Medicine and Health Sciences Commons^™

It's What We're Here For: Nurses Caring For Military Personnel During The Persian Gulf Wars, Patricia Rushton, Lynn Clark Callister, Jared E. Scott

Faculty Publications

Military nursing service during wartime represents significant contributions to a unique type of health care. The purposes of this study were to: (1) generate themes that elucidate combat nursing experiences, (2) honor nurses who served by sharing their stories, and (3) permanently archive accounts of nursing personnel who served during the Persian Gulf Wars during the late 20th and early 21st centuries. Eleven military nurses who provided health care to American troops in the Persian Gulf participated in a historical study as part of the ongoing Nurses at War oral history project documenting the experiences of nurses during times of …

Emergency Nurses’ Perceptions Of Size, Frequency, And Magnitude Of Obstacles And Supportive Behaviors In End-Of-Life Care, Renea L. Beckstrand, Michelle D. Smith, Sondra Heaston, A. Elaine Bond

Faculty Publications

Introduction: Emergency nurses care for dying patients daily. The process of dying in an emergency department can be complicated. Research on specific obstacles that impede the delivery of end-of-life care in emergency departments and behaviors that support it is limited.

Methods: A 70-item questionnaire was mailed to randomly selected ENA members. Subjects were asked to rate items on the size, frequency, and manitude of obstacles and supportive behaviors that relate to end-of-life care for ED patients.

Results:

The perceived obstacles with the greatest magnitude were as follows: (a) ED nurses’ work loads being too high to allow adequate time for …

Heart Rate Variability Characteristics In Sedentary Postmenopausal Women Following Six Months Of Exercise Training: The Drew Study, Conrad P. Earnest, Carl J. Lavie, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Decreased heart rate variability (HRV) is associated with a higher risk of mortality. Overall, postmenopausal women have lower levels of HRV than premenopausal women, which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity. Though cardiorespiratory exercise training increases HRV, little is known regarding the exercise dose necessary to promote improvement.

Methodology/Principle Findings: Our primary aim was to measure HRV in post-menopausal women following 6-moths of exercise training. We examined supine resting HRV in 373 post-menopausal women (45-75 y) after 6-months of randomly assigned and double-blinded administered exercise training exercise training at 50%, 100% …

Acoustic Characteristics Of English Lexical Stress Produced By Native Mandarin Speakers, Shawn L. Nissen, Yanhong Zhang, Alexander L. Francis

Faculty Publications

Native speakers of Mandarin Chinese have difficulty producing native-like English stress contrasts. Acoustically, English lexical stress is multidimensional, involving manipulation of fundamental frequency (F0), duration, intensity and vowel quality. Errors in any or all of these correlates could interfere with perception of the stress contrast, but it is unknown which correlates are most problematic for Mandarin speakers. This study compares the use of these correlates in the production of lexical stress contrasts by 10 Mandarin and 10 native English speakers. Results showed that Mandarin speakers produced significantly less native-like stress patterns, although they did use all four acoustic correlates to …

Word Recognition Materials For Native Speakers Of Taiwan Mandarin, Shawn L. Nissen, Richard W. Harris, Alycia Dukes

Faculty Publications

Purpose: To select, digitally record, evaluate, and psychometrically equate word recognition materials that can be used to measure the speech perception abilities of native speakers of Taiwan Mandarin in quiet. Method: Frequently used bisyllabic words produced by male and female talkers of Taiwan Mandarin were digitally recorded and subsequently evaluated using 20 native listeners with normal hearing at 10 intensity levels (-5 to 40 dB HL) in increments of 5 dB. Results: Using logistic regression, 200 words with the steepest psychometric slopes were divided into 4 lists and 8 half-lists that were relatively equivalent in psychometric function slope. To increase …

Maximal Exercise Electrocardiography Responses And Coronary Heart Disease Mortality Among Men With Diabetes Mellitus, G. William Lyerly, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Gregory A. Hand, Steven N. Blair

Faculty Publications

Background - An abnormal ECG during maximal exercise testing has been shown to be a powerful predictor of future coronary heart disease (CHD) mortality in asymptomatic men. However, little is known about the relationship between exercise ECG responses and CHD risk in men with diabetes mellitus.

Methods and Results - We examined the association between exercise ECG responses and mortality in 2854 men with documented diabetes mellitus (mean age 49.5 years) who completed a maximal treadmill exercise test during the period from 1974 to 2001 and who were without a previous cardiovascular disease (CVD) event at baseline. Mortality due to …

The Changing Role Of Physicians In Disaster Management And Hospital Incident Command, F. Matthew Mihelic, M. David Stockton, Stephen A. Cole, Gregory H. Blake

Faculty Publications

Recent changes in governmental policy toward disaster medicine and hospital incident command foreshadow a significant change in the role that physicians will play in disaster preparedness and response. The distinct discipline of Disaster Medicine has received authoritative recognition and promotion in the recent Homeland Security Presidential Directive 21, and recently established guidelines for incident command within hospitals have included a new position designated as “Medical/Technical Specialist(s)” that will assist the Incident Commander in disaster-related decision-making. This is a multidisciplinary position, and its functions can be filled by one or more individuals. As physician training and competency in Disaster Medicine increases, …

Physical Activity And Neighborhood Resources In High School Girls, Russell R. Pate, Natalie Colabianchi, Dwayne E. Porter, Maria João C. A. Almeida, Felipe Lobelo, Marsha Dowda

Faculty Publications

Background - Physical activity behavior is influenced by a person's physical environment, but few studies have used objective measures to study the influences of the physical environment on physical activity behavior in youth. The purpose of this study was to examine the relationship between selected neighborhood physical activity resources and physical activity levels in high school girls.

Methods - Participants were students in schools that had participated in a large physical activity intervention trial. The 3-Day Physical Activity Recall was completed by 1506 12th-grade girls. Data on physical activity facilities and resources in the participating communities were collected using a …

Race Differences In Activity, Fitness, And Bmi In Female Eighth Graders Categorized By Sports Participation Status, John R. Sirard, Karin A. Pfeiffer, Marsha Dowda, Russell R. Pate

Faculty Publications

The purpose of this study was to identify racial differences in physical activity (PA), fitness, and BMI in female 8th-grade sports participants and nonparticipants. Girls from 31 South Carolina middle schools (N=1,903, 48% White; mean age=13.6 ± 0.63) reported PA and previous year sports-team participation, completed a submaximal fitness test, and had height and weight measured. Sports team participation was positively associated with PA and negatively associated with television viewing and BMI, in a dose-response manner. Compared with Whites, African-Americans reported less PA and more television viewing, and had greater BMI scores. Whereas PA intervention programs that incorporate …

Paripartum Cardiomyopathy: Implications For Nps, Jeffrey A. Goss, A. Elaine Bond, Renea L. Beckstrand, Lynn C. Callister

Faculty Publications

Peripartum cardiomyopathy (PPCM), the fifth leading cause of death in pregnancy, is often overlooked or misdiagnosed because of vague symptoms and a lack of specific criteria for diagnosis. The authors performed a literature review of articles published between January 2000 and November 2007, and found that early diagnosis via echocardiography and interventions with specific treatment modalities can reduce mortality. Dobutamine stress testing may be prognostic for left ventricular (LV) dysfunction. Standard heart failure (HF) drug regimens, heart transplantation, and mechanical assist devices are viable treatment modalities, depending on individual needs. Subsequent pregnancies must be followed closely. The authors recommend that …

Peripheral Intravenous Catheters Started In Prehospital And Emergency Department Settings, Ligia Zarate, Barbara Mandleco, Russell Wilshaw, Patricia K. Ravert

Faculty Publications

The purpose of this study was to determine the rates of phlebitis in trauma patients according to where the peripheral intravenous catheter (PIVC) was inserted in a prehospital setting or in an emergency department setting. Variables investigated also included where the catheter was anatomically placed, the gauge of the catheter, and the patients' Injury Severity Score. The overall phlebitis rate was 5.79%. The rate of phlebitis was 2.92% when started by an RN in the emergency department, 6.09% when started by an intermediate emergency medical technician and 7.78% when started by a paramedic in prehospital setting. There was no significant …

Promoting Physical Activity In Middle School Girls: Trial Of Activity For Adolescent Girls, Larry S. Webber, Diane J. Catellier, Leslie A. Lytle, David M. Murray, Charlotte A. Pratt, Deborah Rohm Young, John P. Elder, Timothy G. Lohman, June Stevens, Jared B. Jobe, Russell R. Pate

Faculty Publications

Background - Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls.

Design - Group randomized controlled trial.

Setting/participants - Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States. Random, cross-sectional samples were drawn within schools: 6th graders in 2003 (n=1721) and 8th graders in 2005 (n=3504) and 2006 (n=3502).

Intervention - A 2-year study-directed intervention (fall 2003 to spring 2005) targeted schools, community agencies, …

Accumulating Disadvantage Over The Life Course: Evidence From A Longitudinal Study Investigating The Relationship Between Educational Advantage In Youth And Health In Middle Age, Katrina M. Walsemann, Arline T. Geronimus, Gilbert C. Gee

Faculty Publications

Recent studies suggest the importance of examining cumulative risk or advantage as potential predictors of health over the life course. Researchers investigating the cumulative health effects of education, however, have mainly conceptualized education in years or degrees, often disregarding educational quality and access to educational opportunities that may place individuals on divergent academic trajectories. We investigate whether educational advantages in youth are associated with an individual's health trajectory. We develop a novel index of educational advantage and employ random-intercept modeling using data from the National Longitudinal Survey of Youth. We find a widening health disparity in adulthood between respondents with …

Promoting Self-Confidence In Clinical Nursing Students, Karen M. Lundberg

Faculty Publications

Clinical nursing instructors are continually telling their students that they just need more confidence. But how do students find this needed confidence and how can nursing instructors help them? The author discusses sources and principles of confidence in relationship to teaching behaviors and strategies for increasing self-confidence, such as simulations, peer modeling, story telling, skill review sessions, and journaling.

Novel Role Of Antioxidant-1 (Atox1) As A Copper-Dependent Transcription Factor Involved In Cell Proliferation, S. Itoh, H. W. Kim, O. Nakagawa, K. Ozumi, Susan M. Lessner, H. Aoki, K. Akram, R. D. Mckinney, M. Ushio-Fukai, T. Fukai

Faculty Publications

Copper plays a fundamental role in regulating cell growth. Many types of human cancer tissues have higher copper levels than normal tissues. Copper can also induce gene expression. However, transcription factors that mediate copper-induced cell proliferation have not been identified in mammals. Here we show that antioxidant-1 (Atox1), previously appreciated as a copper chaperone, represents a novel copper-dependent transcription factor that mediates copper-induced cell proliferation. Stimulation of mouse embryonic fibroblasts (MEFs) with copper markedly increased cell proliferation, cyclin D1 expression, and entry into S phase, which were completely abolished in Atox1^-/- MEFs. Promoter analysis and EMSA revealed that copper …

Articulatory Changes Following Treatment Of Muscle Tension Dysphonia: Preliminary Acoustic Evidence, Christopher Dromey, Shawn L. Nissen, Ray M. Merrill, Nelson Roy

Faculty Publications

Purpose: Primary muscle tension dysphonia (MTD), a voice disturbance that occurs in the absence of structural or neurological pathology, may respond to manual circumlaryngeal techniques, which ostensibly alter the posture of the larynx and/or the configuration of the vocal folds without directly targeting supralaryngeal articulatory structures. Although the phonatory benefits of these techniques have been documented previously, this investigation examined whether acoustic evidence exists for articulatory changes accompanying successful management. Method: In this retrospective study of a clinical database, pre- and post-treatment speech samples from 111 women with MTD were analyzed for acoustic evidence of supraglottal vocal tract changes associated …

Hospital Nursing Research Program: Partnership Of Service And Academia, Patricia Ravert, Katreena Collette Merrill

Faculty Publications

Hospitals in a nonprofit mountain west corporation conducted a gap analysis to determine readiness for Magnet Recognition. Major gaps included nursing research and availability of consultation and resources for research. Based on the findings, the development of a dynamic research program promoting nursing research and evidence-based practice within hospitals was undertaken. A nursing research council was reestablished with representatives from service and academia. A literature review and analysis of corporate/academia resources were completed. The plan called for a nursing research coordinator position and development of a research budget. Academia continues to be represented on the hospital institutional review board. A …

Early Life Determinants Of Physical Activity In 11 To 12 Year Olds: Cohort Study, Calum Mattocks, Kevin Deere, Sam D. Leary, Andy R. Ness, Kate Tilling, Steven N. Blair, Chris J. Riddoch

Faculty Publications

Objective: To examine factors in early life (up to age 5 years) that are associated with objectively measured physical activity in 11-12 year olds.

Design: Prospective cohort study

Setting: Avon longitudinal study of parents and children, United Kingdom.

Participants: Children aged 11-12 years from the Avon longitudinal study of parents and children.

Main outcome measure: Physical activity levels in counts per minute (cpm) and minutes of moderate to vigorous physical activity for seven days measured with a uniaxial actigraph accelerometer.

Results: Valid actigraph data, defined as at least three days of physical activity for at least 10 hours a day, …

Disparities In Use Of Mental Health And Substance Abuse Services By Asian And Native Hawaiian/Other Pacific Islander Women, Van M. Ta Park, H. S. Juon, A. C. Gielen, D. Steinwachs, A. Duggan

Faculty Publications

The purpose of this study was to determine if disparities exist in lifetime utilization of mental health/substance abuse services among Asian, Native Hawaiian/Other Pacific Islander (NHOPI) and white mothers. The study sample was comprised of mothers assessed to be at-risk (n = 491) and not at-risk (n = 218) for child maltreatment in the Hawaii Healthy Start Program study. Multiple logistic regression models were used to test the effects of predisposing, need, and enabling factors on utilization of services. Results revealed that, among mothers with depressive symptoms, compared with whites, Asians and NHOPI were significantly less likely to have received …

Child Psychosocial Adjustment And Parenting In Families Affected By Maternal Hiv/Aids, Tanya L. Tompkins, Gail E. Wyatt

Faculty Publications

Child adjustment and parenting were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of …

The Effect Of Question Order On Reporting Physical Activity And Walking Behavior, Brent E. Hutto, Patricia A. Sharpe, Michelle L. Granner, Cheryl L. Addy, Steven P. Hooker

Faculty Publications

Background: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. Methods: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Results: …

An Uncertain Privilege: Implied Waiver And The Eviseration Of The Psychotherapist Patient Privilege In The Federal Courts, Deirdre M. Smith

Faculty Publications

Twelve years ago in Jaffee v. Redmond, 518 U.S. 1 (1996), the United States Supreme Court first recognized a federal common law psychotherapist-patient privilege and held that federal courts must protect confidential communications arising in psychotherapy despite the "likely evidentiary benefit" of such communications. This article examines the sharply conflicting authority in the federal courts that has developed since that landmark decision on the question of whether a plaintiff to a civil lawsuit waives the psychotherapist-patient privilege merely by seeking emotional distress damages. The federal courts' inconsistent and unprincipled approaches to this question renders the privilege itself nearly illusory and …

Individual Differences In The Conceptualization Of Food Across Eating Contexts, Christine E. Blake

Faculty Publications

Individual differences in food-related knowledge structures were explored by applying schema theory to examine the categories 42 adults used to classify foods across four eating contexts. Food card-sort labels were organized in 12 categories, category salience for each person was evaluated, and cluster analysis was used to identify clusters of participants according to the salience of their categories. Clusters were further evaluated for complexity and consistency of category use across contexts. Seven food schema clusters were identified. Meal/time and Routine categories were the most salient overall and were used by most clusters. Well-being, Person, Source, Convenience, Meal component, and Food …

Where's The Kale? Environmental Availability Of Fruits And Vegetables In Two Racially Dissimilar Communities, Edith M. Williams, Bamidele O. Tayo, Beverly Mclean, Ellen Smit, Christopher T. Sempos, Carlos J. Crespo

Faculty Publications

Minority communities across the United States have limited numbers of stores that offer a variety of fruits and vegetables, creating major barriers to good eating habits and nutritional practices among minority groups such as African Americans. Factors like environmental availability of healthy food options have not been fully investigated as possible sources of current cross-population differences in disease. The present study examined whether a predominantly African American neighborhood had disproportionately less availability of fruits and vegetables than a predominantly non-Hispanic White neighborhood. Availability was judged on the bases of the types of stores available in each community and the specific …

Polymorphisms In Methionine Synthase, Methionine Synthase Reductase And Serine Hydroxymethyltransferase, Folate And Alcohol Intake, And Colon Cancer Risk, Susan E. Steck, Temitope O. Keku, Lesley M. Butler, Joseph Galanko, Beri Massa, Robert C. Millikan, Robert S. Sandler

Faculty Publications

Background/Aims - We examined associations among folate and alcohol intake, SNPs in genes involved in one-carbon metabolism and colon cancer risk.

Methods - Colon cancer cases (294 African Americans and 349 whites) were frequency matched to population controls (437 African Americans and 611 whites) by age, race and sex from 33 North Carolina counties from 1996 to 2000. Folate and alcohol intakes were collected by dietary interview. Five SNPs were genotyped using DNA from whole blood: SHMT C1420T; MTRR A66G; MTR A2756G, and the previously-reported MTHFR C677T and MTHFR A1298C. Adjusted odds ratios (OR) and 95% …

Use Of Accelerometers In A Large Field-Based Study Of Children: Protocols, Design Issues, And Effects On Precision, Calum Mattocks, Andy R. Ness, Sam D. Leary, Kate Tilling, Steven N. Blair, Julian Shield, Kevin Deere, Joanne Saunders, Joanne Krikby, George Davey Smith, Jonathan Wells, Nicholas Wareham, John J. Reilly, Chris J. Riddoch

Faculty Publications

Background: Objective methods can improve accuracy of physical activity measurement in field studies but uncertainties remain about their use.

Methods: Children age 11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), were asked to wear a uni-axial accelerometer (MTI Actigraph) for 7 days.

Results: Of 7159 children who attended for assessment, 5595 (78%) provided valid measures. The reliability coefficient for 3 days of recording was .7 and the power to detect a difference of 0.07 SDs (P ≤ .05) was > 90%. Measures tended to be higher on the first day of recording (17 counts/min; 95% CI, …

Physical Activity And Blood Pressure In Childhood: Findings From A Population-Based Study, Sam D. Leary, Andy R. Ness, George Davey Smith, Calum Mattocks, Kevin Deere, Steven N. Blair, Chris J. Riddoch

Faculty Publications

The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute …

Assessing The Professional Development Needs Of Public Health Educators In Light Of Changing Competencies, A. R. Demers, Edward M. Mamary

Faculty Publications

Introduction Because of the need for a well-trained public health workforce, professional competencies have been recently revised by the Institute of Medicine and the National Health Educator Competencies Update Project. This study compared the self-identified training needs of public health educators with the updated competencies and assessed employer support for continuing education. Methods A convenience sample of public health educators was recruited from an e-mail list of San Jose State University master of public health alumni. Respondents completed a Web-based survey that elicited information on emerging trends in public health education, training needs, and employer support for continuing education. Results …

State Policies Matter: The Case Of Outpatient Drug Treatment Program Practices, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, D Eidson

Faculty Publications

This study examined relationships between state policy requirements governing outpatient substance abuse treatment services and reported outpatient treatment program practices. State policies effective as of February 1, 2003, and February 1, 2004, were collected and analyzed via primary legal research; data were validated by state officials (88% response rate; > 90% validation rate). Treatment practice data were obtained from the National Survey of Substance Abuse Treatment Services for the years 2003 and 2004. Multivariate analyses clustered by state were conducted, controlling for state, program, and state-aggregated client admission characteristics. Results indicated that treatment programs located in states with requirements for comprehensive …

Patient Simulator Sessions And Critical Thinking, Patricia K. Ravert

Faculty Publications

The project purpose was too determine whether measures of critical thinking show differences between three groups (simulator, non-simulator, control) of baccalaureate nursing students. The second purpose was to determine the moderating effect of students' preferred learning style. All groups experienced a moderate to large effect size in critical thinking scores. The corrected model for the total scale gain score was statistically significant but not significant for learning style or group.