Nurse faculty perceptions regarding psychiatric-mental health nursing behavioral interventions: a cross-cultural comparison

Mental disorders are internationally responsible for significant disease burden and disability. However, limited cross-culturally comparisons, related to psychiatric-mental health nurses and the care they deliver, have been conducted. Therefore, the purpose of this article is to present information obtained from nurse faculty from Australia, Hong Kong, Japan, South Korea, Thailand and the USA (State of Hawaii) about: a) titles and educational preparation of the psychiatric-mental health nurses; b) the role and perception of others about the psychiatric-mental health nurses; c) nursing behavioral interventions, including medications; d) length of stay of hospitalized psychiatric patients; e) leading mental health problems; and, f) the profile of the population with a mental illness. The findings reflect diversity in the role and educational preparation of psychiatric-mental health nurses, as well as how psychiatric-mental health patients are treated.     

Whole-body fat oxidation rate and plasma triacylglycerol concentrations in men consuming an ad libitum high-carbohydrate or low-carbohydrate diet

BACKGROUND: High-carbohydrate diets may increase plasma triacylglycerol concentrations either by increasing production of triacylglycerols or by reducing their clearance. OBJECTIVE: We assessed whether the changes in plasma triacylglycerol concentrations induced by dietary interventions were associated with the changes in whole-body fat oxidation rates. DESIGN: In a parallel study, 37 healthy male subjects [body mass index (in kg/m(2)): 28 +/- 5, age: 34 +/- 11 y (x +/- SD)] consumed an ad libitum high-carbohydrate (60% of energy; n = 19) or low-carbohydrate (46% of energy), high-fat (41% of energy, 23% as monounsaturated fatty acids; n = 18) diet for 7 wk. The following variables were measured before and after the dietary interventions: 1) plasma triacylglycerols before and 2, 4, 6, and 8 h after a meal (containing 40% of daily energy needs and 41% fat); 2) indirect calorimetry throughout the 8-h test; and 3) postheparin plasma lipoprotein lipase (phLPL) activity at time 8 h of the test. RESULTS: The diets induced changes in 1) body weight: -2.5 +/- 2.8 kg (P < 0.01) and -1.7 +/- 3.1 kg (P < 0.05) and 2) fasting plasma triacylglycerols: 0.0 +/- 0.4 mmol/L (NS) and -0.3 +/- 0.3 mmol/L (P < 0.05) for the high-carbohydrate and the low-carbohydrate diets, respectively. In normoinsulinemic subjects (fasting insulin < 100 pmol/L), dietary changes in postprandial triacylglycerols were significantly predicted by changes in phLPL, body weight, respiratory quotient (or fat oxidation), and the type of diet (stepwise multiple linear regression). CONCLUSION: Postprandial plasma triacylglycerol concentrations may depend at least partly on fat oxidation, body weight, and LPL activity.     

Recommendations for appeal to another resource in a health case brought by nurses in the Info-Health Service CLSC: convergence between utilization declarations and informants' data

OBJECTIVES: To examine the perception of telephone advice-line users as to whether or not a formal recommendation had been made to seek another consultation and to compare users' perception to what the nurse documented. To analyze the effects of different users' and call characteristics on the incorrectness of the self-report. DATA SOURCES/STUDY SETTING: This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted among users of Info-Santé CLSC, a free-of-charge telenursing health-line service (THLS) available throughout the province of Quebec. STUDY DESIGN/DATA COLLECTION: Self-reported advice from follow-up survey phone interviews, conducted within 48-120 hours after the participant's call, were compared to the data consigned by the nurse in the computerized call-record. Covariables concerned characteristics of callers, context of the call, and satisfaction with the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses. PRINCIPAL FINDINGS: Advice to consult another health resource was recorded by the nurse in 42% of cases, whereas 39% of callers stated they had received such a recommendation. Overall disagreement between the two sources is 27% (12% by false positive and 15% by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR = 2.5), calls relating to psychological problems (OR = 2.8), perceived seriousness (OR = -2.6) as well as others, were associated with inaccurate reports. CONCLUSIONS: Telephone health-line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, ensure better understanding of advice by callers, and contribute to more effective service.     

The preventive and health promotion services for infants,children and youth. What is problematic for clients of the CLSCs

OBJECTIVE: This article presents the results of a survey on preventive and health promotion (PHP) services provided by Quebec CLSCs for infants, children and youth. Two dimensions of services are examined: the diversity of PHP issues addressed and the type of clientele targeted by the CLSC team. METHODS: Questionnaire survey. RESULTS: Although identified a priori as public health priorities, many PHP issues remain less often addressed by CLSCs. This is particularly the case for activities aimed at children and youth as compared to infants. In addition, the data show that CLSC teams are less inclined to target specific clienteles; when they do so, it is more often in the context of services for infants. DISCUSSION: This study is important in that it constitutes one of the first efforts to systematically document PHP services for infants, children, and youth. In shedding new light on intervention sectors that need to be reinforced, these results should help managers and policymakers as they reflect on the role of PHP services in CLSCs within the context of health reform.     

Examination of the clinical,familial and personal characteristics on homelessness of at-risk adolescents

OBJECTIVE: Our research pertains to juveniles coming under the responsibility of the Centres jeunesse du Quebec (delinquency and youth protection regional services). Some of these teenagers fled their family and made use of their social network to cope with residential instability. These youths were then in a situation of "hidden homelessness", sleeping neither in the streets nor at shelters. Two objectives are pursued: 1) a comparison of youth's and parent's evaluations of significant dimensions of their family life, and 2) an identification of the adolescents' characteristics (clinical, familial and individual) related to their "hidden homelessness". METHOD: Using bivariate analysis, a group of adolescents who had experienced homelessness was paired (on sex, age and urban or rural areas of origin) to a sample of non-homeless youths. The analysis uses both adolescents and parent/caretaker reports on measures of family characteristics and adolescent self-reports on measures of clinical and personal characteristics. FINDINGS: Our results show 1) that, in general, adolescents report a higher level of parental maltreatment and more problems related to the family dynamics and their relationship with their parents than their parents do; 2) that hidden homelessness of distressed youths is generally associated with the same familial risk factors as the ones identified by the studies concerning street youths; 3) in contrast to some other comparative studies, the homeless adolescents in our study did not differ from the non-homeless youths as to the importance of the depressive diagnostic and the use of hard drugs.     

Appropriate calcium fortification of the food supply presents a challenge

Fortification with calcium to increase dietary intakes of this mineral is currently under evaluation in Canada. To model the potential dietary consequences of food fortification, data from a large national survey of Canadians (n = 1543) were used. Food fortification scenarios were based on reference amounts for labeling requirements. Consumption of milk, cheese and other dairy products was associated with high calcium intakes, and there was a low prevalence of inadequacy in men < 50 y old; however, other age-sex groups had lower intakes. The aim of the fortification modeling was to determine which scenario would most effectively reduce the proportion of the population with low intakes of calcium while minimizing the proportion of individuals who exceeded the tolerable upper intake level (UL). Given the correlation between energy and calcium (r = 0.60, P < 0.01), it appeared that any fortification scenario sufficient to increase the mean intake for women to near the adequate intake led to 6-7% of the men having calcium intakes above the UL. The results suggest that fortification of widely consumed foods is not a realistic way to address the issue of low calcium intakes and illustrate the need for concern about the growing use of fortification practices.     

Associations between smoking and adenocarcinomas and squamous cell carcinomas of the uterine cervix (United States)

Objectives: Few studies of smoking and cervical carcinoma have addressed the rare cervical adenocarcinomas or used DNA-based tests to control for human papillomavirus (HPV) infection. Methods: This multicenter case–control study included 124 adenocarcinoma cases, 307 community controls (matched on age, race, and residence to adenocarcinoma cases), and 139 squamous carcinoma cases (matched on age, diagnosis date, clinic, and disease stage to adenocarcinoma cases). Participants completed risk-factor interviews and volunteered cervical samples for PCR-based HPV testing. Polychotomous logistic regression generated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both histologic types. Results: Eighteen percent of adenocarcinoma cases, 43% of squamous carcinoma cases, and 22% of controls were current smokers. After control for HPV and other questionnaire data, adenocarcinomas were consistently inversely associated with smoking (e.g. current: OR = 0.6, 95% CI 0.3–1.1; 1 pack per day: OR = 0.7, 95% CI 0.4–1.3), while squamous carcinomas were positively associated with smoking (e.g. current: OR = 1.6, 95% CI 0.9–2.9; 1 pack per day: OR = 1.8, 95% CI 1.0–3.3). Results in analyses restricted to HPV-positive controls were similar. Conclusion: Smoking has opposite associations with cervical adenocarcinomas and squamous carcinomas. Although both histologic types are caused by HPV and arise in the cervix, etiologic co-factors for these tumors may differ.     

Influence of gender, BMI and Hispanic ethnicity on physical activity in children.

OBJECTIVE: The purpose of this study was to examine the association between overweight status and physical activity (PA) among gender and ethnic (Hispanic vs. non-Hispanic) sub-groups in elementary school-age children. METHODS: PA was assessed over five days using the Actigraph accelerometer in 169 fourth grade students (mean age 9.4 years; 50% female; 63% Hispanic; and 43% overweight, defined as body mass index, BMI > or = 85th percentile for age and gender) from four elementary schools in Los Angeles County, California. RESULTS: In the total sample, boys and normal weight students had higher levels of total PA (counts per minute, cpm; p<0.05). Boys spent less time in sedentary PA (p=0.02) and more time in combined moderate to vigorous PA (MVPA, p=0.01). There was a significant gender, ethnicity, and overweight interaction for total PA and MVPA (both p<0.01). MVPA and counts per minute were significantly lower in overweight non-Hispanic girls and Hispanic boys (p<0.05) and marginally lower in overweight non-Hispanic boys (p=0.10) when compared with non-overweight students, while overweight Hispanic girls were more physically active than Hispanic non-overweight girls, though the difference was non-significant (p>0.05). CONCLUSIONS: Data from the present study does not consistently support the prevailing hypothesis that overweight subjects engage in less PA. Results show overweight students engage in less PA than non-overweight students, with the exception that non-overweight Hispanic girls do not engage in more PA than their overweight peers. These results suggest the need for further investigation into the role that ethnicity and overweight status plays in PA levels, particularly among ethnic and gender sub-groups.