The Network for Nursing in Child Health.

The Network for Nursing in Child Health was launched in 2006 building on earlier collaboration of a group of nurses in Latin America to study the needs for strengthening pediatric nursing curricula in the region. This Network is one of more than 10 specialty nursing networks being developed with support from the Pan American Health Organization (PAHO) as a mechanism for promoting collaboration and communication between nurses of different countries to improve nursing practice and health care. The initial goals of the Network for Nursing in Child Health are to share knowledge and experience related to child health nursing and to promote incorporation of guidelines related to the Integrated Management of Childhood Illnesses (IMCI) in nursing curricula. At this time, membership in the Network is open to all nurses interested in working toward the Network's objectives, although communications are in Spanish. This collaborative network demonstrates the power of nursing working in a concerted way to build on its strengths and increase the capacity of nurses and health care workers to address global health priorities related to children's health care.

Relationships between parenting styles and risk behaviors in adolescent health: an integrative literature review.

Research over the past 20 years suggests that the quality of the parent-adolescent relationship significantly affects the development of risk behaviors in adolescent health. The purpose of this paper is to present a review of studies published between 1996-2007 that address specific relationships between parenting styles and six priority adolescent risk behaviors. The review supports the substantial influence of parenting style on adolescent development. Adolescents raised in authoritative households consistently demonstrate higher protective and fewer risk behaviors than adolescents from non-authoritative families. There is also considerable evidence to show that parenting styles and behaviors related to warmth, communication and disciplinary practices predict important mediators, including academic achievement and psychosocial adjustment. Careful examination of parenting style patterns in diverse populations, particularly with respect to physical activity and unintentional injury, will be a critical next step in the development of efficacious, culturally tailored adolescent health promotion interventions.

Relationships between parenting styles and risk behaviors in adolescent health: an integrative literature review / Relações entre modelos de pais e comportamentos de risco na saúde do adolescente: uma revisão integrativa da literatura / Relaciones entre los tipos de padres y comportamientos de riesgo en la salud del adolescentes: una revisión bibliográfica integrada

Research over the past 20 years suggests that the quality of the parent-adolescent relationship significantly affects the development of risk behaviors in adolescent health. The purpose of this paper is to present a review of studies published between 1996-2007 that address specific relationships between parenting styles and six priority adolescent risk behaviors. The review supports the substantial influence of parenting style on adolescent development. Adolescents raised in authoritative households consistently demonstrate higher protective and fewer risk behaviors than adolescents from non-authoritative families. There is also considerable evidence to show that parenting styles and behaviors related to warmth, communication and disciplinary practices predict important mediators, including academic achievement and psychosocial adjustment. Careful examination of parenting style patterns in diverse populations, particularly with respect to physical activity and unintentional injury, will be a critical next step in the development of efficacious, culturally tailored adolescent health promotion interventions.

Resultados de investigaciones realizadas durante los últimos 20 años muestran que la calidad en las relaciones entre padres e hijos ha provocado un impacto significativo en el desarrollo de comportamientos de riesgo para la salud del adolescente. El objetivo de este artículo es mostrar una revisión bibliográfica de estudios publicados entre 1996-2007, analizando relaciones específicas entre los tipos de padres y los seis principales comportamientos de riesgo en adolescentes. Adolescentes criados bajo una disciplina autoritaria muestran comportamientos más seguros y menores comportamientos de riesgo al ser comparados con adolescentes que provienen de familias poco autoritarias. El tipo paternal y comportamientos relacionados con la afectividad, comunicación familiar y disciplina predicen importantes mediadores para la formación del adolescente, incluyendo desarrollo académico y adaptación psico-social. Cuidadosas evaluaciones sobre los tipos de padres estándar en poblaciones diversas será una próxima etapa crítica para el desarrollo de intervenciones eficaces y adaptadas culturalmente para la promoción de la salud del adolescente.

Pesquisas realizadas durante os últimos 20 anos sugerem que a qualidade da relação entre pais e adolescentes tem obtido impacto significante no desenvolvimento de comportamentos de risco a saúde dos adolescentes. A finalidade deste estudo é apresentar uma revisão bibliográfica de estudos publicados entre o ano de 1996 e 2007, que analisam relações especificas entre modelos de pais e seis principais comportamentos de risco em adolescentes. Os adolescentes crescidos sob disciplina autoritária demonstraram consistentemente mais comportamentos seguros e menos comportamentos de risco comparados a adolescentes vindos de famílias não autoritárias. O modelo dos pais e comportamentos relacionados a afetividade, comunicação familiar e práticas disciplinares, predizem importantes mediadores na formação do adolescente, incluindo o desenvolvimento acadêmico e o ajuste psico-social. Avaliações cuidadosas de modelos padrões de pais em diversas populações, será uma próxima etapa crítica no desenvolvimento de intervenções eficazes e culturalmente adaptadas, na promoção de saúde a adolescentes.

A physiologically based pharmacokinetic/pharmacodynamic model for carbofuran in Sprague-Dawley rats using the exposure-related dose estimating model.

Carbofuran (2,3-dihydro-2,2-dimethyl-7-benzofuranyl-N-methylcarbamate), a broad spectrum N-methyl carbamate insecticide, and its metabolite, 3-hydroxycarbofuran, exert their toxicity by reversibly inhibiting acetylcholinesterase (AChE). To characterize AChE inhibition from carbofuran exposure, a physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) model was developed in the Exposure-Related Dose Estimating Model (ERDEM) platform for the Sprague-Dawley (SD) rat. Experimental estimates of physiological, biochemical, and physicochemical model parameters were obtained or based on data from the open literature. The PBPK/PD model structure included carbofuran metabolism in the liver to 16 known metabolites, enterohepatic circulation of glucuronic acid conjugates, and excretion in urine and feces. Bolus doses by ingestion of 50 microg/kg and 0.5 mg/kg carbofuran were simulated for the blood and brain AChE activity. The carbofuran ERDEM simulated a half-life of 5.2 h for urinary clearance, and the experimental AChE activity data were reproduced for the blood and brain. Thirty model parameters were found influential to the model outputs and were chosen for perturbation in Monte Carlo simulations to evaluate the impact of their variability on the model predictions. Results of the simulation runs indicated that the minimum AChE activity in the blood ranged from 29.3 to 79.0% (as 5th and 95th percentiles) of the control level with a mean of 55.9% (standard deviation = 15.1%) compared to an experimental value of 63%. The constructed PBPK/PD model for carbofuran in the SD rat provides a foundation for extrapolating to a human model that can be used for future risk assessment.

Child health needs of rural Alabama Latino families.

This article presents findings from a study that used focus group methodology to identify perceptions of Latino parents living in rural Alabama related to their children's health needs. Sixteen focus groups were held with a total of 89 parents (54 mothers and 35 fathers). The groups were led by native Spanish speakers, and group meetings were tape recorded. The main themes that emerged related to (a) what children need to be healthy, (b) common children's health problems, (c) what we do when children are ill, (d) barriers to receiving health care, (e) parenting issues and concerns, (f) experiences with children's schools, and (g) services needed. The findings can be used to guide the development of culturally appropriate, community-based programs to address the priority health needs of the growing Latino community in rural areas of the United States.

An examination of sociocultural factors associated with health and health care seeking among Latina immigrants.

The purpose of this study was to examine the sociocultural factors associated with health maintenance and health care seeking among Latina immigrants. Data were collected from eight focus groups with 54 Latina immigrants between the ages of 19 and 62 (M=29.3+/-9.34). The PEN-3 model provided the framework for the study. Most of the participants came from Mexico; 46% had not completed high school; 85.2% had been in the United States for less than 7 years, and 73.6% reported not having health insurance coverage. Participants identified both positive and negative perceptions, enablers, and nurturers associated with health maintenance and health care seeking. Participants acknowledged the importance of physical, mental, and spiritual health and what they should do to be healthy. Despite such knowledge, they tended to engage in unhealthy behaviors due to a variety of nonstructural barriers such as lack of time, "tradition," and procrastination. They tended to use alternative/complementary medicine first, and then seek medical help if these practices are not effective. Many women believe that they do not have control over their own health attributing this lack of control to the "system." Participants also mentioned structural barriers to seeking health care such as lack of transportation, lack of proper documentation, lack of health insurance, language barriers, long waiting time at the clinics, and lack of knowledge on where to go for affordable care. Our study suggests that there are important structural and nonstructural barriers that hinder health maintenance and care seeking. The findings also lend support to the PEN-3 model, and suggest that positive perceptions, enablers, and nurturers associated with health maintenance and health care seeking, if properly reinforced, can counterbalance negative perceptions, enablers and nurturers in this population.

Competencias en investigación para diferentes niveles de formación de enfermeras: una perspectiva latinoamericana / Research competencies for differents levels in nursing education: a latin american perspective

El propósito de este estudio fue identificar las competencias en investigación correspondientes a licenciatura, magíster y doctorado en enfermería. Método: Diseño descriptivo y transversal, se aplicó una encuesta enviada por correo a 200 enfermeras obtuviéndose un 26 por ciento de respuestas. El instrumento contiene 33 ítemes con competencias en investigación en las áreas de conocimiento, análisis y aplicación. Frente a cada ítem se presenta una escala de cuatro tramos, que indica el grado en que la competencia tiene que estar presente según nivel de formación. La validez fue realizada por expertas en el tema. La confiabilidad fue calculada con test-retest utilizando porcentaje de acuerdo. Resultados: El mayor porcentaje de respuestas se obtuvo de Chile, seguido de México. El 82 por ciento de las respuestas provino de profesoras de investigación o guías de tesis. Para el nivel de licenciatura se considera esencial el conocimiento de las etapas del proceso investigativo y la realización de búsqueda bibliográfica. Se encontraron discrepancias entre los niveles con relación a los ítemes de conocimiento y tendencia de la investigación, organismos que financian investigaciones, métodos de análisis de datos, uso de programas estadísticos computacionales, aplicación y enseñanza de la investigación, preparación de propuestas y publicaciones. El aspecto ético se señala como esencial en todos los niveles. Conclusiones: Las encuestadas perciben diferencias en las competencias para los diferentes niveles de preparación académica. Los resultados del estudio orientan el diseño de programas de formación en investigación en enfermería.

Perspectives of Latin American nursing professors and leaders about research competencies needed by nurses with different levels of academic preparation.

This article describes a study to identify perspectives of Latin American nursing professors and leaders about the research competencies needed by students with different levels of academic preparation (bachelor's, master's, and doctoral). The sample included 42 nurses from eight Latin American countries who wrote narrative comments on a questionnaire sent by e-mail. The responses were analyzed by a process of content analysis. The participants identified differences that should be emphasized in the different academic levels. The findings could be used to develop educational programs to prepare nurse researchers.

The relationship between physiological and behavioral measures of stress in preterm infants.

OBJECTIVE AND DESIGN: The purpose of this exploratory descriptive analysis was to explore relationships among physiological stress, behavioral stress, and motor activity cues in preterm infants when they were not being handled or disturbed, and to determine whether there were differences between younger and older preterm infants in these variables or relationships. SETTING AND PARTICIPANTS: The convenience sample included 42 preterm infants who had been 27 to 33 weeks gestational age at birth and were from 6 to 19 days old at the time of data collection in the neonatal intensive-care unit. MEASURES: In each 10-minute observation, heart rate (HR) and oxygen saturation (O2 sat) levels were recorded every 5 seconds, and observational measures of behavioral distress and motor activity were recorded twice a minute. The physiological data were coded to reflect the percentage of each 10-minute period during which HR levels were less than 100 bpm or more than 200 bpm or O2 sat levels were abnormally low (less than 90 mg%). Data were analyzed with correlational and general linear mixed models procedures. RESULTS: Stress cues and motor activity were more often related to low levels of O2 sat than to low or high HR. Physiological status was more often related to motor activity than to stress cues. Few differences in the relationships were observed between younger and older preterm infants. CONCLUSION: Although these results are preliminary, they suggest that neonatal nurses should monitor preterm infants' behavioral stress and motor activity cues in response to caregiving and minimize stimuli that evoke stress responses linked to physiological instability.

A study abroad experience in Guatemala: learning first-hand about health, education, and social welfare in a low-resource country.

The demographic characteristics of the United States are rapidly changing as the nation becomes more culturally, racially, and ethnically diverse. In light of these changes, it is increasingly important that health care professionals develop cultural competence and understanding. Study abroad experiences can help students learn first-hand about other cultures and can promote the development of enhanced cultural sensitivity and competence. Although there are many advantages and benefits of study-abroad experiences, these experiences also present unique challenges for both students and faculty. This article presents a description of a 3-credit elective study abroad course that was offered for graduate or undergraduate credit in the summer of 2003 in Guatemala, including a description of course objectives, the process of planning and implementing the course from the faculty's perspective, and one student's perceptions of her study abroad experience.

The biobehavioral effects of gentle human touch on preterm infants.

This study examined the physiological and behavioral effects of a gentle human touch nursing intervention on medically fragile preterm infants (27 to 32 weeks gestational age). The Roy adaptation model of nursing was the framework for the study. The results of this study suggest that the immediate and short-term effects of a gentle human touch nursing intervention were not aversive or stressful to preterm infants of 27 to 32 weeks gestational age; furthermore, the findings document several positive, beneficial behavioral effects of the intervention on preterm infants and indicate this type of touching may be appropriate for infants in the neonatal intensive care unit.