The Clergy Occupational Distress Index (CODI): background and findings from two samples of clergy.

This study demonstrates the reliability and validity of the Clergy Occupational Distress Index (CODI). The five-item index allows researchers to measure the frequency that clergy, who traditionally have not been the subject of occupational health studies, experience occupational distress. We assess the reliability and validity of the index using two samples of clergy: a nationally representative sample of clergy and a sample of clergy from nine Protestant denominations. Exploratory factor analysis and Cronbach's scores are generated. Construct validity is measured by examining the association between CODI scores and depressive symptoms while controlling for demographic, ministerial, and health variables. In both samples, the five items of the CODI load onto a single factor and the Cronbach's alpha scores are robust. The regression model indicates that a high score on the CODI (i.e., more frequent occupational distress) is positively associated with having depressive symptoms within the last 4 weeks. The CODI can be used to identify clergy who frequently experience occupational distress and to understand how occupational distress affects clergy's health, ministerial career, and the functioning of their congregation.

Psychotropic medication claims among religious clergy.

This study examined psychotropic medication claims in a sample of Protestant clergy. It estimated the proportion of clergy in the sample who had a claim for psychotropic medication (i.e., anti-depressants and anxiolytics) in 2005 and examined associations between sociodemographic characteristics, occupational distress and having a claim. Protestant clergy (n = 749) from nine denominations completed a mail survey and provided access to their pharmaceutical records. Logistic regression models assessed the effect of sociodemographic characteristics and occupational distress on having a claim. The descriptive analysis revealed that 16 % (95 % Confidence interval [CI] 13.3 %-18.5 %) of the clergy in the sample had a claim for psychotropic medication in 2005 and that, among clergy who experienced frequent occupational distress, 28 % (95 % CI 17.5 %-37.5 %) had a claim. The regression analysis found that older clergy, female clergy, and those who experienced frequent occupational distress were more likely to have a claim. Due to recent demographic changes in the clergy population, including the increasing mean age of new clergy and the growing number of female clergy, the proportion of clergy having claims for psychotropic medication may increase in the coming years. To the best of our knowledge, this is the first study to examine the use of psychotropic medication among clergy.

Religious coping and quality of life among individuals living with schizophrenia.

OBJECTIVE: This study investigated the relationship between positive and negative religious coping and quality of life among outpatients with schizophrenia. METHODS: Interviews were conducted with 63 adults in the southeastern United States. Religious coping was measured by the 14-item RCOPE and quality of life by the World Health Organization Quality of Life­BREF. Data were examined via descriptive bivariate statistics and controlled analyses. RESULTS: Most participants reported participation in private religious or spiritual activities (91%) and participation in public religious services or activities (68%). Positive religious coping was related to the quality-of-life facet of psychological health (r=.28, p=.03). Negative religious coping and quality of life were inversely related (r=­.30, p=.02). Positive religious coping was associated with psychological health in the reduced univariate general linear model (B=.72, p=.03, adjusted R(2)=.08). CONCLUSIONS: Greater awareness of the importance of religion in this population may improve cultural competence in treatment and community support.

Pilgrimage to wellness: an exploratory report of rural African American clergy perceptions of church health promotion capacity.

Churches serve vital roles in African American communities, where disease burden is disproportionately greater and healthcare access is more limited. Although church leadership often must approve programs and activities conducted within churches, little is known about their perception of churches as health promotion organizations, or the impact of church-based health promotion on their own health. This exploratory study assessed perceptions of church capacity to promote health among 27 rural, African American clergy leaders and report the relationship between their own health and that of their congregation. Results indicate a perceived need to increase the capacity of their churches to promote health. Most common were conducting health programs, displaying health information, kitchen committee working with the health ministry, partnerships outside of the church, and funding. Findings lay the foundation for the development of future studies of key factors associated with organizational change and health promotion in these rural church settings.

Breakout session: Gender disparities in knee osteoarthritis and TKA.

BACKGROUND: Biologically derived (sex-based) and behaviorally influenced (gender-based) disparities exist in knee osteoarthritis and treatment with TKA. QUESTIONS/PURPOSES: We sought to highlight sex- and gender-based differences with respect to knee osteoarthritis and its treatment. Our purposes were to (1) define where we are now, (2) outline where we need to go, and (3) generate solutions to how we can get there. WHERE ARE WE NOW?: A growing body of evidence shows sex- and gender-based disparities contribute to differences in the incidence, treatment, and outcomes of patients with knee osteoarthritis. Moreover, the influence of unconscious provider bias in disparities in care is becoming recognized. WHERE DO WE NEED TO GO?: Sex- and gender-based differences need to be identified and translated into clinical practice to effect patient-centered sex- and gender-based medicine. Equitable and evidence-based care must be provided. HOW DO WE GET THERE?: Research must continue to focus on sex-based differences in cartilage degeneration and gender-related factors influencing the development and progression of knee osteoarthritis. Development of evidence-based guidelines for optimal timing of TKA would assist patients and clinicians with surgical decision-making. Training of healthcare providers to mitigate again unconscious basis is essential. Care must be patient-focused, with patients empowered to be full partners with providers in healthcare outcomes.

Spirituality in medical school curricula: findings from a national survey.

OBJECTIVE: No systematic information exists on what U.S. medical schools are teaching on spirituality and health or on the attitudes of faculty toward inclusion of this subject in the medical curriculum. We systematically surveyed U.S. medical school deans and assessed both attitudes about and the extent to which spirituality is addressed in medical school curricula. METHODS: The responses to a questionnaire were solicited from deans representing 122 U.S. medical schools accredited by the Liaison Committee for Medical Education. Completed surveys were received from 85% (n = 104), with 94% (n = 115) responding to the primary question. Outcomes were proportion of medical schools with curricular content on spirituality and attitudes of deans toward such material. RESULTS: Ninety percent (range 84%-90%) of medical schools have courses or content on spirituality and health (S&H), 73% with content in required courses addressing other topics and 7% with a required course dedicated to S&H. Although over 90% indicate that patients emphasize spirituality in their coping and health care, only 39% say that including S&H is important. When asked if their institution needs more S&H curricular content, 43% indicated they did; however, even if funding and training support were available, only 25% would open additional curricular time. National policy statements, established competencies, or methods to evaluate student competencies in S&H were generally considered unimportant. CONCLUSIONS: Most U.S. medical schools have curricular content on S&H, although this varies greatly in scope. Despite acknowledging its importance to patients, the majority of deans are uncertain about including spirituality and do not think more content is needed.

A new homogeneous high-throughput screening assay for profiling compound activity on the human ether-a-go-go-related gene channel.

Long QT syndrome, either inherited or acquired from drug treatments, can result in ventricular arrhythmia (torsade de pointes) and sudden death. Human ether-a-go-go-related gene (hERG) channel inhibition by drugs is now recognized as a common reason for the acquired form of long QT syndrome. It has been reported that more than 100 known drugs inhibit the activity of the hERG channel. Since 1997, several drugs have been withdrawn from the market due to the long QT syndrome caused by hERG inhibition. Food and Drug Administration regulations now require safety data on hERG channels for investigative new drug (IND) applications. The assessment of compound activity on the hERG channel has now become an important part of the safety evaluation in the process of drug discovery. During the past decade, several in vitro assay methods have been developed and significant resources have been used to characterize hERG channel activities. However, evaluation of compound activities on hERG have not been performed for large compound collections due to technical difficulty, lack of throughput, and/or lack of biological relevance to function. Here we report a modified form of the FluxOR thallium flux assay, capable of measuring hERG activity in a homogeneous 1536-well plate format. To validate the assay, we screened a 7-point dilution series of the LOPAC 1280 library collection and reported rank order potencies of ten common hERG inhibitors. A correlation was also observed for the hERG channel activities of 10 known hERG inhibitors determined in this thallium flux assay and in the patch clamp experiment. Our findings indicate that this thallium flux assay can be used as an alternative method to profile large-volume compound libraries for compound activity on the hERG channel.

Coping styles, well-being, and self-care behaviors among African Americans with type 2 diabetes.

PURPOSE: The purpose of this study was to describe how coping styles among African Americans with type 2 diabetes relate to diabetes appraisals, self-care behaviors, and health-related quality of life or well-being. METHODS: This cross-sectional analysis of baseline measures from 185 African Americans with type 2 diabetes enrolled in a church-based randomized controlled trial uses the theoretical framework of the transactional model of stress and coping to describe bivariate and multivariate associations among coping styles, psychosocial factors, self-care behaviors, and well-being, as measured by validated questionnaires. RESULTS: Among participants who were on average 59 years of age with 9 years of diagnosed diabetes, passive and emotive styles of coping were used most frequently, with older and less educated participants using more often passive forms of coping. Emotive styles of coping were significantly associated with greater perceived stress, problem areas in diabetes, and negative appraisals of diabetes control. Both passive and active styles of coping were associated with better diabetes self-efficacy and competence in bivariate analysis. In multivariate analysis, significant proportions of the variance in dietary behaviors and mental well-being outcomes (general and diabetes specific) were explained, with coping styles among the independent predictors. A positive role for church involvement in the psychological adaptation to living with diabetes was also observed. CONCLUSIONS: In this sample of older African Americans with diabetes, coping styles were important factors in diabetes appraisals, self-care behaviors, and psychological outcomes. These findings suggest potential benefits in emphasizing cognitive and behavioral strategies to promote healthy coping outcomes in persons living with diabetes.

Intimate partner violence among Latinas in eastern North Carolina.

This article explores the correlates of intimate partner violence (IPV) among rural, southern Latinas. A sample of 1,212 women in blue-collar work sites in rural North Carolina completed a questionnaire assessing IPV and other social, demographic, and health-related variables. Social and demographic correlates of IPV were examined. Adult lifetime prevalence of IPV in Latinas was 19.5%, similar to that of non-Latinas. As compared to Latinas who did not experience IPV and non-Latinas who experienced IPV, Latinas who experienced IPV were more likely to lack social support and to have children in the home. Agencies that provide services to victims of IPV in the rural South need to be prepared to meet the unique needs of Latina immigrants.

Positive affect, exercise and self-reported health in blue-collar women.

OBJECTIVES: To determine if positive affect is related to the self-reported health and health behaviors of blue-collar women. METHODS: Analysis of baseline survey data of 1093 women participating in a worksite health promotion intervention at 12 workplaces in 5 rural counties. RESULTS: Positive affect was related to women's self-reported health and exercise. Also, positive coping behaviors were related to exercise. CONCLUSIONS: These findings suggest that incorporating strategies to encourage positive emotional states and positive coping into health promotion interventions might be helpful for improving women's levels of physical activity and overall reported health.

Disaster down East: using participatory action research to explore intimate partner violence in eastern North Carolina.

In the aftermath of Hurricane Floyd in 1999, a Community Advisory Committee requested assistance from its university partners (University of North Carolina) to address stress and increased risk for intimate partner violence (IPV). Collected from 12 study work sites, baseline data indicated that IPV rates were higher among blue-collar women in eastern North Carolina than national population-based rates suggest. IPV victims reported higher levels of perceived stress, psychological distress, somatic complaints, and post-traumatic stress disorder (PTSD) symptoms than did nonvictimized coworkers. As for the relationship of the flood to IPV, no significant increase in IPV incidence occurred after the flood. Regardless of their flood experience, however, IPV victims consistently reported greater stress, PTSD symptoms, and somatic and psychological problems. Moreover, IPV victims may be at higher risk for stress-mediated chronic illnesses and for using negative coping behaviors. This study uses an established trusting relationship between researchers and community members to explore community needs and inform intervention design.