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Robert Atkins, Ph.D., R.N.
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August 17, 2010
Although there is a considerable literature on how adolescents make decisions which lead to risky behaviors (e.g., unprotected sex, drug use) and adversely affect the health and well-being of youth, little is known about the routine behaviors youth engage in which influence their health (e.g., having permanent teeth extracted, discontinuing antibiotics prematurely, delaying or going without treatment of subacute illnesses and minor injuries) and concomitantly the factors which influence these behaviors. In an effort to begin to fill this gap, we have undertaken a study of routine health behaviors and the factors which bear on them in adolescents from a high-poverty urban neighborhood. In this article, we present the results of the pilot phase of the study in which we documented the behavior of 10 adolescents from Camden, New Jersey, the fifth poorest city in the United States, and explored with them their perceptions of the decisions they made and the factors that gave rise to them. We found that participants had an insufficient understanding of their health problems and consequences of their health actions, problems in understanding and being understood by health care professionals, and reluctance to involve parents in routine health care decisions. The implications of these findings are discussed in relation to improving the health of vulnerable youth.
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Joachim Voss, Ph.D., R.N.
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June 8, 2010
Adults age 55 and older with hematological malignancies who require hematopoietic cell transplantation (HCT) for survival are at risk for a number of nonmalignancy-related, potentially life-threatening outcomes, often due to suboptimal immune function. Evidence is emerging regarding how abnormal glycemic levels-newly termed malglycemia-impair cells of the immune system. Further, older adult HCT recipients appear highly susceptible to malglycemic states, particularly hyperglycemia, due to treatment regimens, nutritional imbalances, states of immobility, and stress, all coupled with the natural aging process. Patients with preexisting diabetes may be at further risk for malglycemic states. The growing number of older adults receiving HCT will substantially increase the likelihood nurses will have to provide care to HCT survivors. Therefore, it is important nurses in all practice settings have an understanding of the short- and long-term effects of glycemic status on immune function. Copyright 2009, SLACK Incorporated.
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Kathryn Laughon, Ph.D., R.N.
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May 19, 2010
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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Nancy Hanrahan, Ph.D., R.N.
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March 1, 2010
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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Cindy Anderson, Ph.D., R.N.
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February 22, 2010
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.