Ann K. Carruth

Adiponectin responses to continuous and progressively intense intermittent exercise.

PURPOSE Adiponectin is a recently discovered adipocyte protein that is lower in patients with coronary artery disease and in Type II diabetics who have insulin resistance. Regular exercise is known to be a preventative factor in the development of atherosclerosis and Type II diabetes. Acute exercise increases insulin sensitivity; however, it also increases beta-adrenergic and glucocorticoid activities that may suppress adiponectin expression. Two experiments were conducted to determine whether acute exercise affects adiponectin concentrations. METHODS In the first experiment, six healthy male subjects completed 30 min of heavy continuous running exercise at 79% of VO (2max). In the second experiment, well-trained runners completed strenuous intermittent exercise consisting of treadmill running at 60, 75, 90, and 100% VO (2max). A resting control trial for the second experiment was also conducted. RESULTS Glucose and insulin were not altered significantly in the first experiment, but both increased significantly (P < 0.05) in the second experiment. A significant increase (P < 0.05) in adiponectin in the first experiment was no longer significant after correction for plasma volumes shifts. In the second experiment, there were significant (P < 0.05) changes in adiponectin concentrations over time but not a significant difference between adiponectin responses in exercise and control trials. CONCLUSIONS The data suggest that 30 min of heavy continuous running or more strenuous intermittent running does not stimulate an increase in production and release of adiponectin, and small increases in adiponectin concentrations resulting from the exercise may be attributed to normal plasma volume shifts.

RECIPROCITY, EMOTIONAL WELL-BEING, AND FAMILY FUNCTIONING AS DETERMINANTS OF FAMILY SATISFACTION IN CAREGIVERS OF ELDERLY PARENTS

The purpose of this study was to test a theoretical model developed to explain family satisfaction among 171 caregivers of elderly parents. Using LISREL to estimate path coefficients, the findings support family satisfaction as directly and indirectly influenced by reciprocity, emotional well-being and family functioning. Explanatory variables accounted for 70% of the variance in predicting family satisfaction. Intrinsic rewards derived from giving care, positive affect, and family functioning contributed to higher levels of family satisfaction, while dysphoria contributed significantly to lower levels. Family satisfaction was also indirectly influenced by positive and negative exchanges received by the parent. Increasing caregivers awareness of the reciprocal nature of their relationships with all family members may be an effective strategy in helping them appreciate their contribution to the well-being of their parents and achieve satisfaction in the caregiving role.

Depressive symptoms in farm women: effects of health status and farming lifestyle characteristics, behaviors, and beliefs

A multitude of responsibilities, environmental and social influences, and stressors place farm women at high risk for depressive symptoms. This cross sectional survey design study examines demographic, health status, and farm lifestyle characteristics, behaviors and beliefs as risk factors contributing to depressive symptoms among farm women in southeast Louisiana. The study was conducted in a stratified, random sample of 657 women 18 years and older. Factors predictive of depressive symptoms in adjusted logistic regression included those who experience poor health, perceive hazards associated with farming, experience recent farm-related injuries and engage in farming over longer periods of time. These findings help target interventions toward women at risk for depressive symptoms.

Evaluation of a School-Based Train-the-Trainer Intervention Program to Teach First Aid and Risk Reduction Among High School Students

BACKGROUND Farming is a hazardous occupation posing health risks from agricultural exposures for the farm owner and family members. First Aid for Rural Medical Emergencies (F.A.R.M.E.) was developed to support a train-the-trainer (TTT) program to prepare high school students to teach first aid skills and risk reduction through peer interaction. This study was designed to evaluate the educational effectiveness for first aid skill development and awareness of safety issues and injury prevention impacting agricultural communities. METHODS Forty-three agricultural science students from a rural high school participated in the study. A quasi-experimental design was used to evaluate knowledge acquisition and anticipatory action among groups: those participating in training and a comparison group with no training. The intervention group included 27 participants trained as first aid peer instructors using the F.A.R.M.E. manual, return demonstration, case scenario facilitation training, and teaching evaluation sessions. The effectiveness of the program was evaluated using triangulated data. Independent t test analyses were conducted on post-test scores to evaluate the knowledge acquisition and anticipatory action scores between groups. Focus group sessions assessed attitudes, experiences, and values held following the intervention of teaching peers. RESULTS Results indicate that the intervention group scored significantly higher on anticipatory action (t = 2.23, p = .03) but not knowledge acquisition (t = 1.37, p = .18). Focus group data suggest that the TTT format bolstered confidence in teaching, confirmed that teens enjoy learning from teens, and fostered pride in team work. CONCLUSIONS The F.A.R.M.E. TTT resulted in a theory and evidence-based intervention that can be implemented in a school setting to promote knowledge and skill acquisition of first aid and injury prevention among rural high school students.

Motivating factors, exchange patterns, and reciprocity among caregivers of parents with and without dementia

The purpose of this study was to explore the impact of background characteristics, motivating factors, exchange patterns, and diagnosis of dementia on caregiver reciprocity. Adult children of parents with dementia (n = 110) and without dementia (n = 195) completed the Caregiver Reciprocity Scale, Motivating Factors Index, Exchange Patterns Index, and a demographic data sheet. ANCOVA analysis indicated adult children of parents with dementia gave more direct instrumental and supervisory care, received more negative and fewer positive exchanges, and reported significantly lower levels of warmth and regard, intrinsic rewards of giving, and balance within family caregiving when compared to adult children of parents without dementia. Hierarchical multiple regression analyses indicated that 64% of the variance of warmth and regard; 42% of intrinsic rewards of giving; 48% of love and affection; and 31% of balance within family caregiving was explained by antecedent demographic variables, motivating factors, exchanges given and received, and dementia. Surprisingly, the diagnosis of dementia did not contribute to explained variance in caregiver reciprocity.

Graduate Nursing Online Orientation Course: Transitioning for Success

Graduate nursing students beginning their graduate education often lack technological preparedness when beginning the journey in a virtual e-learning environment. These gaps in preparedness include lack of understanding course delivery, accessing resources remotely, participating in asynchronous course activities, and use of emerging health care technologies. This article describes an educational innovative online orientation course that simulates course activities so that students get a true perspective of what e-learning entails. With enhanced education through the accelerated learning modules, students became proficient with distance education, which promotes success in an online masters of science in nursing program.

Development and Testing of the Caregiver Reciprocity Scale

The purpose of this study was to develop and validate the dimensions of caregiver reciprocity. Social exchange and equity theory served as a conceptual framework for examining recprocal intergenerational exchanges of assistance and support. In the first phase of the study, 12 caregivers of elderly parents, including in-laws, were interviewed to provide narrative data from which items were developed. Content validity was judged by two separate panels of experts. The revised CRS was tested with 303 adult children for reliability and validity, including internal consistency, test-retest reliability, exploratory factor analysis, and convergent and discriminant validity testing using structural equation modeling. Support for construct validity was demonstrated for four factors: Warmth and Regard, Intrinsic Rewards of Giving, Love and Affection, and Balance within Family Caregiving.

Association of Maternal Obesity and Childhood Obesity: Implications for Healthcare Providers

The purpose of this critical appraisal was to assess the available literature on the association of maternal obesity as a risk factor for childhood obesity and to explore the implications for incorporating this evidence into practice. The increasing prevalence of childhood obesity, with its documented adverse health effects, is a critical public health threat in the United States and worldwide. Research studies have documented increased rates of childhood obesity associated with maternal obesity. Healthcare providers are challenged to expand their competencies to recognize the association of maternal obesity and childhood obesity and to address both primary and secondary prevention of childhood obesity. Stopping the cycle of obesity before it becomes the leading cause of preventable disease and death in the United States is a priority for community health nurses.

Cultural Influences on Safety and Health Education Among Vietnamese Fishermen

ABSTRACT Every ethnic group has its own cultural background and history that influences how it views health behaviors. By virtue of their work history, many Vietnamese have pursued the fishing industry when migrating to the United States. Even though the fishing trades are among the most dangerous jobs in the world, there has been little attention in the literature to the significant role that culture plays in the expression and experience of occupational health practices among Vietnamese shrimp fishermen. Three focus group sessions were conducted to identify factors that hinder or facilitate receptivity to available training and to guide culturally appropriate content. Participants were recruited using purposive sampling among various Vietnamese shrimp fishermen communities in Texas. Utilizing a series of open-ended questions, sessions were conducted in their native language among owners/captains/deckhands; support infrastructure—adult family members and religious/community leaders; and industry management and insurance representatives. Translations of transcribed documents were compared with simultaneous translations to ensure thematic consistency. Conducting hands-on training among Vietnamese by experienced fishermen, specifically targeting captains, was considered key to safety culture on the vessels. Findings of the study support that training should occur in a variety of formats (hands-on), but should be periodic, current, practical, convenient, taught in the primary language of the audience by an experienced individual, culminate in a certificate of completion, and target captains first. These findings illustrate the importance of considering cultural factors in the design of workplace interventions that focus on changes in safety and occupational health behaviors.

The Impact of Hearing Impairment, Perceptions and Attitudes about Hearing Loss, and Noise Exposure Risk Patterns on Hearing Handicap among Farm Family Members:

Farm noise exposure is the major cause of noise-induced hearing loss among farmers. Hearing impairment associated with hearing loss, however, may not adequately represent communication handicap and the impact on quality of life. This descriptive correlational study examines the impact of hearing impairment, perceptions and attitudes about hearing loss, and noise exposure risk patterns on hearing handicap among farm family members. A convenience sample of 56 farmers and family members recruited from community-based agricultural events was studied. A hearing impairment was noted in the majority of the participants (80.4%). Fewer than 10 reported regularly wearing protection during work or recreational activities. High-frequency hearing loss in the left ear (F = 10.30, p < .002), the attitude that wearing hearing protection prevents others from getting ones attention (F = 11.90, p < .001), and the self-reported description of hearing (F = 6.66, p < .013) significantly predicted hearing handicap using multiple regression analysis. Farmers and family members do not use hearing protection because they are concerned they will not hear others who are trying to communicate with them. The findings of this study confirm that this attitude, along with hearing loss in the left ear, is associated with a communication handicap in work settings. Although being able to hear others on a day-to-day basis is important, this attitude may contribute to behaviors leading to hearing loss and decreased communication over time.