, range = 1-10).Methods: Secondary analysis of questionnaire data measuring cognitive dysfunction and two QOL domains. Descriptive statistics, Pearson or Spearman correlations, and multiple regression analysis were used.Main Research Variables: Capacity to direct attention, as well as psychological and physical well-being.Findings: Deficits in capacity to direct attention were related to poorer QOL, including more depressive symptoms, lower well-being, poorer physical functioning, and greater fatigue.Conclusions: Capacity to direct attention was related to psychological and physical well-being in breast cancer survivors.Implications for Nursing: Nurses are in a prime position to assess breast cancer survivors' capacity to direct attention and resulting relationships with QOL. Findings suggest that nursing interventions that address survivors' capacity to direct attention may have a broad impact on QOL.