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PubMed2006

Substance use, medications for sexual facilitation, and sexual risk behavior among traveling men who have sex with men.

OBJECTIVES: The objective of the study was to examine correlates of sexual risk behavior among men who have sex with men (MSM) traveling for leisure. STUDY DESIGN: MSM (N = 304) visiting popular tourist areas completed a brief survey assessing sexual behavior and substances used while on vacation, including the use of erectile dysfunction medications (e.g., Viagra). RESULTS: Forty-seven percent of the respondents were sexually active during their vacation, with a mean of 1.33 unprotected anal sex acts during their brief stay (mean = 3.6 days). More than half of the sexually active men reported sex with a partner of unknown HIV status. Individuals reporting substance use or taking erectile dysfunction medications reported higher rates of sexual risk behaviors. CONCLUSION: Many MSM travelers report behaviors that may put their health at risk, including substance use and unprotected sexual activity. Interventions designed to reduce risk behaviors among MSM tourists are needed.

Adult↗
PubMed1985

Neuroscience nursing elective for senior nursing students.

In response to baccalaureate student requests for additional clinical experience and expanded opportunities in neurological and neurosurgical nursing, an experimental course was designed for the winter session semester in cooperation with a local teaching hospital. A three-credit elective, "Discovering Neuroscience Nursing," was offered to senior students for five weeks. The course included thirty hours of lecture and laboratory, field trips, and over 200 hours of clinical experience. A student stipend was provided by the hospital. Goals for the course centered on providing an opportunity for the student to gain competence and confidence in caring for patients with neurological dysfunctions and providing family support. Students were assigned staff nurse preceptors as they rotated to every clinical setting caring for patients with alterations to the nervous system. Evaluations from students and staff preceptors indicated the successful acceptance of the program which will be modified and continued as a senior elective.

Curriculum↗
PubMed1994

Environmental safety preparation for community-based nursing educational experiences: measurable indices.

Cities, formerly the hub of cultural activities and entertainment, are now more often associated with crime statistics and poverty. Students' emotional comfort and safety must therefore be prime considerations in planning community-based nursing education. This study piloted an instrument that promises to be useful in labeling situations that affect an individual's comfort level in an urban setting. Questions that guided the study included: (1) Does the Environmental Comfort Scale (ECS) score vary with the respondents' residential zone (urban = 1, suburban = 2, rural = 3)? (2) Is the instrument (Environmental Comfort [Fear] Scale) reliable? A one-shot, one-group, pre-experimental design was employed. Participants were self-selected from a junior baccalaureate nursing class (N = 79) that was a predominantly suburban-bred, relatively privileged population. The ECS contained nine specific environmental-situation items that could be construed as potentially threatening to safety. Respondents were to indicate on a five-point Likert scale the extent to which they would be fearful in each situation; 1 = least fearful and 5 = most fearful. Findings showed practically no difference in responses by residential zone and suggest a need for item refinement and a need to lengthen the tool to improve alpha coefficients. Further, the increasing demand for measurable outcomes underscores the need for continued work on instruments to produce such data. The deinstitutionalization of health care from contained grounds to uncontained community-based settings makes it imperative that nursing education attend to the challenges of safety education.

Community Health Nursing↗
PubMed1996

Managing fear associated with nursing in urban environments: first steps.

Improvement of the health of the nation demands that we prepare nurses to deliver care to those within our urban settings. Yet students frequently are uncomfortable visiting clients in urban settings. Our initial efforts were to refine the Environmental Comfort Scale (Carter, Carroll, & Hayes, 1994), an instrument developed to measure comfort levels in various urban scenarios. This article reports the results of this instrument refinement as well as the inductive process leading to the initial conceptualization of a model that addresses threats to safety. These threats, in turn, generate fear of nursing in community-based settings. The study participants were 120 volunteer junior students in a baccalaureate nursing program. The Environmental Comfort Scale II was administered to students at the beginning of an orientation session prior to their initial clinical nursing course. The instrument consisted of 15 items: 3 demographic items, 11 items asking students to rate their level of comfort and of fear in relation to various urban situations, and 1 open-ended question. Analysis of data led to conceptualization of two factors that could influence comfort levels in the urban environment. The first factor was personal-emotional (affective) and the second factor was cognitive (objective). The interaction and interdependency of these two factors led to the creation of a model.

Adult↗
PubMed1987

Evaluation of school-based, high school health services.

This article describes the cost-effectiveness of the Middletown Adolescent Health Project (MAHP), a school-based, comprehensive health services project that provides students with written parental permission for treatment of minor and acute illnesses, sports and routine physical examinations, laboratory work-ups, screenings, health promotion/wellness activities, medical social services, and nutrition counseling. These free services are offered at Middletown High School. An evaluation was conducted after the project's first year. Cost comparisons for medical care at the high school vs. private care were substantial. Potential out-of-pocket expenses for obtaining care in a private physician's office were 89% more than through the MAHP.

Adolescent↗
PubMed1996

Obstacles and opportunities in designing cancer control communication research for farmworkers on the Delmarva Peninsula.

Little is known about the incidence of cancer among farmworker populations or about effective strategies for communicating with farmworkers about cancer prevention. Some studies suggest that farmworkers may have unusually high incidences of skin and cervical cancers. With these two cancers as the focus, a group of interviewers, researchers, and health communication specialists set out to create, implement, and evaluate a cancer control demonstration project geared toward farmworkers. In 1994, a situation analysis was conducted to identify constraints and opportunities for providing farmworkers with cancer control information and services. The situation analysis provided valuable information to aid in developing intervention and evaluation strategies. This paper outlines how and why the situation analysis was conducted and what was learned with regard to the farmworker population on the Delmarva Peninsula. Living conditions and the local availability of cancer control services are described. Obstacles to conducting research and interventions with farmworkers are highlighted. Based on what was learned, recommendations are made for designing cancer control research and intervention for farmworkers.

Agriculture↗
PubMed1990

Attitudes and behaviors of dental hygienists concerning tobacco use.

This study surveyed a proportionate random sample of licensed dental hygienists in five states and the District of Columbia, to assess their antitobacco use behaviors and attitudes. The response rate was 79.4 percent. Descriptive data as well as chi-square, analysis of variance (ANOVA), and Duncan's multiple range test statistical results were reported. Only 6.9 percent of the hygienists sampled currently smoked. These hygienists appeared to exhibit significantly different aggregate attitudes and select clinical practice behaviors than their nonsmoking counterparts. Years of employment and geographic location showed no significant relationship to aggregate clinical practice behaviors or attitudes, although each was related to individual behaviors and attitudes. Overall, dental hygienists appeared committed to involvement in both individualized and community-based antitobacco-use efforts. Measures to coordinate hygienists' involvement at both of these levels need to be enhanced.

Analysis of Variance↗
PubMed1987

Vertical distribution of an estuarine snail altered by a parasite.

Estuarine snails Ilyanassa obsoleta bearing larvae of the trematode Gynaecotyla adunca behave singularly in comparison with conspecifics lacking this parasite. Following high tides, and especially at night, infected snails were found stranded high on beaches and sandbars. Semiterrestrial crustaceans living well up on the shore serve as the next host, and the modified (induced) snail behavior is apparently a parasite adaptation facilitating cercarial transmission to these crustaceans. The altered behavior is unusual because of its apparent enhancement of host-to-host transmission by cercariae rather than predation, the process commonly recognized as being enhanced by parasitic modification of host behavior.

Animals↗
PubMed1995

Analysis of Bordetella pertussis isolates from an epidemic by pulsed-field gel electrophoresis.

We examined genetic variation among 78 clinical isolates of Bordetella pertussis, including 54 strains recovered during a 1986 pertussis epidemic. A total of 16 pulsed-field gel electrophoresis (PFGE) profiles, generated with each of three different enzymes (XbaI, SpeI, and DraI), were obtained from the epidemic and sporadic isolates included in the study. Indistinguishable profiles were seen among strains unrelated temporally or geographically, as well as among strains isolated sporadically from the same geographic areas. All isolates from the epidemic had indistinguishable PFGE profiles. The PFGE pattern of the epidemic strains was shared with only 1 of 25 strains isolated independently of the outbreak. This isolate was cultured from a specimen from a laboratory scientist who had been working with the epidemic strains, further implicating the usefulness of PFGE for the epidemiologic study of clinical strains of B. pertussis. Differences in PFGE profiles for single epidemic strains occurred occasionally upon repeated passage on agar medium, suggesting that subculturing of initial isolates should be minimized before pulsed-field analysis.

Bordetella pertussis↗
PubMed2000

Risk factors for infective endocarditis: oral hygiene and nondental exposures.

BACKGROUND: The risks of infective endocarditis (IE) associated with various conditions and procedures are poorly defined. METHODS AND RESULTS: This was a population-based case-control study conducted in 54 Philadelphia, Pa-area hospitals from 1988 to 1990. Community-acquired IE cases unassociated with intravenous drug use were compared with matched community residents. Subjects were interviewed for risk factors. Diagnoses were confirmed by expert review of medical record abstracts with risk factor data removed. Cases were more likely than controls to suffer from prior severe kidney disease (adjusted OR [95% CI]=16.9 [1.5 to 193], P:=0.02) and diabetes mellitus (adjusted OR [95% CI]=2.7 [1.4 to 5.2], P:=0.004). Cases infected with skin flora had received intravenous fluids more often (adjusted OR [95% CI]=6.7 [1.1 to 41], P:=0.04) and had more often had a previous skin infection (adjusted OR [95% CI]=3.5 [0.7 to 17], P:=0.11). No association was seen with pulmonary, gastrointestinal, cardiac, or genitourinary procedures or with surgery. Edentulous patients had a lower risk of IE from dental flora than patients who had teeth but did not floss. Daily flossing was associated with a borderline decreased IE risk. CONCLUSIONS: Within the limits of the available sample size, the data showed that IE patients differ from people without IE with regard to certain important risk factors but not regarding recent procedures.

Adolescent↗
PubMed2002

Antiphospholipid antibodies and stroke in young women.

BACKGROUND AND PURPOSE: Antiphospholipid antibodies have been associated with ischemic stroke in some but not all studies. METHODS: We performed a population-based case-control study examining antiphospholipid antibodies (anticardiolipin antibodies and lupus anticoagulants) using stored frozen sera and plasma in 160 cases and 340 controls enrolled in the Stroke Prevention in Young Women study. We evaluated for the presence of anticardiolipin antibody (IgG, IgM, and IgA isotypes) by an enzyme-linked immunosorbent assay and for the lupus anticoagulant using several phospholipid-dependent coagulation tests (activated partial thromboplastin time, dilute Russell's viper venom time) with mixing studies. If mixing studies were prolonged, confirmatory tests were performed. RESULTS: A positive anticardiolipin antibody level of any isotype was seen in 43 cases (26.9%) and 62 controls (18.2%) (P=0.03), lupus anticoagulant in 29 cases (20.9%) and 38 controls (12.8%) (P=0.03), and either anticardiolipin antibody or lupus anticoagulant in 61 cases (42.1%) and 86 controls (27.9%) (P=0.003). After adjustment for age, current cigarette smoking, hypertension, diabetes, angina, ethnicity, body mass index, and high-density lipoprotein levels, the relative odds of stroke for women with anticardiolipin antibody immunoreactivity of any isotype or a lupus anticoagulant was 1.87 (95% confidence interval, 1.24 to 2.83; P=0.0027). CONCLUSIONS: The results from this study support the importance of antiphospholipid antibodies as an independent risk factor for stroke in young women.

Adolescent↗
PubMed2001

Alcohol intake, type of beverage, and the risk of cerebral infarction in young women.

BACKGROUND AND PURPOSE: The relationship between alcohol consumption and cerebral infarction remains uncertain, and few studies have investigated whether the relationship varies by alcohol type or is present in young adults. We examined the relationship between alcohol consumption, beverage type, and ischemic stroke in the Stroke Prevention in Young Women Study. METHODS: All 59 hospitals in the greater Baltimore-Washington area participated in a population-based case-control study of stroke in young women. Case patients (n=224) were aged 15 to 44 years with a first cerebral infarction, and control subjects (n=392), identified by random-digit dialing, were frequency matched by age and region of residence. The interview assessed lifetime alcohol consumption and consumption and beverage type in the previous year, week, and day. ORs were obtained from logistic regression models controlling for age, race, education, and smoking status, with never drinkers as the referent. RESULTS: Alcohol consumption, up to 24 g/d, in the past year was associated with fewer ischemic strokes (<12 g/d: OR 0.57, 95% CI 0. 38 to 0.86; 12 to 24 g/d: OR 0.38, 95% CI 0.17 to 0.86; >24 g/d: OR 0.95, 95% CI 0.43 to 2.10) in comparison to never drinking. Analyses of beverage type (beer, wine, liquor) indicated a protective effect for wine consumption in the previous year (<12 g/wk: OR 0.58, 95% CI 0.35 to 0.97; 12 g/wk to <12 g/d: OR 0.55, 95% CI 0.28 to 1.10; >/=12 g/d: OR 0.92, 95% CI 0.23 to 3.64). CONCLUSIONS: Light to moderate alcohol consumption appears to be associated with a reduced risk of ischemic stroke in young women.

Adolescent↗