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Background and Purpose: Nurses' attitudes play an important role in the consistent practice of safe patient handling behaviors. The purposes of this study were to develop and assess the psychometric properties of a newly developed instrument measuring attitudes of nurses related to the care and safe handling of patients who are obese. Methods: Phases of instrument development included (a) item generation, (b) content validity assessment, (c) reliability assessment, (d) cognitive interviewing, and (e) construct validity assessment through factor analysis. Results: The final data from the exploratory factor analysis produced a 26-item multidimensional instrument that contains 9 subscales. Conclusions: Based on the factor analysis, a 26-item instrument can be used to examine nurses' attitudes regarding patients who are morbidly obese and related safe handling practices. [ABSTRACT FROM AUTHOR]

Appalachia's River and non-River Bordering Counties. Children living in Ohio's Appalachian counties that border the Ohio River are disproportionally exposed to adverse environmental conditions prevalent along the river that may contribute to disparities in health, access to care and care utilization. This study examined if there were differences in health, access to care and care utilization between Ohio's Appalachian children living in counties that border the Ohio River and those living in counties that do not border the river. A secondary analysis of the 28 Appalachian counties from Ohio's 88 counties included in the 2008 Ohio Family Health Survey was conducted using a Bayesian Hierarchical Modeling strategy. Descriptive analyses comparing geographic groups across demographic, health, access, utilization, and health insurance also were conducted. Childhood asthma was more prevalent in the river-bordering counties (16.4%) compared to the non-river counties (9.4%). Children with asthma had more sere symptoms in the river bordering counties (8.2%) compared to the non-river bordering counties (4.4%). Children residing in river bordering counties had higher rates of obesity (24.4%) and overweight (17%). After controlling for child health and insurance status, children living in the river bordering counties had less access to care (est. −7.14, CI = −17.3,0.74) and more difficulty accessing specialty care. Children residing in the non-river counties had more sickness care utilization (est. 0.25, CI = 0.01, 0.49). Regardless of region, children with a regular health care provider and place for care were healthier. Differences in child health, access to care and utilization of services exist within Ohio's Appalachian region. [ABSTRACT FROM AUTHOR]

Objectives: We sought to report the efficacy of oral melatonin as treatment for chronic tinnitus and to determine whether particular subsets of tinnitus patients have greater benefit from melatonin therapy than others. Methods: This was a prospective, randomized, double-blind, crossover clinical trial in an ambulatory tertiary referral otology and neurotology practice. Adults with chronic tinnitus were randomized to 3 mg melatonin or placebo nightly for 30 days followed by a 1-month washout period. Each group then crossed into the opposite treatment arm for 30 days. The tests audiometric tinnitus matching (TM), Tinnitus Severity Index (TSI), Self Rated Tinnitus (SRT), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI) were administered at the outset and every 30 days thereafter to assess the effects of each intervention. Results: A total of 61 subjects completed the study. A significantly greater decrease in TM and SRT scores (p < 0.05) from baseline was observed after treatment with melatonin relative to the effect observed with placebo. Male gender, bilateral tinnitus, noise exposure, no prior tinnitus treatment, absence of depression and/or anxiety at baseline, and greater pretreatment TSI scores were associated with a, positive response to melatonin. Absence of depression and/or anxiety at baseline, greater pretreatment TSI scores, and greater pretreatment SRT scores were found to be positively associated with greater likelihood of improvement in both tinnitus and sleep with use of melatonin (p < 0.05). Conclusions: Melatonin is associated with a statistically significant decrease in tinnitus intensity and improved sleep quality in patients with chronic tinnitus. Melatonin is most effective in men, those without a history of depression, those who have not undergone prior tinnitus treatments, those with more severe and bilateral tinnitus, and those with a history of noise exposure. [ABSTRACT FROM AUTHOR]