Brenda P. Haughey

Self-Efficacy and Confidence in Outcomes as Determinants of Self-Care Practices in Inner-City, African-American Women with Non-Insulin-Dependent Diabetes

The puipose of this study was to examine the extent to which Perceived self-efficacy and confidence in outcomes, selected demographic variables, and disease characteristics (age, duration of diabetes, presence of documented complications) affect an individuals adherence over time to a diabetes regimen of home glucose testing, medication/insulin administration, diet, and exercise. A convenience sample of 118 inner-city, African-American women with type II, non-insulin-dependent diabetes mellitus receiving outpatient care at a large urban hospital were asked to complete measures of each of the psychosocial variables on two occasions, separated by an interval of 4 to 5 months, and coinciding with their next scheduled clinic visit. Bivariate and multivariate analyses at Times 1 and 2 demonstrated the ability of self-efficacy alone to explain diet, exercise, and home-testing behaviors while suggesting variability within individuals in sense of self-efficacy over time.

Diet, smoking, and alcohol in cancer of the larynx : a case-control study

A case-control study among white men in western New York was conducted from 1975 through 1985 to examine diet and other risk factors for laryngeal cancer. Incident pathologically confirmed cases (250) and age- and neighborhood-matched controls (250) were interviewed to determine usual diet and lifetime use of tobacco and alcohol. Cigarettes were strongly associated with risk; pipes and cigars were not. Beer and hard liquor but not wine were associated with increased risk. Dietary fat and carotenoids were related to risk in opposite ways. The upper quartile odds ratio for dietary fat was 2.40 [95% confidence interval 1.26, 4.55], and the upper quartile odds ratio for carotenoids was 0.51 (0.26, 1.01). There was effect modification by smoking. Carotenoids were most negatively associated with risk among the lightest smokers, whereas dietary fat was most positively associated with risk among the heaviest smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamin C, vitamin E, carbohydrate, or dietary fiber. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high in fat may increase risk.

Alcohol consumption and lung cancer in White males

Experimental and epidemiologic investigations in alcoholic and nonalcoholic populations have suggested a role of alcohol in lung carcinogenesis. The association between alcohol consumption and lung cancer was investigated among 280 White males with histologically confirmed, primary lung cancer and 564 White male controls, participants in the Western New York Diet Study (United States). Among heavy smokers (over 40 pack-years), total alcohol consumption was associated with an increased risk of lung cancer with adjustment for age, years of education, pack-years of cigarette smoking, and intake of carotenoids and fat. In this group, the odds ratio for drinkers of more than 24 drinks per month was 1.6 compared with those who drank less. Drinkers of more than 12 beers per month were 1.6 times more likely to develop lung cancer than nondrinkers of beer after controlling for age, years of education, and cigarette smoking (95 percent confidence interval = 1.0–2.4, P for trend = 0.003). Occupational and dietary factors did not seem to explain these findings. Although cigarette smoking is the major cause of lung cancer, the role of alcohol, independent or in interaction with cigarette smoking, deserves further investigation.

Lifetime alcohol intake and risk of rectal cancer in western New York.

The lifetime intake of total alcohol, beer, wine, and hard liquor was measured for 277 males and 145 females with pathologically confirmed, first, single, primary cancers of the rectum in western New York from 1978 to 1986. Controls who were age, sex, and neighborhood matched were also interviewed. Intake of beer and total alcohol was positively associated with rectal cancer risk. Most of the excess risk was found for the heaviest drinkers. Odds ratios for fourth quartile intakes for males were 1.80 (95% CI, 1.12, 2.89) for total alcohol and 1.86 (1.13, 3.06) for beer. No association was found with wine or hard liquor intake. Females drank considerably less in this population; trends were similar although not of as great magnitude as those for males. Adjustment for dietary risk factors did not change risk estimates appreciably. A high lifetime intake of beer and total alcohol was associated with an increased risk of rectal cancer, and this was independent of either socioeconomic status or diet.

Understanding the Effects of a Myocardial Infarction on Sexual Functioning: A Basis for Sexual Counseling

&NA; Sexual counseling is an integral component of the rehabilitative process for clients who have experienced a myocardial infarction (MI). This article describes myths and fears concerning the dangers of resuming sexual intercourse after a heart attack, positions for intercourse, and the effects of intercourse on arrhythmias, angina, and blood pressure. The purpose is to provide the results of empirical research to dispel myths and fears and to consider the causes of sexual dysfunction, the changes MI brings about in sexual activity for men and women, and the effects of age, exercise, and antihypertensive drugs on the resumption of sexual activity. Guidelines are provided for conducting a sexual/cardiac history as part of the counseling model with specific information for the post‐MI client.

Occupational exposure to extreme temperature and risk of testicular cancer

A study of 250 patients with pathologically confirmed testicular cancer diagnosed between January 1977 and June 1980 and 250 population controls matched for age and residence was carried out to investigate risk factors for testicular cancer. This paper reports results of risk associated with occupational exposure to extreme (< or = 60 degrees F or > or = 80 degrees F), high (> or = 80 degrees F), and low (< or = 60 degrees F) temperature. Interviews of approximately 1.5 h duration were conducted by trained male interviewers, using a standardized interview schedule. Mantel-Haenszel methods and logistic regression models were employed to estimate these temperature effects on risk of testicular cancer. The estimated adjusted odds ratios of testicular cancer, when 16 potential confounders were controlled for, were 1.71 (95% Cl: 1.13-2.60) for occupational exposure to extreme temperatures; 1.70 (1.04-2.78) for low temperature; and 1.20 (0.80-1.80) for high temperature. The findings suggest that occupational exposure to extreme, low, and high temperature may increase risk of testicular cancer, independent of other potential risk factors.

Smoking Practices Among Nursing Students: A Comparison of Two Studies

Findings of numerous studies that have explored the smoking practices of nurses reveal a high incidence of smoking that is incongruent with the health beliefs of the profession. Nurses who smoke are less likely to teach or positively influence patients who smoke. They may even undermine health teaching efforts of other health professionals. Studies of smoking practices of nursing students also reveal high incidences of smoking. Included among the determinants of this practice are lack of knowledge of the health effects of smoking, the academic setting, and the role that nursing education may play. In this comparison of two independent studies similar in design, smoking rates were similar to that of the female population and to registered nurses. Students who smoke either started smoking or increased their smoking in nursing school. They knew the health hazards of smoking and most had tried to quit in the past. Challenging opportunities exist for nurse educators to study and implement strategies to prevent smoking initiation and encourage cessation among future nurses.