Spirituality As a Coping Mechanism for Individuals with Parkinson's Disease.

Parkinson's disease (PD) is a chronic neurodegenerative disease that can render individuals totally disabled. Spiritual practices can help mitigate stress and provide a source of strength in PD. This article demonstrates a gap that exists between PD and spiritual coping specific research; discusses existing spiritual coping research in chronic illness; and explores the use of spirituality in managing PD care. Healthcare providers need to provide holistic care and explore mechanisms to assist individuals to manage the demands of living with PD.

REFLECTING TOGETHER: REFLECTIVE FUNCTIONING AS A FOCUS FOR DEEPENING GROUP SUPERVISION.

This article proposes how group reflective supervision, informed by the theory of reflective functioning, may provide a powerful method for developing reflective capacity of staff serving families, infants, and young children in multidisciplinary settings. An explanation of reflective functioning, related research, and its relevance to relational treatment and preventive intervention are discussed. Other approaches to reflective practice are referenced. We describe the necessary tension and encounters with distressing affect that mark reflective supervision groups using this focus. In addition, we identify areas of heightened difficulty in infant family work and describe how a group supervision process that enables use of self alongside perspectives of others may address these challenges while leading to increased reflective capacity among participants. Finally, we touch on relevant research on group supervision and parameters of size and focus, and highlight facilitation skills needed to create group safety and coherence. Areas for further study are proposed.

Overwintering, Oviposition, and Larval Survival of Hunting Billbugs (Coleoptera: Curculionidae) and Implications for Adult Damage in North Carolina Turfgrass.

The hunting billbug, Sphenophorus venatus vestitus Chittenden, is one of the most widely recognized billbug turfgrass pests. Since 2000, damage to warm-season turfgrass caused by hunting bill bugs has increased and a need for information on hunting billbug biology is necessary for the development of management plans. Field and laboratory studies were conducted to collect data on overwintering, oviposition behavior, larval survival at various levels of soil moisture, and adult damage. Turfgrass samples from 'Tifway 419' bermudagrass(Cynodon dactylon (L.) Pers x Cynodon transvaalensis Burtt Davy) on golf courses were collected to determine overwintering behavior, and 10 female adult billbugs were collected weekly to determine oviposition behavior.Survival of medium-sized larvae (head capsule width: 1.0 and 1.7 mm) was evaluated in containers with 20, 40,60, or 80% of the total pore space occupied by water. Zero, two, four, or six adult billbugs were placed in bermudagrass, zoysiagrass, or tall fescue containers and images were collected for 4 weeks to determine adult damage. We observed that hunting billbugs overwinter as adults and all larval sizes. Adults became active in March and began to oviposit, which continued through October. Larval mortality was lowest with 20% of the total pores pace occupied by water, while increases in moisture caused significant mortality. Adults caused a greater reduction in warm-season turfgrass cover than cool-season turfgrass cover. This research builds on the existing biological information for the hunting billbug biology in transition zones and will be pivotal in developing practical and sustainable management plans.

Variability of Passing Grades in Undergraduate Nursing Education Programs in New York State.

AIM: The purpose of this descriptive study was to provide information about passing grades and their corresponding numeric grades for undergraduate nursing programs in New York State. An additional purpose was to report on differences in grading between faculty teaching in associate versus baccalaureate nursing programs, full-time versus adjunct faculty, and tenured versus nontenured faculty. BACKGROUND: There is a paucity of research on grade variability in undergraduate nursing programs. METHOD: Three hundred eighty-four full-time and 96 adjunct faculty responded to an invitation to complete an online survey. RESULTS: Grades are not uniformly awarded across institutions. Passing grades ranged from 70 to 85 percent (C- to B+, respectively), with a mean of 74.79 percent. CONCLUSION: Wide variations in grades in different institutions across the country may undermine grade point average as a reliable measure of education, making it difficult to evaluate individual student performance.

The association of alcohol consumption with mammographic density in a multiethnic urban population.

BACKGROUND: Alcohol consumption is associated with higher breast cancer risk. While studies suggest a modest association between alcohol intake and mammographic density, few studies have examined the association in racial/ethnic minority populations. METHODS: We assessed dense breast area and total breast area from digitized film mammograms in an urban cohort of African American (42%), African Caribbean (22%), white (22%), and Hispanic Caribbean (9%) women (n = 189, ages 40-61). We examined the association between alcohol intake and mammographic density (percent density and dense area). We used linear regression to examine mean differences in mammographic density across alcohol intake categories. We considered confounding by age, body mass index (BMI), hormone contraceptive use, family history of breast cancer, menopausal status, smoking status, nativity, race/ethnicity, age at first birth, and parity. RESULTS: Fifty percent currently consumed alcohol. Women who consumed >7 servings/week of alcohol, but not those consuming ≤7 servings/week, had higher percent density compared to nondrinkers after full adjustments (servings/week >7 ß = 8.2, 95% Confidence Interval (CI) 1.8, 14.6; ≤7 ß = -0.5, 95% CI -3.7, 2.8). There was a positive association between high alcohol intake and dense area after full adjustments (servings/week >7 ß = 5.8, 95% CI -2.7, 14.2; ≤7 ß = -0.1, 95% CI -4.4, 4.2). We did not observe race/ethnicity modification of the association between alcohol intake and percent density. In women with a BMI of <25 kg/m(2), drinkers consuming >7 servings/week of alcohol had a = 17% increase in percent density compared to nondrinkers (95% CI 5.4, 29.0) and there was no association in women with a BMI ≥ 25 kg/m(2) (BMI ≥ 25-30 kg/m(2) > 7 ß = 5.1, 95% CI -8.5, 18.7 and BMI > 30 kg/m(2) > 7 ß = 0.5, 95% CI -6.5, 7.5) after adjusting for age and BMI (continuous). CONCLUSION: In a racially/ethnically diverse cohort, women who consumed >7 servings/week of alcohol, especially those with a BMI < 25 kg/m(2), had higher percent density.

Correlations in global DNA methylation measures in peripheral blood mononuclear cells and granulocytes.

Alterations in global DNA methylation levels have been associated with chronic diseases. Despite the increase in the number of studies measuring markers of global methylation, few have adequately examined within-individual differences by source of DNA and whether within-individual differences by source of DNA differ by age, race and other lifestyle factors. We examined correlations between peripheral mononuclear cell (PBMC) and granulocyte DNA methylation levels measured by the luminometric methylation assay (LUMA), and in LINE-1, Sat2, and Alu by MethyLight and pyrosequencing, in the same individual in 112 women participating in The New York City Multiethnic Breast Cancer Project. Levels of DNA methylation of Sat2 by MethyLight (r = 0.57; P < 0.01) and LINE-1 by pyrosequencing (r = 0.30; P < 0.01) were correlated between PBMC and granulocyte DNA of the same individuals, but LUMA and Alu levels were not. The magnitude of the correlations for Sat2 and LINE-1 varied when stratified by selected demographic and lifestyle factors, although the study sample size limited our comparisons across subgroups. These results lend further support to the importance of considering the source of DNA in epidemiologic studies of white blood cell DNA methylation. Results from studies that combine individuals with different available DNA sources need to be interpreted with caution.

Religiosity and parental acceptance of human papillomavirus (HPV) vaccine in 9-18 year-old girls.

The religious affiliation of parents/guardians may factor into the decision to accept human papillomavirus vaccine (HPV) vaccination for their 9- to 18-year-old girls but prior research findings are inconsistent on religious impact. This study assessed degree of religiosity and impact on HPV vaccination. No correlation was found between religiosity and vaccination status; however, significant correlations were found between religiosity and other assessed variables.

Mammographic density and serum 25-hydroxyvitamin D levels.

BACKGROUND: Vitamin D, which influences cellular proliferation and breast tissue characteristics, has been inversely correlated with breast cancer risk. Dietary vitamin D intake has been associated with lower mammographic density (MD), a strong intermediate marker of breast cancer risk. FINDINGS: We examined the relationship between MD and serum 25-hydroxyvitamin D [25(OH)D], an integrated measure of vitamin D status from dietary sources and sunlight exposure, in a multi-ethnic cohort of women undergoing screening mammography. We recruited women age 40-60 years without a history of breast cancer at the time of their routine screening mammogram, and conducted in-person interviews and collected blood specimens. We enrolled 195 women from 2007-2008, 120 gave blood, and 114 were evaluable, including 25% white, 41% African American, 18% African Caribbean, and 16% Hispanic. We digitized mammograms and calculated percent density, dense area, and non-dense area on cranial-caudal images. We measured serum 25(OH)D in batched, archived specimens. Median serum 25(OH)D was 22 ng/ml (range, 8-66 ng/ml). In univariable analysis, higher serum 25(OH)D was associated with white race, higher educational level, ever breast feeding, and blood draw during the summer. After adjusting for body mass index and other confounders, we found no association between serum 25(OH)D and different measures of MD. However, when stratified by season, 25(OH)D was inversely associated with dense area during July-December (p = 0.034). CONCLUSIONS: Overall, our findings suggest that circulating vitamin D, a potentially modifiable breast cancer risk factor, is not associated with MD; the seasonal effects we observed need to be replicated in larger cohorts.

Multiple metabolic risk factors and mammographic breast density.

PURPOSE: We examined whether obesity and a history of diabetes, hypertension, and elevated cholesterol, individually and in combination, are associated with breast density, a strong risk factor for breast cancer. METHODS: We measured percent density and dense area using a computer-assisted method (n = 191; age range = 40-61 years). We used linear regression models to examine the associations of each metabolic condition and the number of metabolic conditions (zero, one, two, and three or four conditions) with breast density. RESULTS: Among individual metabolic conditions, only high blood cholesterol was inversely associated with percent density (ß = -5.4, 95% confidence interval [CI]: -8.5, -2.2) and dense area (ß = -6.7, 95% CI = -11.1, -2.4). Having multiple metabolic conditions was also associated with lower breast density, with two conditions and three or four conditions versus zero conditions associated with 6.4% (95% CI: -11.2, -1.6) and 7.4% (95% CI: -12.9, -1.9) reduction in percent density and with 6.5 cm(2) (95% CI: -13.1, -0.1) and 9.5 cm(2) (95% CI: -17.1, -1.9) decrease in dense area. CONCLUSIONS: A history of high blood cholesterol and multiple metabolic conditions were associated with lower relative and absolute measures of breast density. The positive association between metabolic abnormalities and breast cancer risk may be driven by pathways unrelated to mammographic breast density.

Testing a model for parental acceptance of human papillomavirus vaccine in 9- to 18-year-old girls: a theory-guided study.

Gardasil is the first vaccine developed to prevent cervical cancer and other diseases caused by certain types of genital human papillomavirus in females, but little is known about parental acceptance of this vaccine. The purpose of this study was to test a model that predicts intention to vaccinate that includes constructs from the health belief model and the theory of reasoned action.

Reproductive and menstrual factors and mammographic density in African American, Caribbean, and white women.

OBJECTIVE: We investigated the associations between reproductive and menstrual risk factors for breast cancer and mammographic density, a strong risk factor for breast cancer, in a predominantly ethnic minority and immigrant sample. METHODS: We interviewed women (42% African American, 22% African Caribbean, 22% White, 9% Hispanic Caribbean, 5% other) without a history of breast cancer during their mammography appointment (n = 191, mean age = 50). We used a computer-assisted method to measure the area and percentage of dense breast tissue from cranio-caudal mammograms. We used multivariable linear regression analyses to estimate the associations between reproductive and menstrual risk factors and mammographic density. RESULTS: Age was inversely associated with percent density and dense area, and body mass index (BMI) was inversely associated with percent density. Adjusting for age, BMI, ethnicity and menopausal status, later age at menarche (e.g., ß = -7.37, 95% CI: -12.29, -2.46 for age ≥ 13 years vs. ≤ 11 years), and any use of hormonal birth control (HBC) methods (ß = -5.10, 95% CI: -9.37, -0.84) were associated with reduced dense area. Ethnicity and nativity (foreign- vs. US-born) were not directly associated with density despite variations in the distribution of several risk factors across ethnic and nativity groups. CONCLUSIONS: The mean level of mammographic density did not differ across ethnic and nativity groups, but several risk factors for breast cancer were associated with density in ethnic minority and immigrant women.

Prostate cancer screening in African American men: barriers and methods for improvement.

African American men have the highest rate of incidence for prostate cancer in the world and are more likely to die from the disease than other ethnic groups (National Institutes of Health, 1996). Routine screening for prostate cancer can lead to early detection of the disease, thereby reducing negative outcomes, but studies have shown that African American men are less likely than Caucasian men to engage in screening practices. Lack of access to health care, socioeconomic status, inadequate knowledge, fear, patient-provider communication, distrust of the medical profession, and aversion to digital rectal exam have been identified as possible barriers to prostate cancer screening in African American men. This literature review explores causes of this striking disparity between prostate cancer incidence and mortality in African American men and cites strategies used to improve prostate cancer screening rates among this population.

African American spirituality: a process of honoring God, others, and self.

PURPOSE: The purpose of this pilot study was to explore African American definitions of practicing spirituality and to describe the process of spirituality and its relationship to health promotion. METHOD: Data were collected using semi-structured interview questions via two focus groups from a total of 12 participants who self-identified as African American. FINDINGS: This grounded theory methodology generated three categories of spirituality: (a) love in action, (b) relationships and connections, and (c) unconditional love. The overall process of practicing spirituality and its relationship to health identified a process of honoring God, self, and others. CONCLUSION: Research studies that investigate the concept of spirituality and its relationship to health promotion and disease management need to address the subjective experience of spirituality based on participant definitions rather than researcher-focused definitions of spirituality.

Literature review of theory-based empirical studies examining adolescent tanning practices.

Lifetime exposure to ultraviolet radiation is a major risk factor for all types of skin cancer. The purpose of this manuscript is to examine theory-guided empirical studies examining adolescent tanning practices.

Juvenile maladaptive aggression: a review of prevention, treatment, and service configuration and a proposed research agenda.

OBJECTIVE: To review prevention programs, psychosocial and psychopharmacologic treatments, and service delivery configurations for children and adolescents with maladaptive aggression. To propose a research agenda for disorders of aggression in child and adolescent psychiatry. DATA SOURCES: Recent empirical studies were reviewed using searches of MEDLINE and PsycINFO (text terms: aggression, antisocial, violence, conduct, oppositional, psychosocial treatment, psychopharmacology, and prevention), relevant books, review articles, and bibliographies. DATA EXTRACTION: Articles met the following criteria: published in an English-language, peer-reviewed journal between 1980 and 2005, included a focus on individuals < 18 years old, and included an outcome measure of relevant significance. STUDY SELECTION: Results of 154 randomized, controlled psychosocial treatment trials, 20 controlled psychopharmacology studies, 4 open-label medication studies, and 2 psychopharmacology meta-analyses were reviewed. RESULTS: Prevention programs show promise for reducing future aggression in at-risk populations. Empirical support is available for the effectiveness of multifocused psychosocial treatments in reducing aggression in children and adolescents. Atypical antipsychotics, lithium, divalproex sodium, and stimulants for conduct problems associated with attention-deficit/hyperactivity disorder have empirical support for reducing aggression in selected patient populations. CONCLUSIONS: Therapeutic nihilism in the treatment of aggressive children and adolescents with conduct problems is no longer warranted. Multifocused psychosocial interventions given early in life to at-risk children have the most support for effectiveness. However, treatments for children who routinely present to the child psychiatrist with already well-established disorders of aggression are neither robust nor well-established. Further research into maladaptive aggression in referred children and adolescents within and across psychiatric diagnoses is important for the field of child and adolescent psychiatry.

Examining spirituality among women with breast cancer.

A diagnosis of cancer can conjure up a whole host of emotions. Many women with breast cancer will try to deal with the disease by ascribing meaning for its occurrence and searching for mechanisms by which to cope with its sequelae. Research supports that women who have been diagnosed with breast cancer are employing complementary and alternative medicine use as a means of gaining a sense of control over the disease as well as reducing stress and achieving inner peace. Spirituality is one such mechanism that women with breast cancer utilize in order to achieve that goal; an underlying premise being that taking care of the soul is a necessary element in healing the body.

Cervical cancer in Hispanic/Latino women.

Cervical cancer is largely preventable if detected early. Minority populations and people of low socioeconomic status are affected disproportionately by cervical cancer. When compared to non-Hispanic white women, Hispanic/Latino women residing in the United States have twice the incidence rate of and 1.4 times the mortality from cervical cancer. Contributing factors include lack of awareness about cancer prevention and available services; lack of access to quality health care; feelings of embarrassment, fear, and fatalism; and limited linguistically and ethnically sensitive information about cervical cancer prevention and detection. Education and screening programs targeted at this population have the potential to decrease the morbidity and mortality associated with cervical cancer, and nurses play an important role in educating Hispanic/Latino women about cervical cancer.