Nancy A. Rudd

Hypoplastic Left Heart Syndrome : Current Considerations and Expectations

In the recent era, no congenital heart defect has undergone a more dramatic change in diagnostic approach, management, and outcomes than hypoplastic left heart syndrome (HLHS). During this time, survival to the age of 5 years (including Fontan) has ranged from 50% to 69%, but current expectations are that 70% of newborns born today with HLHS may reach adulthood. Although the 3-stage treatment approach to HLHS is now well founded, there is significant variation among centers. In this white paper, we present the current state of the art in our understanding and treatment of HLHS during the stages of care: 1) pre-Stage I: fetal and neonatal assessment and management; 2) Stage I: perioperative care, interstage monitoring, and management strategies; 3) Stage II: surgeries; 4) Stage III: Fontan surgery; and 5) long-term follow-up. Issues surrounding the genetics of HLHS, developmental outcomes, and quality of life are addressed in addition to the many other considerations for caring for this group of complex patients.

Body Image: Linking Aesthetics and Social Psychology of Appearance

Body image is the mental picture we have of our bodies, has both perceptual and affective components, affects how we interact with clothes, and affects how that clothed appearance is presented publicly. The purpose of this article is to theoretically justify the inclusion of body image in textiles and clothing subject matter in institutions of higher education. Although pioneering efforts have addressed the body from aesthetic and social psychological standpoints, no theoretical justification integrates both aesthetic theory and social psychological concepts as applied to body image. We present discussions of both aesthetic and social psychological theories and concepts related to body image, make suggestions for curricular strategies at both undergraduate and graduate levels, and provide links to various stakeholders. We argue that textiles and clothing educators have a significant role to play in research, education, and outreach efforts related to body image and appearance-related behaviors and can address important quality of life issues.

Compulsive Consumption Tendencies Among Television Shoppers

Compulsive buying and binge eating are consumption behaviors that are similarly related to low self-esteem and poor impulse control, occurring more frequently in women. Using a national random sample, the authors examined the extent to which compulsive buying and binge eating were related in a nonclinical population of known television shoppers. Mailed questionnaires were completed by 334 women. Multiple regression analyses revealed that (a) binge-eating and compulsive-buying scores were positively related, and (b) both compulsive-buying and bingeeating scores were positively related to television shopping channel exposure. About 10% of the television shoppers in this study were found to have compulsive-buying tendencies. Strategies for coping with unwise compulsive consumption are offered.

Linkages between Attitudes toward Gender Roles, Body Satisfaction, Self‐Esteem, and Appearance Management Behaviors in Women

The purpose of this research was to examine possible linkages between attitudes toward gender roles, body satisfaction, self-esteem, and appearance management behaviors. Results of a survey of 194 undergraduate women indicated that women holding nontraditional attitudes toward gender roles had higher self-esteem (p < .01), but not body satisfaction, than women holding traditional attitudes toward gender roles. A post hoc analysis indicated that body satisfaction and a nontraditional attitude toward gender roles predicted high levels of self-esteem (p < .0001 and p < .01, respectively), whereas the likelihood of using painful appearance management procedures predicted low levels of self-esteem (p < .05). Suggestions are offered for adult education andfor socially responsible marketing practices for appearance-related products.

Attitudes Toward Gender Roles, Self-esteem, and Body Image: Application of a Model:

The Rudd and Lennon (1994) model of body aesthetics is used in this research to guide research investigating relationships among body image, attitudes toward gender roles, and self-esteem. Questionnaires were completed by 202 Korean college women, 52 Singaporean college women, 171 African-American college women, and 109 Caucasian-American college women. Significant differences were found among the groups on gender ideology, self-esteem, and the body image variables. African-American college women had the highest self-esteem and appearance evaluation scores. More importantly, however, across all groups high self-esteem was associated with positive body images and non-traditional attitudes toward gender roles. Additionally, social group membership and individualism were related to body image. Results are explained within the context of the Rudd and Lennon (1994) model of body aesthetics and suggestions are offered for future research within that context.

Preferences for Aesthetic Attributes in Clothing as a Function of Body Image, Body Cathexis and Body Size:

This study examines the relationship between physical and psychosocial attributes of the body, and aesthetic attribute preferences in clothing. Building upon a clothing comfort model, the purpose is to determine whether womens aesthetic response to apparel is related to their body size, body cathexis and body image and if so, to provide insight into underlying patterns of similarity in their response. An Internet survey was administered to a random sample of 199 female undergraduate students. The results indicated that body image and body cathexis had a negative linear relationship with aesthetic preference in styling, implying that lower body image and body cathexis correlate with preference for greater body coverage through clothing and vice versa. Body size showed a positive linear association with styling preferences, implying that increase in body size correlates with preference for greater body coverage in clothing and vice versa. Theoretical, methodological and practical implications are discussed.

Self-Schema or Self-Discrepancy? Which Best Explains Body Image?

We investigated the discrepancy between womens actual and ideal appearance and its relationship to body image, mood, and self-esteem. In a two-part experimental design, 88 college women completed measures of appearance self-discrepancy and appearance self-schema. Two weeks later they were exposed to 16 photos of attractive media images and subsequently completed measures of mood, body image, and self esteem. One-way between subjects multivariate and univariate analyses of variance revealed that appearance self-discrepancy was related to all the body image variables and self-esteem, but not to the mood variables. Appearance self-schema may better explain body image than appearance self-discrepancy. Results are discussed in light of self-discrepancy theory, schema theory, and the Rudd and Lennon (1994) model of body aesthetics.

Is Internalized Homonegativity Related to Body Image

The authors examined relationships among internalized homonegativity, body image, eating disturbance, and self-esteem of gay men. Internalized homonegativity is believed to be experienced by all gay men and is tied to self-esteem, which is a factor in the etiology of eating disorders and body image disturbance. It was hypothesized that internalized homonegativity would predict body image, self-esteem, and eating disturbance. A total of 213 gay men participated in an online survey that used established measures. Results showed that specific components of internalized homonegativity predict body image, self-esteem, and bulimic behaviors. Findings imply that internalized homonegativity is a viable link for assessing body image and self-esteem among gay men. This study adds new dimension to the literature by linking internalized homonegativity with body image and by demonstrating a specific component of internalized homonegativity as predicting the variables tested. Future research and limitations are discussed.

Urinary interleukin-18 and urinary neutrophil gelatinase-associated lipocalin predict acute kidney injury following pulmonary valve replacement prior to serum creatinine.

BACKGROUND It is becoming increasingly recognized that manifestations of congenital heart disease (CHD) extend beyond the cardiovascular system. The factors contributing to renal dysfunction in patients with CHD are multifactorial, with acute kidney injury (AKI) at time of cardiac surgery playing a major role. AKI is often diagnosed based on changes in serum creatinine and estimated glomerular filtration rate (eGFR). Such measurements are often late and imprecise. Recent data indicate that urinary biomarkers interleukin-18 (IL-18) and neutrophil gelatinase-associated lipocalin (NGAL) are earlier markers of AKI. We sought to determine the efficacy of urinary IL-18 and NGAL for detecting early AKI in patients undergoing surgical pulmonary valve replacement (PVR). METHODS Twenty patients presenting for surgical PVR with a history of previous repair of a conotruncal anomaly were enrolled. Preoperative clinical data were measured and urine samples and serum creatinine were collected at 6, 12, 24, and 72 hours post bypass. Urine was evaluated for NGAL and IL-18. AKI was determined using the Risk, Injury, Failure, Loss and End Stage Renal Disease (RIFLE) classification system. RESULTS Using the RIFLE classification system, seven patients (35%) were found to have AKI defined as a drop in the eGFR or an increase in serum creatinine. All seven patients with AKI had marked increase from preoperative baseline in urine IL-18 (sixfold) and NGAL (26-fold). Using NGAL and IL-18, AKI was detected at 6 hours postoperatively, resulting in AKI being identified 12-36 hours prior to detection by conventional methods. No preoperative predictors for AKI were identified. CONCLUSION Both NGAL and IL-18 are early predictive biomarkers of AKI, and both increase in tandem after surgical PVR. Importantly, both rise before an increase in creatinine or a decrease in eGFR is present. Monitoring both biomarkers may allow for earlier detection and subsequent interventions to prevent AKI at time of surgery for CHD.

Shopping Behavior Among Gay Men: Issues of Body Image

Literature on gay men and body image are examined in relation to shopping behaviors, with hypotheses developed to test whether ones body image affects consumer choices. The researchers studied credit card debt, shopping frequency, amount of time spent shopping, and shopping venue. An online questionnaire was used to collect data from 213 gay men. Results indicate that Appearance Orientation positively affects shopping in a specialty store, shopping in a thrift store, frequency of shopping, and time spent shopping, whereas Appearance Satisfaction negatively affects television shopping. Thus, body image and shopping are linked. For many gay men, shopping may be a means of establishing or reinforcing cultural identity or a way to express individuality and novelty. Findings can be used by academics and practitioners in developing and examining innovative retail environments. Future research is discussed.