Novel European lineages of bat astroviruses identified in Hungary.

KEYWORDS: bat, astroviruses, coronaviruses, snRT-PCR, Hungary.

Osteoporosis in older men: knowledge and health beliefs.

PURPOSE: The purpose of this theory-based descriptive study was to describe older men's (> or = 65 years of age) knowledge of osteoporosis, their health beliefs about osteoporosis (specifically their perceived susceptibility), their confidence to perform osteoporosis-prevention behaviors, and actual performance of osteoporosis-prevention behaviors. DESIGN: A descriptive design was used to determine men's knowledge and health beliefs of osteoporosis, confidence to perform osteoporosis prevention behaviors, and performance of osteoporosis prevention behaviors. SAMPLE: A community-based convenience sample of 138 men 65 years of age and older was obtained in Northeastern Ohio community centers where men were likely to gather. METHOD: Men completed a questionnaire that included the Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, Osteoporosis Self-Efficacy Scale (Kim, Horan & Gendler, 1991), and the Osteoporosis Preventing Behaviors Survey (Doheny & Sedlak, 1995). MAIN RESEARCH CLASSIFICATIONS: Osteoporosis, Men, Prevention, Health Beliefs, Orthopaedic Nursing. FINDINGS: Men had poor knowledge of osteoporosis, did not perceive themselves as susceptible to osteoporosis, and engaged in few osteoporosis preventing behaviors such as weight-bearing exercises and dietary calcium intake. CONCLUSION: Men need osteoporosis education and modification of lifestyle to include osteoporosis prevention behaviors. IMPLICATIONS FOR NURSING RESEARCH: Future research should include the development of osteoporosis awareness programs for men.

Alcohol use in women 65 years of age and older.

The purpose of this study was to examine the relationships between depression, codependency, self-coherence, and alcohol use and health outcomes in women 65 years of age and older. The framework is Erikson's ego-development theory. A convenience sample of 238 women was obtained from women attending flu shot clinics. This cross-sectional field study used survey methodology. Measures included the Beck Depression Inventory, Codependency Assessment Tool, Self-Coherence Survey Form C, Alcohol Use Disorders Identification Test, Alcohol Use Questionnaire, Self-Rated Health Tool, Quality of Life Visual Analogue Scale, Functional Ability Scale, Illness Prevention Screening Behaviors Checklist, and Sociodemographic Data. Results indicate a low consumption and little variation in use of alcohol. There were no significant associations between alcohol consumption and the dependent variables. Depression was significantly related to all the health outcomes; codependency was significantly related to all health outcomes except perceived quality of life; and self-coherence was significantly related to all health outcomes except illness prevention behavior. These findings have important implications for those providing care for older women.

Codependency in male and female helping professionals.

The purpose of this study is to determine and compare the prevalence of codependency in a group of 77 female and a group of 72 male helping professionals. Relatively low rates of codependency were observed in this sample, and the five-factor structure of the Codependency Assessment Tool (CODAT) was replicated. Males showed slightly higher codependency than females on the total CODAT and on the Hiding Self and Family of Origin Issues subscales. The CODAT was shown to be relevant to both males and females. Further research is needed to determine if a general population of male and female subjects would yield similar results.

The relationship between eating disorders and running in women.

The purpose of this study was to determine the extent to which eating disorders in women are related to a general tendency toward addiction, addiction to running, and level of running intensity. A stratified sample of 265 women runners/nonrunners (ages 20-35) included 66 nonrunners, 69 low-level runners, 67 medium-level runners, and 63 high-intensity runners. The women were weighed, measured, and had body fat and 4-day nutritional intake assessed. A questionnaire included scales to assess psychological and behavior traits common in women with anorexia (AN) and/or bulimia, general addiction, and running addiction. ANCOVA with age and income as covariates and multiple regression analyses were used. There were significant differences among the groups on the eating disorder scores and percent body fat with higher level runners scoring higher on eating disorder measures and running addiction and lower on body fat. A major finding for those providing health care for women was that 25% of the women who ran >30 miles/week had Eating Attitude Test scores indicating a high risk for anorexia.

Nutrient intake of women runners and nonrunners.

The nutrient intakes of women who ran at different levels of intensity and the relationship between nutrient intake and ovulatory disturbances were studied. Ninety-five women, including sedentary non-runners (n = 16), low-level runners (n = 27), medium-level runners (n = 29), and high-level runners (n = 23), completed data for a 3-day nutritional assessment. The high-level runners met the Food and Nutrition Board's Recommended Daily Allowances (RDAs) for all 17 nutrients examined, with the exception of calcium. The other groups of women failed to meet RDAs for iron, carbohydrate, and fiber. In general, the women in the study reported healthier diets than did women in a general national survey of nutrient intake conducted in 1985. Eighty-two of the women reported luteinizing hormone level data that were accurate enough to indicate ovulatory functioning; of these women, 30 had ovulatory disturbances. There was no relationship between ovulatory disturbance and nutrient intake; however, 5 amenorrheic women reported a significantly lower nutrient density intake of fat and higher intake of carbohydrate, fiber, and vitamin A than did the nonamenorrheic women.

Menstrual response to running: nursing implications.

Overt (length of menstrual cycle, duration of menses, and amount of menses) and covert (luteal surge indicative of ovulation and length of luteal phase) menstrual cycle characteristics were studied in a sample of 146 women who participated in four levels of running intensity. Menstrual and running data were collected for 4 months or 3 cycles. There was a significant difference among the four groups in duration of menses and in the amount of menses, with nonrunners having significantly more days of menses and larger amounts of menses than the two highest intensity running groups. However, when a history of skipping menstrual periods between menarche and age 18 was controlled, the differences between the groups were not significant. There were no significant differences among the four groups in incidence of luteal surge or length of luteal phase. When runners were compared to nonrunners, runners reported, on average, a shorter luteal phase than nonrunners. This difference remained when controlling for age and history of skipping menstrual periods. There was no significant difference between the four groups on incidence of ovulatory disturbances (anovulation or more than one cycle with a shortened luteal phase). But, when compared to nonrunners, runners were found to have significantly more ovulatory disturbances. The best predictors of the variance in menstrual cycle characteristics were history of skipping periods between menarche and age 18, and running versus nonrunning.

Professional and lay interrater reliability of urinary luteinizing hormone surges measured by OvuQuick test.

OBJECTIVE: To determine the reliability of women, unmotivated by fertility problems, to accurately assess and record the urinary luteinizing hormone surge indicated by color changes on OvuQuick test pads. DESIGN: A descriptive, correlational study testing the reliability and validity of an instrument. SETTING: The participants' homes. PARTICIPANTS: 114 college-educated, white women. INTERVENTIONS: An OvuQuick Test Kit and a Menstrual Cycle Diary were mailed to each participant. The monthly diary and test pads of the participants were reassessed by a master's-prepared nurse. MAIN OUTCOME MEASURES: Women without medical or health-care training are reliable in judging the color changes on the OvuQuick test pads and recording these results in a menstrual diary. RESULTS: Investigator and subject assessment and recording of luteinizing hormone surge results agreed 95% (284 of 300 instances) of the time. In addition, the validity of the luteinizing hormone surge for predicting ovulation was accurate in 93% (26 of 28 instances) of the cases. CONCLUSION: OvuQuick is a reliable and valid test for home evaluation of luteinizing hormone surge and prediction of ovulation.

Use of patient-controlled analgesia to compare the efficacy of epidural to intravenous fentanyl administration.

Fentanyl, unlike morphine, is highly lipophilic and rapidly diffuses out of the epidural space. Respiratory depression is, therefore, unlikely when fentanyl is given epidurally. However, much of fentanyl's analgesic effect is mediated by systemic rather than spinal receptor binding. To test this hypothesis, we performed a prospective, double-blind, cross-over study comparing epidural and intravenous (IV) administration of fentanyl in 16 patients for the first 12 h after lower abdominal or lower extremity surgery. To allow direct comparison of these two routes of administration, patient-controlled analgesia was used so patients could self-titrate their analgesia. Patients were randomized to receive fentanyl initially by an epidural (group A, n = 8) or IV (group B, n = 8) catheter for 6 h, after which they were crossed-over to the alternate route by means of a hidden three-way stopcock. The degree of analgesia was subjectively evaluated by a visual analogue scale, and by an observer rating patient's comfort and sedation. Cumulative dosage of fentanyl was recorded, and plasma fentanyl concentrations were measured. The onset of analgesia and increase in plasma fentanyl concentrations were more rapid with intravenous fentanyl. However, after 60 min, analgesia (visual analogue scale 2-4 cm) or plasma fentanyl concentrations (0.3-0.7 ng/mL) did not differ between the two routes of administration. There were also no significant differences in the cumulative dosage of fentanyl within each group (epidural vs IV) or between the groups. Thus, the analgesic effects of epidural fentanyl appear largely mediated by systemic absorption. Intravenous fentanyl achieves a similar degree of analgesia and a more rapid onset of effect without the need for epidural catheterization.

Potential psychological attachments formed by donors involved in fertility technology--another side to infertility.

Donor participation has become an integral component in the treatment of infertility. While the donors' reproductive capabilities continue to be utilized to support fertility technology, little effort has been directed at understanding the experience of these participants. Based on attachment theory, it can be argued that donors have the potential to form parent-offspring attachments. This bonding may result in psychological sequelae from the separation inherent in technology that disconnects the genetic, gestational and social functions of parenthood. Implications for health care providers involved in infertility care are discussed.

Body-fat measurements and athletic menstrual irregularity.

The purpose of this study was to compare four measurements used as estimates of body fat that have been used in previous studies to determine whether the association between body fat and athletic menstrual irregularity (AMI) is measurement dependent. In a sample of 112 marathon runners, 94 responded to questions regarding their menstrual cycle. Of these, 30 (32%) reported irregular or absent menses, and 64 (68%) reported regular menses. Of the 30 subjects reporting menstrual irregularities or amenorrhea, 13 (43%) reported having had menstrual irregularity or amenorrhea prior to taking up running. Estimates of body fat were based on Mellits and Cheek's (1970) equation for estimating percentage of body water, Lutter and Cushman's (1982) height and weight categories, actual gross body weight, and weight loss of 10 lb (4.5 kg) or more since taking up the sport. In this sample of marathon runners, none of the four methods used to estimate body fat supported a relationship between menstrual irregularity and low body fat. A significant (p less than .001) relationship was found between prior menstrual irregularity and the development of AMI after starting to run.

The meanings of menopause.

Multiple meanings have been assigned to menopause and to women experiencing menopause. Meanings are not inherent in reality but are assigned by humans in response to interaction. Once meanings are assigned to entities, they become coercive and influence interactions. Freidson's (1988) theoretical framework includes the imputation of responsibility, legitimacy, and seriousness to a deviance or illness and provides the basis for an analysis of the various meanings of menopause that are found in the literature. This analysis is concerned with the social, political, economic, and health care consequences of the assigned meanings of menopause for women.

Running addiction and dyadic adjustment.

Running motivated by an addictive mechanism may overpower the sensible, beneficial approach to exercise. Neglect of family responsibilities and relationships may occur as a result of this addiction. Thirty-five marathon runners and their spouses were studied; 22 of the runners were women and 13 were men. Each runner and spouse completed the dyadic adjustment (DAS) and running addiction (RAS) scales; the spouses were asked to rate their own dyadic adjustment and the runners' addiction. Findings indicated little relationship between the runners' RAS and DAS scores; however, there was a significant negative relationship between spouses' rating of the runners' RAS and their own DAS, (r = -.59, p less than .001). The relationship between higher perceived levels of running addiction in the spouse and lower DAS scores was stronger in those spouses who did not run; (r = -.61, p less than .01) and for male spouses of female runners; (r = -.67, p less than .01).

Marathon running: comparison of physical and psychosocial risks for men and women.

Physical and psychosocial risks of running and addiction were compared in a sample of female (n = 112) and male (n = 108) marathon runners. While female runners reported more pain in the knee, shin, hip, and heel, and more stress fractures, than the men, no injuries were significantly higher in women. Over 40% of both male and female subjects reported knee injury, making it the most common running injury reported. There were no significant differences in level of self esteem, anxiety, or running addiction between the two groups. There was, however, a significant relationship between level of negative addiction scores and two injuries: torn ligaments X2 (2,202) = 8.45, p less than .02, and hematuria X2 (2,202) = 11.31, p less than .005.

Screening tool for daily fetal movement.

Knowledge of the expected pattern of fetal movements is important to both health care providers and childbearing women since altered patterns can signal fetal compromise. The daily fetal movement count (DFMC) chart, a tool that is inexpensive, uncomplicated and non-invasive, is a clinically effective means of screening for fetal well-being after 20 weeks' gestation. The DFMC requires pregnant women to begin a fetal movement count at a selected time each day, count 10 movements and record the elapsed time from the first to the tenth movement. Findings which would indicate possible danger to the fetus, and which should be reported immediately, include less than 10 movements in 12 hours; no perception of movement in an eight-hour period; a change in the usual pattern of fetal movement; or a sudden increase in violent fetal movements followed by complete cessation of movement. Development of fetal movement assessment, fetal movement recording methods, teaching patients the DFMC method and nursing implications are described in this article. Use of the DFMC by nurse practitioners can enhance the physical and emotional well-being of pregnant clients.

Jogging: cardiovascular benefits and risks.

The cardiovascular benefits and risks of jogging are frequently debated. This article presents information on the effects of jogging and other aerobic exercise on heart rate, cardiac output, tissue oxygen consumption and blood pressure. The indirect effects of jogging on cardiac risk factors, such as serum lipids, blood clotting and glucose metabolism, are discussed. Along with the positive outcomes from jogging, the risks to the cardiovascular system are presented. These risks include a sudden drop in blood pressure at the cessation of intense jogging, cardiac arrhythmias and ischemia. The primary care nurse practitioner can play an important role in prescribing a level of exercise that is safe and will enhance physical fitness, particularly cardiovascular fitness. Guidelines for prescribing an exercise program for a variety of patient populations are reviewed, and the need for exercise monitoring by the individual is stressed.