Medicine and Health Sciences Commons^™

Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson

Melissa L. Anderson

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility in the design of study methodology. To inform such considerations, we conducted a secondary analysis of a mixed-methods study that explored 16 Deaf trauma survivors’ help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that can be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged are what we would expect of any research participant, Deaf or hearing – a need for communication access, empathy, respect, strict …

Judy Savageau And Kathy Muhr On Working With Different Data Sources, Judith A. Savageau, Kathy Muhr

Judith A. Savageau

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness.

The Clinical Benefits Of The Bladder Scanner: A Research Synthesis, Amy Sparks, D. Boyer, A. Gambrel, M. Lovett, J. Johnson, T. Richards, J. Johnson, E. Grimm, C. Daniels, S. Tylka, H. Mattingly, M. Harper, D. Palermo

Amy E.T. Sparks

No abstract provided.

The Effect Of Music Therapy On Patients' Perception And Manifestation Of Pain, Anxiety, And Patient Satisfaction, T. Richards, J. Johnson, Amy Sparks, H. Emerson

Amy E.T. Sparks

An extensive review and synthesis of current research was completed to identify the clinical benefit of using music therapy in the hospital setting. It demonstrated that music therapy has the potential to improve the hospital experience of patients.

Influence Of Bedrest Or Ambulation In The Clinical Treatment Of Acute Deep Vein Thrombosis On Patient Outcomes: A Review And Synthesis Of The Literature, V. Gay, R. Hamilton, S. Heiskell, Amy Sparks

Amy E.T. Sparks

A thorough review of current and classic literature was completed to distinguish the influence of bedrest or ambulation on patient treatment outcomes with confirmed deep vein thrombosis.

Integrating Molecular Genetics Analyses Into Clinical Research, D. Schutte, Ann Mccarthy, M. Floria-Santos, Kirsten Hanrahan, J. Murray, Charmaine Kleiber

Kirsten M. Hanrahan

The integration of molecular genetics approaches into the study of complex health phenomena is an increasingly important and available strategy for researchers across the health science disciplines. Pain sensation and response to painful stimuli are examples of complex health phenomena that are particularly amenable to molecular genetics approaches. Both human and animal model research suggests that differences in these responses may be related, in part, to variation in the genes that modulate sensation and behavior. The authors are currently managing a large cross-disciplinary research effort to identify child characteristics, including genotypes, that predict the degree of distress displayed by children …

Non-Surgical Management Of Stress Urinary Incontinence: Ambulatory Treatments For Leakage Associated With Stress (Atlas) Trial, H. Richter, K. Burgio, P. Goode, D. Borello-France, Catherine Bradley, L. Brubaker, V. Handa, P. Fine, A. Visco, H. Zyczynski, J. Wei, A. Weber

Catherine S. Bradley

BACKGROUND: Non-surgical treatment for stress urinary incontinence (SUI) is recommended as first-line therapy, yet few prospective studies and no randomized trials compare the most common non-surgical treatments for SUI. PURPOSE: To present the design and methodology of the ambulatory treatments for leakage associated with stress (ATLAS) trial, a randomized clinical trial comparing three interventions for predominant SUI in women: intravaginal continence pessary; behavioral therapy (including pelvic floor muscle training and exercise and bladder control strategies); and a combination of the two treatments. METHODS: Treatment outcome measures, collected at 12 weeks and six and 12 months post randomization, include the Patient …

External Validity: We Need To Do More, Russell Glasgow, Lawrence Green, Lisa Klesges, David Abrams, Edwin Fisher, Michael Goldstein, Laura Hayman, Judith Ockene, C. Orleans

Laura L. Hayman

The article discusses the implications of two health research trends for improving the design, review and reporting of research and evaluation studies in the U.S. The first trend is the gap between research findings and application in practice. The other trend is the increased emphasis on the methodological quality of health research reports.

Novel Developmental Biology-Based Protocol Of Embryonic Stem Cell Differentiation To Morphologically Sound And Functional Yet Immature Hepatocytes, Terence Bukong, Tracie Lo, Gyongyi Szabo, Angela Dolganiuc

Gyongyi Szabo

BACKGROUND/AIMS: Liver diseases are common in the United States and often require liver transplantation; however, donated organs are limited and thus alternative sources for liver cells are in high demand. Embryonic stem cells (ESC) can provide a continuous and readily available source of liver cells. ESC differentiation to liver cells is yet to be fully understood and comprehensive differentiation protocols are yet to be defined. Here, we aimed to achieve human (h)ESC differentiation into mature hepatocytes using defined recombinant differentiation factors and metabolites. METHODS: Embryonic stem cell H1 line was sub-cultured on feeder layer. We induced hESCs into endodermal differentiation …

Engaging Racial Autoethnography As A Teaching Tool For Womanist Inquiry, Janette Taylor, Melissa Lehan Mackin, A. Oldenburg

Janette Y. Taylor

Racial autobiography, self-narratives on how one learned about the idea of race, has been underutilized as a tool to familiarize and orient students in the process of critical inquiry for nursing research. The aims of this article are to explore how racial autoethnography: (1) repositions students to effect an epistemological change, (2) challenges dominant ideology, and (3) functions as a link between the student and critical theories for use in nursing research. Students engage in and share reflective narrative about a variety of instructional materials used in the course. Reflective narratives are presented in a framework that addresses white racial …

Race And Ethnicity As Variables In Nursing Research, 1952-2000, D. Drevdahl, Janette Taylor, D. Phillips

Janette Y. Taylor

BACKGROUND: Although the use of race and ethnicity as variables in research has increased over the past five decades, there is confusion regarding the meaning of the terms, as well as how the words are defined and determined in scientific inquiry. OBJECTIVE: To review the use of race and ethnicity as variables in nursing research literature. METHODS: Original research articles published in Nursing Research in the years, 1952, 1955, and every 5 years thereafter through 2000 were reviewed. Those articles describing human characteristics (N = 337) were analyzed for content concerning: (a) frequency of racial and ethnic terms, (b) words …

Womanism: A Methodologic Framework For African American Women, Janette Taylor

Janette Y. Taylor

Although nurse scholars have become increasingly engaged in feminist research and theory development, only a few have included important feminist thoughts expressed by African American womanist theorists. This article presents an abbreviated review and synthesis of Afrocentric ways of knowing, which includes Black feminist, womanist, and Afrocentric perspectives. A developing methodology for use with African American women is also described.

Diversity And Homelessness: Minorities And Psychiatric Survivors, Cheryl Forchuk, Elsabeth Jensen, Rick Csiernik, Carolyn Gorlick, Susan Ray, Helene Berman, Pamela Mckane, Libbey Joplin

Rick Csiernik

No abstract provided.

A New Transient Sham Tens Device Allows For Investigator Blinding While Delivering A True Placebo Treatment, Barbara Rakel, N. Cooper, H. Adams, B. Messer, L. Frey Law, D. Dannen, C. Miller, A. Polehna, R. Ruggle, C. Vance, D. Walsh, K. Sluka

Barbara A. Rakel

This study compared a new transient sham transcutaneous electrical nerve stimulation (TENS) that delivers current for 45 seconds to an inactive sham and active TENS to determine the degree of blinding and influence on pain reduction. Pressure-pain thresholds (PPT), heat-pain thresholds (HPT), and pain intensities to tonic heat and pressure were measured in 69 healthy adults before and after randomization. Allocation investigators and subjects were asked to identify the treatment administered. The transient sham blinded investigators 100% of the time and 40% of subjects compared to the inactive sham that blinded investigators 0% of the time and 21% of subjects. …

Validation Of The Chads2 Clinical Prediction Rule To Predict Ischaemic Stroke. A Systematic Review And Meta-Analysis., Claire Keogh, Emma Wallace, Ciara Dillon, Borislav Dimitrov, Tom Fahey

Borislav D Dimitrov

The CHADS2 predicts annual risk of ischaemic stroke in non-valvular atrial fibrillation. This systematic review and meta-analysis aims to determine the predictive value of CHADS2. The literature was systematically searched from 2001 to October 2010. Data was pooled and analysed using discrimination and calibration statistical measures, using a random effects model. Eight data sets (n = 2815) were included. The diagnostic accuracy suggested a cut-point of ≥ 1 has higher sensitivity (92%) than specificity (12%) and a cut-point of ≥ 4 has higher specificity (96%) than sensitivity (33%). Lower summary estimates were observed for cut-points ≥ 2 (sensitivity 79%, specificity …

Description Of The Methodology Used In An Ongoing Pediatric Care Interventional Study Of Children Born With Cleft Lip And Palate In South America [Nct00097149, G. L. Wehby, E. E. Castilla, N. Goco, M. Rittler, V. Cosentino, L. Javois, Ann Marie Mccarthy, G. Bobashev, S. Litavecz, A. Mariona, G. Dutra, J. S. Lopez-Camelo, I. M. Orioli, J. C. Murray

Ann Marie McCarthy

BACKGROUND: The contribution of birth defects, including cleft lip and palate, to neonatal and infant mortality and morbidity is substantial. As other mortality and morbidity causes including infections, hygiene, prematurity, and nutrition are eradicated in less developed countries, the burden of birth defects will increase proportionally. METHODS/DESIGN: We are using cleft lip and palate as a sentinel birth defect to evaluate its burden on neonatal and infant health and to assess the effectiveness of systematic pediatric care during the first month and first two years of life in decreasing this burden. The neonatal intervention, consisting of weekly pediatric evaluation and …

Engaging Racial Autoethnography As A Teaching Tool For Womanist Inquiry, Janette Taylor, Melissa Lehan Mackin, A. Oldenburg

Melissa Lehan Mackin

Racial autobiography, self-narratives on how one learned about the idea of race, has been underutilized as a tool to familiarize and orient students in the process of critical inquiry for nursing research. The aims of this article are to explore how racial autoethnography: (1) repositions students to effect an epistemological change, (2) challenges dominant ideology, and (3) functions as a link between the student and critical theories for use in nursing research. Students engage in and share reflective narrative about a variety of instructional materials used in the course. Reflective narratives are presented in a framework that addresses white racial …

Beyond Knowledge Deficit To A Proposal For Information-Seeking Behaviors, Virginia Conley

Virginia M. Conley

TOPIC: Nursing assessment of knowledge of informational needs. PURPOSE: To present of a brief evolutionary analysis of knowledge deficit in terms of its significance, application, and use, and to present a proposal diagnosis, "information-seeking behaviors." SOURCES: Literature review of knowledge deficit and "information-seeking behaviors." CONCLUSIONS: Knowledge deficit is a nursing diagnosis that is significant for identifying a patient's need for education or knowledge. Its application has revealed limitations to validity and subsequent use. "Information-seeking behaviors" is proposed as an alternative diagnosis. Antecedents and defining characteristics are presented and areas for future research proposed.

Integrating Molecular Genetics Analyses Into Clinical Research, D. Schutte, Ann Mccarthy, M. Floria-Santos, Kirsten Hanrahan, J. Murray, Charmaine Kleiber

Ann Marie McCarthy

The integration of molecular genetics approaches into the study of complex health phenomena is an increasingly important and available strategy for researchers across the health science disciplines. Pain sensation and response to painful stimuli are examples of complex health phenomena that are particularly amenable to molecular genetics approaches. Both human and animal model research suggests that differences in these responses may be related, in part, to variation in the genes that modulate sensation and behavior. The authors are currently managing a large cross-disciplinary research effort to identify child characteristics, including genotypes, that predict the degree of distress displayed by children …

Description Of The Methodology Used In An Ongoing Pediatric Care Interventional Study Of Children Born With Cleft Lip And Palate In South America [Nct00097149, G. L. Wehby, E. E. Castilla, N. Goco, M. Rittler, V. Cosentino, L. Javois, Ann Marie Mccarthy, G. Bobashev, S. Litavecz, A. Mariona, G. Dutra, J. S. Lopez-Camelo, I. M. Orioli, J. C. Murray

Ann Marie McCarthy

BACKGROUND: The contribution of birth defects, including cleft lip and palate, to neonatal and infant mortality and morbidity is substantial. As other mortality and morbidity causes including infections, hygiene, prematurity, and nutrition are eradicated in less developed countries, the burden of birth defects will increase proportionally. METHODS/DESIGN: We are using cleft lip and palate as a sentinel birth defect to evaluate its burden on neonatal and infant health and to assess the effectiveness of systematic pediatric care during the first month and first two years of life in decreasing this burden. The neonatal intervention, consisting of weekly pediatric evaluation and …

Intervention Research In Highly Unstable Environments, Kathleen Buckwalter, M. Grey, B. Bowers, Ann Mccarthy, D. Gross, M. Funk, C. Beck

Ann Marie McCarthy

This article highlights issues and presents strategies for conducting intervention research in highly unstable environments such as schools, critical care units, and long-term care facilities. The authors draw on their own experiences to discuss the challenges that may be encountered in highly unstable settings. The concept of validity provides a framework for understanding the value of addressing the many methodological issues that can emerge in settings characterized by instability. We explain unstable environments by elaborating on knowable elements that contribute to instability. Strategies are provided for improving success of intervention research in unstable settings by carrying out an environmental assessment …

Portraits Of Caregivers Of End-Stage Dementia Patients Receiving Hospice Care, S. Sanders, Howard Butcher, P. Swails, J. Power

Howard K. Butcher

The purpose of this study was to investigate how caregivers respond to the end stages of dementia with the assistance from hospice. Data were collected from 27 family caregivers over the course of 10 months, with each caregiver being interviewed up to 4 times during the time that the patient received hospice care. Chart review data were also collected. Four distinct caregiver portraits emerged: (a) disengaged; (b) questioning; (c) all-consumed; and (d) reconciled. Caregivers in each portrait differed in how they responded to the impending death of the care recipient, the disease progression, and hospice care. Recognizing the differences in …

Inadequate Reporting Of Research Ethics Review And Informed Consent In Cluster Randomised Trials: Review Of Random Sample Of Published Trials, Monica Taljaard, Andrew Mcrae, Charles Weijer, Carol Bennett, Stephanie Dixon, Julia Taleban, Zoe Skea, Martin P Eccles, Jamie Brehaut, Allan Donner, Raphael Saginur, Robert Boruch, Jeremy Grimshaw

Charles Weijer

OBJECTIVES: To investigate the extent to which authors of cluster randomised trials adhered to two basic requirements of the World Medical Association's Declaration of Helsinki and the International Committee of Medical Journal Editors' uniform requirements for manuscripts (namely, reporting of research ethics review and informed consent), to determine whether the adequacy of reporting has improved over time, and to identify characteristics of cluster randomised trials associated with reporting of ethics practices.

DESIGN: Review of a random sample of published cluster randomised trials from an electronic search in Medline.

SETTING: Cluster randomised trials in health research published in English language journals …

Inadequate Reporting Of Research Ethics Review And Informed Consent In Cluster Randomised Trials: Review Of Random Sample Of Published Trials, Monica Taljaard, Andrew Mcrae, Charles Weijer, Carol Bennett, Stephanie Dixon, Julia Taleban, Zoe Skea, Martin P Eccles, Jamie Brehaut, Allan Donner, Raphael Saginur, Robert Boruch, Jeremy Grimshaw

Stephanie Dixon

OBJECTIVES: To investigate the extent to which authors of cluster randomised trials adhered to two basic requirements of the World Medical Association's Declaration of Helsinki and the International Committee of Medical Journal Editors' uniform requirements for manuscripts (namely, reporting of research ethics review and informed consent), to determine whether the adequacy of reporting has improved over time, and to identify characteristics of cluster randomised trials associated with reporting of ethics practices. DESIGN: Review of a random sample of published cluster randomised trials from an electronic search in Medline. SETTING: Cluster randomised trials in health research published in English language journals …

Management And Outcomes Of Renal Disease And Acute Myocardial Infarction, Paul Santolucito, Dennis Tighe, David Mcmanus, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Contemporary trends in the management and outcomes of chronic kidney disease patients who develop an acute myocardial infarction have not been adequately described, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study population consisted of 6219 residents of the Worcester, Massachusetts, metropolitan area who were hospitalized with acute myocardial infarction in 6 annual periods between 1995 and 2005. Patients were categorized as having preserved kidney function (n=3154), mild to moderate chronic kidney disease (n=2313), or severe chronic kidney disease (n=752) at the time of hospital admission. RESULTS: Patients with chronic kidney disease were more likely …

Narrowing Gender Differences In Procedure Use For Acute Myocardial Infarction: Insights From The Worcester Heart Attack Study, Leslie Harrold, Julian Esteban, Darleen Lessard, Jorge Yarzebski, Jerry Gurwitz, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: To examine age-specific gender differences and trends over time in the management of patients with acute myocardial infarction (AMI). DESIGN: Cross-sectional study of patients admitted with AMI from a community-wide perspective over a 10-year period (1990-1999). SETTING: All hospitals in the Worcester (Mass) metropolitan area (1990 census = 437000). PATIENTS/PARTICIPANTS: We identified 2037 women and 2645 men who were hospitalized in the Worcester metropolitan area with confirmed AMI during six 1-year periods between 1990 and 1999. Four age groups (<55, 55 to 64, 65 to 74 and >or=75 years) of men and women were studied. MEASUREMENTS AND MAIN RESULTS: Use of echocardiography, exercise treadmill testing (ETT), …

Design And Methods For A Randomized Clinical Trial Treating Comorbid Obesity And Major Depressive Disorder, Kristin L. Schneider, Jamie S. Bodenlos, Yunsheng Ma, Barbara C. Olendzki, Jessica Oleski, Philip A. Merriam, Sybil L. Crawford, Ira S. Ockene, Sherry L. Pagoto

Sybil L. Crawford

BACKGROUND: Obesity is often comorbid with depression and individuals with this comorbidity fare worse in behavioral weight loss treatment. Treating depression directly prior to behavioral weight loss treatment might bolster weight loss outcomes in this population, but this has not yet been tested in a randomized clinical trial. METHODS AND DESIGN: This randomized clinical trial will examine whether behavior therapy for depression administered prior to standard weight loss treatment produces greater weight loss than standard weight loss treatment alone. Obese women with major depressive disorder (N = 174) will be recruited from primary care clinics and the community and randomly …

Ethical And Policy Issues In Cluster Randomized Trials: Rationale And Design Of A Mixed Methods Research Study, Monica Taljaard, Charles Weijer, Jeremy Grimshaw, Judith Brown, Ariella Binik, Robert Boruch, Jamie Brehaut, Shazia Chaudhry, Martin Eccles, Andrew Mcrae, Raphael Saginur, Merrick Zwarenstein, Allan Donner

Charles Weijer

Background: Cluster randomized trials are an increasingly important methodological tool in health research. In cluster randomized trials, intact social units or groups of individuals, such as medical practices, schools, or entire communities--rather than individual themselves--are randomly allocated to intervention or control conditions, while outcomes are then observed on individual cluster members. The substantial methodological differences between cluster randomized trials and conventional randomized trials pose serious challenges to the current conceptual framework for research ethics. The ethical implications of randomizing groups rather than individuals are not addressed in current research ethics guidelines, nor have they even been thoroughly explored. The main …

Grounded Theory, Mixed Methods, And Action Research, Lorelei Lingard, Mathieu Albert, Wendy Levinson

Lorelei Lingard

No abstract provided.

Critically Appraising Qualitative Research, Ayelet Kuper, Lorelei Lingard, Wendy Levinson

Lorelei Lingard

No abstract provided.