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To compare relative rates of pediatric poisoning before and after COVID-19, including by demographic and urban-rural status, and by agent identified, using data from one university healthcare system and children's hospital. Using retrospective, cross sectional design from deidentified healthcare claims data, we extracted all encounters with the ICD-10-CM for Poisoning by, Adverse effects of, and Underdosing of drugs, medicants and biological substances (T36-T50) and grouped the encounters as those after state mandates regulating activity came into effect (Post-COVID-19 (3/17/2020–3/18/2021)) Pre-COVID-19 (3/18/2019–3/17/2020). We then compared poisoning agent, age at the time of the encounter, recorded sex, race, ethnicity, rural/urban residence, and visit type using Mann-Whitney U test, chi-square test of association, incidence rates and incident rate ratios between the time periods. The sample included 1608 unique patients 0–17 years of age and 4216 encounters. We also identified IRRs >1 in nearly every demographic subgroup with the exception of Non-Hispanic Blacks. The comparison of specific drugs or medicants identified a significant decrease in poisoning by Systemic antibiotics (T36); but an increase in Hormones and their synthetic substitutes and antagonists (T38), Non opioid analgesics antipyretic and antirheumatic (T39), Psychotropic Drugs (T39) and Systemic and hematologic agents (T45). This study identifies pediatric subgroups highly affected by pediatric poisoning during the time-period immediately after the identification of COVID-19 and characterizes the drugs commonly associated with poisonings. With a further understanding nursing has the potential to impact pediatric poisoning in the inpatient, outpatient and public health setting. [ABSTRACT FROM AUTHOR]

The first Doctor of Nursing Practice (DNP) program was opened at the University of Kentucky College of Nursing (UKCON) in 2001. As the CON celebrates 20 plus years of DNP education, leaders decided to do an assessment of the accomplishments and outcomes from the work of graduates. The purpose of this study was to delineate the achievements, outcomes and perception of the impact of graduates from the UKCON DNP program and assess the correlations of specific "perception of impact" variables. DNP graduates from 2005 to 2021 (n = 348) received an email about the study and a link to the survey. Ninety graduates who resided in 14 states responded. Over 84 % of participants indicated that their DNP degree helped them stand out as a leader. Participants reported that having a DNP education increased their knowledge and expertise in multiple areas, including how to lead, to influence, and to improve outcomes within their organizations. Narrative feedback related to top achievements since graduation included career advancement/promotion (n = 22), improving patient care quality/implementation of evidence-based initiatives (n = 21), and becoming a better leader (n = 19). This study illustrated the broad return on investment and the quantification of value that a DNP education brings, both to practice and academia. • A Doctor of Nursing Practice (DNP) degree helps one stand out as a leader • DNP graduates identify multiple career accomplishments due to their DNP • DNP nurses verbalize the ability to work across boundaries to translate evidence into practice and impact outcomes • DNP graduates express having increased credibility due to their degree [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if a web-based educational intervention increased knowledge, attitudes, and intention of perianesthesia nurses regarding opioid discharge education (including safe use, storage, and disposal of opioids). Secondary outcomes were to determine Perceived Behavioral Control, subjective norms, and familiarity with American Society of PeriAnesthesia Nurses (ASPAN) guidance on opioid education. A pre-test, post-test longitudinal design. An email described the study and had a link for those choosing to participate. The intervention was a web-based voiceover module with patient education scenarios focused on information required for patients before discharge home. Responses to the evidence-based pre-survey, post-survey one, and post-survey two were collected. The survey was developed using components of the Theory of Planned Behavior. Data analysis included descriptive summary and evaluation of changes in knowledge and domains of Theory of Planned Behavior using repeated measures mixed modeling. The participants were invited to complete a pre-test survey (n = 672), the immediate post-test (n = 245), and the 4-week post-test (n = 172). The analysis presented is limited to 245 who completed at least the first post-survey. Most were staff nurses (82%), and the majority had a BSN (62%); participants most typically worked in a hospital-based PACU (73%). For all outcomes, there was an immediate increase in the measure following the intervention; this pairwise difference (between pretest and the immediate post-test) was significant in all but one of the models. The immediate and 4-week post-test scores exceeded the corresponding pre-test score, though for Perceived Behavioral Control, attitude, and intention, the degree of increase between baseline and week 4 was not significant. In all cases, both the immediate and 4-week post-test scores exceeded the corresponding pre-test score, though, for three of the TPB constructs, the difference between baseline and week 4 was not significant, while nearly all of the increases between baseline and immediately following the intervention were significant. These findings suggest a more intensive intervention, possibly with the inclusion of booster sessions, may be needed. [ABSTRACT FROM AUTHOR]

Make It POP (Pathway Optimizing Professionalism) Series (MIPS) leadership educational sessions were developed and taught by the Dean as a curricular focus on professionalism for Doctor of Nursing Practice (DNP) students. Evaluating the association between Behavioral Beliefs, Normative Beliefs, Control Beliefs, and Intention to advance professional identity and values was a focus of this study. A secondary focus was to discern whether these Belief measures and attendance to the MIPS education series were predictive of Intention to increase professional identity and values. Over a two-year period, 227 students were invited to attend the MIPS courses, which included four once per semester sessions. Students were invited to complete a survey structured around the tenants of the Theory of Planned Behavior prior to attending the MIPS and following each session; 91 students completed the survey at least once. A significant relationship was not noted between attendance to one or more MIPS sessions and Intention to advance professional identity and values. Behavioral Beliefs and Control Beliefs had the strongest associations with Intentions, but normative beliefs were not significantly associated with Intentions. Integrating curricular innovation with meaningful engagement and reflection in DNP education may advance DNP student's commitment for sustained professional growth. • The "Make It POP Series" (MIPS) education program focused on professionalism, professional values, and professional identity. • Topics included impact as a leader, showcasing one's accomplishments, communicating impact, and professional generosity. • The association between the Theory of Planned Behavior tenants and MIPS educational series impact was the focus. • Attendance to MIPS sessions and Intention to advance professional identity and values was not significantly related. • Higher Behavioral Beliefs and Control Beliefs resulted in greater Intentions to advance professional identity. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2008.10.001 Byline: Jia-Rong Wu (a), Debra K. Moser (a), Marla J. De Jong (b), Mary Kay Rayens (a), Misook L. Chung (a), Barbara Riegel (c), Terry A. Lennie (a) Abstract: Despite the importance of medication adherence in heart failure, clinically relevant cutpoints for distinguishing the level of adherence associated with outcomes are unknown. Author Affiliation: (a) University of Kentucky, College of Nursing, Lexington, KY (b) DoD Blast Injury Research Program Coordinating Office, US Army Research and Materiel Command, Fort Detrick, MD (c) University of Pennsylvania, School of Nursing, Philadelphia, PA Article History: Received 9 July 2008; Accepted 1 October 2008 Article Note: (footnote) This study was supported by funding from the Philips Medical-American Association of Critical Care Nurses Outcomes Grant, University of Kentucky General Clinical Research Center (M01RR02602), grant R01 NR008567 from the National Institute of Nursing Research, and a center grant to the University of Kentucky College of Nursing from NIH, NINR, 1P20NR010679. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health., The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Air Force or the Department of Defense.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.12.013 Byline: Chizimuzo T.C. Okoli (a)(b), Mary Kay Rayens (a), Ellen J. Hahn (a) Keywords: Secondhand tobacco smoke; Nicotine dependence; Behavioral effects Abstract: This study explores the behavioral effects of nicotine exposure from secondhand tobacco smoke (SHS) on bar and restaurant workers. Baseline data were obtained from a longitudinal study of 105 bar and restaurant workers. Hair nicotine, self-reported SHS exposure, smoking status, symptoms of nicotine exposure after being exposed to a smoky environment, and nicotine dependence were assessed. Nonsmokers reporting four or more symptoms of nicotine exposure had higher hair nicotine levels than those reporting less than four symptoms. Nonsmokers with higher hair nicotine levels were 2.2 times more likely to report 4 or more behavioral symptoms. Self-reported secondhand tobacco smoke exposure and hair nicotine were not predictive of nicotine dependence among smokers. Nicotine exposure from secondhand tobacco smoke may have important behavioral outcomes in nonsmokers. This study provides further evidence for the importance of prohibiting smoking in hospitality venues to protect the health of workers. Author Affiliation: (a) University of Kentucky, College of Nursing, 760 Rose Street, Lexington, KY 40536, USA (b) University of British Columbia, 302-6190 Agronomy Rd, Vancouver, Canada BC V6T 1Z3

The purpose of this study was to determine perianesthesia nurses' knowledge and promotion of safe use, storage, and disposal of opioids to patients in the ambulatory surgery setting. A mixed methods descriptive survey. Perianesthesia nurses who have responsibility for discharge education of patients after ambulatory surgery were eligible to participate. An evidence-based survey was e-mailed to all American Society of PeriAnesthesia Nurses members. A total of 1,977 nurses agreed to participate; 1,632 nurses met inclusion criteria and completed the survey. Responses to open-ended questions were coded and analyzed. Perianesthesia nurses were generally knowledgeable about opioids and a large majority (82%) discuss side effects of opioids with every patient. A smaller percentage of perianesthesia nurses reported promoting safe use (27%), storage (23%), and disposal of opioids (18%) with every patient. Perianesthesia nurses have an opportunity to develop standard guidelines for patient education to uniformly promote postoperative opioid safety. [ABSTRACT FROM AUTHOR]

Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months. A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth. After the study, women assigned to the intervention group were over three times more likely to EBF their baby through all four postpartum assessed time points (odds ratio = 3.1, 95% confidence interval: 1.1–8.7). This culturally and linguistically diverse intervention contributed to increased EBF duration and decreased formula supplementation in Hispanic mothers up to 6 months postpartum. [ABSTRACT FROM AUTHOR]

Objective Inconclusive findings about infection risks, importantly the use of immunosuppressive medications in patients who have undergone large-joint total joint arthroplasty, challenge efforts to provide evidence-based perioperative total joint arthroplasty recommendations to improve surgical outcomes. Thus, the aim of this study was to describe risk factors for developing a post-operative infection in patients undergoing TJA of a large joint (total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty) by identifying clinical and demographic factors, including the use of high-risk medications (i.e., prednisone and immunosuppressive medications) and diagnoses [i.e., rheumatoid arthritis (RA), osteoarthritis (OA), gout, obesity, and diabetes mellitus] that are linked to infection status, controlling for length of follow-up. Methods A retrospective, case-control study ( N = 2212) using de-identified patient health claims information from a commercially insured, U.S. dataset representing 15 million patients annually (from January 1, 2007 to December 31, 2009) was conducted. Descriptive statistics, t -test, chi-square test, Fisher’s exact test, and multivariate logistic regression were used. Results Male gender (OR = 1.42, p < 0.001), diagnosis of RA (OR = 1.47, p = 0.031), diabetes mellitus (OR = 1.38, p = 0.001), obesity (OR = 1.66, p < 0.001) or gout (OR = 1.95, p = 0.001), and a prescription for prednisone (OR = 1.59, p < 0.001) predicted a post-operative infection following total joint arthroplasty. Persons with post-operative joint infections were significantly more likely to be prescribed allopurinol ( p = 0.002) and colchicine ( p = 0.006); no significant difference was found for the use of specific disease-modifying anti-rheumatic drugs and TNF-α inhibitors. Conclusion High-risk, post-operative joint infection groups were identified allowing for precautionary clinical measures to be taken. [ABSTRACT FROM AUTHOR]

Background: Smoking during pregnancy and prenatal secondhand smoke exposure increase the risk of preterm birth. As Kentucky has the second highest rate of smoking in the United States and no statewide smoke-free law, an examination of the effect of municipal smoke-free legislation on preterm birth is warranted.Objective: This study used state-level live birth data and county-level municipal smoke-free legislation status to assess the association between the presence and strength of smoke-free laws and the likelihood of preterm birth. Moreover, this study hypothesized that pregnant persons living in counties with comprehensive municipal smoke-free laws prohibiting smoking inside all workplaces and enclosed public places would exhibit a lower likelihood of preterm birth than those living in counties with weak or moderate laws (ie, smoke-free laws with exemptions that do not cover all workplaces and enclosed public places) or no smoke-free law.Study Design: Using live birth data from the Kentucky Office of Vital Statistics with birth years ranging from 2004 to 2020, a total of 894,372 live births were recorded that indicated that a childbearing person was between the ages of 18 and 49 years and a resident of Kentucky; these live births formed the sample for the study. Municipal ordinances implemented during a given calendar year were coded in the model as present starting with the following calendar year, as the birth records were time deidentified except for the year of birth. This lagged law convention maximized the likelihood that pregnant persons included in the study were exposed to the smoke-free policy for at least a portion of their pregnancy. Multilevel logistic regression was used to assess the effect of smoke-free ordinances on the likelihood of preterm birth, with personal- and county-level variables included as potential covariates and pregnant persons nested within the county of residence. Data analysis was conducted using SAS (version 9.4; SAS Institute, Cary, NC), with an alpha level of .05.Results: Nearly all personal-level variables were associated with preterm birth status. Personal factors associated with an increased likelihood of preterm birth included being older (relative to 18-24 years old; odds ratios [95% confidence intervals]: 1.02 [1.01-1.04] and 1.27 [1.24-1.31] for ages 25-34 and 35-49 years, respectively); having a history of preterm birth (odds ratio, 4.65; 95% confidence interval, 4.53-4.78); and smoking before pregnancy (odds ratio, 1.14; 95% confidence interval, 1.12-1.16). Pregnant persons living in counties with comprehensive laws were 9% less likely to have a preterm birth than those living in counties without a smoke-free ordinance (odds ratio, 0.91; 95% confidence interval, 0.89-0.94; P<.001). There was no difference in the likelihood of preterm birth between those living in counties with moderate or weak laws and those unprotected by any smoke-free ordinance in their county of residence.Conclusion: This study demonstrated that comprehensive municipal smoke-free laws are associated with reduced risk of preterm birth and that moderate or weak smoke-free laws are not. The findings have major implications for public health policy and underscore the potential influence of healthcare providers' advocacy for strong smoke-free policies, prohibiting smoking in all workplaces (including restaurants, bars, and casinos), to support healthy pregnancies. [ABSTRACT FROM AUTHOR]

Purpose Nearly half of all adolescents in the United States are exposed to secondhand smoke (SHS) daily, primarily at home, resulting in respiratory infections, asthma exacerbations, and reduced lung function. A concise self-report measure is needed to identity adolescents exposed to SHS. The purpose of this study was to test whether nonsmoking adolescents who reported exposure to peer and/or family smoking on the Peer and Family Smoking Index had higher salivary cotinine levels than those reporting no exposure to either peer or family smoking. Methods A convenience sample of 135 English-speaking adolescents ages 15–18 years was recruited from two high schools. Those who reported use of nicotine replacement therapy, cigarette smoking (past 30 days), smokeless tobacco use (past 30 days), or who self-reported pregnancy were excluded. Salivary cotinine and self-report data from the Peer and Family Smoking Index were collected after obtaining parental consent and assent from the adolescent. Results Mean salivary cotinine levels differed by exposure group (none, family, peer, or family and peer), F (3, 130) = 5.44, p = .001. The post hoc analysis identified a significantly higher mean cotinine level among those exposed to SHS from both family and peers than among those with no exposure ( p = .001). Conclusions Known groups validity of the index was supported. Adolescents who reported family smoking or a combination of family and peer smoking had significantly higher salivary cotinine levels than unexposed adolescents. The Peer and Family Smoking Index is a concise and valid self-report measure for SHS exposure in adolescents. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effect of peak flow monitoring on asthma quality of life (QOL) for school-age children with asthma (N = 77) who participated in a 16-week asthma self-management program. QOL was measured using the Children''s Health Survey for Asthma. Findings indicated significant improvement in asthma QOL from baseline to Week 16 and higher QOL scores for those with better asthma health outcomes. [Copyright &y& Elsevier]

Abstract: Objective: We investigated the relationship between anxiety and event-free survival (ie, composite endpoint of death, emergency department visits, or hospitalizations) for patients with heart failure (HF), and examined whether behavioral and physiologic mechanisms mediate any association between anxiety and outcomes. Methods: In this longitudinal study, patients with HF completed the anxiety subscale of the Brief Symptom Inventory, and heart-rate variability and plasma norepinephrine levels were measured. Dietary adherence and medication adherence were measured according to 24-hour urine sodium level and the Medication Event Monitoring System, respectively. Patients were followed at least 1 year for event-free survival. Results: In total, 147 patients were enrolled. Patients with high anxiety had a shorter (hazard ratio, 2.2; 95% confidence interval, 1.1-4.3; P = .03) period of event-free survival than patients with lower anxiety. Anxiety independently predicted adherence to medication (P = .008), which in turn predicted event-free survival (hazard ratio, 2.0; 95% confidence interval, 1.2-3.3; P = .008). The effect of anxiety (P = .17) on event-free survival was less significant when the regression model included both anxiety and adherence to medication than when the model only included anxiety (P = .03), indicating that adherence to medication mediated the relationship between anxiety and event-free survival. Conclusion: This is the first study to show that nonadherence to medication links anxiety and event-free survival for patients with HF. Interventions that reduce anxiety and improve adherence may benefit outcomes. [Copyright &y& Elsevier]

Background: Evidence of health disparities between urban and rural populations usually favors urban dwellers. The impact of rurality on heart failure (HF) outcomes is unknown. Objective: We compared event-free survival between HF patients living in urban and rural areas. Methods: In this longitudinal study, 136 patients with HF (male, 70%; age, mean ± SD 61 ± 11 years; New York Heart Association class III/IV, 60%) were enrolled. Patients'' emergency department visits for HF exacerbation and rehospitalization during follow-up were identified. Rural status was determined by rural-urban commuting area code. Survival analysis was used to determine the effect of rurality on outcomes while controlling for relevant demographic, clinical, and psychosocial variables. Results: Rural patients (64%) had longer event-free survival than urban patients (P = .015). Rurality (P = .04) predicted event-free survival after controlling for age, marital status, New York Heart Association class, medications, adherence to medications, depressive symptoms, and social support. Conclusions: Rural patients were less likely than their urban counterparts to experience an event. Further research is needed to identify protective factors that may be unique to rural settings. [Copyright &y& Elsevier]

The aim of this longitudinal exploratory study was to identify and follow persons with the first episode of major depression (MD) to determine whether sense of coherence (SOC) changes over time. An additional purpose was to assess whether SOC is associated with depressive symptoms, aggression, and functional status either immediately after diagnosis or at 4 years postdiagnosis. The study design was longitudinal; participants participated in semistructured interviews and completed surveys every 6 months starting at diagnosis and concluding 4 years later. The sample consisted of 33 adult patients who were being treated for the first episode of MD according to the Diagnostic and Statistical Manual of Mental Disorders. Twenty-two participants completed all nine sessions. SOC was measured using the SOC scale; depressive symptoms using the Montgomery Åsberg Depression Rating Scale; aggression, including the total score and subscales of anger and hostility, using the Aggression Questionnaire-revised Swedish version; and functional status using the Global Assessment of Functioning (GAF) scale and the 36-item Short-Form Health Survey (SF-36). At baseline, SOC was significantly correlated with total aggression (r = −45) and the hostility subscale (r = −.73); baseline SOC was unrelated to depressive symptoms or functional status. SOC increased significantly over time (P < .0001). At the 4-year follow-up, SOC was significantly related to depressive symptoms (r = −.60), the aggression summary score (r = −.65), the anger subscale (r = −.52), the hostility subscale (r = −.77), the GAF (r = .64), and the physical and mental health components of the SF-36 (r = .74 and .72, respectively). The finding that SOC increases as patients recover from MD suggests that treatment of depression may also bolster the patient''s ability to cope, in addition to lowering depressive symptoms. The relationship between SOC and aggression in MD, with higher SOC correlated with lower aggression, needs to be examined further. [Copyright &y& Elsevier]

Background: Secondhand tobacco smoke increases the risk for the development and increasing severity of asthma among adults and children. Reducing exposure to secondhand smoke decreases symptomatic exacerbations among patients with asthma. Emergency department (ED) visits for asthma were assessed before and after the implementation of smoke-free legislation in Lexington-Fayette County, Ky. Objective: To evaluate the effects of a smoke-free law on the rate of ED visits for asthma. Methods: The study included ED visits for asthma from 4 hospitals in Lexington-Fayette County, Ky. Age-adjusted rates of asthma ED visits were determined. Poisson regression analysis of ED visits from January 1, 2001, to December 31, 2006 compared the ED visit rates between prelaw and postlaw, adjusting for seasonality, secular trends over time, and differences among demographic subgroups. The actual rates were graphed with the Poisson curve showing the rates predicted by the model. A second prediction curve was generated to show the projected rates in the postlaw period if the law had not been implemented. Results: Adjusting for seasonality, secular trends, and demographic characteristics, ED visits for asthma declined 22% from prelaw to postlaw (P < .0001; 95% CI, 14% to 29%). The rate of decline was 24% in adults age 20 years and older (P < .0001), whereas the decrease among children 19 years or younger was 18% (P = .01). Conclusion: Although this study did not establish causation, the smoke-free law was associated with fewer asthma ED visits among both children and adults, with a more significant decline among adults. [Copyright &y& Elsevier]

Background: There has been an upward trend in smoke-free laws in countries, states, and municipalities in recent years. However, these laws are more likely to be enacted in urban areas. The purpose of this study was to examine public opinion of smoke-free laws and to determine if there was a difference in support for these laws between urban and rural dwellers. Methods: A series of random-digit-dialed phone surveys was conducted in 2005–2006 with 3672 adult Kentucky residents living in rural and urban communities without smoke-free laws. In addition to demographics, respondents were asked whether they would support a local law prohibiting smoking in public places. Responses were weighted to adjust for an over-representation of women in the sample relative to the population. Logistic regression was used to test for a rural/urban difference in support; data analysis was conducted in 2007. Results: Respondents were primarily women, Caucasian, with at most a high school education, and nonsmokers; the average age was 49.3 years. About half lived in rural communities. More than half (59.6%) supported a local smoke-free law. Controlling for age, gender, ethnicity, education, and smoking status, there was a significant difference in the level of support for a smoke-free law between rural and urban respondents. Compared to urban dwellers, rural residents were more likely to support these laws (OR=1.21; 95% CI=1.03, 1.42). Conclusions: When controlling for demographic differences between groups, rural residents were more likely than those in urban settings to support a law for local smoke-free public places. [Copyright &y& Elsevier]

Abstract: Background: Chronic illness burdens some groups more than others. In studies of ethnic/racial groups with chronic illness, some investigators have found differences in health-related quality of life (HRQL), whereas others have not. Few such comparisons have been performed in persons with heart failure. The purpose of this study was to compare HRQL in non-Hispanic white, black, and Hispanic adults with heart failure. Methods: Data for this longitudinal comparative study were obtained from eight sites in the Southwest, Southeast, Northwest, Northeast, and Midwest United States. Enrollment and 3- and 6-month data on 1212 patients were used in this analysis. Propensity scores were used to adjust for sociodemographic and clinical differences among the ethnic/racial groups. Health-related quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. Results: Significant ethnic/racial effects were demonstrated, with more favorable Minnesota Living with Heart Failure Questionnaire total scores post-baseline for Hispanic patients compared with both black and white patients, even after adjusting for baseline scores, age, gender, education, severity of illness, and care setting (acute vs. chronic), and estimating the treatment effect (intervention vs. usual care). The models based on the physical and emotional subscale scores were similar, with post hoc comparisons indicating more positive outcomes for Hispanic patients than non-Hispanic white patients. Conclusion: Cultural differences in the interpretation of and response to chronic illness may explain why HRQL improves more over time in Hispanic patients with heart failure compared with white and black patients. [Copyright &y& Elsevier]

Academic nurse-managed centers (ANMCs) can be important sites for addressing the tripartite mission of the academy. Yet, limited information about numbers of ANMCs and the schools sponsoring them is available. This paper presents an update on schools of nursing (SONs) operating ANMCs. A survey was sent to 683 deans and directors of baccalaureate and higher-degree SONs, with 565 responding (response rate: 83%). Ninety-two SONs indicated they had one or more ANMCs. The largest percentage of the SONs with ANMCs were classified as doctoral/research-intensive or extensive universities, a proportion much higher than the national percent of SONs in this category. Schools of Nursing were financially supporting centers at a lower percentage of actual costs than was reported in earlier studies, although grants continue to be a major source of funding. Academic nurse-managed centers are likely to be supported by SONs with substantial research, practice, faculty, and student resources. Overall, the national number of ANMCs seems stationary over the past two decades. [Copyright &y& Elsevier]

This study measured service satisfaction, perceptions of service quality and general health, and overall quality of care among 787 adult recipients of Medicaid mental health services. Methods included cross-sectional retrospective design and stratified random sampling technique. Respondents were satisfied with consumer-provider relationships and were dissatisfied with functional outcomes resulting from treatment. Satisfaction was positively correlated with ratings of mental health care and the mental health component score of the SF-12. Predictors of satisfaction included ratings of mental health care and overall health. Recommendations include coordination of services that promote patient functioning and measurement of consumer satisfaction as an indicator of quality. [Copyright &y& Elsevier]

Introduction: One in 8 US women will develop invasive breast cancer in their lifetime. Despite evidence that mammography is an effective method of early detection, certain vulnerable groups, such as those using the emergency department as a medical home, do not adhere to mammography screening guidelines, and suffer disparate mortality from breast cancer. The purpose of this study was to investigate differences in beliefs regarding mammography screening among women attending the emergency department for nonurgent care and ultimately to develop interventions that promote mammography for this vulnerable population. Methods: We explored the relationship between stage of readiness to adopt mammography behavior and barriers, benefits, and perceived susceptibility by administering scales for risk, benefits, and barriers to a sample of 110 women who had presented to the emergency department of a public hospital for nonurgent complaints or were seated in the ED waiting room. We also collected sociodemographic information and stage of readiness. Results: Mammography adherence was about 60%. Most women who were not compliant with current guidelines were contemplators. Those who were not contemplating being screened were significantly less likely to perceive themselves to be at risk of getting breast cancer. Women who had more barriers to mammography perceived less benefit from having a mammogram. African American women perceived less benefit from having a mammogram. Discussion: Mammography promotion is appropriately placed in the ED waiting room given the suboptimal rate at which this population is being screened. Beliefs regarding mammography differ for women in various stages of mammography adoption and for minority women. Understanding these differences will allow intervention in this setting to be tailored to the population. ED nurses are an important and sometimes sole point of health care contact for patients who routinely visit the emergency department. As such, they have a valuable opportunity to provide cancer screening promotion messages. It is critical that nurses in this setting understand the complexities of delivering this information and the need to do so. [Copyright &y& Elsevier]

Objective: To examine the relationship among nicotine, alcohol, and marijuana use; level of sensation seeking (SS); and pubertal development. Method: Subjects were early and middle adolescent males and females recruited from a psychiatric clinic (n = 77) and two general pediatric clinics (n = 131). SS was measured by using the Sensation Seeking Scale for Children. Pubertal development was measured with a modified Pubertal Development Scale that was completed by the adolescent and his/her parent about the adolescent. Adolescent self-reports of nicotine, alcohol, and marijuana use were also obtained using questionnaires. Results: SS was higher in males and females who reported nicotine and alcohol use and in males who reported marijuana use. SS was positively associated with pubertal development in males and females, even when controlling for age. Furthermore, SS mediated the relationship of pubertal development and drug use in males and females. Conclusions: The observation that SS mediates the relationship between pubertal development and drug use in males and females may contribute to understanding changes in drug use that are seen during adolescence. In addition, SS is associated with drug use and is easily measured in a variety of clinical settings. Jo Am. Acad. ChildAdolesc. Psychiatry, 2002, 41 (12):1495-1502. [ABSTRACT FROM AUTHOR]

Radon exposure is the second leading cause of lung cancer, yet few Americans test their homes for radon, particularly in rural areas. The academic team and community partners engaged the public library systems in four rural counties to offer digital radon detectors for check-out as a means of increasing the public's access to free radon testing. The check-out procedures and instructional materials were created through an iterative process, and library personnel were educated on radon and home radon testing prior to launching the lending program. Library patrons reported high usability, feasibility, and acceptability of the program. Library patron-staff interactions mainly included discussions about the logistics of radon testing. Given that public libraries are invested in making communities thrive and promoting health, providing library lending programs for radon detectors is a novel, feasible, and acceptable way to reduce the risk of lung cancer in the community. • The radon detector library loan program was designed and evaluated using citizen science methods. • The radon detector library loan program was usable, feasible and acceptable to library patrons. • Library patrons were appreciative of having access to radon detector kits at no cost. • Public libraries can serve as partners to promote the health of communities. • Radon detector loan programs are innovative and attract community members who may not have otherwise utilized the library. [ABSTRACT FROM AUTHOR]

Though e-cigarette aerosol has been associated with altered lung cell function, few studies have examined the effects of use on immune response and respiratory symptoms. The purpose of this study was to examine if recent persistent cough or cytokine levels are related to Electronic Nicotine Delivery Systems (ENDS) use in college students. In April 2019, 61 undergraduate students at the University of Kentucky completed surveys and provided a salivary sample to evaluate cytokine levels (Interleukin (IL-) 2, 4, 6, 8, 10, 12, 13 and TNFα, INFγ), using quota sampling to obtain comparable numbers of ENDS users and non-ENDS users. Data analysis included chi-square tests and multivariable logistic and linear regression. All ENDS users reported JUUL as their primary product. ENDS users were more likely to be younger, use cigarettes and marijuana, and report a persistent cough. Controlling for cigarette and marijuana use, there was a trend toward greater likelihood of persistent cough among ENDS users. Compared with nonusers, salivary IL-2 and INFγ were elevated and IL-4 was decreased, controlling for cigarette and marijuana use. There was a trend toward lower IL-12p70 values among ENDS users with these covariates. Findings reveal dysregulation of salivary immune profiles toward a TH1 phenotype in emerging adult ENDS users and short-term immune function may be dysregulated in young adult e-cigarette users. [ABSTRACT FROM AUTHOR]

Obesity is a key risk factor for Type 2 diabetes (T2D). Alarmingly, 87% of US adults have overweight or obesity, with non-Hispanic black adults having higher obesity and T2D prevalence than non-Hispanic white. The Diabetes Prevention Program (DPP) demonstrated the clinical benefits of lifestyle intervention (LI). While the DPP LI is effective, some participants don't achieve clinically significant weight loss in the current group-based translation paradigm. Black adults have the lowest adjusted weight loss (3.2%) among all racial/ethnic groups. Early intervention nonresponse defined as ≤1% weight loss at intervention week 4 is linked to lower probability of achieving weight loss goals. This paper describes the design and methods of a cluster randomized controlled trial among black weight loss nonresponders nested in 20 community sites (primarily churches). Descriptions of the adaptations made to transition the program to virtual format during the COVID-19 pandemic are also included. Trained community health workers deliver a group-based, 6-month long DPP over 18 sessions via Zoom. Additionally, nonresponders in the enhanced group receive weekly telephone support to provide individual-level intervention to help overcome weight loss barriers. Outcomes include weight, physical activity level, blood pressure, and dietary behaviors; these are compared between nonresponders in the enhanced intervention group and nonresponders in the active control group. Cost, mediators, and moderators are explored. If found to efficacious, these enhanced strategies could be standardized as a supplement for use with DPP nonresponders. [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms and anxiety are common in heart failure patients as well as their spousal caregivers. However, it is not known whether their emotional distress contributes to their partner's quality of life (QoL). This study examined the effect of patients' and partners' depressive symptoms and anxiety on QoL in patient-spouse dyads using an innovative dyadic analysis technique, the Actor-Partner Interdependence Model (APIM).Method: A total of 58 dyads (patient: 43% in males, mean age 62 years, mean ejection fraction 34% +/-11, 43% in New York Heart Association III-IV) participated in the study. Depressive symptoms and anxiety were assessed using the Brief Symptom Inventory. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire. Dyadic data were analyzed using the APIM with distinguishable dyad regression model. In APIM, actor effect is the impact of a person's emotional distress on his/her own QoL. Partner effect is the impact of a person's emotional distress on his/her partner's QoL.Result: Depressive symptoms exhibited actor effect of both patients (P<.001) and spouses (P<.001) and only partner effect of patients (P<.05) on QoL. Patients and spouses with higher depressive symptoms had poorer QoL. Patients whose spouses had higher depressive symptoms were more likely to indicate their own QoL was poorer. Anxiety has similar actor and partner effects on QoL as depressive symptoms.Conclusion: Interventions to reduce depression and anxiety and to improve patients' QoL should include both patients and spouses. [ABSTRACT FROM AUTHOR]

Risk factors for child abuse and neglect and commonly used reporting mechanisms were highly affected by SARS-Cov-2 pandemic; yet, little is known about the effects of SARS-Cov-2 on rates of child abuse and neglect. To compare overall rates, demographics, types of abuse and acuity of child abuse and neglect encounters seen at one university health system for the 6 months before and after school closings due to the SARS-Cov-2 pandemic. Data was extracted from a database of billed ICD10 codes for child abuse and neglect including sexual abuse codes. There were 579 encounters for patients <18 years of age and 476 unique patients. In addition to ICD10 code and pre/post school closing, each encounter was identified to be inpatient, outpatient and/or emergency department. Demographic data such as age, gender, ethnicity, and race were extracted. Incident rate ratios in addition to descriptive statistics, Mann-Whitney U test, two-sample t -test, or the chi-square test of association were used in the analysis. No significant differences were identified for total rates of child abuse and neglect encounters (p =.08), physical abuse (p =.91) nor child maltreatment (p =.86) codes or in the age (p =.46), gender (p =.58), and race/ethnicity (p =.15) of patient encounters pre- versus post-school closings. The sexual abuse incidence and inpatient encounters increased by 85% (IRR = 1.85, p <.0001; IRR = 1.85, p =.004, respectively). Our findings provide a unique contribution to the existing literature in that we identified a significant increase in the incidence of sexual abuse and higher patient acuity as evidenced by higher rates of inpatient encounters after school closing due to SARS-Cov-2. • Overall rates, demographics and types and acuity of child abuse encounters were compared before and after the SARS-Cov-2 pandemic. • The sexual abuse incidence increased by 85% (IRR=1.85, p <.0001). • Total inpatient encounters for all types of child abuse and neglect increased by 85% (IRR=1.85, p =.004, respectively). • The increased rates of child sexual abuse after school closing due to SARS-Cov-2 are unreported in published literature. [ABSTRACT FROM AUTHOR]