Long-term nurse-patient interactions: factors in patient compliance or noncompliance to the dietary regimen

Noncompliance to treatment regimens is a widespread, costly problem. The present study examines nurse-patient interactions as factors in compliance/noncompliance to the hemodialysis dietary regimen. Several research studies have evidenced these interactions to be central to patient compliance. However, no research has been reported that has controlled for the nature of the treatment regimen; rather, practitioners' interactions with patients who are being treated for a variety of disorders have been examined. An interaction-process-analysis technique was used to code the verbal behaviors that occur during treatment between 38 hemodialysis outpatients with chronic renal disease and the nurses who provide their treatment. These verbal interactions were analyzed in relation to levels of dietary compliance/noncompliance of patients and length of nursing tenure. It was found that emotionally positive and negative responses by nurses were both positively associated with noncompliance to the dietary regimen; however, treatment-related responses by nurses were not associated with compliance/noncompliance level. With regard to length of nursing tenure, it was found that emotionally positive and negative responses by patients were positively associated with nursing tenure and that treatment-related questions by nurses were negatively associated with nursing tenure.     

Temporal associations of cigarette smoking with social influences, academic performance, and delinquency: a four-wave longitudinal study from ages 13-23.

This study examined the temporal associations of cigarette smoking with prosmoking social influences, academic performance, and delinquency in a cohort of 6,527 adolescents surveyed at ages 13, 16, 18, and 23 years. Prosmoking peer and family influences were risk factors for future smoking throughout adolescence, with family influences perhaps also operating indirectly through the adolescent's exposure to prosmoking peers. There were reciprocal associations of youth smoking with parental approval, peer smoking, and poor grades (but not delinquency), with youth smoking emerging as a stronger antecedent than consequence of these psychosocial factors. Few gender differences in these associations were observed. Implications of these findings for efforts to prevent youth smoking are discussed.     

Genetic Counselor Workforce Issues: a Survey of Genetic Counselors Licensed in the State of Indiana

The aims of this study were to document movement of genetic counselors (GCs) out of clinical positions and identify factors that might help employers attract and retain clinical GCs. A confidential on-line survey of GCs ever licensed in the state of Indiana was conducted. Of the 46 respondents, most provide direct patient care (69.6 %), have worked in their current position for 5 years or less (72.1 %), and are experienced genetic counselors, having graduated between 6 and 15 years ago (43.5 %). One-third (32.6 %) reported thinking about leaving their current position at least monthly. GCs were more likely to think about leaving their current position when they provided direct patient care (p = 0.04) and worked in a hospital/clinic setting (p = 0.01). Among the 18 respondents that changed jobs in the past two years, 55.6 % currently work in a laboratory/industry setting and 44.4 % provide direct patient care, compared to 8 % of those in a stable position (N = 25) who work in a laboratory/industry setting (p < 0.01) and 88 % who provide direct patient care (p < 0.01). Genetic counselors who have changed jobs within the past 2 years were more satisfied with the possibility for advancement (p = 0.01), the recognition for work they do (p = 0.03) and feeling value from the organization (p = 0.04) in their current positions than those who have not changed jobs. Salary and flexibility were most often reported as reasons for changing jobs. This is the first documentation of the movement of GCs out of clinical roles into industry positions. This changing landscape may impact the access to clinical services and the training of genetic counseling students. This data will provide employers with data to help attract and retain GCs in clinical roles.     

Predicting Parent-Child Aggression Risk in Mothers and Fathers: Role of Emotion Regulation and Frustration Tolerance

Efforts to identify targets that could be instrumental for child abuse prevention programs have often implicated stress as a key risk factor. However, existing research has not adequately considered the role of emotion dysregulation and frustration intolerance in predicting parents’ risk to engage in parent-child aggression (PCA). In addition, research in this field continues to focus heavily on mothers, with limited attention to fathers. Thus, the current study investigated whether perceived stress and distress, emotion dysregulation, and frustration intolerance independently predicted risk of PCA in a sample of 81 couples; moreover, the study evaluated whether emotion regulation or frustration tolerance mediated or moderated the association between stress and PCA risk. Findings indicated that each of the risk factors uniquely predicted PCA risk after controlling for demographic factors; neither emotion dysregulation nor frustration intolerance moderated the association between stress and PCA risk but emotion regulation did partially mediate this association. No significant differences in the pattern of these relationships were observed between mothers and fathers. Future research directions are discussed, including methodological considerations as well as evaluating how emotion regulation skills training and improved parental frustration tolerance may prevent parent-child aggression.     

Five‐Year Prospective Study of Risk Factors for Daily Smoking in Adolescence Among Early Nonsmokers and Experimenters1

Grade 7 nonsmokers and experimenters (N= 4,165) were compared on a wide range of risk factors for future smoking derived from four prominent theories and whether these factors predicted daily smoking at Grade 12. Early experimenters scored consistently higher than did early nonsmokers on risk factors for future smoking. Common predictors of Grade 12 daily smoking for both groups included early exposure to an important adult who smokes, being young for one's cohort, and weak academic bonds. For Grade 7 non‐smokers, unique predictors of daily smoking included exposure to pro‐smoking social influences (cigarette offers, sibling who smokes), early binge drinking, and being female. Unique predictors for early experimenters were less sharply delineated, although certain family factors appeared to be more important for this group. African Americans and His‐panics were also less likely to progress from experimental to daily smoking. Results point to the importance of adapting prevention efforts to the special needs of early nonsmokers and experimenters.     

Using culturally sensitive theories and research to meet the academic needs of low-income African American children

The economic and social barriers to the academic and social success of many African American children remain in place as the new millennium begins. These realities provide impetus for developing community-based partnership education programs designed to self-empower African American children for academic and social success under any socioeconomic conditions that exist in their lives. Progress toward effective program development, however, has been hindered by a dearth of culturally sensitive theories and research. The Research-Based Model Partnership Education Program (Model Program) is an effective, community-based, university-school-community partnership education program for self-empowering African American children for success. The formative and summative research of the Model Program is described in hopes of advancing theory and research for meeting the academic and social needs of low-income African American children.     

Action priming by briefly presented objects

Three experiments investigated how visual objects prime the actions they afford. The principal concern was whether such visuomotor priming depends upon a concurrent visual input--as would be expected if it is mediated by on-line dorsal system processes. Experiment 1 showed there to be essentially identical advantages for making afforded over non-afforded responses when these were made to objects still in view and following brief (30 or 50 ms) object exposures that were backward masked. Experiment 2 showed that affordance effects were also unaffected by stimulus degradation. Finally, Experiment 3 showed there to be statistically equal effects from images of objects and their names. The results suggest that an active object representation is sufficient to generate affordance compatibility effects based on associated actions, whether or not the object is concurrently visible.