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Aim: Digital platforms such as YouTube are popular sources of health-related information. Although there are studies evaluating the quality of different online medical content, studies focusing on the quality of dementia-related content are limited. This study aimed to investigate the quality of YouTube videos related to dementia patient care. Material and Methods: Using the term "Dementia care" on the YouTube platform, 100 English videos that met the inclusion criteria were identified and analyzed. In addition to video popularity measurements, to evaluate content quality, the global quality scale (GQS), modified DISCERN scale, Journal of the American Medical Association (JAMA) quality scale, and the patient education materials assessment tool for audio/visual materials (PEMAT-A/V) are used. Results: It was observed that most of the videos were uploaded by non-academic health institutions (36%) and health professionals (23%). When the content of the videos was evaluated, it was determined that general care strategies were the most common content with 52%. Scores indicating high levels of reliability and accuracy were determined on all applied content quality scales. Videos sourced from academic healthcare institutions were found to have the highest scores on content quality scales. In correlation analyses, video metrics such as duration, view ratio, number of comments, and video power index values were positively correlated with content quality scores. Conclusion: Videos about dementia patient care on YouTube generally exhibit high popularity and content quality. Individuals seeking information about dementia care on online platforms should be directed to videos uploaded by healthcare institutions. [ABSTRACT FROM AUTHOR]

Trauma anesthesia care can be among the most challenging situations anesthesia providers may encounter. The challenges encountered are helped by providing anesthesia providers on forward-deployed surgical teams with the best equipment available that meets the limitations of light weight, easily movable, and not reliant on electrical supply. This study assesses three questions derived out of the recent formation and equipping of the U.S. Army's Forward Resuscitative and Surgical Detachment. The highly advanced field transport ventilator, the Hamilton-T1 is being used by the detachments' anesthetists with the Universal Portable Anesthesia, Complete (UPAC) draw-over vaporizer. However, no literature supports best use practices regarding use in a push- or pull-through configuration, adding supplemental oxygen, and the impact on the ventilator from contamination with inhaled anesthetics. Utilizing a human patient simulator, these questions were examined in a quasiexperimental and descriptive manner, using the Hamilton-T1 and UPAC vaporizer in multiple configurations. The findings support the efficacy of both push- and pull-through configurations, offer options for the most efficacious use of oxygen, and appear to show no adverse effects from anesthetic vapor entering the ventilator's compression mechanism. [ABSTRACT FROM AUTHOR]

Research has provided compelling evidence that employee referrals result in positive outcomes for organizations and job seekers, but it has been limited on how organizations can increase the likelihood of obtaining employee referrals. Using the theoretical lens of social exchange theory and tenets from expectancy theory, we tested two common assumptions of most employers: A referral bonus motivates employees to refer, and higher bonus amounts incite greater likelihood of referring. We theoretically developed and tested a model integrating the effects of perceived risk in referring and affective commitment and their interactions with the referral bonus to better explain the likelihood of referring. Results largely supported our predictions. Referral bonus presence, referral bonus amount, and affective commitment positively related to likelihood of referring, while perceived risk in referring negatively related to likelihood of referring. The findings also suggest that larger referral bonuses can help offset perceived risk in referring and low affective commitment levels. We contribute to the literature by developing theory, expanding the scope of the current referral literature, and offering a quantitative examination of previously theorized variables in the referring process. We conclude with suggestions to practicing managers on ways to improve the motivating potential of their employee referral programs. [ABSTRACT FROM AUTHOR]

Little is known about the prevalence of young adult refugees' primary care use following resettlement in Colorado. Among a sample of Bhutanese and Burmese young adult refugees resettled in Colorado, proportions with a primary care provider (PCP), physical exam in the last 12 months, and knowledge to make an appointment were calculated across 4 years and compared within the refugee population by demographics using Pearson's Chi-Squared tests and compared to older refugees and to the general population using two-tailed tests of proportions. Greater than 70% of young adult refugees reported a physical exam in the last 12 months during the 4 years after arrival. Disparities were identified within young adult refugees by sex, marital status and country of origin. Young adult refugees were significantly different than both refugees over 55 and the general population in terms of their primary care use. Young adult refugees need support to identify PCPs earlier in resettlement and maintain primary care use years after resettlement. [ABSTRACT FROM AUTHOR]

Introduction. Physical therapists (PTs) from various educational and clinical backgrounds are being hired to address the faculty shortage issue. Little is known about how junior PT faculty feel about their experiences in academia. the purpose of this study was to 1) explore current demographic and self-perceived experiences of junior faculty in PT education programs across the United States, 2) compare beliefs and experiences based on the highest academic degree held and the type of faculty line held, and 3) explore the relationships between job satisfaction and experiences in academia with the likelihood to remain in academia. Full-time junior faculty employed 5 years or less at accredited PT education programs. Methods: Descriptive correlational study using a 63-item, self-report, electronic, job satisfaction survey was sent to faculty employed at 223 accredited PT education programs in the United States. Results: Two hundred twenty-four fulltime junior faculty completed the survey. Respondents with clinical degrees were more satisfied in their position and more likely to stay in academia than those with terminal academic degrees. Similarly, respondents in nontenure-track positions were more satisfied and more likely to stay in academia than those in tenure-track positions. Social support, teaching, and scholarly activity mentorship were found to contribute to job satisfaction. Also, an association was found between job satisfaction and intention to remain in academia for all cohorts (rs ≥ 0.72; P = .001). Discussion and Conclusions: Junior PT faculty who received support and mentorship were more satisfied with their jobs and more likely to remain in academia. PT education programs should consider new or expanded mentorship programs for junior faculty, regardless of academic background, to promote professional progress, positive role-modeling, and faculty retention. [ABSTRACT FROM AUTHOR]

Purpose: To examine the determinants of radiation safety culture among radiologic technologists in the United States. The specific aims were to report descriptive statistics related to radiation safety culture determinants and examine relationships between specific determinants of radiation safety culture and overall perception of radiation safety (OPRS). Methods: Radiologic technologists working in radiography, mammography, and computed tomography were identified using the American Society of Radiologic Technologists membership database. The researcher implemented a quantitative cross-sectional design using the Radiation Actions and Dimensions of Radiation Safety (RADS) survey instrument, which contained the study's determinants and OPRS variable, to guide hypotheses testing. Descriptive statistics were used to report RADS survey item outcomes, and Pearson correlation and multiple linear regression tests were conducted to analyze the hypothesis. Results: A total of 425 radiologic technologists completed the survey. Ten variables significantly correlated with OPRS. The variables of leadership actions (β = .402; P < .001), teamwork across imaging stakeholders (β = .304; P = .011), organizational learning (β = .121; P = .007), and questioning attitude (β = .110; P = .001) predicted OPRS, with leadership actions being most important in the model. Discussion: The correlation between OPRS scores and the 10 determinants suggests that each variable is a relevant determinant of radiation safety culture among radiologic technologists in the United States. The outcomes establish key priorities and provide an actionable foundation to facilitate a positive radiation safety culture in medical imaging. Conclusion: The study presented a unique examination of OPRS determinants among American radiologic technologists. Findings can be used to support clinically-oriented interventions in improving radiation safety culture. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to examine the existence of a relationship between the grading of reflective journals and student honesty in reflective journal writing. BACKGROUND: Journal writing is often used to gauge skills and knowledge. However, disagreement exists as to whether journals should be graded as studentsmay embellish experiences or write what the instructor wants to read. If students are not engaged in honest reflection, the benefit of reflective practice is reduced. METHOD: Data were collected using an anonymous online survey. The nonprobability sampling technique was used to examine the existence of a relationship between the grading of reflective journals and student honesty in reflective journal writing. RESULTS: Findings indicated a statistically significant positive relationship between grading of reflective journals and student honesty. CONCLUSION: Instead of grading the written component, the process of reflective practice should be assessed, possibly changing to a grade of complete/incomplete. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the knowledge, attitudes, practices and barriers faced by dental health care professionals (DHCP) regarding the Centers for Disease Control and Prevention (CDC) infection control guidelines in dental settings and summary (2003, 2016) prior to onset of the SARS-CoV-2 (COVID-19) pandemic. Methods: A descriptive, cross-sectional study design was used to create a 42-item electronic survey. A convenience sample of dental assistants registered dental hygienists, and dentists (n=397) was recruited through professional dental social media groups, face-to-face recruitment, and snowball sampling. Descriptive statistics were used to analyze the data. Results: The completion rate was 66.7% (n=265). The mean knowledge score for the CDC infection control guidelines was 58%. Less than half (39%) of the respondents were able to correctly identify hand hygiene as the most important measure in preventing the spread of infections among patients and DHCP. One third (33%) of the respondents were unaware of the CDC guidelines regarding respiratory hygiene/cough etiquette measures in dental settings. Participants indicated that the greatest barrier in following infection control guidelines was a heavy workload (37%), followed by time restraints (25%), and expense (15%). Conclusion: Although DHCPs reported familiarity (perceived knowledge) with 2003/2016 CDC infection control guidelines in dentistry, their knowledge and practices were inadequate. This information may serve as a baseline for future consideration of infection control continuing education as a requirement for licensure, particularly given the impact of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objectives: Community, school, family, and individual factors protect against mental illness in general samples of adolescents. How these assets apply to Somali youth resettled to the United States (U.S.), a group with significant trauma exposure, remains unclear. We aimed to quantify which protective factors are associated with lower prevalence of depressive symptoms, suicidality, and self-injury among Somali youth in the U.S. compared with their non-Hispanic white peers. Design: Participants consisted of 8th, 9th, and 11th grade respondents to the 2016 Minnesota Student Survey, an anonymous school-administered statewide survey with 85.5% school district participation, who identified as Somali ethnicity (n = 1552) or as non-Hispanic white (n = 80,583). Multivariable logistic regression assessed odds of depressive symptoms, suicidal ideation and attempts, and self-harm, using eight protective factors (i.e. internal developmental assets, school engagement, empowerment, and family and teacher connectedness, caring adults and after-school activity frequency and quality) as independent variables. Models were run separately for Somali and white youth. Results: Somali youth reported similar rates of depressive symptoms, but lower levels of suicidal ideation or attempts and self-harm behaviors than their white peers (p < 0.001). All eight protective factors were associated with outcomes in the expected direction for white youth. For Somali youth, internal developmental assets (aOR 0.79, 95% CI: 0.65–0.97), empowerment (aOR 0.58, 95% CI: 0.45–0.73), family connectedness (aOR 0.60, 95% CI: 0.51–0.71), perception of caring adults in the community (aOR: 0.84, 95% CI: 0.76–0.92), and quality of after-school activities (aOR: 0.72, 95% CI: 0.61–0.86) were protective against depressive symptoms, with similar patterns for other outcomes. Other school factors protected Somali youth less consistently. Conclusions: Previously established protective factors against mental illness, particularly school factors, do not universally apply to Somali youth. Interventions that strengthen individual, family, or community factors, or that increase the relevance of school factors, should be explored for these youth. [ABSTRACT FROM AUTHOR]

BACKGROUND: Some patients with acute heart failure (AHF) who are treated initially with noninvasive ventilation (NIV) will require endotracheal intubation, which indicates NIV failure. The incidence and prognosis of NIV failure in patients with AHF are not well characterized. METHODS: Using the National In-Patient Sample (NIS), we conducted a retrospective cohort study of subjects hospitalized with AHF between 2008 and 2014 who were treated with NIV within 24 h of hospital admission. We determined predictors of NIV failure and determined the association between NIV failure and in-hospital mortality using Cox proportional hazard models. RESULTS: Of 279,534 subjects hospitalized with AHF and treated with NIV, 4,257 (1.52%) failed NIV and required intubation. Cardiogenic shock (odds ratio 8.79, 95% CI 6.89-11.2) and in-hospital arrest (odds ratio 24.9, 95% CI 18.71-33.14) were associated with NIV failure. In-hospital mortality was 26.5% for NIV failure compared to 5.6% for those without NIV (P < .001). After adjustment for demographics, comorbidities, cardiogenic shock, and in-hospital arrest, NIV failure was associated with nearly a 2-fold risk of inhospital mortality (odds ratio 1.95, 95% CI 1.59-2.40). CONCLUSIONS: Intubation after initial NIV treatment was required in 1.5% of subjects hospitalized with AHF and treated with NIV, and was associated with high in-hospital mortality. These findings can guide future prospective interventional trials and quality improvement ventures. [ABSTRACT FROM AUTHOR]

The institutional anomie theory is a proposal that states competitive materialism, an intense cultural pressure for economic success at any costs, and increased female employment may be related to a high homicide rate. The current work tested this proposition by utilizing homicide data collected from 45 developed and developing countries. Regression results did not support the proposition. Competitive materialism and female employment were not significantly related to the cross-national variation of homicide rates. [ABSTRACT FROM AUTHOR]

Jail-based student-run clinics, though uncommon, have the potential to impact the future health workforce. We evaluated, via a survey of student attitudes and a collection of lessons learned, a student–faculty collaborative clinic that was implemented in a jail in 2015. Clinic participation led to significantly greater student volunteer ratings of the importance of collaborating with oral health providers and of comfort in providing care to incarcerated populations. We report lessons learned regarding logistical considerations, volunteer behavior, and common issues arising in clinic visits. The clinic proved feasible and sustainable over several years, offering a new model for the involvement of trainees in correctional health care. [ABSTRACT FROM AUTHOR]

We assessed overall job satisfaction and factors of job satisfaction among physician assistants (PAs) practicing cardiovascular medicine in the United States. Job satisfaction among health care providers is associated with provider satisfaction and retention, reduced health care costs, increased patient satisfaction, and improved health care. Research regarding job satisfaction among physicians and nurse practitioners has been conducted, but knowledge of job satisfaction among PAs is limited, dated, and inadequate. Job satisfaction among PAs in cardiology, a specialty with a disparity between provider supply and demand, has not been investigated. A quantitative, correlational, descriptive study was conducted using participants from the Association of Physician Assistants in Cardiology database. Overall job satisfaction, 45 factors of job satisfaction, and 6 composite factors were calculated. Correlational analysis was performed for factors most associated with overall job satisfaction. Overall job satisfaction was high. Most PAs (87.3%) were satisfied or very satisfied. Physician assistants were most satisfied with job factors related to challenge and autonomy, and these factors had the greatest correlation to overall job satisfaction. Findings can guide employers, health care administrators, and policy makers to promote job satisfaction among PAs in cardiology and provide insights into job satisfaction among PAs in general. [ABSTRACT FROM AUTHOR]

Background Ongoing development and expansion of trauma centers in the United States necessitates empirical analysis of the effect of investment in such resources on population-level health outcomes. Methods Multiple linear regressions were performed to predict state-level trauma-related mortality among adults and the elderly across 50 US states in 2010. The number of trauma centers per capita in each state and the percentage of each state's population living within 45-min of a trauma center served as the key independent variables and injury-related mortality served as the dependent variable. All analyses were stratified by age (adult versus elderly; elderly ≥ 65 years old) and were performed in SPSS. Results The proportion of a population with geographic proximity to a trauma center demonstrates a consistent inverse linear relationship to injury-related mortality. The relationship reliably retains its significance in models including demographic covariates. Interestingly, access to Levels I and II trauma centers demonstrates a stronger correlation with mortality than was observed with Level III centers. Conclusion Trauma center access is associated with reduced trauma-related mortality among both adults and the elderly as measured by state reported mortality rates. Ongoing efforts to designate and verify new trauma centers, particularly in poorly-served 'trauma deserts', could lead to lower mortality for large populations. [ABSTRACT FROM AUTHOR]

Effective health education programs for adolescent substance use prevention need to be developed. However, the evidence supporting the use of specific instructional strategies for youth substance use prevention programs is insufficient. The purpose of this study was to develop and implement a community-based program aiming for smoking, alcohol, and substance use prevention based on multiple disciplinary literacy strategies. A one-group pretest-and-posttest comparison design was used to test the feasibility of the new substance use prevention program. Thirty-two adolescents, most from families with minority and low-socioeconomic status backgrounds, participated. The group met for a 1-hour session once a week for 10 weeks. The program was implemented in a suburban setting in a southeastern state in the United States. Pretests and posttests were administered to assess the program's effectiveness in improving participants' knowledge, skills, and assets regarding substance use. Overall, the participants were satisfied with the program and reported significant growth in their knowledge, skills, assets, and perceptions of benefits. These findings suggest that disciplinary literacy strategies may promote adolescents' perceptions of and knowledge regarding substance use. [ABSTRACT FROM AUTHOR]

Objective: We evaluated how nighttime media use is associated with sleep behaviors in first-semester college students, and variation by weight status. Methods: In September 2016, first-semester college students (N = 114) completed surveys evaluating nighttime media usage (NMU) and sleep behaviors. Height, weight, and waist circumference were measured, and weight status was determined by body mass index. Results: Students reported a mean sleep duration of 7.26 ± 0.93 hours. Only 33% (N = 38) reported sleeping at least 8 hours/night on average. Higher scores on the Pittsburgh Sleep Quality Index were correlated with reports of texting after bed (r = .199, p = .04). Total time in bed was correlated with texting in bed (r = .217, p = .026) and devicerelated sleep interruptions (r = .215, p = .028). Social media usage (r = 0.270, p = .005), mobile gaming (r = .208, p = .033), and texting (r = .293, p = .002) were correlated with sleep interruptions. NMU was positively correlated with weight and weight status. Conclusions: These results suggest NMU is associated with reduced sleep quality. [ABSTRACT FROM AUTHOR]

Cultural competence is a "Foundational Behavior of Clinical Practice (CAATE, 2016)" for Athletic Training education. The objective of this study was to determine whether classroom activities are effective for improving cultural competence in undergraduate athletic training students. Twenty-seven participants completed an Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version pre-test to establish a baseline level of cultural competence and completed a post-test after participating in the classroom activities. The mean score increased from 60.44 to 67.78 after participation in classroom activities exceeding the minimal detectable change of the tool and demonstrating significant improvement in cultural competence. [ABSTRACT FROM AUTHOR]

Background: Nursing students sometimes engage in academically dishonest behaviors despite honor codes and policies. We believe that learning more about nursing students’ perceptions of and engagement in academically dishonest behaviors will aid faculty in crafting more effective codes, policies, and educational modules. Method: Baccalaureate nursing students from accredited programs across the nation were invited to participate in an online cross-sectional descriptive correlational survey. Data were analyzed using descriptive and correlational statistics. Results: Nursing students do not perceive all academically dishonest behavior as dishonest. There is a positive relationship between perceptions of behaviors in the classroom and clinical setting. Students have higher rates of engagement in behaviors they do not perceive as dishonest. Those who engage in the behaviors considered dishonest have higher rates of rationalization. Conclusion: Faculty need to delineate to students what behaviors are deemed dishonest in a course. Eliminating ambiguity has potential to reduce engagement in dishonest behavior. [ABSTRACT FROM AUTHOR]

Aim Research conducted by dietitians is encouraged by national and international organisations, yet research output remains low. The attitudes towards and experiences with research and research methods course work of students and practitioners in Australia and the United States were examined. Methods A cross-sectional online survey was conducted. Participants were contacted by email; 173 Australian (N = 50 students; 123 practitioners) and 499 US (N = 231 students; 268 practitioners) respondents completed the survey. Results A smaller proportion of American students (74%) indicated that they would consider conducting research in the future compared to Australian students (84%) ( P < 0.001). More Australian than American practitioners indicated interest in conducting research in their current position (87% vs 66%; P < 0.001). Research training did not increase future research plans, but respondents who had conducted research either as a student or at work responded more favourably to conducting research in the future ( P < 0.001). In general, Australian respondents were more supportive of and more experienced with research. Conclusions Unlike classroom training, past research experiences supported plans for future research. Further work needs to investigate how the culture of the profession can be changed to support more dietitian-conducted research. [ABSTRACT FROM AUTHOR]

Many assessment measures have only been validated for one specific diagnostic population, which is costly and reduces the clinical utility of assessments. The Eyberg Child Behavior Inventory (ECBI) is one popular measure designed to assess disruptive behavior problems in youth. The ECBI has sound psychometric properties in typically developing youth, but the factor structure has never been examined in children with autism spectrum disorder (ASD). Therefore, the current study conducted a comprehensive psychometric analysis of the ECBI in children with ASD. Retrospective data from a nationally representative sample was collected from 335 children with ASD ages 2-12 years old. A four factor solution was identified for this sample. Implications of these findings and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Background Job stress and cumulative exposure to traumatic events experienced by critical care nurses can lead to psychological distress and the development of burnout syndrome and posttraumatic stress disorder. Resilience can mitigate symptoms associated with these conditions. Objective To identify factors that affect resilience and to determine if the factors have direct or indirect effects on resilience in development of posttraumatic stress disorder. Methods Data from 744 respondents to a survey mailed to 3500 critical care nurses who were members of the American Association of Critical-Care Nurses were analyzed. Mplus was used to analyze a mediation model. Results Nurses who worked in any type of intensive care unit other than the medical unit and had high scores for resilience were 18% to 50% less likely to experience posttraumatic stress disorder than were nurses with low scores. Nurses with a graduate degree in nursing were 18% more likely to experience posttraumatic stress disorder than were nurses with a bachelor's degree. Conclusion Because of their effects on resilience, working in a medical intensive care unit and having a graduate degree may influence the development of posttraumatic stress disorder. Future research is needed to better understand the impact of resilience on health care organizations, development of preventive therapies and treatment of posttraumatic stress disorder for critical care nurses, and the most appropriate mechanism to disseminate and implement strategies to address posttraumatic stress disorder. [ABSTRACT FROM AUTHOR]

Objectives. To determine the number and type of US workers taking maternity or paternity leave. Methods. We created a publicly available ecological long-term series for measuring parental leave from 1994 to 2015 by using the Current Population Survey, which interviews about 60 000 randomly selected households monthly. Results. The average month from 1994 to 2015 saw 273 000 women and 13 000 men on maternity or paternity leave. Maternity leave rates per 10 000 births showed no trend over 22 years (mean = 677.6). Paternity figures increased by a factor of 3, but started from a small base (14.7-54.6).We observed no national impact on maternity or paternity leave after implementation of state laws that provided paid leave. About half (51.1%) of employees on maternity or paternity leave during 2015 received paid time off. The typical woman on maternity leave was older, more likely married, more likely non-Hispanic White, and more educated than the typical woman who gave birth. Conclusions. Although the US economy has expanded dramatically since 1994, this improvement does not appear to have translated into more women taking maternity leave. [ABSTRACT FROM AUTHOR]

This study constructed and tested models using the mediators of resilience and self-efficacy to help explain the relationship between social support and positive health practices (PHPs) in Black late adolescents. A cross-sectional, correlational design was used with a convenience sample of 179 Black college students, aged 18 to 23 years. Participants responded to four instruments; the five bivariate hypotheses were supported. Social support correlated positively with PHPs (r = .45, p < .001), resilience (r = .28, p < .001), and self-efficacy (r = .40, p < .001). Resilience (r = .31, p < .001) and self-efficacy (r = .38, p < .001) correlated positively with PHPs. Regression analyses indicated that resilience and self-efficacy were partial, not complete mediators of the relationship between social support and PHPs. This research has relevance for practice involving Black late adolescents, with social support playing a role in promoting PHPs. [ABSTRACT FROM AUTHOR]

Objectives To examine adherence to the American College of Sports Medicine and American Cancer Society guidelines on leisure-time aerobic and muscle-strengthening physical activity ( PA) of older cancer survivors. Design Cross-sectional study based on the 2014 National Health Interview Survey. Setting United States. Participants Young-old (65-74) (n = 627), old-old (≥75) (n = 656), and middle-aged (45-64) (n = 786) cancer survivors and adults without cancer (n = 18,369), stratified according to the same age groups. Measurements Weighted percentages were used to describe sociodemographic and health-related characteristics of the study population. Unadjusted and adjusted predicted probabilities from generalized ordered and multinomial logistic regressions were estimated to examine levels of aerobic and muscle-strengthening PA in the study population. Results Cancer survivors and those without a cancer diagnosis had similarly low rates of adherence to PA guidelines according to age group. In unadjusted analyses, the age effect was statistically significant in long-term cancer survivors only. Adjusting for sociodemographic and health-related characteristics, on average, 34.0% of young-old and 35.4% of old-old cancer survivors engaged in sufficient levels of aerobic PA, versus 44.3% of their middle-aged counterparts ( P's <.05). Approximately 10% of older cancer survivors met aerobic and muscle-strengthening guidelines, compared with 19.1% of middle-aged cancer survivors ( P = .001). Conclusion Adherence to the recommended levels of leisure-time aerobic and muscle-strengthening PA is lower in older than middle-aged cancer survivors in the United States. Greater efforts must be made to encourage and support PA participation in this population. [ABSTRACT FROM AUTHOR]

Background: Dietary pattern analysis represents a departure from the traditional focus on single foods and nutrients and provides a comprehensive understanding of the role of the diet in chronic disease prevention and etiology. Dietary patterns of Canadians have not been evaluated comprehensively with the use of an updated a priori dietary quality index. Objectives: We aimed to update the Dietary Guidelines for Americans Adherence Index (DGAI) on the basis of the 2015 Dietary Guidelines for Americans (DGA), to evaluate the construct validity and reliability of the revised index, and to examine whether closer adherence to this index is associated with a lower risk of obesity with or without an accompanying chronic disease. Design: Data from 11,748 participants (≥18 y of age) in the crosssectional Canadian Community Health Survey cycle 2.2 were used in weighted multivariate analyses. Multinomial logistic regression was used to test the association between diet quality and obesity risk. Results: With the use of principal component analyses, the multidimensionality of the 2015 DGAI was confirmed, and its reliability was shown with a high Cronbach's α = 0.75. Moving from the first to the fourth (healthiest) quartile of the 2015 DGAI score, there was a trend toward decreased energy (2492 ± 26 compared with 2403 ± 22 kcal, respectively; ±SE) and nutrients of concern (e.g., sodium), whereas intakes of beneficial nutrients increased (P-trend < 0.05). In the age- and sex-adjusted model, a lack of adherence to the 2015 DGA recommendations increased the OR of being unhealthy obese from 1.42 (95% CI: 1.02, 1.99) in quartile 3 to 2.08 (95% CI: 1.49, 2.90) in quartile 2 to 2.31 (95% CI: 1.65, 3.23) in the first quartile of the 2015 DGAI score, compared with the fourth quartile (healthiest) (P-trend < 0.0001). The odds of being obese without a chronic disease (healthy obese) and having a chronic disease without being obese also increased in the lowest DGAI quartile compared with the highest DGAI quartile, albeit not as much as in the unhealthy obese group. Conclusion: The 2015 DGAI provides a valid and reliable measure of diet quality among Canadians. [ABSTRACT FROM AUTHOR]

Youth aggression is a serious global issue, but research identifying personality traits associated with aggression has focused on adults. Little is known about whether similar associations exist during adolescence; even less is known about these associations across cultures. This study examined links between personality and physical aggression in U.S. and Chinese adolescents, and tested whether temper mediates these associations. U.S. (N = 250) and Chinese (N = 199) young adolescents ( X ¯ age = 13.43 years) completed self-reports describing personality, temper, and aggression. Path analyses demonstrated that temper significantly mediated associations from agreeableness and neuroticism to aggression in both samples. The mediating effect of temper was marginally stronger in the Chinese sample than in the U.S. sample, suggesting temper plays a more important role in youth aggression in China than in the United States. Findings highlight the universal role of affect in aggression and demonstrate the importance of cultural context in understanding links between personality and youth aggression. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a condition that can have diverse and wide-ranging effects. Individuals who sustain TBIs often experience a unique constellation of symptoms with cognitive, emotional, and physical sequelae. These symptoms can have deleterious effects on romantic relationships. Despite this potential impact on romantic functioning, there is a paucity of research that examines the effects of TBI on romantic relationships. The present study sought to address this gap in the extant literature by examining factors that help a person who acquires a TBI respond to the new challenges that come with this disability. A sample of 122 individuals who have sustained a TBI completed an online survey. All participants were at least 18 years old and were in a romantic relationship of at least six months' duration. Participants were surveyed regarding their health-related quality of life (HRQOL), attachment security, partner support, and relationship satisfaction. Results from a multiple regression analysis indicated that attachment security accounted for a significant amount of variance in HRQOL whereas relationship satisfaction and partner support did not. Implications for theory and practice and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Mental health concerns are a major factor in the overall wellness and stability of resettled refugees. While the need for mental health treatment for this population has been well-documented, less is known about the effectiveness of various treatment modalities on mental health outcomes. The purpose of this quasi-experimental study was to assess the impact of three different mental health interventions among refugees from Burundi, Burma, The Democratic Republic of Congo, Rwanda, and Bhutan. The effects of eight weeks of randomly assigned office-based counseling (treatment as usual [TAU]), home-based counseling (HBC), and a community-based psycho-educational group (CPG) on posttraumatic stress symptoms, depression, anxiety, somatization, and social support were evaluated using a pre–post design. Results indicate merit in each of the treatment modalities, with varying efficacy across intervention according to mental health symptoms. In general, however, participants in HBC and CPG demonstrated greater overall improvement in mental health outcomes than participants receiving TAU. [ABSTRACT FROM AUTHOR]

Background: Controversy exists over the disparate circulating 25-hydroxyvitamin D [25(OH)D] concentrations between black and white Americans. Objective: We sought to determine whether there are differences in total and directly measured free 25(OH)D concentrations between black and white American adults and how daily supplementation with cholecalciferol changes these concentrations. Design: Cross-sectional and longitudinal analyses were conducted with the use of data from 2 placebo-controlled, randomized trials at 2 academic medical centers in the United States: CaDDM (Calcium and Vitamin D in Type 2 Diabetes) and DDM2 (Vitamin D for Established Type 2 Diabetes). A total of 208 subjects with pre- or well-controlled diabetes with a mean age of 59.1 y and mean body mass index (BMI; in kg/m²) of 31.6 were randomly assigned to receive daily cholecalciferol supplementation at 1 of 2 doses (2000 or 4000 IU) or a matching placebo for 16 wk. We measured serum total 25(OH)D, vitamin D-binding protein (DBP) by 2 different immunoassays (with the use of monoclonal or polyclonal antibodies), parathyroid hormone, and albumin. Free 25(OH)D concentration was directly measured and calculated. Results: Blacks had lower total 25(OH)D concentrations than whites [adjusted median: 20.3 ng/mL (95% CI: 16.2, 24.5 ng/mL) compared with 26.7 ng/mL (95% CI: 25.2, 28.1 ng/mL), respectively; P = 0.026)], and a higher proportion of blacks had total 25(OH)D concentrations < 20 ng/mL (46% compared with 19%, respectively; P, 0.001). Directly measured free 25(OH)D concentrations were lower in blacks than in whites [adjusted median: 4.5 ng/mL (95% CI: 3.7, 5.4 ng/mL) compared with 5.7 ng/mL (95% CI: 5.4, 5.9 ng/mL), respectively; P = 0.044] and were strongly correlated with total 25(OH)D without an effect of race. DBP was lower in blacks when measured by the monoclonal but not the polyclonal antibody immunoassay. Cholecalciferol supplementation increased total and measured free 25(OH)D concentrations proportionally to the dose and without a difference between races. Conclusions: The relation between free and total 25(OH)D did not vary systematically by race in this multiracial population with pre- or well-controlled diabetes. The results need to be replicated in additional cohorts before concluding that the clinical assessment of vitamin D status in blacks and whites should follow a single standard. The CaDDM and DDM2 trials were registered at clinicaltrials.gov as NCT00436475 and NCT01736865, respectively. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to determine the effectiveness of an evidence-based practice (EBP) learning module within a nursing residency program (NRP). BACKGROUND: Utilization of EBP has been shown to improve patient outcomes; however, new-graduate nurses lack the practice application ability, attitudes, knowledge, and skills to incorporate EBP into their personal practice. METHODS: New-graduate nurses in a hospital NRP participated in this nonexperimental, descriptive, correlational, study. The Evidence-Based Practice Questionnaire was utilized in a prestudy-poststudy format to collect data for analysis. RESULTS: Statistically significant changes occurred throughout the EBP module in regard to new-graduate nurse practice and knowledge of EBP. CONCLUSION: Enabling novice nurses to foster a spirit of inquiry through EBP literacy is essential to patient outcomes; nonetheless, new-graduate nurse readiness must be further assessed in order to determine appropriate timing of EBP education within NRPs in an effort to improve the application of evidence at the bedside. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the relationships between role stress, emotional eating, and obesity in clergy. A random sample of United States Lutheran Church Missouri Synod clergy who met the study criteria (N = 430), response rate 38%, completed the Role Stress and Emotional Eating Behavior Scales, and self-reported height and weight for Body Mass Index (BMI) calculation. Obesity was high (81.4% overweight/obese, 36.7% obese), and emotional eating partially mediated the relationship between role stress and obesity. This study tested relations of the Neuman Systems Model. [ABSTRACT FROM AUTHOR]

Background: In the United States, approximately 30% of adults drink at risky levels or meet the criteria for harmful or dependent alcohol use. Screening, brief intervention, and referral to treatment (SBIRT) in primary care settings is indicated. This study assessed whether knowledge, attitudes, and beliefs about SBIRT, evaluated after a three-part, mixed-methods training, predicted whether 21 family nurse practitioner (FNP) students screened for alcohol use during clinical patient encounters. Method: After training, students completed a survey and documented implementation of SBIRT during their clinical practice-specific management courses. Results: FNP students who reported higher levels of perceived competence in their posttraining surveys were more likely to screen for alcohol in the clinical setting. Conclusion: Screening for alcohol misuse and identifying patients engaged in hazardous drinking meet important nurse practitioner competencies. Further research is needed to explore training programs that specifically emphasize activities to increase perceived competence, knowledge, and comfort regarding SBIRT. [ABSTRACT FROM AUTHOR]

Background: Childhood acquired brain injuries can disrupt communication functions needed for success in school, work and social interaction. Cognitive-communication difficulties may not be apparent until adolescence, when academic, environmental and social-emotional demands increase. Objective: The Functional Assessment of Verbal Reasoning and Executive Strategies for Students (S-FAVRES) is a new activity-level measure of cognitive-communication skills in complex, contextual and integrative tasks that simulate real world communication challenges. It is hypothesized that S-FAVRES performance would differentiate adolescents with and without acquired brain injury (ABI) on scores for Accuracy, Rationale, Reasoning Subskills and Time. Methods: S-FAVRES was administered to 182 typically-developing (TD) and 57 adolescents with mild-to-severe ABI aged 12–19. Group differences, internal consistency, sensitivity, specificity, reliability and contributing factors to performance (age, gender, brain injury) were examined statistically. Results: Those with ABI attained statistically lower Accuracy, Rationale and Reasoning sub-skills scores than their TD peers. Time scores were not significantly different. Performance trends were consistent across tasks, administrations, gender and age groups. Inter-rater reliability for scoring was acceptable. Conclusion: The S-FAVRES provides a reliable, functional and quantifiable measure of subtle cognitive-communication difficulties in adolescents that can assist speech-language pathologists in planning treatment and integration to school and real world communication. [ABSTRACT FROM AUTHOR]

Integrating the perspectives of psychological contract and sex differences, this study examines how organizational decision to reduce labour costs influences employees' perceived psychological contract breach and their commitment to their organizations. Using two experiments, we found three-way interaction effects among the decision to reduce labour costs, employee sex, and the managerial control over the decision. The decision of labour costs reduction leads to stronger feelings of psychological contract breach for females when the decision is in low than in high levels of managerial control, but the same decision leads to stronger psychological contract breach for males when the decision is in high than in low levels of managerial control. Furthermore, the indirect effect of labour costs reduction on employees' organizational commitment through psychological contract breach is also contingent upon the interaction between employee sex and managerial control. Our findings expand the literature of psychological contract and shed light on timely practical issues of management's decisions regarding labour costs reduction. Practitioner points Labour costs reductions in economic downturns lead to different responses from employees, and managers are advised to plan their actions bearing in mind such differences., Management in crisis or difficulties calls for more delicate considerations of employees' psychological feelings towards the organization., Nuanced empirical evidence informs us about the different needs and responses of a diverse group of employees and how their responses contradict. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the sociocultural factors related to weight behaviors in African American adolescents utilizing a social ecological approach. A descriptive correlational design included a sample of 145 African American adolescents. Perceived familial socialization, ethnic identity, physical activity, and eating behavior patterns were measured. Data were analyzed using descriptive statistics, Pearson product–moment correlations, and multiple regression equations. Perceived maternal socialization was significantly related to adolescent eating behaviors and physical activity whereas perceived paternal socialization was significantly related only to their physical activity. The adolescents’ ethnic identity was not significantly related to their eating behaviors or physical activity. Health care providers who work with adolescents and their families can use the initial findings from this study to encourage healthy weight-related behaviors while reducing the obesity epidemic within the African American adolescent population in a developmentally appropriate and culturally sensitive manner. [ABSTRACT FROM AUTHOR]

Background: Carbohydrate quality may be an important determinant of type 2 diabetes (T2D); however, relations between various carbohydrate quality metrics and T2D risk have not been systematically investigated. Objective: The purpose of this study was to prospectively examine the association between carbohydrates, starch, fibers, and different combinations of these nutrients and risk of T2D in women. Design: We prospectively followed 70,025 women free of cardiovascular disease, cancer, and diabetes at baseline from the Nurses' Health Study (1984-2008). Diet information was collected with the use of a validated questionnaire every 4 y. Cox regression was used to evaluate associations with incident T2D. Results: During 1,484,213 person-years of follow-up, we ascertained 6934 incident T2D cases. In multivariable analyses, when extreme quintiles were compared, higher carbohydrate intake was not associated with T2D (RR = 0.98; 95% CI: 0.89, 1.08; P-trend = 0.84), whereas starch was associated with a higher risk (RR = 1.23; 95% CI: 1.12, 1.35; P-trend,0.0001). Total fiber (RR = 0.80; 95% CI: 0.72, 0.89; P-trend < 0.0001), cereal fiber (RR = 0.71, 95% CI: 0.65, 0.78; P-trend < 0.0001), and fruit fiber (RR = 0.79; 95% CI: 0.72, 0.85; P-trend < 0.0001) were associated with a lower T2D risk. The ratio of carbohydrate to total fiber intake was marginally associated with a higher risk of T2D (RR = 1.09; 95% CI: 1.00, 1.20; P-trend = 0.04). On the other hand, we found positive associations between the ratios of carbohydrate to cereal fiber (RR = 1.28; 95% CI: 1.17, 1.39; P-trend < 0.0001), starch to total fiber (RR = 1.12; 95% CI: 1.02, 1.23; P-trend = 0.03), and starch to cereal fiber (RR = 1.39; 95% CI: 1.27, 1.53; P-trend < 0.0001) and T2D. Conclusions: Diets with high starch, low fiber, and a high starch-to-cereal fiber ratio were associated with a higher risk of T2D. The starch-to-cereal fiber ratio of the diet may be a novel metric for assessing carbohydrate quality in relation to T2D. [ABSTRACT FROM AUTHOR]

The article presents the study that explores on the use of haematopoietic stem cell transplantation (SCT) in the treatment of Fanconi anemia (FA) patients in Canada and the U.S. The topics discussed include the attributes of FA, the factors that influenced the decision making of FA patients and family members on SCT, and the benefits and probable risks of SCT.

BackgroundPatient adherence to medical treatment recommendations can affect disease prognosis, and may be beneficially or deleteriously influenced by psychological factors.AimWe examined the relationships between both adaptive and maladaptive psychological factors and treatment adherence among a sample of primary care patients.MethodsOne hundred and one rural, primary care patients completed the Life Orientation Test-Revised, Trait Hope Scale, Future Orientation Scale, NEO-FFI Personality Inventory (measuring positive and negative affect), and Medical Outcomes Study General Adherence Scale.FindingsIn independent models, positive affect, optimism, hope, and future orientation were beneficially associated with treatment adherence, whereas pessimism and negative affect were negatively related to adherence. In multivariate models, only negative affect, optimism and hope remained significant and, in a comparative model, trait hope was most robustly associated with treatment adherence.ImplicationsTherapeutically, addressing negative emotions and expectancies, while simultaneously bolstering motivational and goal-directed attributes, may improve adherence to treatment regimens. [ABSTRACT FROM PUBLISHER]

Ethnic minority midlife women frequently do not recognize cardiovascular symptoms that they experience during the menopausal transition. Racial/ethnic differences in cardiovascular symptoms are postulated as a plausible reason for their lack of knowledge and recognition of the symptoms. The purpose of this study was to explore racial/ethnic differences in midlife women’s cardiovascular symptoms and to determine the factors related to these symptoms in each racial/ethnic group. This was a secondary analysis of the data from a larger study among 466 participants, collected from 2006 to 2011. The instruments included questions on background characteristics, health and menopausal status, and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics, including Poisson regression and logistic regression analyses. Significant racial/ethnic differences were observed in the total numbers and total severity scores of cardiovascular symptoms (p< .01). Non-Hispanic Asians had significantly lower total numbers and total severity scores compared to other racial/ethnic groups (p< .05). The demographic and health factors associated with cardiovascular symptoms were somewhat different in each racial/ethnic group. Further studies are needed about possible reasons for the racial/ethnic differences and the factors associated with cardiovascular symptoms in each racial/ethnic group. [ABSTRACT FROM AUTHOR]

Childhood maltreatment places individuals, including African American women who are undereducated and economically disadvantaged, at risk for developing posttraumatic stress disorder (PTSD) symptoms. Participants were 192 African American women with a history in the prior year of both a suicide attempt and intimate partner violence (IPV) exposure. They were recruited from a public hospital that provides medical and mental health treatment to mostly low-income patients. A simple mediator model was used to examine if (a) existential well-being (sense of purpose) or religious well-being (relationship with God) mediated the link between childhood maltreatment and adult PTSD symptoms. Sequential multiple mediator models determined if physical and nonphysical IPV enhanced our understanding of the mediational association among the aforementioned variables. Findings suggest that existential well-being mediated the association between childhood maltreatment and adult PTSD symptoms in a simple mediator model, and existential well-being and recent nonphysical IPV served as sequential multiple mediators of this link. However, religious well-being and physical IPV were not significant mediators. Findings underscore the importance of enhancing existential well-being in the treatment of suicidal African American women with a history of childhood maltreatment and IPV. [ABSTRACT FROM AUTHOR]

Objective To correlate the amount and types of pain medications prescribed to CRPS patients, using the Medication Quantification Scale, and patients' subjective pain levels. Design An international, multisite, retrospective review. Setting University medical centers in the United States, Israel, Germany, and the Netherlands. Subjects/Methods A total of 89 subjects were enrolled from four different countries: 27 from the United States, 20 Germany, 18 Netherlands, and 24 Israel. The main outcome measures used were the Medication Quantification Scale III and numerical analog pain scale. Results There was no statistically significant correlation noted between the medication quantification scale and the visual analog scale for any site except for a moderate positive correlation at German sites. The medication quantification scale mean differences between the United States and Germany, the Netherlands, and Israel were 9.793 ( P < 0.002), 10.389 ( P < 0.001), and 4.984 ( P = 0.303), respectively. Conclusions There appears to be only a weak correlation between amount of pain medication prescribed and patients' reported subjective pain intensity within this limited patient population. The Medication Quantification Scale is a viable tool for the analysis of pharmaceutical treatment of CRPS patients and would be useful in further prospective studies of pain medication prescription practices in the CRPS population worldwide. [ABSTRACT FROM AUTHOR]

Research suggests that community reintegration (CR) after injury and rehabilitation is difficult for many servicemembers. However, little is known about the influence of the contextual factors, both personal and environmental, on CR. Framed within the International Classification of Functioning, Disability and Health and social cognitive theory, the quantitative portion of a larger mixed-methods study of 51 injured, community-dwelling servicemembers compared the relative contribution of contextual factors between groups of servicemembers with different levels of CR. Cluster analysis indicated three groups of servicemembers showing low, moderate, and high levels of CR. Statistical analyses identified contextual factors that significantly discriminated between CR clusters. Multivariate analysis of variance and discriminant analysis indicated significant contributions of general selfefficacy, services and assistance barriers, physical and structural barriers, attitudes and support barriers, perceived level of disability and/or handicap, work and school barriers, and policy barriers to CR scores. Overall, analyses indicated that injured servicemembers with lower CR scores had lower general self-efficacy scores, reported more difficulty with environmental barriers, and reported their injuries as more disabling. [ABSTRACT FROM AUTHOR]

Poor patient–provider interaction among racial/ethnic minorities is associated with disparities in health care. In this descriptive, cross-sectional study, we examine African American women’s perspectives and experiences of patient–provider interaction (communication and perceived discrimination) during their initial prenatal visit and their influences on perceptions of care received and prenatal health behaviors. Pregnant African American women (n = 204) and their providers (n = 21) completed a pre- and postvisit questionnaire at the initial prenatal visit. Women were also interviewed face to face at the subsequent return visit. Women perceived high quality patient–provider communication (PPC) and perceived low discrimination in their interaction with providers. Multiple regression analyses showed that PPC had a positive effect on trust in provider (p < .001) and on prenatal care satisfaction (p < .001) but not on adherence to selected prenatal health behaviors. Findings suggest that quality PPC improves the prenatal care experience for African American women. [ABSTRACT FROM PUBLISHER]

Mental health disorders (MHDs), mild traumatic brain injury (mTBI), and alcohol use disorder (AUD) are endemic among recent Veterans, resulting in a population with heterogeneous, co-occurring conditions. While alcohol craving negatively affects rehabilitation and leads to relapse, no studies have examined alcohol craving among Veterans with co-occurring MHDs and mTBI. The purpose of this preliminary cohort study is to describe alcohol craving in a convenience sample of Iraq and Afghanistan Veterans (n = 48), including those exposed to traumatic events and experiencing active symptoms. Veterans completed weekly telephone interviews that included the Alcohol Use Disorder Identification Test, consumption questions (AUDIT-C) (week 1) and the Penn Alcohol Craving Scale (PACS) (weeks 1-6). Sixty percent of the sample screened positive on the AUDIT-C for probable AUD. Using Rasch analysis, the person separation reliability of the PACS was strong (0.87) among AUDIT-C positive Veterans. Higher PACS scores were reported among AUDITC positive versus AUDIT-C negative Veterans (mixed effects analysis, p < 0.001). PACS scores were higher among AUDIT-C positive Veterans with MHDs with and without mTBI versus AUDIT-C positive combat comparison Veterans (pairwise comparison, p < 0.001). Rates of hazardous alcohol use are high among Iraq and Afghanistan conflict Veterans and suggest that alcohol craving is elevated among those with MHDs with and without mTBI. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a leading cause of end stage renal disease among African Americans. The complications associated with diabetes can largely be reduced with effective diabetes self-management. Selected variables were tested as predictors of self-reported self-care, and self-reported self-care was tested as a predictor of A1C among 100 African-American individuals with diabetes. Participants scored high on their understanding of diabetes, its treatment, and engagement in self-care activities, but this was not reflected in their body mass index levels or A1C values. [ABSTRACT FROM AUTHOR]

This study is grounded in theories of information management. Patients with a diagnosed heart-related condition (N = 253) completed a survey regarding their perceptions of sharing/not sharing information with a partner about their health condition. Data were analyzed using descriptive and inferential statistics. Results indicated that although most patients reported sharing “everything” with their partner, others reported not sharing certain topics such as health issues and physical symptoms/ailments. In addition, patients who reported sharing everything with a partner reported significantly greater communication efficacy, and breadth, depth, and frequency of communication about a heart-related condition compared with those who reported not sharing certain topics. Finally, as hypothesized, there were no significant group differences in terms of sharing specific physical and psychological health information. We discuss the findings and implications of the study for nursing practice. [ABSTRACT FROM PUBLISHER]

Abuse is highly prevalent among HIV+ women, leading to behaviors, including lower adherence to highly active antiretroviral therapy (HAART) that result in poor health outcomes. Resilience (functioning competently despite adversity) may buffer the negative effects of abuse. This study investigated how resilience interacted with abuse history in relation to HAART adherence, HIV viral load (VL), and CD4+ cell count among a convenience sample of 138 HIV+ women from the Ruth M. Rothstein CORE Center/Cook County Health and Hospital Systems site of the Women's Interagency HIV Study (WIHS). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HAART adherence (≥95% vs. <95% self reported usage of prescribed medication) and current or prior sexual, physical, or emotional/domestic abuse, were reported during structured interviews. HIV viral load (≥20 vs. <20 copies/mL) and CD4+ count (200 vs. <200 cells/mm) were measured with blood specimens. Multiple logistic regressions, controlling for age, race, income, enrollment wave, substance use, and depressive symptoms, indicated that each unit increase in resilience was significantly associated with an increase in the odds of having ≥95% HAART adherence and a decrease in the odds of having a detectable viral load. Resilience-Abuse interactions showed that only among HIV+ women with sexual abuse or multiple abuses did resilience significantly relate to an increase in the odds of ≥95% HAART adherence. Interventions to improve coping strategies that promote resilience among HIV+ women may be beneficial for achieving higher HAART adherence and viral suppression. [ABSTRACT FROM AUTHOR]

The role of inner strength in quality of life (QOL) and self-management, primary variables in the Theory of Inner Strength, were examined with demographic and clinical characteristics in 107 women with cancer. The strongest predictors of QOL were depressive symptoms, inner strength, and time since diagnosis, respectively, accounting for 82% of the variance in QOL. When depressive symptoms were excluded due to multicollinearity, 64% of variance in QOL was explained by inner strength, time since diagnosis, and comorbidities, with inner strength the strongest predictor. The strongest predictors of self-management were depressive symptoms and inner strength, accounting for 17% of the variance. Results contribute to theory development and suggest the value of supporting inner strength to enhance QOL in cancer survivors. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]