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The objectives of this study were to: (a) Determine the potential for child abuse among the Joint New Parent Support Program Hawaii (Joint NPSP) client population, (b) Determine whether client participation in this program can reduce the potential for child abuse, and (c) Determine what client demographics correlate with the potential for child abuse. Joint NPSP is a prevention program for child abuse, screening all pregnant military families in Hawaii. The instrument used in this study was the Child Abuse Potential Inventory (CAP), a reliable and valid instrument used in the screening of physical child abuse. The CAP was completed by 142 pregnant Joint NPSP patients, ages 13-40 years, at the beginning of service provision and approximately 16 months later. Statistical measures used in analyzing the data were the t test and analysis of variance (ANOVA). Paired t tests were used to compare pre- and postprogram scores. Relations between the demographic profile information and CAP scores were analyzed with multiple regression analysis to identify risk factors for high child abuse. Out of 142 surveyed, 77 scored > 166 (signal detection) on the pretest abuse scale, and 65 scored < 166. In the > 166 group the pretest mean was a score of 257, and the posttest mean was 137. T-test results in the > 166 group were highly significant at .0001 on the scales of abuse, distress, rigidity, unhappiness, problems with family, and problems with others. ANOVA results in the > 166 group revealed a significant difference between an elevated abuse scale and patients with psychiatric problems (.0485), relationship problems (.0452), and past or present spouse abuse (.0421). This study validated that Joint NPSP is servicing a population at risk for child abuse potential. After intense home visitation by the community health nurses, the scores for child abuse potential decreased. A major limitation was the lack of a control group, the problem of maturation and history, and the possibility of regression toward the mean in scores. These limitations should be addressed in future studies with the use of 2 treatment modalities. Results highlight the need for focusing on relationship and spouse abuse issues in a military population. [ABSTRACT FROM AUTHOR]

An in vitro agar-diffusion system was used to assay human serum for inhibition of Trichophyton mentagrophytes growth. Sera were obtained for 30 adults representative of three major classes of susceptibility to dermatophytosis: (1) immunologically nonexperienced, (2) experienced immune, and (3) chronically infected. Although the three classes represent polar degrees of resistance/susceptibility to infection, there was no significant difference in the inhibitory power of their sera. Furthermore, nonexperienced subjects undergoing a primary infection were not found to acquire any increase in serum inhibitory activity, despite the simultaneous acquisition of a strong relative immunity. Nevertheless, other evidence suggests this unknown factor may play a role in defense against dermatophyte infection. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study to test a model of certain factors influencing people engaging in osteoporosis preventive behaviours, and to estimate the direct and indirect effects of personal and social factors on whether people engage in those behaviours. BACKGROUND: Osteoporosis preventive behaviours, including exercise and calcium intake, help decreasing the risk of developing osteoporosis. Reasons for engaging in osteoporosis preventive behaviours are complex and influenced by personal and social factors. Years of education, self-efficacy, knowledge of osteoporosis, social support and social capital have been indicated to increase people engaging in osteoporosis preventive behaviours; but age has been shown to decrease those behaviours. METHODS: The proposed model was developed using Social Cognitive Theory and a conceptual framework for addressing the social context of health behaviour. A correlational cross-sectional study was carried out in 2005, using questionnaires and a convenience sample of 243 participants. Data analysis included descriptive statistics, correlation techniques and path analysis. RESULTS: Self-efficacy was a better predictor of engaging in osteoporosis preventive behaviours than were the other variables. Social capital had a statistically significant direct and indirect effect on osteoporosis preventive behaviours. The modified path model showed good fit with the data. CONCLUSION: The associations between personal and social factors extend our knowledge from previous studies and increase our understanding of the complex relationships among the study variables. The model provides guidance for future nursing practice, research, and education programs related to osteoporosis prevention. [ABSTRACT FROM AUTHOR]

In an attempt to cross-culturally compare factors that may contribute to the nursing shortage within countries that have produced a limited number of research findings on role stress in nurses, this research examined work stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses from Japan, South Korea, Thailand and the USA (Hawaii). Subjects (n = 1554 hospital-based nurses) were administered four self-report questionnaires: Demographic Questionnaire, 'Nursing Stress Scale', 'Ways of Coping Questionnaire' and 'SF-36 Health Survey'. Findings suggested that nurses indicated similar workplace stressors, ways of coping, and levels of physical and mental health. While subjects, across countries, demonstrated a variety of predictors of physical and mental health, several predictors were found to be the same. Cross-culturally the role of nurses may vary; however, certain factors are predictive of the status of hospital nurses' physical health and mental health. [ABSTRACT FROM AUTHOR]

Symptom management for persons living with HIV disease is recognized as an extremely important component of care management. This article reports the validation of a new sign and symptom assessment tool designed to assess the intensity of HIV-related symptoms using two samples (study 1: n=247; study 2: n=686) of people living with HIV disease. Study 1 data were collected between 1994 and 1996 before the initiation of highly active antiretroviral therapy (HAART). Study 2 data were collected between 1997 and 1998 after the wide adoption of HAART therapy. The initial version of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV) included 41 signs and symptoms. This scale was submitted to a principal components factor analysis with a varimax rotation. The final solution reports six factors explaining 68.9% of the variance. The six symptom clusters (factors), the number of items in the factor, and the Cronbach alpha reliability estimates were: malaise/weakness/fatigue (six items, alpha=0.90); confusion/distress (four items, alpha=0.90); fever/chills (four items, alpha=0.85); gastrointestinal discomfort (four items, alpha=0. 81); shortness of breath (three items, alpha=0.79); and nausea/vomiting (three items, alpha=0.77). These six factors have strong reliability estimates and a stable factor structure that supports the construct validity of the 26-item instrument. Additional evidence supports the concurrent validity of the scale as well as its sensitivity to change over time. The final version of the SSC-HIV is a 26-item scale available for use by clinicians and researchers to measure the patient's self-report of HIV-related signs and symptoms. [ABSTRACT FROM AUTHOR]

The objective of the study was to measure the change in physicians' attitudes toward preventive care guidelines over a 2-year period. The study was conducted at a Southern California managed care medical group that was experiencing intense price competition. We analyzed individualized survey responses of 62 HMO primary care physicians over the study period. We found that physicians increasingly believed that clinical guidelines were being used for cost containment (first survey 71% vs second survey 92%, p < .005) and less for quality improvement (first survey 85% vs second survey 67%, p < .008) over time. These findings may create a barrier to physicians' adoption of practice guidelines. [ABSTRACT FROM AUTHOR]