Inclusion of women in nursing research: 1995-2001

BACKGROUND: Although the inclusion of women in research has been examined in medical publications, little is known about how federal mandates have influenced the inclusion of women in research published in nursing journals. OBJECTIVE: This study aimed to examine the inclusion of women in published nursing research from 1995 to 2001, with a focus on the leading causes of mortality. METHOD: All the articles in each journal were reviewed, and all the research articles that focused on the top 10 causes of death were sampled to measure the inclusion of women, the characteristics of the women included, the funding source, and the topic. RESULTS: Of the 1,149 studies reviewed, 139 met the inclusion criteria, and 117 of these studies included women. Only 15 of the studies reported the age of the women in their samples, and 10 of these included women between the ages of 35 and 64 years. The most frequently reported race was White (n = 21), followed by African American (n = 17), Hispanic (n = 6), and Asian (n = 2). There were no associations among year of publication (p =.62), federal funding (p =.30), and inclusion of women. Among the studies including women, heart disease was the most frequent topic (n = 52), followed by Alzheimer's disease (n = 21), cancer (n = 14), respiratory illness (n = 14), and diabetes (n = 8). DISCUSSION: Although the majority of the research included women, continuing efforts must be made to include sufficient numbers of women.     

Shifting paradigms. Teaching gerontological nursing from a new perspective

Gerontological health care is undergoing a revolution, much like that of the feminist movement of the 1960s. Fundamental changes in health care require revisions in nursing education to ensure appropriate care of older adults in the least restrictive environment. The purpose of this study is to promote the preparation of future nurses who have the knowledge and the skills necessary to provide nursing care for the growing cohorts of older adults. A theoretical rationale for a new perspective in nursing education is discussed. An experiential clinical learning activity based on the functional model of gerontological health care is examined. This home visit clinical learning activity provides nursing students with the opportunity to practice nursing reflective of the health care needs of older adults. Strategies for replication of this clinical learning activity are provided.     

On the importance of using multiple methods of dietary assessment

BACKGROUND: Plasma carotenoid concentrations reflect intake of vegetables and fruits, the major food sources of these compounds. This study compared the ability of 2 measures of dietary intake (24-hour diet recalls and food frequency questionnaires [FFQs]) to corroborate plasma carotenoid concentrations in a subset of women participating in a diet intervention trial. METHODS: Plasma carotenoid concentrations and dietary intakes, estimated from 24-hour diet recalls and FFQs, were examined at baseline and 1 year later in a subset of 395 study participants (197 intervention and 198 comparison group). We used longitudinal models to examine associations between estimated intakes and plasma carotenoid concentrations. These analyses were stratified by study group and adjusted for body mass index (BMI), plasma cholesterol concentration, and total energy intake. We conducted simulations to compare mean-squared errors of prediction of each assessment method. RESULTS: In mixed-effects models, the estimated carotenoid intakes from both dietary assessment methods were strongly associated with plasma concentrations of alpha-carotene, beta-carotene, and lutein. Furthermore, modeling the 2 sources of intake information as joint predictors reduced the prediction error. CONCLUSION: These findings underscore the importance of using multiple measures of dietary assessment in studies examining diet-disease associations.     

Regulation of lipolysis and lipoprotein lipase after weight loss in obese, postmenopausal women

OBJECTIVE: To test the hypothesis that the greater beta-adrenoceptor (beta-AR)-stimulated lipolysis and sensitivity (half-maximal lipolytic response) in abdominal (ABD) adipocytes, greater gluteal (GLT) adipose tissue-lipoprotein lipase (AT-LPL) activity, and dyslipidemia associated with obesity in older women are modifiable by weight loss (WL) and are not due to menopause or aging. RESEARCH METHODS AND PROCEDURES: The metabolic effects of 6 months of hypocaloric diet and low-intensity walking WL program on the regional regulation of in vitro lipolysis and AT-LPL activity in subcutaneous ABD and GLT adipocytes were measured in 34 obese (48.7 +/- 0.7% body fat, mean +/- SE) postmenopausal (59 +/- 1 years) white women. RESULTS: The lipolytic responsiveness to the beta-AR agonist isoproterenol and basal lipolysis in the presence of 1 U/mL adenosine deaminase-uninhibited (lipolysis) were greater (p < 0.01) in ABD than GLT adipocytes before and after WL, but there were no regional differences in postreceptor (dibutyryl 3',5'-cyclic adenosine monophosphate)-stimulated lipolysis. beta-AR sensitivity was greater in ABD than GLT adipocytes before (p < 0.01) but not after WL. Regional AT-LPL did not change after WL, but the change in the activity of ABD (but not GLT) AT-LPL correlated with the baseline adenosine deaminase-uninhibited lipolysis (r = 0.38, p = 0.03). There were no relationships between the declines in plasma triglyceride or increases in high-density lipoprotein cholesterol associated with WL and the changes in regional fat cell metabolism. DISCUSSION: Thus, despite improving lipoprotein lipid profiles in obese, postmenopausal women, WL does not affect the regulation of regional fat metabolism, and a greater tonic inhibition of basal lipolysis by endogenous adenosine may increase the activity of AT-LPL after WL and predispose older women to develop ABD adiposity.     

Associations of patella lead with polymorphisms in the vitamin D receptor, delta-aminolevulinic acid dehydratase and endothelial nitric oxide synthase genes

A cross-sectional analysis was performed to evaluate associations of polymorphisms in the vitamin D receptor (VDR), delta-aminolevulinic acid dehydratase (ALAD), and endothelial nitric oxide synthase (eNOS) genes with patella lead concentrations in 652 lead workers in the Republic of Korea. There was a wide range of patella lead (from below detection limit to 946 microg Pb/g bone mineral), with a mean (standard deviation) of 75.2 (101.0). There were no associations of ALAD or eNOS genotypes with patella lead, but workers with the VDR B allele had significantly (P value < 0.05) higher patella lead (on average, 25% or approximately 6.6 microg Pb/g bone mineral) than lead workers with the VDR bb genotype. There was evidence that the relation between age and patella lead was modified by both the VDR and eNOS genotypes.     

The G(894)-T(894) polymorphism in the gene for endothelial nitric oxide synthase and blood pressure in lead-exposed workers from Korea

We evaluated whether the G -T polymorphism in exon 7 of the endothelial nitric oxide synthase (eNOS) gene is associated with blood pressure or modifies the relation between lead dose and blood pressure in 803 lead workers in Korea. A total of 84.9% of individuals were homozygous GG, 14.4% heterozygous GT, and 0.8% homozygous TT. The T allele was not significantly associated with systolic or diastolic blood pressure. The prevalence of hypertension did not differ by T status (OR = 0.82; 95% CI = 0.50-1.37). There was no evidence of effect modification by eNOS genotype on relations of lead dose with blood pressure. These data provide no evidence that the T allele is associated with higher blood pressure or modifies the association of lead dose with blood pressure.