Chad L. Cross

The effect of modified jazz dance on balance, cognition, and mood in older adults

Purpose: The purpose of this pilot study was to evaluate the impact of jazz dance class instruction on balance, cognition, and mood (specifically depression) in 13 healthy, community‐dwelling, English‐speaking older women with a mean age of 68. Data sources: Data were collected using self‐report questionnaires (Folstein Mini Mental Status Examination [MMSE] and Geriatric Depression Scale [GDS]), and the sensory organization test (SOT) for balance measurements (using the NeuroCom Smart Balance Master) was performed at three time periods in the study: time 1: between week 1 and week 2 of jazz class (baseline), time 2: between week 8 and week 9 of jazz class (midpoint), and time 3: after week 15 of jazz class (final measurement). Conclusions: Differences in mean MMSE and GDS scores over time were not significant; however, SOT scores showed an increasing trend (p < .001). Data analysis using analysis of variance with repeated measures showed that balance measures improved throughout the duration of the study (F2,10 = 19.68, p < .001). Post hoc analyses using paired t tests with a Bonferroni correction indicated that significant increases in balance occurred from time 1 to time 2 and from time 2 to time 3. These preliminary pilot study findings suggest that jazz dance does not impact cognition or mood but may improve balance in older women. This finding may have significant implications for fall prevention in the postmenopausal population. Implications for practice: Because falls are a leading cause of morbidity and mortality in older adults of both genders, research is needed to evaluate both the impact of jazz dance on balance in older men and jazz dance as a fall prevention strategy in aging adults. Additionally, longitudinal research with a larger sample size is needed to test the effectiveness of jazz dance as a strategy for improving balance, cognition, and mood.

Neurocognitive endophenotypes for bipolar disorder.

OBJECTIVES Neurocognitive deficits have been proposed as vulnerability markers or endophenotypes for the development of bipolar I disorder (BD I). However, few research studies have examined whether neurocognitive deficits also exist in first-degree relatives of individuals with BD I. METHODS This prospective study examined neurocognitive function in individuals with BD I, their first-degree relatives and a normal control group using a comprehensive battery of neurocognitive tests. RESULTS Results indicated that individuals with bipolar disorder and their unaffected relatives demonstrated neuropsychological deficits in comparison to the normal control group in the domains of visuospatial/constructional abilities, executive function, visual learning and memory, and motor speed. In general, the unaffected relatives demonstrated an intermediate level of performance in comparison to the normal control and bipolar group. After adjustment for mood symptoms, significant differences were present for the visuospatial/constructional, executive function, and motor domains. Individuals with bipolar disorder also demonstrated a differential right versus left hemisphere deficit with respect to neurocognitive tasks. CONCLUSIONS Results suggest that deficits on specific neuropsychological tests, most notably Digit Symbol, Block Design and Judgment of Line Orientation, may be indicative of cognitive endophenotypes for bipolar disorder. Replication studies are needed to further identify these deficits as endophenotypes for BD I.

Preliminary outcomes of a local residency programme for new graduate registered nurses

AIM The present study reports preliminary findings regarding new graduate nurses participating in a year-long local residency programme at two hospitals in Las Vegas, NV. BACKGROUND Nurse resident programmes are purported to increase the level of clinical competency and professional transition in new graduate registered nurses (RNs) and to decrease first-year turnover rates. The effectiveness of this programme was assessed using data of the first two cohorts participating in this new residency programme. METHOD Clinical competencies, anxiety, stress, professional transition and retention were measured on 55 nurse residents who have participated in the nurse residency programme. RESULTS The findings indicate improved clinical competency throughout the programme, a decreased sense of threat, and improved communication and leadership skills. The first-year cohorts employment retention rate was 78%, and the second-year cohort is presently 96%. CONCLUSIONS The results of this study demonstrate the positive impact of a year-round residency programme for new graduate RNs. Implications for nursing management The need for a consistent nurse workforce demands that new graduates be transitioned into competent practitioners as soon as possible. Nurse residency programmes can provide this support and decrease replacement costs involved in high turnover.

Memory and Attention Profiles in Pediatric Traumatic Brain Injury

Traumatic brain injury (TBI) causes heterogeneous patterns of neurocognitive deficits. In an attempt to identify homogenous subgroups within this heterogeneity, cluster analysis was used to examine memory and attention abilities as measured by the Test of Memory and Learning (TOMAL) in 300 children, 150 with TBI and 150 matched nonbrain injured controls (standardization sample [SS]). Significant differences were present between the TBI and the SS groups on all TOMAL subscale and index scores, with the TBI groups performing approximately 1.3 SD below the SS. Factor analysis of the TOMAL indicated six factors that assessed various aspects of verbal and nonverbal learning and memory, as well as attention/concentration. Cluster analyses of TOMAL factor scores indicated that a four-cluster solution was optimal for the SS group, and a five-cluster solution for the TBI group. For the TBI clusters, differences were present for clinical, achievement, neurocognitive, and behavioral variables, providing some support for the validity of the cluster solution. These findings suggest that TBI results in unique patterns of neurocognitive impairment that are not accounted for by individual differences in test performance commonly observed in normal populations. Additionally, neurocognitive profiles identified using cluster analysis may prove useful for identifying homogeneous subgroups of children with TBI that are differentiated by a number of important clinical, cognitive, and behavioral variables associated with treatment and outcomes.

Postural balance in young adults: the role of visual, vestibular and somatosensory systems.

Purpose: The purpose of the study is to examine what sensory system predominates to maintain balance (e.g., visual, vestibular, and somatosensory) among people in their twenties and thirties. Data sources: A subset of individuals from a larger descriptive cross‐sectional study was assessed. A sample of 194 (males = 28%, females = 72%) young adults in the second and third decades of life had anthropometric measurements (height, weight, waist circumference, hip circumference, and leg length) taken and body mass index and waist‐to‐hip ratio were calculated. Balance was assessed using the NeuroCom Balance Master machine. Results: There was a significant difference among the three sensory systems for postural balance among the young population, F (2, 576) = 111.741, p < .001. Post hoc Bonferroni tests were maintained at the 0.05 level which showed significance for the visual system compared to vestibular and somatosensory system: visual (M = 93.7, SD = 2.07); vestibular (M = 90.4, SD = 2.74); and somatosensory (M = 90.0, SD = 3.13). Based on the results, the visual system is the predominant sensory system used by young adults to maintained optimal postural balance. Significance for Practice: There is very little known about balance of younger adults. If balance issues are identified early in adult life it is possible to prevent exacerbation of balance decline as one age. If nurse practitioners are aware of what dominant sensory systems for balance young adults use, perhaps strategies to preserve these can avoid falls as they age.

Are working memory deficits in bipolar disorder markers for psychosis

Working memory deficits have been identified in bipolar disorder, but there is evidence suggesting that these deficits may be markers for psychosis rather than affective disorder. The current study examined this issue by comparing two groups of individuals with bipolar disorder, one with psychotic features and one without psychotic features, with a group of normal controls. Working memory was conceptualized as a multicomponent system that includes auditory and visuospatial short-term stores, executive control processes, and an episodic buffer that allows for communication between short- and long-term memory stores (Baddeley & Logie, 1999). Results indicated that only executive control processes significantly differentiated the psychotic and nonpsychotic bipolar groups, although visuospatial working memory differentiated both bipolar groups from controls. The results support the idea that some aspects of working memory performance are markers for psychosis, while others may be more general markers for bipolar disorders.

Susceptibility of quagga mussels (Dreissena rostriformis bugensis) to hot-water sprays as a means of watercraft decontamination.

The recent spread of dreissenid mussels to various bodies of water in the western US has sparked interest by many state and federal agencies to develop protocols to stop further expansion. Quagga mussels (Dreissena rostriformis bugensis) are of particular importance as they are currently the most widespread dreissenid species in the region. This project examined the susceptibility of quagga mussels to hot-water sprays at different temperatures and durations of spray contact at Lake Mead (Nevada-Arizona, USA). Emersed adult quagga mussels were exposed to hot-water sprays at 20, 40, 50, 54, 60, 70, and 80°C for 1, 2, 5, 10, 20, 40, 80, and 160 s. Sprays at ≥60°C for 5 s were shown to be 100% lethal. Sprays of 54°C for 10 s, 50°C for 20 s, and 40°C for 40 s also resulted in 100% mortality. A spray temperature of 60°C for 5 s is recommended for mitigating fouling by quagga mussels.

A controlled evaluation of family behavior therapy in concurrent child neglect and drug abuse.

OBJECTIVE Approximately 50% of child protective service (CPS) referrals abuse drugs; yet, existing treatment studies in this population have been limited to case examinations. Therefore, a family-based behavioral therapy was evaluated in mothers referred from CPS for child neglect and drug abuse utilizing a controlled experimental design. METHOD Seventy-two mothers evidencing drug abuse or dependence and child neglect were randomly assigned to family behavior therapy (FBT) or treatment as usual (TAU). Participants were assessed at baseline, 6 months, and 10 months postrandomization. RESULTS As hypothesized, intent-to-treat repeated measures analyses revealed mothers referred for child neglect not due to their children being exposed to illicit drugs demonstrated better outcomes in child maltreatment potential from baseline to 6- and 10-month postrandomization assessments when assigned to FBT, as compared with TAU mothers and FBT mothers who were referred due to child drug exposure. Similar results occurred for hard drug use from baseline to 6 and 10 months postrandomization. However, TAU mothers referred due to child drug exposure were also found to decrease their hard drug use more than TAU mothers of non-drug-exposed children and FBT mothers of drug-exposed children at 6 and 10 months postrandomization. Although effect sizes for mothers assigned to FBT were slightly larger for marijuana use than TAU (medium vs. large), these differences were not statistically significant. Specific to secondary outcomes, mothers in FBT, relative to TAU, increased time employed from baseline to 6 and 10 months postrandomization. Mothers in FBT, compared to TAU, also decreased HIV risk from baseline to 6 months postrandomization. There were no differences in outcome between FBT and TAU for number of days children were in CPS custody and alcohol intoxication, although FBT mothers demonstrated marginal decreases (p = .058) in incarceration from baseline to 6 months postrandomization relative to TAU mothers. CONCLUSION Family-based behavioral treatment programs offer promise in mothers who have been reported to CPS for concurrent substance abuse and child neglect of their children. However, continued intervention development in this population is very much needed.

Development and preliminary evaluation of a training method to assist professionals in reporting suspected child maltreatment.

The understudied process of reporting suspected child maltreatment to authorities is often difficult for both mental health professionals and family members who are intimately involved. Therefore, the current study was conducted to develop a training curriculum to assist professionals in reporting suspected child maltreatment. Fifty-five professional and student mental health practitioners were randomly assigned to workshop conditions that were relevant to either (a) reporting suspected child maltreatment or (b) learning to be sensitive to ethnicity. Results indicated participants in the reporting suspected child maltreatment condition demonstrated significant improvement in knowledge of child maltreatment reporting laws, accuracy in recognizing child maltreatment, and clinical expertise in reporting. Implications to clinical practice are discussed in light of the results.

Student stress and academic performance: Home hospital program

The purpose of this study was to evaluate whether nursing students assigned to a home hospital experience less stress and improved academic performance. Students were assigned to a home hospital clinical placement (n = 78) or a control clinical placement (n = 79). Stress was measured using the Student Nurse Stress Index (SNSI) and Spielbergers State Anxiety Inventory. Academic performance included score on the RN CAT, a standardized mock NCLEX-RN(®)-type test; nursing grade point average; and first attempt pass-fail on the NCLEX-RN. There were no statistically significant differences between the two groups for age, gender, marital status, ethnicity, or score on the nurse entrance examination. There were significant changes in SNSI over time but not between groups. Academic load and state anxiety showed an interaction of time by group, with the home hospital group showing reductions over time, compared with the control group.