Recent Research Publications and Funding

  •  | September 4, 2013 4:00AM

    OBJECTIVE: To test instrumentation and develop analytic models to use in a larger study to examine developmental trajectories of body temperature and peripheral perfusion from birth in extremely low-birth-weight (EBLW) infants.

    DESIGN: A case study design.

    SETTING: The study took place in a Level 4 neonatal intensive care unit (NICU) in North Carolina.

    PARTICIPANTS: Four ELBW infants, fewer than 29 weeks gestational age at birth.

    METHODS: Physiologic data were measured every minute for the first 5 days of life: peripheral perfusion using perfusion index by Masimo and body temperature using thermistors. Body temperature was also measured using infrared thermal imaging. Stimulation and care events were recorded over the first 5 days using video which was coded with Noldus Observer software. Novel analytical models using the state space approach to time-series analysis were developed to explore maturation of neural control over central and peripheral body temperature.

    RESULTS/CONCLUSION: Results from this pilot study confirmed the feasibility of using multiple instruments to measure temperature and perfusion in ELBW infants. This approach added rich data to our case study design and set a clinical context with which to interpret longitudinal physiological data.

  •  | August 22, 2013 4:00AM

    Determine the predictors and correlates of HPV vaccination among girls and boys ages 9 to 13 living in rural Georgia to determine intervention points to increase HPV vaccination knowledge in areas where health disparities exist and HPV vaccine rates are extremely low.

  •  | August 14, 2013 4:00AM

    This nonpharmacologic intervention reduced depressive symptoms in both African-American subjects with and without financial strain. However, screening for and helping people manage financial strain may boost the magnitude of intervention benefit for those with financial strain and should be explored as part of depression care.

  • First Trimester Dietary Intake, Biochemical Measures, and Subsequent Gestational Hypertension Among Nulliparous Women
     | August 13, 2013 4:00AM

    The purpose of this study was to evaluate the relationships between first-trimester dietary factors and biochemical measures and subsequent risk of gestational hypertension.

  •  | August 1, 2013 4:00AM

    Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent–child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models.

  •  | August 1, 2013 4:00AM

    Millions of people witnessed early, repeated television coverage of the September 11 (9/11), 2001, terrorist attacks and were subsequently exposed to graphic media images of the Iraq War. In the present study, we examined psychological- and physical-health impacts of exposure to these collective traumas. A U.S. national sample (N = 2,189) completed Web-based surveys 1 to 3 weeks after 9/11; a subsample (n = 1,322) also completed surveys at the initiation of the Iraq War. These surveys measured media exposure and acute stress responses. Posttraumatic stress symptoms related to 9/11 and physician-diagnosed health ailments were assessed annually for 3 years. Early 9/11- and Iraq War-related television exposure and frequency of exposure to war images predicted increased posttraumatic stress symptoms 2 to 3 years after 9/11. Exposure to 4 or more hr daily of early 9/11-related television and cumulative acute stress predicted increased incidence of health ailments 2 to 3 years later. These findings suggest that exposure to graphic media images may result in physical and psychological effects previously assumed to require direct trauma exposure.

  •  | July 16, 2013 4:00AM

    Objective assessment in human immunodeficiency virus (HIV)-related fatigue has been elusive because the biological mechanisms are not well characterized. We tried to identify low-abundance plasma proteins that correlate with self-reported fatigue intensity in people living with HIV. We used plasma samples from 32 patients with HIV with varying degrees of fatigue who were either treated with nucleoside reverse transcriptase inhibitors or treatment naïve. The plasma samples were enriched for low-abundance proteins and trypsinized. The peptides were analyzed using shotgun proteomics. Five targets correlated with severity of fatigue: apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB), histine-rich glycoprotein, alpha-1 B glycoprotein, and orosomucoid 2. These targets were selected based on total abundance and spectral count differences, and ApoA1 and ApoB were analyzed via Western blots to verify the mass spectrometry results. ApoA1 levels were higher in untreated patients, while ApoB results suggested a possible positive trend in treated patients. Further analysis is needed to identify additional low-abundance proteins and confirm already-identified proteins as potential fatigue biomarkers.

  •  | July 1, 2013 4:00AM

    We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates.

  •  | June 23, 2013 4:00AM

    The mental health system is inefficient and ineffective in providing behavioral health care services to the 1 in 4 Americans who have a mental illness or a substance abuse problem. Current health care reform initiatives present a significant opportunity for advanced practice psychiatric nurses-psychiatric mental health (APRN-PMH) to develop action-oriented recommendations for developing their workforce and thereby increasing access to high-quality and full-spectrum behavioral health care services. If endorsed by the professional nursing associations and the APRN-PMH workforce, the strategies presented in this paper provide a blueprint for developing the APRN-PMH workforce. Achieving these goals will significantly reform the APRN-PMH workforce, thereby contributing to the overall goal of supporting an integrated model of behavioral health care. No change has as much potential to influence the APRN-PMH workforce as the uniting of all APRN-PMHs in a "Blueprint for APRN-PMH Workforce Development."

  •  | June 1, 2013 4:00AM

    Purpose/Objectives: To examine the feasibility and acceptability of using a decision aid with an interactive decision-making process in patients with solid tumors and their caregivers during cancer-related treatment.

    Research Approach: A phenomenologic approach was used to analyze qualitative data, with a focus on the meaning of participants’ lived experiences. Interviews were conducted by telephone or in person.

    Setting: Outpatient clinics at two regional cancer centers.

    Participants: 160 total individuals; 80 patients with newly diagnosed breast (n = 22), advanced-stage prostate (n = 19), or advanced-stage lung (n = 39) cancer, and their caregivers (n = 80).

    Methodologic Approach: Twenty-seven of the 80 pairs engaged in audio recorded interviews that were conducted using a semistructured interview guide. Continuous text immersion revealed themes. Validity of qualitative analysis was achieved by member checking.

    Findings: Significant findings included three themes: (a) the decision aid helped patients and caregivers understand treatment decisions better, (b) the decision aid helped patients and caregivers to be more involved in treatment decisions, and (c) frequent contact with the study nurse was valuable.

    Conclusions: Decision making was more complex than participants expected. The decision aid helped patients and caregivers make satisfying treatment decisions and become integral in a shared treatment decision-making process.