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A multicultural awareness scale completed by 72 nursing students obtained a Cronbach's alpha reliability coefficient of .91. An expert panel analyzed content validity and the revised scale was completed by 118 students. Factor analysis supported the measure's construct validity. (Contains 30 references.) (SK)

Describes the development of Inclusion Inventory, a tool designed to survey educators' perceptions of inclusive educational practices in their schools. The survey was administered to 72 schools across a southwestern state. Respondents with experience in inclusive educational practices and those from schools where teams implemented inclusive education tended to have higher ratings on the Inclusion Inventory. (Author/JDM)

A study of 27 employees of an agency that provides services to persons with developmental disabilities investigated using the six-item Guttman scale, based on the Levels of Use framework, for monitoring the adoption and implementation of person-centered planning and other supports-oriented programs. High scores indicated likelihood of person-centered training. (Author/CR)

Purpose: Cognitive training improves mental abilities in older adults, but the benefit to minority elders is unclear. We conducted a subgroup analysis of subjects in the SeniorWISE (Wisdom Is Simply Exploration) trial to examine this issue. Design and Methods: SeniorWISE was a Phase 3 randomized trial that enrolled 265 nondemented communityd-welling older adults aged 65 years and older between 2001 and 2006. Participants were randomly assigned to 12 hr of either memory or health training. Results: The sample was 79% female, 71% Caucasian, 17% Hispanic, and 12% African American. On the Rivermead Behavioural Memory Test (RBMT), 28% of the sample scored normal, 47% scored poor, and 25% impaired. Memory performance changed differently over time depending on the demographic characteristics of participants. Both Hispanics and Blacks performed better than Whites on visual memory, and Blacks performed better over time on instrumental activities of daily living. On all performance measures, lower pretest scores were associated with relatively greater improvements over time. Implications: Our analyses suggested that minority participants received differential benefits from the memory training; however, this remains speculative because the 3 ethnic groups in the sample were not equivalent in size. The question of why Black and Hispanic participants often made greater improvements needs further exploration. Key Words: Differential benefits of training, Minority elderly adults, Memory training, Cognitive performance doi: 10.1093/geront/gnq017

Purpose: The original version of the Direct Assessment of Functional Status (DAFS), a measure of instrumental activities of daily living (IADLs), was found to have a ceiling effect in older adults living independently in the community. This suggested that the tasks measured, although relevant, do not require full use of this population's abilities, and thus, the instrument may not be sensitive to the early decrements in IADLs that can signal initial cognitive impairment and may not detect improvements in IADLs over time, which is especially important in intervention research. Design and Methods: By removing items with little to no variation and adding more difficult subscales that emphasized medication management skills, we designed the DAFS-Extended (Direct Assessment of Functional Status-Revised [DAFS-R]) to be more challenging for elders living independently. Results: Analysis with a sample of 45 older adults suggested that scores on the DAFS-R appear to be more normally distributed than on the original version. The DAFS was able to differentiate individuals with varying standard profile scores on the Rivermead Behavioural Memory Test memory performance instrument (normal, poor, and impaired). In addition, the reliability and validity of the DAFS-R were supported in this sample. Implications: Given the large number of older adults who regularly take multiple prescription medications, deficits in medication management skills can have serious consequences. A performance measure that emphasizes these higher level daily living skills can help providers screen for initial signs of functional decline. Key Words: Older adults, Methodological, Performance-based instrumental activities doi: 10.1093/geront/gnp139

The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from the southwestern United States. Nearly one third of the sample (n = 24, 30.77%) reports CSA histories. There is no correlation between CSA history and intimate parenting anxiety, no difference between breast-feeding and formula-feeding mothers in CSA severity, and intimate parenting anxiety does not predict dissociation, These findings are inconsistent with previous research. Supportive resources may explain the inconsistency and play a role in adolescent mothers' responses to CSA. Further research is necessary to explore these possibilities. Keywords: sexual abuse; adolescent mothers; breast-feeding; adolescent parenting; dissociation

A study was conducted to evaluate the benefits of adjuvant chemotherapy among older women with breast cancer aged 65 years or above as compared to other standard chemotherapies. Results indicated that adjuvant chemotherapy was found to be more effective among older women as compared to other standards forms like capecitabine.

The purpose of the study was to examine the factors associated with hormone therapy (HT) use among women with mobility impairments. A non-probability sample of 188 menopausal women (average age = 53 years) from 38 states was recruited in 2004 for the study. Twenty-two percent of participants were currently taking HT; 33% were past users. Using multinomial logistic regression, this study found that those most likely to be taking HT now or in the past were older women, knowledgeable about HT, had had a hysterectomy, had bone loss, and had their provider's encouragement. Implications for health care providers are discussed. KEYWORDS. Hormone therapy, mobility impairment, women's health

The purpose of this study was to investigate the relationship between marital status, marital concern, perceived impairment, health-promoting behaviors, and acceptance of disability using cross-sectional and longitudinal data from a sample of persons witth multiple sclerosis (MS). We hypothesized that the quality and stability of the marital relationship would influence people's ability to accept their disability and protect from accumulation of impairment over time. Furthermore, men and women would receive dissimilar benefits from marriage. These hypotheses were considered with repeated measures analysis, Pearson correlations, and independent sample t tests of data obtained from a longitudinal study of persons with MS. The findings indicate that acceptance of disability and perceived impairment increase significantly over time for men and women. For men, being married was associated with a greater acceptance of disability and less perceived impairment. Men were more concerned than the women about how MS affected their sexual relationships. Keywords: disability; acceptance; gender; marital concern; multiple sclerosis

The Expect Respect Project, a violence prevention program, was developed to reduce the incidence of bullying and sexual harassment by creating a positive school climate in which inappropriate behaviors are not tolerated and staff members respond consistently to incidents. The project implemented an educational intervention for students, parents, and staff members on expecting respect in student relationships and strategies for responding to inappropriate student behaviors. This article describes the educational intervention and evaluation of the project. Findings from the project showed a significant increase in awareness of bullying following the educational intervention. Bullying was reported to have occurred in areas with less adult supervision such as the playground, cafeteria, hallway, and buses. Students thought staff would respond to inappropriate behaviors by telling students to ignore verbal bullying or sexual harassment. In contrast, staff at the elementary schools thought adults would respond to inappropriate behaviors by telling the bully to stop, calling his or her parents, or giving a specific punishment. Keywords: violence prevention; student victimization; bullying; sexual harassment

A true experimental design with random assignment to groups protects against false causal inferences that could be made when both the treatment and control groups change because of factors such as testing effects, reactivity, contamination, maturation, history, and other measurement effects. The occurrence of these phenomena, however, provides interesting information about factors affecting health care attitudes, knowledge, and behavior change, which can interfete with a nursing study's ability to demonstrate an experimental effect. In this article, we discuss these design threats, illustrate them with examples from recent health research, and suggest strategies for decreasing them in clinical nursing studies. Keywords: threats to validity; experimental design

Background: Adolescent and young adult (AYA) survivors--particularly those from historically underserved groups--may encounter different challenges than other cancer survivors. Objectives: To assess needs of female AYA breast cancer (BC) survivors who may be from racial/ethnic minority groups, and/or have low income, live outside urban settings, and/or have metastatic cancer, as well as the perspectives of those who provide services to them. Methods: Focus groups were held with 33 survivors who had received services from a community center for BC survivors. Ten professionals (primarily oncology nurse navigators) who provide services to AYAs in different healthcare systems were recruited for key informant interviews. Themes were identified from audio recordings and interview/ focus group notes. Results: Although AYAs face many of the same challenges as other cancer survivors, some concerns, such as childcare and infertility, are especially salient for them. Black women may encounter "race-based nonchalance," and many women do not receive needed referrals. Financial toxicity is particularly problematic because many AYAs are in the early years of employment. Both patients and providers express a need for greater care coordination and better communication among healthcare team members and between patients and service providers. Conclusions: An underlying theme was the need to educate providers to think beyond medical diagnosis and treatment and communicate information about long-term symptom management, signs of recurrence or metastasis, and complementary therapies--particularly mental health services. This communication must take into account social determinants of health, such as race/ethnicity and health literacy. The results underscore the key role navigators can play in providing support or facilitating referrals tailored to individual AYA needs. Findings also highlight the importance of continued advocacy and public education to raise awareness that insurance does not eliminate the financial burdens that AYA cancer survivors may face. [ABSTRACT FROM AUTHOR]

Background: Because multiple sclerosis (MS) is an autoimmune disease and many individuals with MS take disease-modifying drugs that suppress immune response, serious concerns have been expressed about the potential effect of COVID-19 on those with this chronic condition. Objectives: The purpose of this research was to utilize the most recent 5 years of data from an ongoing longitudinal study of health promotion and quality of life (QoL) among people with long-standing MS to investigate changes across time in functional limitations, health promotion, and health-related QoL. Methods : Participants are mailed an annual survey to complete about their health promotion, depressive symptoms, health status, social support, MS-related functional limitations, and QoL. Differences across time were analyzed with repeated measures of analysis of variances and planned contrasts. Results : In 2021, the 141 participants had a mean age of 69 years and had been diagnosed with MS for 34 years, on average. Most had attended college, were married/partnered women, and reported adequate economic resources. Thirty-seven percent reported they were in poor to fair health. Physical activity and health responsibility scores decreased significantly during 2020-2021 compared with 2017-2019. Significant changes in depressive symptoms, social support, and functional limitation scores followed a different pattern, with the largest changes occurring between 2018 and 2019. QoL and other health promotion scores did not change significantly across time. Discussion : The relatively small changes in health indicators revealed here suggest that older people with long-standing MS may have generally been able to maintain their health promotion, functional abilities, and QoL from before to during the COVID-19 pandemic. However, nurses and other providers should support them to resume their physical activity and regular provider contact as COVID-19 restrictions are eased. The patterns observed here demonstrate the importance of examining changes across an extended period, rather than simply looking at 1 year before and 1 year after a major event, such as COVID-19. These findings can help nurses understand how to help their patients with chronic health conditions maximize their health as they move forward. [ABSTRACT FROM AUTHOR]

Whereas making decisions during menopause can be challenging for all women, those with physical impairments face special issues with respect to menopause in general and hormone replacement therapy (HRT) in particular. In this correlational study, the authors explored the factors such women consider when making decisions about HRT. One hundred sixty-seven women with physical impairments throughout the United States completed surveys concerning their attitudes and knowledge about HRT. Approximately half the menopausal women were currently taking HRT. The strongest predictor of HRT use was women's perceptions of their health care providers' opinions about their taking HRT, combined with their motivation to comply with the provider's recommendation. This finding points to the significant role that nurses and other health care providers play in assisting women to make informed health care choices during menopause.

Finding cost-effective ways to increase response to mailed surveys is a concern for many nurse researchers. This study compared two follow-up methods: sending a second questionnaire packet versus sending a reminder postcard to those who did not respond to an initial mailing. Although the second questionnaire yielded a higher response than did the postcard, the cost per additional response was approximately 2 1/2 times higher for the questionnaire than for the postcard when the differential cost of the two mailings is considered.