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Objective: To examine associations between various measures of the food environment and BMI percentile among youth.Design: Cross-sectional, observational.Setting: Pitt County, eastern North Carolina.Subjects: We extracted the electronic medical records for youth receiving well child check-ups from January 2007 to June 2008. We obtained addresses for food venues from two secondary sources and ground-truthing. A geographic information systems database was constructed by geocoding home addresses of 744 youth and food venues. We quantified participants' accessibility to food venues by calculating 'coverage', number of food venues in buffers of 0·25, 0·5, 1 and 5 miles (0·4, 0·8, 1·6 and 8·0 km) and by calculating 'proximity' or distance to the closest food venue. We examined associations between BMI percentile and food venue accessibility using correlation and regression analyses.Results: There were negative associations between BMI percentile and coverage of farmers' markets/produce markets in 0·25 and 0·5 mile Euclidean and 0·25, 0·5 and 1 mile road network buffers. There were positive associations between BMI percentile and coverage of fast-food and pizza places in the 0·25 mile Euclidean and network buffers. In multivariate analyses adjusted for race, insurance status and rural/urban residence, proximity (network distance) to convenience stores was negatively associated with BMI percentile and proximity to farmers' markets was positively associated with BMI percentile.Conclusions: Accessibility to various types of food venues is associated with BMI percentile in eastern North Carolina youth. Future longitudinal work should examine correlations between accessibility to and use of traditional and non-traditional food venues. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To test the validity, reliability, and uses of the multidimensional Salutogenic Wellness Promotion Scale (SWPS). METHODS: Self-reported (n = 2140) demographic and scale data from a large university (23,000+ students) were collected and analyzed. Dependent measures included grade point average (GPA) and perceived health. RESULTS: Analyses confirmed the SWPS's 7-factor multidimensional structure and its use for describing and predicting associated outcomes. The analyses of frequency distributions, means, correlations, and regressions found significant relationships between measured health behaviors, perceived health, and GPA. CONCLUSIONS: The SWPS provides valid and reliable information about positive health potential for research and field health professionals. [ABSTRACT FROM AUTHOR]

This methodological study sought to determine the psychometric properties of the Spanish version of the Child and Adolescent Self-Care Performance Questionnaire originally developed by Moore (1995). In this study, the questionnaire, written originally in English, was translated into Spanish, and some items were adapted for the Latin American culture. The instrument was administered to 536 children of moderate socioeconomic status, ages 10 to 15 years, living in Chile. Evidence for reliability and validity involved examining Coefficient Alpha for the total scale and each of the subscales, item analysis, and factor analysis with varimax rotation. Coefficient alpha for the total scale (35 items) was 0.82, similar to the reliability reported by Moore (1995) for the original instrument. Factor analysis supported eight factors. Use of the instrument in Central and South America may assist in determining self-care practices of Latin American children and the effect of interventions to improve such practices. [ABSTRACT FROM AUTHOR]

It is essential to examine conflict between patients and health care professionals from the patient's perspective. The purposes of this study were to 1) identify sources of conflict, 2) determine nursing interventions that alleviate conflict, and 3) test a conceptual framework of sources of conflict. This phenomenological study focused on children with cancer and their parents' perceptions of conflicts with health care professionals as well as what they thought helped with such conflicts. Their reports of conflict were compared to C. W. Moore's circle of conflict conceptual framework. A purposive sample of 27 participants (9 children, 14 mothers, and 4 fathers) participated in the study. Study findings showed that conflict occurred between health care professionals and families originating from differences in expectations and desires regarding data, interests, structure, relationships, and values, consistent with C. W. Moore's conceptual framework. Nursing interventions reported by children and parents to be helpful in preventing or alleviating conflict were identified. C. W. Moore's framework may provide a valuable structure for assessing conflict and designing nursing interventions to alleviate conflict. © 2006 by Association of Pediatric Oncology Nurses [ABSTRACT FROM AUTHOR]

Although the researchers had been conducting nutrition education classes and collecting qualitative dietary information such as 24-hour dietary recall and usual meal content on girls in Nicaragua for several years, determining dietary change and, therefore, program effectiveness, from such information was very difficult. First, it was not possible to identify specific nutrition behavior, particularly intellectual behavior, from such information. Further, when changes in the diet occurred, it was unclear whether it was due to a girl's or her mother's influence. To resolve these issues, the researchers decided to develop a quantitative, self-report approach to measure behavior change for both girls and mothers asking for typical self-care activities before and after the nutrition education classes. The following paper relates the process of development of these instruments. [ABSTRACT FROM AUTHOR]

This article describes the process of setting up a 3-year, school-based after-school physical activity intervention in elementary schools. The primary aim of the study is to determine whether adiposity and fitness will improve in children who are exposed to a fitogenic versus an obesogenic environment. Eighteen schools were randomized to the control (obesogenic) or intervention (fitogenic) group. The study design, program components, and evaluation of the intervention are described in detail. The intervention consists of (a) academic enrichment, (b) a healthy snack, and (c) physical activity in a mastery-oriented environment. Successful implementation would show the feasibility of schools' being able to provide a fitogenic environment. Significant differences between the groups would provide evidence that a fitogenic environment after school has positive health benefits. If feasibility and efficacy are demonstrated, implementing an after-school program like this one in elementary schools could play a major role in preventing and reducing childhood obesity. [ABSTRACT FROM AUTHOR]

Because of the risk of calculation errors in the clinical setting, it is important to identify factors that predict math performance in nursing students. Those students who cannot perform calculations correctly should be identified prior to entry into clinical courses so that they can be provided with remediation. [ABSTRACT FROM AUTHOR]

The purposes of this descriptive study were to examine the relationships between self-concept and (a) self-care, (b) dependent-care, and (c) basic conditioning factors for children with cancer, and to compare the self-concept of children on- and off-therapy. The theoretical framework was Orem's self-care deficit theory of nursing. The sample consisted of 74 children with cancer and their mothers. Results showed small but significant correlations between variables, providing some evidence that if children had higher self-concept scores they performed more self-care activities and received more dependent-care from their mothers. The self-concept scores of the on- and off-therapy groups were not significantly different. This study supports Orem's theory and reinforces the need to promote positive self-concept. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test Orem's theory of self-care deficit, one of three constituent theories included in her general self-care deficit theory of nursing. Specifically, the relationship between dependent care agent performance and basic conditioning factors was examined. Dependent care agent performance for children was defined as health promotion and self-care activities provided by a responsible adult on behalf of the child. The Dependnet Care Agent Questionnaire was used with a sample of 380 mothers of children from ages 1 to 16 years. The hypothesis that basic conditioning factors influenced dependent care agent performance was supported (R2 = .13, p = .0001). [ABSTRACT FROM AUTHOR]

This study examined possible predisposing factors that may contribute to rural adolescents' early sexual behavior. Sexual behaviors, demographics, family structure, history of abuse, sexually active friends, and substance use were analyzed in 410 rural and urban adolescents, aged 10 to 19 years, who were enrolled in a school-based health center in North Carolina between 2005 and 2007. Results indicated that Black students residing in single-parent urban households were more likely to engage in sex earlier than other analyzed ethnic groups (odds ratio [OR] = 5.2; 95% confidence interval [CI] = 1.1-23.6). As age increased, risk of engaging in sex also increased. Rural students reporting history of abuse had a higher risk of engaging in early sexual behaviors than urban students (OR = 2.6; 95% CI = 1.0-6.8) with a similar history. Students residing in a single-or no-parent household had requested more health education services than those residing in a dual-parent household. An inverse association was observed between the amount of parental communication among urban adolescents and engagement in risky sexual behaviors (OR = 0.3; 95% CI = 0.1-0.9). Rural/urban location and student race should be considered as moderators of the relationships between demographic characteristics and sexual behaviors in adolescents enrolled in a school-based health center. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) has been shown to benefit glucose tolerance. Walking is a convenient low-impact mode of PA and is reported to be the most commonly performed activity for those with diabetes. The purpose of this study was to determine whether a recommendation to accumulate 10,000 steps/day for 8 weeks was effective at improving glucose tolerance in overweight, inactive women.Methods: Eighteen women (53.3 +/- 7.0 years old, 35.0 +/- 5.1 kg/m(2)) with a family history of type 2 diabetes completed a 4-week control period followed by an 8-week walking program with no changes in diet. The walking program provided a goal of accumulating at least 10,000 steps/day, monitored by a pedometer.Results: During the control period, participants walked 4972 steps/day. During the intervention period, the participants increased their accumulated steps/day by 85% to 9213, which resulted in beneficial changes in 2-h postload glucose levels (P < 0.001), AUC(glucose) (P = 0.025), systolic blood pressure (P < 0.001), and diastolic blood pressure (P = 0.002). There were no changes in body mass, body fat percentage, and waist circumference during the walking intervention.Conclusions: The 10,000 steps/day recommendation resulted in improved glucose tolerance and a reduction in systolic and diastolic blood pressure in overweight women at risk for type 2 diabetes. This demonstrates that activity can be accumulated throughout the day and does not have to result in weight loss to benefit this population. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression in people with epilepsy are common and associated with poor outcomes; yet, they often go untreated due to poor mental health specialist access. Collaborative care is an integrated care model with a strong evidence base in primary care and medical settings, but it has not been evaluated in neurology clinics. Evaluating implementation outcomes when translating evidence-based interventions to new clinical settings to inform future scaling and incorporation into real-world practice is important., Objective: The Collaborative Care for Posttraumatic Epilepsy (CoCarePTE) trial aims to evaluate the effectiveness (improvement in emotional quality of life) and implementation of a collaborative care intervention for people with anxiety or depressive symptoms and posttraumatic epilepsy., Methods: CoCarePTE is a 2-site, randomized, single-blind, hybrid type 1 effectiveness-implementation trial that will randomize 60 adults to receive either neurology-based collaborative care or usual care. Adults receiving neurological care at participating centers with anxiety or depressive symptoms and a history of at least mild traumatic brain injury before epilepsy onset will be enrolled. The collaborative care intervention is a 24-week stepped-care model with video or telephone calls every 2 weeks by a care manager for measurement-based anxiety and depression care, seizure care monitoring, and brief therapy intervention delivery. This is supplemented by antidepressant prescribing recommendations by psychiatrists for neurologists via case conferences and care manager-facilitated team communication. In step 2 of the intervention, individuals with <50% symptom reduction by 10 weeks will receive an added 8-session remote cognitive behavioral therapy program. The study is powered to detect a moderate improvement in emotional quality of life. As a hybrid type 1 trial, effectiveness is the primary focus, with the primary outcome being a change in emotional quality of life at 6 months in the intervention group compared to control. Secondary effectiveness outcomes are 6-month changes in depression, anxiety, and overall quality of life. Implementation outcomes, including fidelity, acceptability, feasibility, and appropriateness, are evaluated before implementation and at 3 months. The primary effectiveness analysis will compare changes in emotional quality of life scores from baseline to 6 months between the intervention and control arms using multiple linear regression modeling, adjusting for study site and using an intent-to-treat approach., Results: Enrollment commenced in 2023, with modifications in the inclusion and exclusion made after the first 6 enrollees due to slow recruitment. Enrollment is expected to continue at least into early 2025., Conclusions: The CoCarePTE trial is novel in its use of a hybrid effectiveness-implementation design to evaluate an evidence-based mental health intervention in epilepsy, and by incorporating seizure care into a collaborative care model. If a significant improvement in emotional quality of life is found in the intervention group compared to usual care, this would support next step scaling or clinical implementation., Trial Registration: ClinicalTrials.gov NCT05353452; https://www.clinicaltrials.gov/study/NCT05353452., International Registered Report Identifier (irrid): DERR1-10.2196/59329., (©Heidi M Munger Clary, Beverly M Snively, Christian Cagle, Richard Kennerly, James N Kimball, Halley B Alexander, Gretchen A Brenes, Justin B Moore, Robin A Hurley. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.11.2024.)