Recent Research Publications and Funding

  •  | May 15, 2008 12:00AM

    The study identified risk factors for young adult intimate partner femicide. Secondary analysis of proxies of 23 young adult (ages 18-20 years) femicide victims identified from police or medical examiner records in 11 U.S. cities were interviewed using the Danger Assessment Scale. The femicide cases were compared with 53 abused young women (ages 18-20). Risk factors for young adult intimate partner femicide differ from their abused counterparts. More hostile violence, threats, unemployment, access to a gun, controlling activities, and having a nonbiological child of the abusive partner placed young adult women at higher risk for murder. Risk factors in younger femicides identified are consistent with risk factors identified in cases of femicides in older adult women. Although consistent, jealousy and controlling behaviors, partner unemployment, and perpetrator being an ex-partner appear to have increased importance for younger women. A validated lethality assessment, such as the Danger Assessment, may be useful to identify risk factors for lethal violence in young adult intimate partner violence.  

  •  | April 30, 2008 4:00AM

    BACKGROUND: The information processing demands associated with behavioral self-management of diabetes are extensive. Pairing personal digital assistant (PDA)-based self-monitoring with a behavioral self-management intervention may improve adherence and patient outcomes. METHODS: ENHANCE is a randomized controlled trial to test an intervention designed to improve regimen adherence in adults with type 2 diabetes. The intervention, based on Social Cognitive Theory (SCT), is paired with PDA-based self-monitoring. In this paper we describe the: (a) manner in which PDA-based self-monitoring is integrated within the SCT-based intervention, (b) feasibility and acceptability of PDA-based dietary self-monitoring, and (c) issues encountered in teaching participants to self-monitor using a PDA. RESULTS: During the first 30 months of this 5-year study, 232 participants were screened and 151 were randomized. To date, 6 cohorts have completed the study. The retention rate is 85% (n=129). Of those randomized to the intervention (n=74) and completing the study (n=61), 88% reported understanding the usefulness of PDA-monitoring, 85% reported ease in entering foods into the device, 70% reported ease in interpreting feedback graphs, and 82% indicated that they would continue to use the PDA for self-monitoring after the study concluded. Assuming 3 meals per day, participants entered an average of 58% of their meals in their PDA, and 43% were entered assuming 4 meals per day. If we eliminate from the analysis those individuals who entered less than 10% of their expected meals (n=12), the average rate of self-monitoring was 69% assuming 3 meals per day, and 52% assuming 4 meals per day. CONCLUSIONS: PDA-based dietary monitoring is perceived by participants to be useful and acceptable. The approach used to instruct participants in use of the PDA and lessons learned are discussed. PDA technology shows promise as a tool for assisting those with type 2 diabetes in their efforts to manage their disease.  

  •  | April 30, 2008 12:00AM

    The purpose of this article is to describe the experiences of adult women who, when they were children, experienced the homicide of their mother by their father. Two qualitative interviews were conducted with a convenience sample of 31 women survivors of uxoricide to create a qualitative description of the phenomenon. A number of themes have emerged including descriptions of the daughter "seeking understanding," "forgiving the father" (or not), and descriptions of the father in terms of his being her father or in terms of his behavior and the homicide.

  •  | April 1, 2008 4:00AM

    PURPOSE: The purpose of this study was to examine the impact of family and friends on the management of persons with diabetes and their willingness to be involved in a culturally tailored program. METHODS: This qualitative study was based within a larger quasi-experimental study that focused on the impact of a culturally tailored group intervention compared with individual standard diabetes education on the outcomes of self-management and glycemic control among rural African Americans with type 2 diabetes. Twenty-one participants were randomly assigned to an individual education group or a culturally tailored intervention group. Family members/peers (n = 6) attended invited group sessions to obtain information about diabetes and family/peer support. The facilitator of the invited group sessions used a guide to help with group discussions. The investigators used an iterative approach to enhance the examination of the responses from the discussion guide, thus identifying recurring themes within the participants' responses. RESULTS: The data revealed that family and friends made a difference in the diabetes management of individuals with diabetes. Although family and friends may have been helpful at times, they also created moments of problems and an environment that made it more difficult to care for diabetes. The data also revealed that diabetes is hard to manage and control. Participants reported that taking medications and being aware of types of foods to keep a well-maintained glucose level were often challenging. CONCLUSIONS: These findings confirm that family and peers greatly influence diabetes management among rural African Americans. The study's results will help health care providers understand the importance of involving family members and friends in the treatment and diabetes management of individuals with type 2 diabetes, particularly within rural African American communities where resources are limited.

  •  | April 1, 2008 4:00AM

    PURPOSE: This paper aims to explore the role of facial expression in pediatric pain assessment. A comparison of tools employing facial expression methodology is presented. The concept of the primal face of pain (PFP) is introduced. CONCLUSION: The PFP offers an explanation to the utility and deficiency of facial pain scales and facial expression in pain assessment. PRACTICE IMPLICATIONS: The complexities of pain measurement should preclude the clinical application of untested instruments. For reported tools, a careful evaluation of the psychometric properties and the clinical context must precede application. The concept of the PFP warns against the application of facial pain scales as proxy measures in their intended population. Reliance on facial expression to assess pain in the school-age child is imprecise.

    Pain, Pain
  •  | April 1, 2008 4:00AM

    Organizational culture consists of the deep underlying assumptions, beliefs, and values that are shared by members of the organization and typically operate unconsciously. The four organizational culture traits of the Denison Organizational Culture Model (DOCM) are characteristics of organizational effectiveness, which include adaptability, involvement, consistency, and mission. Effective organizations demonstrate high levels of the four cultural traits which reflect their ability to balance the dynamic tension between the need for stability and the need for flexibility within the organization. The Denison Organizational Culture Survey (DOCS) is a measurement tool that was founded on the theoretical framework of the DOCM, and in the field of business, is one of the most commonly used tools for measuring organizational culture. The DOCS offers a promising approach to operationalizing and measuring the link between organizational culture and organizational effectiveness in the context of nursing units.

  •  | April 1, 2008 12:00AM

    A focused microarray (huMITOchip) was developed to study alterations of human mitochondrial and nuclear gene expression in health and disease. The huMITOchip contains 4,774 probe sets identical to the Affymetrix U 133 plus 2.0 chip covering genes affecting mitochondrial, lipid, cytokine, apoptosis, and muscle function transcripts. Unlike other gene chips, the huMITOchip has 51 probe sets that interrogate 37 genes of the mitochondrial genome. The human mitochondrial gene chip was validated against the Affymetrix U133 plus 2.0 array using an in vitro system of CCL136 muscle cell line stimulated with or without interferon gamma (IFN-gamma). The 37 genes from the mtDNA demonstrated absolute gene expression levels ranging from 0.1 to 3,182. The comparison of the two gene chips yielded an excellent Pearson's correlation coefficient (r = 0.98). At least 17 probe sets were differentially expressed in response to IFN-gamma on both chips, with a high degree of concordance. This is the first report on the development of a focused oligonucleotide microarray containing genes of the mitochondrial genome.  

  •  | March 1, 2008 1:00AM

    African Americans are at greater risk for hypertension than are other ethnic groups. This study examined relationships among hypertension, stress, and depression among 120 urban African American parents and grandparents. This study is a secondary analysis of a larger nurse-managed randomized clinical trial testing the effectiveness of a telemonitoring intervention. Baseline data used in analyses, with the exception of medication compliance, were collected at 3 months' follow-up. Health indicators, perceived stress, and social support were examined to determine their relationship with depressive symptoms. A total of 48% of the variance in depressive symptomology was explained by perceived stress and support. Health indicators including average systolic blood pressure explained 21% of the variance in depressive symptomology The regression analysis using average diastolic blood pressure explained 26% of the variance in depressive symptomology Based on study results, African Americans should be assessed for perceived stress and social support to alleviate depressive symptomology.  

  •  | February 29, 2008 6:00AM

    AIM: This study examined factors associated with mood disturbance prior to, during and after adjuvant therapy. BACKGROUND: Breast cancer is the most common cancer in women worldwide. Mood disturbance affects between 20% and 30% of women with breast cancer and is associated with other debilitating symptoms. However, factors associated with mood disturbance across the breast cancer diagnosis-treatment trajectory are not clearly understood. METHOD: A stress-coping framework guided this longitudinal study. A convenience sample of 49 American women with newly diagnosed breast cancer aged 37-77 years completed questionnaires assessing age, optimism, disease stage, type of adjuvant therapy, lymph node status, emotional support, aid (tangible) support, perceived stress and mood disturbance. Data were collected over an 18-month period in 2002-2003 at three time points: prior to, during and after adjuvant therapy. Descriptive statistics, Pearson's correlation and multiple regression were used. FINDINGS: At all three time points, higher stress was significantly related to greater mood disturbance. Perceived stress mediated the relationship between (1) emotional support and mood disturbance prior to and after adjuvant therapy and between (2) aid support and mood disturbance during adjuvant therapy. In addition, the type of support that was most important to mood disturbance varied over time. Emotional support was related to reduced mood disturbance prior to and after adjuvant therapy, whereas aid support was most important during adjuvant therapy. CONCLUSIONS: Nurses may use this information to develop interventions that bolster appropriate types of support to reduce stress and ultimately lower mood disturbance. Further research across cultures is needed.  

  •  | February 29, 2008 6:00AM

    The purpose of this longitudinal study was to examine potential predictors of cancer-related fatigue (CRF) before, during, and after adjuvant therapy in women with breast cancer. A convenience sample of 44 women postsurgery (M = 18) aged 38 to 77 years (M = 52) were recruited from a Southern breast clinic. Based on Piper's Integrated Fatigue Model, the women (1) completed questionnaires assessing innate host factors (age, income, and education level), disease and treatment patterns (disease stage, surgery type, and adjuvant therapy), psychological patterns (perceived stress, mood disturbance, and optimism), social patterns (type and satisfaction with social support) and (2) provided a blood sample to examine regulation patterns (morning cortisol levels, interleukin-1 beta, tumor necrosis factor alpha, and natural killer cell activity) before adjuvant therapy. The Piper Fatigue Scale-Revised was completed at all 3 time points. Mood disturbance was the most significant predictor of CRF at all time points. Interleukin-1 beta predicted CRF levels before adjuvant therapy and morning cortisol before adjuvant therapy predicted CRF during and after adjuvant therapy. These findings suggest that interventions to reduce mood disturbances might be effective in decreasing CRF. Further research regarding the physiological mechanisms underlying the relationships between CRF, mood disturbance, interleukin-1 beta, and cortisol is needed.