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T H E U N I V E R S I T Y O F N O R T H C A R O L I N A A T C H A P E L H I L L S C H O O L O F N U R S I N G �� F a l l 2 0 0 3 Carolina NURSING Chronicle highlights several of the important research initiatives that are designed to improve the health of you and your fellow North Carolinians. From the tree-topped mountains of Buncombe County to the sandy beaches of New Hanover County, SON researchers are work-ing in your communities to learn how to better care for the health of North Carolinians. Examples high-lighted within these pages include studies to help Latina mothers suf-fering from depression learn how to deal with their symptoms; efforts to reduce the uncertainty that many cancer patients face with treatment and recovery; and work to empower those with arthritis to better care for themselves. Nearly 50 SON scientists were engaged in research projects from July 2002 to the end of the fiscal year this June, bringing in over $10 million in funding, $7.5 mil-lion from the National Institutes of Health alone. These funds support-ed a wide variety of new research initiatives, including the creation of the Center for Innovation in Health Disparities Research, an important collaborative initiative with North Carolina Central University and Winston-Salem State University to recruit and train a greater number of minority nurses, to conduct more culturally competent research and to develop innovative methodologies in health disparities research. Of course, our researchers could not do their work without your con-tinued support. On behalf of each scientist at the School of Nursing, I thank you for all that you do, from sharing your time and resources to representing the SON so well in our communities. I hope you enjoy this issue dedicated to the health of North Carolina and wish you and your family another healthy and happy year. Sincerely, Sandra G. Funk, PhD, FAAN Professor and Associate Dean for Research Dear Alumni and Friends, Many people know North Carolina as the home of the Outer Banks, the loblolly pine and the best barbecue and basketball around, yet do enough of us know that we’re among the top states in our nation for contracting diabetes and cardiovascular disease? Or that our Latino population, the nation’s largest minority group and the state’s fasting growing population, faces ongoing disparity in the avail-ability and quality of patient care right here in our own backyard? What exactly is the state of health for North Carolina’s nearly 8.3 mil-lion citizens, and what is your School of Nursing doing to improve it? This year’s issue of the Research FROM THE Associate Dean Carolina NURSING On the cover: Research assistant Brent Woodard tests blood samples from North Carolina schoolchildren for Dr. Joanne Harrell’s study on risk factors for cardiovascular disease and type 2 diabetes. 2 For the Health of North Carolina: How SON Researchers Are Improving the Well-Being of Our State 10 The Genetics Revolution at UNC: One Nurse’s View 12 From A Different Perspective: UNC’s International Nurse Researchers 14 Interdisciplinary Research: A Team-Based Approach to Improving Health 16 Centers of Activity: An Update on CRCI and CIHDR Projects 18 Research Space: The Next Frontier 19 In Brief 21 Faculty Research Activity 2002-2003 21 Faculty Research Grants 23 Education and Professional Grants 24 Faculty Publications 27 Doctoral Student and Post-Doctoral Fellow Activities Carolina Nursing is published by The University of North Carolina at Chapel Hill School of Nursing for the School’s alumni and friends. Dean Linda R. Cronenwett, PhD, RN, FAAN Executive Content Editor Sandra G. Funk, PhD, FAAN Professor and Associate Dean for Research Managing Editor Sunny Smith Nelson Contributing Writers Brittany Dunstan Jim Vickers Photography Janna Dieckmann, PhD, RN Brittany Dunstan Jean Goeppinger, PhD, RN, FAAN Norma Singleton Hawthorne Kabira Kirby Sunny Smith Nelson Anne Aldridge Webb Design and Production Alison Duncan Design Research Support Center Staff Dana Hunter Gregory Workman Office of Advancement Norma Singleton Hawthorne, Director Anne Aldridge Webb, Associate Director, Alumni Affairs and Annual Fund Sunny Smith Nelson, Associate Director, Public Relations and Communications Brittany Dunstan, Health Affairs Communications Intern School of Nursing The University of North Carolina at Chapel Hill Carrington Hall, CB# 7460 Chapel Hill, NC 27599-7460 (919) 966-4619 E-mail: sonalum@unc.edu http://nursing.unc.edu Research Chronicle Edition IN THIS EDITION 2 CAROLINA NURSING RESEARCH CHRONICLE How SON Researchers Are Improving the Well-Being of Our State NORTH CAROLINA IS A STATE OF MANY COMPLEXITIES. After many years as a state made up of small, scattered farms, half of its population is concentrated now in urban areas such as Charlotte, the Piedmont and the Triangle. The state is one of the biggest producers and consumers of tobac-co in the country, yet its governor, in a former post as the state’s attorney general, brought litigation against the nation’s major tobacco companies and won a multi-billion dollar suit. Nearly one-quarter of its population has earned a baccalaureate degree, yet nearly 13% still live in poverty. And then there’s the issue of the state’s health. Located in the area known as the nation’s “stroke belt,��� the state has serious problems with illnesses such as diabetes, heart disease, obesity and cancer. Yet the state is also home to sev-eral of the country’s preeminent health-care research institutions, includ-ing UNC and Duke University. What are these health-care providers doing to improve the health of the state, and what kind of impact is their research having on its 8.3 million residents? Here at the School of Nursing, researchers are touching the lives of premature babies, cancer survivors, the chronically ill and new immigrants through groundbreaking research projects. Highlighted here are a few examples of how the SON’s researchers are working for the health of North Carolina. For the Health of North Carolina by Sunny Smith Nelson Depression can be a serious and debilitating problem for many Hispanic mothers new to North Carolina. Many are unfamiliar with the language and culture; they may be struggling to make ends meet; and they have children to care for without their usual network of fam-ily and friends to help. Low-income Hispanic mothers are, in fact, at an increased risk for developing depression because of these com-bined social factors. Any form of depression that lasts at least six months at a time for a mother can have negative effects on her chil-dren, too. They may not get the attention and developmental stimu-lation they need to properly build healthy cognitive, emotional and social capabilities during the criti-cal years from birth to three years of age. This, in turn, places the children at increased risk for their own problems, including speech and attention disorders and their own form of depression. SON professor Dr. Linda Beeber recently began a study funded by the U.S. Department of Health and Human Services Administration for Children and Families to help these low-income Hispanic mothers bet-ter cope with their depression. The study, known as Alas, which is Spanish for “wings,” is the first to develop and test a home-based intervention specifically for non- English speaking Hispanic mothers with symptoms of depression. The intervention, conducted in Spanish and reflective of Hispanic cultural values, pairs non-Spanish speaking to the people of North Carolina since we rank first in the nation in the relative growth of newly immi-grated citizens who are of Hispanic origin,” says Beeber. “We believe it will contribute to the growing net-work of resources that will help our Latino community create a promis-ing future for their children. And while this is a test of an innovative model of intervention for depressive symptoms in Latina mothers, it can be replicated with other non- English speaking populations in need of mental health support. My hope is that people of many differ-ent cultures and origins can one day benefit from this work as well.” The Alas study is working to improve the mental and emotional well-being of low-income Latina mothers and their children. 2002–2003 3 psychiatric-mental health nurses and Early Head Start (EHS) bilin-gual staff members as a team to make home visits over 19 weeks to Hispanic mothers in Asheville and Chapel Hill. The team works with each mother on interpersonal problem areas that contribute to her depres-sive symptoms, such as her rela-tionships with those close to her and how they can affect how she feels. “By monitoring her feelings on a weekly basis, the mother can learn how to put her feelings into context,” says Beeber. “She finds that those feelings don’t come out of the blue, but are dependent on what is happening in her life.” Based on how the mother feels, the intervention team offers specific, repetitive coping skills for the mother to practice, from learning how to better manage conflict to better differentiating between good and bad comforts. Fathers are involved in the intervention, too. The team visits alternate with a “booster” session conducted by the nurse on call by cell phone. The intervention gives the mother the support she needs while empower-ing her to independently recognize and deal with her symptoms, explains Beeber. At the end of the intervention, the mother and inter-vention team create a list of her accomplishments during their time together and either secure further care for the mother or provide her with resources should a recurrence of symptoms occur. “This study is especially relevant For the Health of North Carolina WESTERN NC: Giving Mothers Their “Wings” to Fly 4 CAROLINA NURSING RESEARCH CHRONICLE to the aforementioned study in that its goal is to help those who have been diagnosed with cancer deal with the psychological effects of the disease; in this case, however, they are survivors who face enduring uncertainty about the possibility of recurrence and possible long-term health problems related to cancer treatment. Participants of this National Cancer Institute-funded study include older women who have been cancer-free for five years. They receive a self-delivered inter-vention consisting of a tape player and a set of audiotapes of cognitive strategies to help them deal with events that trigger feelings of uncer- Many cancer patients speak of uncertainty when talking about their disease—uncertainty in choosing a treatment option, uncertainty in how it will change their bodies, uncertainty in the face of recurrence. Often, in the back of their minds, are the doubts and dreads that nag. Doctors and nurses work hard to allay these fears, but is there one word, one course of action, that works better than another? Dr. Merle Mishel, Kenan distinguished professor at the SON, and Dr. Barbara Germino, the SON’s Beerstecher Blackwell profes-sor in thanatology, are working on two studies to learn how to help cancer patients and survivors better manage their uncertainty. In “Decision-Making Under Uncertainty Prostate Cancer,” Mishel and Germino are testing whether a patient education booklet and a videotape with vignettes of strategies for communicating with the doctor that they developed, supplemented with nurse contact to help patients use the materials, will be effective in helping both Caucasian and African American men diagnosed with localized prostate cancer become better informed and more active partici-pants in the decision-making process with their doctor. The study is funded by the National Institute of Nursing Research and the National Cancer Institute at the National Institutes of Health. Mishel and Germino believe the training is necessary because, although prostate cancer is the sec-ond most common type of cancer in American men, no universally recommended treatment exists for the disease and most men opt for the treatment their doctor special-izes in without fully considering all their options. “Our goals for the study are to see if the decision-making training can help men recently diagnosed with prostate cancer become more informed about the range of treat-ment options available to them,” says Mishel. “A second important goal is to see if the decision-making training enables men to more fully ask questions and get the informa-tion they want from their health-care providers.” “Managing Uncertainty in Older Breast Cancer Survivors” is similar For the Health of PIEDMONT: Learning to Live with the Uncertainty of Cancer 2002–2003 5 Drs. Barbara Germino and Merle Mishel (middle, left to right) work with research team members Sharon Coop (far left) and Gail Fuller (far right) on a study to help men suffering from prostate cancer become more active participants in the treatment decision-making process with their health-care providers. tainty about breast cancer recur-rence. They also receive a manual that contains information on how to manage long-term side effects from cancer treatment and resources for more assistance. Nurses make follow-up calls to help them learn the skills taught in the materials. At this point in the study, says Mishel, the research team has iden-tified significant gains in women who received the intervention as compared to those in the control group. Both Caucasian and African American women who received the intervention improved in their abil-ity to see their illness in a more positive light, they had more knowledge about the disease and they showed fewer symptoms of long-term side effects. They also improved in their ability to manage the triggers of uncertainty about recurrence by using coping self-statements and by engaging in less catastrophizing about negative out-comes. In addition, they reported significantly greater access to infor-mation and found the information more helpful. “Long-term survivors of breast cancer often face physical and emo-tional changes which can continue years after treatment is finished,” says Germino. “We are very pleased to find that this nursing interven-tion helps long-term cancer survivors manage their fears of recurrence and the long-term side effects of treatment.” North Carolina 6 CAROLINA NURSING RESEARCH CHRONICLE Odds are, if you grew up in a small, rural town in the South, you knew someone with type 2 diabetes. The disease is common among Southerners no matter their cultur-al heritage and is due, in part, to a diet heavy in fried and sugary foods and a sedentary lifestyle. With so much in the headlines nowadays about the importance of diet and exercise, why is it that the disease is so prevalent in the region, particu-larly among rural and low-income populations? According to Dr. Anne Skelly, an associate professor at the SON, no effective, culturally compe-tent interventions have been devel-oped to help these folks prevent the disease. That’s why she’s been spending so much time in a small, rural town in Chatham County, North Carolina lately. Skelly is the principal investiga-tor of “Type 2 Diabetes: Ethnic Variation in Knowledge and Belief,” a study funded by the National Institute of Nursing Research at the National Institutes of Health. She and her co-investigators, Drs. Will Gesler and Molly Dougherty of UNC and Dr. Thomas Arcury of Wake Forest University, are working with at-risk rural and low-income indi-viduals in Chatham County to study their knowledge levels and beliefs about the disease, and in particular where they are receiving this infor-mation. Around 120 European American, African American and Latino men and women between the ages of 30 and 60 are being followed to learn what they know about the causes of the disease, how it affects the body, how to treat it and where to turn in the communi-ty for information on the issue. Their sources for information on the disease are being mapped, which helps Skelly and her research team learn how this ethnically diverse community’s beliefs con-verge, differ and overlap. By better understanding the belief systems of these different populations, Skelly believes health-care researchers can better develop culturally appropri-ate, community-based strategies to prevent or delay the disease. “The exciting news in diabetes research is that we now have strong evidence that type 2 diabetes can be prevented or delayed with the use of modest lifestyle interventions such as diet and physical activity,” she says. “What are needed are effective, culturally-sensitive strategies to assist high-risk individuals in making these changes.” For the Health of Dr. Anne Skelly hopes she will be able to develop culturally appropriate, commu-nity- based prevention strategies for diabetes by learning what rural North Carolinians know about the dis-ease and where they get that information. PHOTO COURTESY OF APRIL SOWARD CENTRAL NC: Sweet Tea, Candied Yams and Fried Chicken: How Do You Beat Type 2 Diabetes in the South? 2002–2003 7 Ask a kid nowadays what his or her favorite game is, and you’ll probably get an answer like “Sony Playstation 2’s Grand Theft Auto” video game instead of hide and seek or kickball. Children and adoles-cents of the twenty-first century are far more sedentary than their par-ents or grandparents ever were, with the majority of their free time spent in front of a television or computer. This immobile form of fun is start-ing to take its toll on the health of today’s kids, as evidenced by the alarming rise in weight and type 2 diabetes that is showing up in youth under the age of 18. Dr. Joanne Harrell, a professor at the SON and the director of the Center for Research on Chronic Illness in Vulnerable People, is principal investigator of a study known as CHIC III, short for Cardiovascular Health in Children and Youth. The study, funded by the National Institute of Nursing Research at the National Institutes of Health, is an investigation of the childhood development of several risk factors for cardiovascular dis-ease and type 2 diabetes and the aggregation of those factors over time. CHIC III is following thou-sands of North Carolina elementary, middle and high school children across all stages of puberty, measur-ing such things as blood pressure, body mass index, body fat, waist circumference, insulin, glucose and lipid levels, eating habits, physical activity and smoking. Family histo-ries of cardiovascular disease and diabetes are taken from parents, and all the factors are added together and evaluated to determine if a child runs a high risk of devel-oping the diseases. From her research, Harrell has learned that school-based interven-tions, both in the classroom and on the playground, are very important. Kids need to get more health educa-tion and more exercise while in school. She has tested different interventions that feature combina-tions of these two components, try-ing to determine which is the best mix for today’s kids. Her results could impact how North Carolina’s schoolchildren exercise and play for years to come. “We have found that almost half of the children we are studying are obese or overweight,” says Harrell. “There is an urgent need to increase physical activity, decrease sedentary activities such as TV view-ing and computer games, and improve eating habits in our children. Families, schools, communities and legislators must work together to help combat this epidemic.” North Carolina Dr. Joanne Harrell and her research team are working with thousands of North Carolina school children to determine their risk for cardiovas-cular disease and diabetes. PHOTO COURTESY OF KABIRA KIRBY Healthier Hearts for Today’s “CHICs” 8 CAROLINA NURSING RESEARCH CHRONICLE African Americans with arthritis and other chronic health problems in eastern North Carolina now have 38 more trained advocates working in their communities to help them deal with their conditions thanks to the “Yes We Can!” project. Directed by Dr. Jean Goeppinger and imple-mented with community partners from Craven, Jones and Pamlico counties, the project recently trained 38 residents from the three counties to act as workshop leaders and community coordinators. As such, they will teach persons with arthritis and other chronic condi-tions like diabetes and heart disease how to deal with their symptoms, pain, and fatigue; plan and imple-ment an individualized exercise program; and manage other chal-lenges related to living a healthy life with chronic health problems. The workshop leaders and com-munity coordinators are part of a larger study funded by the U.S. Centers for Disease Control and Prevention to learn which of two community-based, disease self-management programs, the Arthritis Self-Help Course (ASHC) or the Chronic Disease Self- Management Program (CDSMP), is the most effective in helping per-sons with arthritis and other chron-ic conditions. The study is the first to compare the effectiveness of the two programs for persons with arthritis and to place a particular emphasis on studying their effectiveness among rural and African American populations. The community coordinators will publi-cize the disease-management work-shops in their communities and assist with participant recruitment and enrollment. “Arthritis is one of two leading causes of disability in the U.S. and the second most common co-mor-bid condition,” says Goeppinger, a professor who holds joint appoint-ments with the schools of nursing and public health. “People with chronic diseases such as arthritis live 24 hours a day, seven days a week with their diseases. They need to learn how to live well with their chronic diseases by becoming good self-managers. This study will determine which program is most helpful in accomplishing that goal.” PHOTO COURTESY OF DR. JEAN GOEPPINGER For the Health of EASTERN NC: “Yes We Can!” Project a Community Success Dr. Jean Goeppinger is working with several community partners in eastern North Carolina, including Stephanie Fisher, pictured here, to help those with arthritis learn to manage their symptoms better and to implement an exercise plan to improve their quality of life. 2002–2003 9 Childhood is by far the most definitive time in a person’s life developmentally. From learning to sit up or walk to recognizing social cues and acceptable behavior, the first few years of a child’s life can determine how they act, think and feel for the rest of their lives. As a parent, you want to give your child all the tools necessary to help them develop into happy, healthy adults. And as the parent of a premature infant, you would want to give them even more to make up for what Mother Nature was not able to give them. But what do you do if you are the parent of a premature infant and live in a rural area with-out access to all the necessary serv-ices? And what if you don’t really know what those necessary services are, or aren’t sure how you’d pay for them if you did? How do you deal with the stress of having a pre-mature child and all the challenges associated with it? Dr. Diane Holditch-Davis and Dr. Margaret Miles are working to help mothers with these concerns. Holditch-Davis and Miles are the lead researchers of “Nursing Support Intervention of Mothers with Prematures,” also called the MOMS Project, a National Institute of Nursing Research-funded study to examine the effectiveness of a culturally congruent intervention to support rural African American mothers of premature babies from the time the babies are receiving intermediate care to the age of 18 months. They hope that by improv-ing the psychological well-being of the mothers and helping them identify resources for their children, the mothers will improve their rela-tionships with their children and seek and prolong the use of child health developmental services. The infants ideally will gain by being in more developmentally supportive environments than they might have received without the intervention. Thus far, 212 mothers and their high-risk premature babies have been recruited for the study and are being followed until the children are at 24 months of age, corrected for prematurity. The mothers receive encouraging, instructive vis-its and phone calls from Holditch- Davis, Miles and the research team, and the mothers’ psychological well-being and the babies’ develop-mental status are measured using a series of tests. With the support of caring nurses, Holditch-Davis and Miles hope the mothers will be able to support themselves and their tiny children even better. “There is nothing harder for a mother than the critical illness of her child,” says Holditch-Davis. “The MOMS Project aims to help mothers deal with these feelings and find resources to help so they can better meet the needs of their pre-term infants.” North Carolina Research team members Shannon Wong and Jackie Fowler Pilgrim discuss the MOMS Project, a study by Drs. Diane Holditch-Davis and Margaret Miles to help African American mothers of premature babies find the resources they need to help their babies. Support In a Time of Need 10 CAROLINA NURSING RESEARCH CHRONICLE Van Riper, an associate professor at the School of Nursing, renders those judgments with the authority of one who was engaged in the research of genetic-related health problems a half decade before the gene-mapping project began in 1990. Her experiences as a graduate Van Riper, an associate professor at the School of Nursing, renders these judgements with the authority of one who was engaged in the research of genetic-related health problems a half decade before the gene-mapping project began in 1990. Her experiences as a graduate student, doctoral candidate and fac-ulty member with studies on fami-lies’ responses to testing for Down syndrome and the birth of children with the disorder all led to an epiphany, as she calls it. When attending a genetics summer insti-tute for nursing faculty, she realized the need to include genetic content in her research, teaching and prac-tice if she wanted to keep pace with the genetics revolution. It was, she says, the beginning of her life’s work. A successful proposal to the National Institute of Nursing Research for a three-year mentored research scientist development award entitled “Family Experience of Genetic Testing: Ethical Dimensions” followed in 2000, and Van Riper joined UNC’s faculty in 2001, transferring her research project and knowledge to the campus. UNC Chancellor James Moeser was working on genetics initiatives for UNC around that time as well. In February 2001, Moeser announced a new genomics center that would be funded by a public-private investment of more than $245 million over the next 10 years. The Carolina Center for Genome Sciences (CCGS) would involve fac-ulty from the College of Arts and Sciences and the Schools of Information and Library Science, Law, Medicine, Nursing, Public Health, Pharmacy and Dentistry. Dr. Terry Magnuson, an internationally respected geneticist, was chosen to lead the initiative. Recognizing Van Riper’s expertise, he asked her to help coordinate the Center’s efforts concerning the ethical, legal, and social implications (ELSI) of recent advances in genetics. As a result, Van Riper and colleagues from across campus will lead a class on ELSI this upcoming spring. A health affairs interdisciplinary grant is funding the course. “Recent advances in genetics made possible through the Human Genome Project have revolutionized the field of health care, and nurs-es are in an ideal position to help individuals and families maximize the benefits of the genetic revolution. But first, nurses need a working knowledge of human genetics, an awareness of recent advances in the field of genetics, and an understanding of the potential effects of genetic discoveries on individual and family well-being.” —MARCIA VAN RIPER, PHD, RN The Genetics Revolution at UNC: One Nurse’s View by Jim Vickers PHOTO COURTESY OF DR. MARCIA VAN RIPER “This course will give faculty and students from a wide variety of disciplines an opportunity to come together to discuss possible ways to address important ethical, legal, and social issues related to advances in genetics and genomics,” she notes. Even with a full work load as a CCGS member, associate professor and founding fellow of the UNC Institute of Arts and Humanities Ethics Program, Van Riper is in the process of finishing data collection for her study of how individuals and families define and manage ethical issues that emerge during four types of genetic testing — prenatal screening for Down syn-drome, carrier testing for cystic fibrosis (CF), BRCA 1 & 2 testing for families at high risk for breast cancer and mutation analysis for Huntington disease. She is using a mixed-method design to explore the experiences of more than 40 families using in-depth semi-struc-tured interviews and self-report measures. Preliminary findings underscore the need to use a family perspective when exploring the ethi-cal issues that emerge from genetic testing. Ethical issues encountered by families in the study include concerns about privacy, informed consent, freedom of choice in reproductive decisions, insurability, discrimination and stigmatization. “A number of family members have made a point of noting that the decision to undergo genetic testing is a very personal experience,” she says, “and no two individuals are affected by the experience in the same way.” Van Riper recently submitted a proposal for a pilot study to explore how families from diverse cultural backgrounds make sense of and use genetic testing results from four of the most widely performed genetic tests, including prenatal screening for Down syndrome, screening for sickle cell anemia, BRCA 1 & 2 test-ing and mutation analysis for the Factor V Leiden gene. If funded, the pilot study will move Van Riper’s research on the family experience of being tested for and living with a genetic condition further toward the prediction of individual and family outcomes following genetic testing. In addition, it will provide a basis for the development and testing of tailored, culturally sensitive individ-ual and family-centered interven-tions to improve the experience and outcomes for persons undergoing genetic testing. Quoting one of her mentor’s, Eric Juengst, the first chief of the Ethical, Legal and Social Implications Branch of the National Center for Human Genome Research at NIH, Van Riper says, “The promise of accessi-ble genetic information lies in its ability to allow individuals and families to identify, understand and sometimes control their inherited health risks. This promise puts the individual and families that receive genetic services at the moral center of the enterprise: if genetic assess-ment is to be judged a success, it must be from the recipient's point of view, in terms of their ability to use the information to enrich their lives. “The pace and enormity of recent genetic discoveries has made it virtually impossible for nurses not to be involved in some aspect of genetic health care. My goal is to get our students excited about genetics and help them see how they can make a critical differences in the lives of families being tested for and living with genetic conditions.” Dr. Marcia Van Riper is working with many families, including those of babies with Down syndrome, to better understand how families define and manage ethical issues that emerge during genetic testing. 2002–2003 11 PHOTO COURTESY OF DR. MARCIA VAN RIPER 12 CAROLINA NURSING RESEARCH CHRONICLE by Brittany Dunstan “Pain isn’t just a simple word,” says Nada Lukkahatai, a fourth-year doctoral nursing student at Carolina. “My time here at UNC has helped me learn that.” Lukkahatai has seen a great deal of pain in her time as a nurse in her native Thailand. She spent several years caring for cancer patients, helping them manage their pain through mental and spir-itual techniques. Medications are not as heavily relied upon in Thailand as they are in the United States, she explains, which was a surprising discovery for her when she came to the U.S. to study Western pain management. “For pain relief, Thai patients often rely on non-narcotic medica-tion and their ability to cope,” explains Lukkahatai. “Buddhism is the religion of the majority of the Thai people, and Buddhists believe in impermanence and non-self-hood and are more accepting of suffering because of their beliefs. According to Buddhist teachings, once a person learns to let go of one’s ‘self,’ he or she becomes free from suffering. In light of the importance of these beliefs, I won-dered if Thai cancer patients per-ceive pain differently from how Western studies have shown the majority of Western patients per-ceive pain. I wanted to know if cul- From a Different Perspective: UNC’s International Nurse Researchers tural influences, including religious and spiritual beliefs, affected how people responded to and coped with pain. I knew if this proved to be true that different, culturally informed strategies for pain man-agement should be explored.” Lukkahatai traveled back to her homeland to conduct her research, where cancer is the second leading cause of death. The cancer patients in her sample answered a series of questionnaires, and Lukkahatai says her preliminary results have been fairly on target with her expectations. “To achieve the most effective pain treatment, multidi-mensional strategies are required,” she says. “Knowledge about inte-grating biological, psychological and sociocultural factors of pain is essential. Understanding the influ-ence of culture on the cancer pain experience is one clinical challenge health-care professionals are facing worldwide in improving pain man-agement.” Lukkahatai graduates in December and will return to Thailand to teach and share her findings with other nurses who care for cancer patients. She eventually hopes to return to the U.S. to do further research as a post-doctoral student and would like to work again with her dissertation team comprised of Drs. Jo Ann Dalton, Barbara Germino, Michael Belyea, Julie Barroso and Frances Keefe, all “Medications are not as heavily relied upon in Thailand as they are in the United States…For pain relief, Thai patients often rely on non-narcotic medication and their ability to cope,” explains Lukkahatai. PHOTO COURTESY OF NADA LUKKAHATAI Nada Lukkahatai, a native of Thailand, is exploring the relation-ship between religiosity and pain management. seasoned researchers who she says helped her see pain from a different perspective. Hyekyun Rhee is on the opposite side of the tassel from Lukkahatai, having graduated from the SON’s PhD program in 2002. Originally from Korea, Rhee decided to stay in the US after her studies and cur-rently is serving as an assistant pro-fessor of nursing at the University of Virginia. Like Lukkahatai, her expe-rience as a UNC doctoral student was a formative one, where she learned to see nursing research in a new light. “My research interests focus on adolescent health,” she explains, “which is a matter of serendipity, really. When I was searching for a dissertation topic, my advisor, Dr. Margaret Miles, suggested I look at data from a newly available nation-al longitudinal study of adolescent health. From that database, I was able to do secondary data analyses that explored the prevalence of physical symptoms such as headache and abdominal pains in healthy adolescents and how these symptoms were related to ecological and developmental factors.” Her UNC research, found with a little luck and a helpful faculty member, has provided her with a solid base that is helping her now springboard into other areas of research she might not have con-sidered before, Rhee says. 2002–2003 13 Originally from Korea but now a faculty member at UVA’s nursing school, Hyekyun Rhee says UNC is where she first developed her nursing research interests. “I feel very blessed to work in such a sup-portive environment as UVA’s SON, and I am grateful to UNC mentors, particularly Dr. Miles, who helped me start my research career…” —HYEKYUN RHEE “I am still interested in researching adolescent health issues in the context of develop-mental science as I did at UNC, but now I’m becoming more interested in the health of adolescents with chronic conditions.” This summer, Rhee received intramural funding to support the development of a program of research on adolescents with asth-ma. She hopes to learn if a cogni-tive- behavioral intervention focus-ing on enhancing the quality of decision-making is effective in reducing risk behaviors in adoles-cents with asthma. In addition to her own study, Rhee has been involved as a co-investigator in a newly funded research project studying adoles-cents’ smoking behavior. “Being a brand-new faculty member, I’m spending a lot of time preparing lectures, writing manu-scripts for publication and submit-ting grant proposals,” she says. “I feel very blessed to work in such a supportive environment as UVA’s SON, and I am grateful to UNC mentors, particularly Dr. Miles, who helped me start my research career. Thanks to looking into an unex-pected research interest, I plan to continue to build my professional career as a competent educator and researcher by enhancing my expert-ise in this field.” PHOTO COURTESY OF HYEKYUN RHEE 14 CAROLINA NURSING RESEARCH CHRONICLE Not only are they leaders of research teams comprised of scien-tists from multiple disciplines, they are important contributors to other scientists’ work as well. The National Institutes of Health and other federal funding sources recognize the importance of this cross-pollination of sciences, favoring proposals that involve interdisciplinary collaborations to encourage scientists to learn methods and theoretical perspec-tives outside of their own fields. Carolina’s nurse researchers cer-tainly recognize the contributions the interdisciplinary approach can make to increase the knowledge base of nursing. More than a dozen current SON research projects involve researchers from other fields. In a study based in central North Carolina, principal investiga-tor Dr. Anne Skelly, a nurse sociolo-gist, and co-principal investigator Dr. Molly Dougherty, a nurse anthropologist, are studying 120 low-income African Americans, Latinos, and European Americans aged 30 to 60 to gather information necessary to create culturally appro-priate community-based strategies to prevent and delay the expression of type 2 diabetes. Both of these SON professors offer an important set of research skills and experi-ences from prior studies that enhance their current collabora-tion. Skelly is an associate professor of nursing who is known for her work on type 2 diabetes, particular-ly with minority communities, while Dougherty, the Frances Hill Fox professor of nursing, is a nationally recognized expert in women’s health, aging and com-munity- based interventions. A key feature of their research is precisely mapping the locations of the sources from which members of the different groups obtain infor-mation about diabetes. For authori-tative assistance they are collabo-rating with co-investigator Dr. Wilbert Gesler of the UNC Geography Department. Well-informed on the global positioning system and the co-author of Medical Geography, Gesler is an internationally recognized expert in a field originated by Dr. John Snow in the nineteenth century when he mapped the residences of cholera victims in London and thereby traced the source of the disease to a single water pump. Gesler’s most recent book, Healing Places, ana-lyzes the effects of environment on healing. “Interdisciplinary research enhances our understanding of the phenomena under study,” explains Skelly. “In our present work, look-ing at the knowledge and beliefs of individuals at high-risk for dia-betes, our team was able to use the-ories from the disciplines of nurs-ing, anthropology, sociology and Interdisciplinary Research: A Team-Based Approach to Improving Health Forget your ideas of nurse researchers in their starched white uniforms holding patients’ hands while taking notes on vital signs. Today’s nurse researchers are often experts in a variety of scientific specialties, from genetics to geography, and are skilled at integrating technology and theory to produce comprehensive approaches to treatment. by Jim Vickers Dr. Barbara Waag Carlson's research team features scientists from many different disciplines. Featured here are Carlson, Charles Leonard, a biochemistry and microbiology graduate student at North Carolina State University, and Sebrina Wiggins, a doctoral student in Pennsylvania State University's biobehavioral health department. medical geography to develop explanatory models of diabetes to guide the development of cultural-ly- sensitive, community-based diabetes prevention programs.” Collecting data from 106 adults aged 70 and greater, Dr. Barbara Waag Carlson and co-investigator Dr. Virginia Neelon are measuring respiratory periodicity (breathing patterns involving repetitive cycles of increased amplitude separated by intervals of either apnea or hypop-nea) and cerebral oxygenation dur-ing sleep to predict their effect on cognitive decline. Carlson, an asso-ciate professor, is trained in experi-mental psychology as well as biobe-havioral nursing and is well versed in measuring brain activities and the development of minimally intrusive research instruments. Neelon, the director of the SON’s Biobehavioral Lab, is a nurse physi-ologist and internationally respect-ed for her work with older adults, having developed the NEECHAM Confusion Scale for measuring acute confusion in elders. This is the fourth research project on which Dr. Marilyn Hartman of the UNC Department of Psychology and Dr. Sunil Dogra of the UNC School of Medicine have worked with Carlson and Neelon, and once again their specialized knowledge and abilities are crucial to a suc-cessful outcome. As a licensed clini-cal psychologist and an expert in age-associated memory and atten-tion changes, Hartman is oversee-ing the collection and interpreta-tion of cognitive data. As an anes-thesiologist specializing in the influence of states of arousal on pain thresholds, Dogra is reviewing health and functional assessments by a nurse practitioner and inter-preting sleep-structure data. Both assist Carlson in training assistants to administer the memory test and assess health functions. Dr. Chris McQuiston began studying sexually transmitted dis-eases and women in 1989 when she was teaching at the University of Akron. Shortly after her arrival in Chapel Hill in 1994, she expanded her program to include African Americans, European Americans and Hispanics. Then in 1997 she concentrated her focus on Mexican immigrants in the Triangle region. In her current study, “Gender, Migration, and HIV Risks among Mexicans,” she has enlisted as a co-investigator Dr. Emilio Parrado from the Department of Sociology at Duke University. Parrado has studied Mexican migration since 1991, gaining astute knowledge as a researcher and project manager 2002��2003 15 of the Mexican Migration Project (MMP) conducted at the University of Pennsylvania, during which he was intimately involved in conduct-ing “ethnosexual” surveys in Mexican and sister-American com-munities. McQuiston, an associate professor at the SON, is employing the MMP survey method and has benefited from Parrado’s experience in having conducted fieldwork in both countries and in having designed both the MMP questionnaire and data management programs. While these experts from other disciplines and campuses enhance SON research, SON researchers have been enriching projects in other UNC divisions and on other cam-puses. Among them, Kenan profes-sor and cancer expert Dr. Merle Mishel is the principal investigator in a study of men diagnosed with prostate cancer being conducted as part of a consortium by Dr. James Mohler of the UNC School of Medicine. Skelly, in addition to serving as principal investigator of her own study, serves as a co-inves-tigator of a study on rural elders’ diabetes self-management now underway at Wake Forest University and as a consultant to Dr. Sharon Utz’s University of Virginia-study of community-based care of African Americans. SON professor Dr. Jo Ann Dalton served as a consultant on pain management for Dr. Francis Keefe at Duke University in a recently completed study of spouse-guided pain management training and for a continuing study of assisted coping skills training for lung cancer patients. “We are pleased that so many School of Nursing researchers head interdisciplinary research teams and participate on teams from other disciplines,” notes Dr. Sandra Funk, associate dean for research. “Interdisciplinary collaboration is a hallmark of research at UNC-Chapel Hill. We are fortunate to have over 50 centers and institutes on campus, such as our Center for Research on Chronic Illness, that facilitate these collaborations, thereby strengthening the research conducted by all faculty.” Amanda DeWitt, also a research assistant in Carlson's study, is a junior studying both biology and psychology at UNC. According to Carlson, half of her research team comes from disciplines other than nursing. Centers of Activity: An Update on CRCI and CIHDR Projects Center for Research on Chronic Illness Purpose: To advance research on the prevention and management of chronic illness in vulnerable people by funding pilot studies, developing new investi-gators, providing research support and facilitating dissemination Established: 1994 Current studies: 25 Funding: National Institute of Nursing Research at the National Institutes of Health Center for Innovation in Health Disparities Research Purpose: A partnership among the schools of nursing at North Carolina Central University, Winston- Salem State University and UNC-Chapel Hill to increase the capacity for culturally competent nursing research by mentoring faculty and students, funding pilot studies and developing and implementing a series of workshops designed to promote innovative methodolo-gies in health disparities research Established: 2002 Current studies: 9 Funding: National Institute of Nursing Research and the National Center on Minority Health and Health Disparities at the National Institutes of Health EXPLORING SOLUTIONS to childhood obesity. Encouraging minority students to inves-tigate their community’s health issues. Recording the rich voices of nurses from previous eras. These are just a few of the projects supported by the School’s two main research centers, the Center for Research on Chronic Illness (CRCI) and the Center for Innovation in Health Disparities Research (CIHDR). These centers provide administrative, financial and outreach support for the majority of the School of Nursing’s research projects. A pictorial update of a few of these initiatives is featured on these pages. Nursing Care for the Chronically Ill: An Oral History of Nurses and Nursing Assistants, 1950-1970 Carrie Robinson, RN, pictured here on the left in her younger nursing days, and a fellow registered nurse, now retired, shown on the right with a grace that comes from time and experience, are both living examples of the importance of a good nurse. These women dedicated many years of their lives to caring for chronically ill patients in North Carolina, and now their stories will be saved for posterity thanks to a new project by Dr. Janna Dieckmann and history doctoral candidate Cristina Nelson. Dieckmann and Nelson traveled the highways and byways of North Carolina this year to record the stories of the state’s nurses and nursing assistants who cared for the chronically ill between 1950 and 1970. The study, funded as a pilot study by the CRCI, investigates patterns of caregiving for the chronically ill in order to broaden our understanding of caring for this group today. Additional project investigators include Dr. Jacqueline Hall and Beth Millwood, director and outreach coordinator of the Southern Oral History Program respectively, and Dr. Joyce Rasin, SON professor. “It is a privilege to be able to document the dignity and worth of these nurses who gave dedicated care to the long-term sick,” says Dieckmann. 16 CAROLINA NURSING RESEARCH CHRONICLE 2002–2003 17 REAP Abu Bangura (left) and Bisola Baruwa (right), nursing students at North Carolina Central University, are both interested in careers in nursing research. As members of the local African-American community, they are all too familiar with the figures on the state of minority health in N.C., which is why they have signed up to participate in REAP, formally known as the Research Enrichment and Apprenticeship Program. The program, a joint collaboration between UNC and NCCU funded by CIHDR, pairs minority nursing students with nurse scien-tists experienced in health disparities research. Students contribute to faculty research by collecting and analyzing data and conducting interventions, and they are given the opportunity to conduct their own original research on a related health disparity issue. This will be REAP’s third year, and program directors say they are seeing positive effects already. Several of the student participants have said they are prepared to pursue careers in minority health research as a result of the program. STOPP-T2D STOPP-T2D, the acronym for Dr. Joanne Harrell’s “Studies to Treat or Prevent Pediatric Type 2 Diabetes,” is testing a school-based intervention to increase physical activity, improve nutrition and prevent type 2 diabetes in children and adolescents. Type 2 diabetes has increased at alarming rates over the past decade in youth under 18. Thus far Harrell and her co-investigators Drs. Robert McMurray, John Buse, Allan Steckler, Anthony Hackney, Maihan Vu and Vivian West have worked with hundreds of middle school students in central and eastern North Carolina counties, piloting the Oral Glucose Tolerance Test, changing the PE curriculum to increase minutes of moder-ate to vigorous physical activity in each class, reducing fat and calorie content for school lunch entrees, snack bars and vending machines and increasing consumption of water by students. This National Institute of Diabetes and Digestive and Kidney Diseases-funded project may revolu-tionize the way adolescents eat and exercise at school once the results are made public upon completion in 2009. by Sunny Smith Nelson In 2003, the School of Nursing boasted 42 faculty members work-ing as principal investigators, co-principal investigators or co-investi-gators of large, extramurally fund-ed research grants. These researchers brought in over $10 million to fund their work and helped thousands of North Carolina citizens improve their health by involving them in their studies. What you won’t find on these scien-tists’ resumes is a skill they’ve per-fected while working at Carrington Hall: space utilization. Here’s how research space in the SON breaks down: there are approx-imately 4,800 square feet of space for funded research projects in Carrington Hall. Divide that among 42 researchers and their 75 to 100 research team members, and that’s around 34 square feet per person. In room dimensions, that’s about 5’ x 6’. Not much space to recruit study participants, hire and train research assistants, crunch data and write conclusive reports on your results. Yet SON researchers manage to do it everyday. There is a light at the end of the tunnel for these researchers, though. The new addition to Carrington Hall will more than double the amount of space dedi-cated to externally-funded projects at the SON. The majority of the new space will be housed on the second and third floors of the addition and will feature a climate-controlled archive room, a welcomed addition and a far cry from the Carrington attic where researchers currently store their data. The addition also will feature 45 new offices, provid-ing all research staff with a better 18 CAROLINA NURSING RESEARCH CHRONICLE working environment. The quality of research per-formed at the SON doesn’t rest with the faculty alone, however. Many of the School’s alumni have commit-ted to support research excellence at the SON. The Class of ’56, when thinking of ways they collectively could support the School, struck upon naming the Biobehavioral Laboratory Suite. “Nursing is a spe-cial field,” says Jane Sox Monroe (BSN ’56) who with her husband, Paul, named the Human Patient Simulator Laboratory for Critical Care Skills Development. “We believe strongly in the program of the School of Nursing and in the opportunities that the new addition will provide.” Margaret Ferguson Raynor (BSN ’67) and her husband, Dr. Bobby C. Raynor, chose to support the Biobehavioral Lab for Genomics. “The new building will allow us to stay at the top of the practice of nursing while providing a pleasing learning and working environment,” says Raynor. “Important new features include state-of-the-art technology and equipment to enable nursing stu-dents and faculty to remain on the cutting edge of the practice, thus ensuring their ability to provide North Carolina citizens with the best nursing care possible.” According to Dr. Maggie Miller, the assistant dean for student and faculty services, the new research space can only add to the quality of the research produced by the SON. “The new addition is a testa-ment to the School’s dedication to quality research,” she says. “It will provide an environment that will match the high caliber research performed here, and hopefully make the SON even more attractive to faculty with established research programs or those wanting to devel-op outstanding programs.” Several opportunities to help support SON research are available, from naming labs or suites to con-tributing to endowed professorships that will support nationally renowned faculty researchers. If you would like to learn more about these opportunities, contact Norma Hawthorne at (919) 966-4619 or norma_hawthorne@unc.edu. The SON’s researchers thank you from the bottom of their 5’ x 6’ research spaces. Research Space: The Next Frontier QUICK FACTS • 21 Funded project areas • Dedicated archiving space • Expanded space for the Research Support Center • 45 new offices NAMING OPPORTUNITIES TO SUPPORT SON RESEARCH Building Addition, to be named by donor ($4 million) Distinguished professorship ($500,000) Faculty Research Award ($250,000) Biobehavioral Laboratory Suite (A Gift of the Class of ’56) Research Support Center Suite ($200,000) Associate Dean for Research Office ($100,000) Biobehavioral Laboratory for Genomics Study (A Gift of Margaret Ferguson Raynor, BSN ’67, and Dr. Bobby C. Raynor) Biobehavioral Laboratory for Human Factors Study ($100,000) Biobehavioral Laboratory for Sleep Study ($100,000) Research Project Suites (20 available; $15,000 each) Two faculty members share this office originally intended to house one person. 2002–2003 19 The numbers are in, and the School of Nursing is once again in the top five in several national rankings. The National Institutes of Health released its research funding rankings this spring, and the SON placed fourth among nursing schools nationwide with $7.5 million received in fiscal year 2002 from the agency. That’s a one-year increase of nearly $1.25 million, enough to bump the SON up a spot in the national ranking from its fifth place spot in 2001. The University fared well overall, placing 13th nationwide in grants funded by the NIH, with the SON, School of Dentistry and School of Public Health all ranking in the top five. News of this ranking came fast on the heels on the U.S.News & World Report ranking of the nation’s best graduate schools. The SON maintained its excellent standing, ranking fifth nationwide for its master’s programs. The nursing service administration program was ranked third; the SON’s family nurse practitioner and psychiatric/mental health programs were both ranked seventh; and the adult nurse practitioner program was ranked ninth. “As I represent the School of Nursing at meetings across the state and nation, people come up to me and ask, 'How does UNC-Chapel Hill do it?'” says Dean Linda Cronenwett. “Indeed, the collective accomplishments of the faculty, staff and students are astounding, year after year. We aim for excel-lence and are proud to achieve recognition for our leadership.” I N B R I E F An estimated 20 million Americans are affected by urinary incontinence, making it a signifi-cant health concern in the United States. Nearly $5.2 billion is spent annually on supplies and services to treat the condition, but according to Dr. Mary H. Palmer, Umphlet dis-tinguished professor in aging at UNC, the responsibility for promot-ing continence and treating incon-tinence lies with health-care providers, particularly nurses. Palmer co-led a national con-ference, funded in part by a grant from the Agency for Healthcare Research and Quality, on preven-tion, detection and treatment options last year, with the recom-mendations from that conference appearing in a seminal document co-edited by Palmer and Diane K. Newman of the Penn Center for Continence and Pelvic Health in the Division of Urology at the University of Pennsylvania Medical Center. “State of the Science on Urinary Incontinence,” an American Journal of Nursing special supple-ment, was released this March with much fanfare, including video press conferences, press releases and interviews with national media. The recommendations reported by Palmer and Newman include improving public awareness and education on the issue; advocating for more education for nurses on the condition; improving clinical care guidelines and practices; increasing reimbursement for edu-cation, evaluation, management and behavioral interventions; and increasing research that compares various interventions, involves minorities and men, and can be implemented in clinical practice. An electronic, full-text version of the issue is available at www.NursingCenter.com/ui. Distinguished professor leads conference on UI, co-edits special AJN supplement on condition Dr. Mary H. Palmer co-led a national conference on incontinence with Dr. Diane K. Newman of the Penn Center for Continence and Pelvic Health and Dr. Diana Mason, editor-in-chief of the American Journal of Nursing. SON Ranks in Top Five—Again! University of Washington, Seattle University of California, San Francisco University of Illinois at Chicago University of North Carolina at Chapel Hill University of Pennsylvania $13,662,728 42 $10,663,305 41 $8,176,294 28 $7,535,184 21 $5,758,381 19 Total Amount Total Awards Top five nursing schools receiving NIH funding PHOTO COURTESY OF DR. MARY H. PALMER 20 CAROLINA NURSING RESEARCH CHRONICLE Depressive symptoms are more prevalent, severe and persistent in many low-income mothers, says Dr. Linda Beeber, SON professor, because of the complex life prob-lems they face with lean resources and poor social support. These symptoms can make it hard for mothers to get the education, job training or enrichment programs that can help break them out of poverty, and their children can suf-fer emotionally and mentally as their mothers sink deeper into depression with no hope of improv-ing the situation. A new study fund-ed by the National Institute of Mental Health that Beeber is lead-ing, “Reducing Depressive Symptoms in Low-Income Mothers,” will seek to help these mothers break the cycle during the first three years of their child’s life when development is so dependent on a mother’s energy. “Although awareness of postpartum depression has increased, maternal depressive symptoms that last more than six months at any time during the first three years of the child’s life can negatively affect development,” explains Beeber. Very similar to a study she also is conducting with low-income Hispanic mothers, this research will test a 5-month intervention to help African American and Caucasian mothers effectively function with their symptoms, manage life issues, utilize social support available through public programs and better parent their children. The study will work with Early Head Start (EHS) programs in Orange, Guilford and McDowell counties, North Carolina; Asheville, North Carolina; and Onondaga County, New York. Beeber and her fellow researchers will recruit 226 depressed mothers of children between six weeks and 30 months enrolled in EHS pro-grams in order to study them at baseline and 14, 22 and 26 weeks later to test how effective the intervention is. “Few controlled interventions with high-risk mothers such as these have been done to date,” says Beeber. “This study will address this gap by bringing an intervention specifically for depressive symptoms alongside of an already existing early child intervention program. By helping these mothers better utilize EHS resources, the positive benefits of the intervention can be maintained and thus result in lasting benefits for the child as well as the mother.” Helping Low-Income Mothers with Depressive Symptoms Help Themselves I N B R I E F More than 84,000 female inmates are being held now in state and federal prisons, and many are at an increased risk for contracting HIV due to histories of promiscuity, prostitution or exchange of sex for drugs. Dr. Cathie Fogel, a professor at the SON, wants to help them reduce their risk. Expanding upon her efforts to improve the health of incarcerated women, Fogel this year began her new study, “Helping Women Prisoners Reduce HIV Risk After Release.” The study, funded by the National Institute of Mental Health, will continue for five years and test a primary prevention women-cen-tered risk reduction intervention with incarcerated women. The intervention is designed to help pre-vent HIV infection by reducing sex-ual risk behaviors and promoting sexual protective practices upon release from prison. If successful, the proposed inter-vention will serve as a model for HIV prevention efforts in women’s prisons and may be translated for broader application. “I am excited to be able to offer this program to a population of vulnerable women who are often forgotten and whose risks are many,” says Fogel. “It is my hope that through our work we will be able to improve the health of the women and, by extension, their families and communities.” Reducing the Risk of HIV in Female Prisoners ARTHRITIS Goeppinger, J., Principal Investigator; Schwartz, T., Statistician. Comparing ASHC and CDSMP Outcomes in Arthritis. Association of Schools of Public Health, Centers for Disease Control, 2002-2004. CANCER Mishel, M., Principal Investigator; Germino, B., Co- Principal Investigator; Gil, K., Carlton-LaNey, I., & Belyea, M., Co-Investigators. Managing Uncertainty in Older Breast Cancer Survivors. National Cancer Institute, National Institutes of Health, 1999-2004. Mishel, M., Principal Investigator; Germino, B., Co- Principal Investigator; Beeber, L., Belyea, M., Gollop, C., Mohler, J., Co-Investigators. Decision Making Under Uncertainty in Prostate Cancer. National Institute of Nursing Research, National Institutes of Health, 2002-2006. CARDIOVASCULAR DISEASE Brown, D., Principal Investigator. Perceived Stress, Cortisol and Cardiovascular Responses During Sleep in Black Women. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2003-2004. Fleury, J., Principal Investigator; Bunker, B., Co- Investigator; Carlson, J., Statistician. Community-based Intervention to Promote Cardiovascular Health. American Heart Association, 1999-2002. Harrell, J., Principal Investigator; McMurray, R., Bangdiwala, S., & Davenport, M., Co-Investigators. Cardiovascular Health in Children and Youth (CHIC III). National Institute of Nursing Research, National Institutes of Health, 2000-2004. Harrell, J., Principal Investigator; McMurray, R., Co- Principal Investigator; Bangdiwala, S., Co- Investigator. Energy Expenditures of Physical Activities in Youth (EEPAY). National Institute of Nursing Research, National Institutes of Health, 1998-2002. CAREGIVING Rasin, J., Principal Investigator. Caregiving Stress in Family Care Homes. Junior Faculty Development Award, The University of North Carolina at Chapel Hill, 2002. Rasin, J., Principal Investigator. Caregiving Stress in Family Care Homes. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2001-2002. CHRONIC ILLNESS Dieckmann, J., Principal Investigator. Caring for the Chronically Ill in North Carolina and Two Neighboring States, 1930-1940. Junior Faculty Development Award, The University of North Carolina at Chapel Hill, 2002. Dieckmann, J., Principal Investigator; Hall, J., & Rasin, J., Co-Investigators. Nursing Care for the Chronically Ill: An Oral History of Nurses and Nursing Assistants, 1950-1970. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2002-2003. Goeppinger, J., Operations Committee Member; Cross, A., Principal Investigator. Prevention Research Centers Program. Centers for Disease Control, 2000-2003. Harrell, J., Principal Investigator; Funk, S., Co-Principal Investigator; Leeman, J., Co-Investigator; Holditch- Davis, D., Mishel, M., & Dougherty, M., Core Directors. Center for Preventing/Managing Chronic Illness in Vulnerable People. National Institute of Nursing Research, National Institutes of Health, 1994-2004. CYSTIC FIBROSIS Christian, B., Principal Investigator; D’Auria, J., Co- Principal Investigator; Retsch-Bogart, G., & Belyea, M., Co-Investigators; Holditch-Davis, D., Senior Research Consultant. Building Life Skills in Children with Cystic Fibrosis. National Institute of Nursing Research, National Institutes of Health, 1998-2002. DEPRESSION Beeber, L., Principal Investigator; Holditch-Davis, D., Perreira, K., Belyea, M., Co-Investigators. EHS Latino Mothers: Reducing Depression and Improving Infant/Toddler Mental Health. Department of Health and Human Services – Administration for Children, Youth, and Families, 2002-2006. Beeber, L., Principal Investigator; Canuso, R., Holditch- Davis, D., Mishel, M., Belyea, M., Co-Investigator. Reducing Depressive Symptoms in Low-Income Mothers. National Institute of Mental Health, National Institutes of Health, 2003-2008. DIABETES Harrell, J., Principal Investigator; McMurray, R., Bangdiwala, S., Hackney, A., & Chapman, J., Co- Investigators. Physical Activity in Youth-Preventing Type 2 Diabetes. National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, 2002-2009. Skelly, A., Site Principal Investigator & Co-Investigator; Quandt, S., Principal Investigator. Rural Elders’ Diabetes Self-Management: Ethnic Variations. Wake Forest University, National Institute on Aging, National Institutes of Health, 2001-2005. Skelly, A., Principal Investigator; Dougherty, M., Arcury, T., Cravey, A., & Gesler, W., Co-Investigators. Type 2 Diabetes: Ethnic Variation in Knowledge and Beliefs. National Institute of Nursing Research, National Institutes of Health, 2000-2004. ELDERS Carlson, B., Principal Investigator; Neelon, V., Hartman, M., Dogra, S., & Carlson, J., Co-Investigators. Respiratory Periodicity and Cognitive Decline in Elders. National Institute of Nursing Research, National Institutes of Health, 2002-2006. Carlson, B., Principal Investigator; Neelon, V., Carlson, J., & Rowsey, P., Co-Investigators. Core Body Temperature Rhythm, Cytokines and Respiratory Periodicity During Sleep in Older Adults with and Without Age-Associated Memory Impairment. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2002-2003. Hudson, M., Principal Investigator; Carlson, J., Co- Investigator; Belyea, M., Psychometric Consultant; Fishel, A., Field Tester. Elder Abuse: A Screening Protocol. National Institute on Aging, National Institutes of Health, 1997-2002. Palmer, M., Subcontract Principal Investigator and Study Co-Investigator; Baumgarten, M., Principal Investigator. Locus of Care and Pressure Ulcers After Hip Fracture. University of Maryland, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 2002. GENETICS Thoyre, S., Co-Principal Investigator; Van Riper, M., Co- Principal Investigator; Brackett, K., Co-Investigator. Feeding Issues for Young Children with Down Syndrome and Their Families. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill, National Institute of Nursing Research, National Institutes of Health, 2002-2003. Van Riper, M., Principal Investigator; Knafl, K., Magnuson, T., Juengst, E., Grabowski, G., & Gregory, P., Mentors. Family Experience of Genetic Testing: Ethical Dimensions. National Institute of Nursing Research, National Institutes of Health, 2001-2003. HEALTH DISPARITIES McQuiston, C., Principal Investigator; Dennis, B., Flack, S., Co-Principal Investigators; Leeman, J., Co- Investigator and Project Director; Miles, M., Rowsey, P., Goeppinger, J., & Eaves, Y., Core Directors. Center for Innovation in Health Disparities Research. National Institute of Nursing Research, National Institutes of Health, 2002-2007. Faculty Research Grants 2002–2003 Academic Year 2002–2003 21 HIV/AIDS Barroso, J., Co-Investigator; Leserman, J., Site Principal Investigator. HIV: Neuropsychiatric and Psychoimmune Relationships. University of Pennsylvania, National Institutes of Health, 2001-2004. Fogel, C., Principal Investigator. The Experiences of HIV-Infected Women Following Incarceration. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill, National Institute of Nursing Research, National Institutes of Health, 2002-2004. McQuiston, C., Principal Investigator; Parrado, E., Co- Investigator; Flippen, C., Project Manager. Gender, Migration, and HIV Risks Among Mexicans. National Institute of Nursing Research, National Institutes of Health, 2001-2005. Pletsch, P., Co-investigator; Stevens, P., Principal Investigator; Keigher, S., Co-Investigator. In-Depth Longitudinal Study of HIV-Infected Women. University of Wisconsin at Milwaukee, National Institute of Nursing Research, National Institutes of Health, 2000-2003. INCONTINENCE Boyington, A., Principal Investigator; Dougherty, M., Sponsor. A Knowledge-Based System for Continence. National Institute of Nursing Research, National Institutes of Health, 1999-2003. Boyington, A., Principal Investigator. Enhanced Recruitment for Phase 3: A Knowledge-Based System for Continence. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2001-2002. Kincade, J., Principal Investigator; Dougherty, M., Co-Principal Investigator; Carlson, J., Co-Investigator and Statistician; Busby-Whitehead, J., & Wells, E., Co-Investigators. Efficacy of Biofeedback to Treat UI in Women. National Institute of Nursing Research, National Institutes of Health, 2000-2004. Kincade, J., Principal Investigator; Dougherty, M., Co- Principal Investigator; Carlson, J., Co-Investigator and Statistician; Busby-Whitehead, Co-Investigator. Effectiveness of Self-Monitoring to Treat UI in Women. National Institute of Nursing Research, National Institutes of Health, 2001-2004. Palmer, M., Principal Investigator. Urinary Incontinence Research, Practice & Policy Issues. Agency for Healthcare Research and Quality, 2002-2003. INFANTS AND CHILDREN Holditch-Davis, D., Principal Investigator; Scher, M., Miles, M., Schwartz, T., & Hack, M., Co- Investigators. Assessment of Biological And Social Risk In Preterm Infants. National Institute of Nursing Research, National Institutes of Health, 1998-2003. Holditch-Davis, D., Principal Investigator; Miles, M., Co- Principal Investigator; Beeber, L., & Thoyre, S., Co- Investigators; Belyea, M., Statistical Investigator; Pedersen, C., & Biddle, A., Consulting Investigators; Black, B., Project Manager; Hubbard, C., & Wereszczak, J., Clinical Investigators; Nursing Support Intervention for Mothers of Prematures. National Institute of Nursing Research, National Institutes of Health, 2001-2006. Thoyre, S., Principal Investigator; Holditch-Davis, D., Sponsor; Carlson, J., Statistical Investigator; Veness- Meehan, K., Consulting Investigator. Contingent Feeding of Preterms to Reduce Hypoxemia. National Institute of Nursing Research, National Institutes of Health, 2002-2005. Thoyre, S., Principal Investigator. Decreasing the Effect of Variability in a Test of Contingent Feeding for Preterm Infants. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2002-2003. NURSING SYSTEMS AND OUTCOMES Cronenwett, L. R., Steering Committee Member; Roper, W., Principal Investigator. Program on Health Outcomes, School of Public Health, The University of North Carolina at Chapel Hill, Glaxo-Wellcome Foundation, 1999-2003. Esposito, N., Principal Investigator; Beeber, L., Psychiatric Nurse; Schwartz, T., Statistician. Women Drug Abusers and Post Sexual Assault Care. National Institute on Drug Abuse, National Institutes of Health, 2001-2002. Foley, B., Principal Investigator; Bingham, M., Kee, C., Minick, P, & Harvey, S., Co-Investigators; Schwartz, T., Statistician. Nursing Processes and Patient Outcomes in U.S. Army Hospitals, Triservice Nursing Research Program, 2002-2004 Jones, C., Principal Investigator. Calculating the Costs of Nursing Turnover in Hospitals. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2001-2004. Jones, C., Principal Investigator. Differential Nursing Employment Patterns: Racial and Geographic Characteristics. Junior Faculty Development Award, The University of North Carolina at Chapel Hill, 2002. Lynn, M., Principal Investigator; Mark, B., Nursing Systems Analyst; Bollen, K., SEM Analyst; Morgan, J., Data Analyst. Testing a Model of Quality Care in Home Health. National Institute of Nursing Research, National Institutes of Health, 2002-2007. Lynn, M., Principal Investigator; Redman, R., Co- Principal Investigator. Canaries in the Coalmine: A View of the Nursing Shortage from the Trenches. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2003-2004. Mark, B., Principal Investigator. Nurse Staffing, Financial Performance, and Quality Care. Agency for Healthcare Research and Quality, 1999-2005. Mark, B., Principal Investigator; Jones, C., Eck, S., & Belyea, M., Investigators. A Model of Patient and Nursing Administration Outcomes. National Institute of Nursing Research, National Institutes of Health, 1995-2007. Mark, B., Co-Sponsor; Radwin, L., Principal Investigator. Testing the Quality Health Outcomes Model in Cancer Care. University of Massachusetts at Boston, Agency for Healthcare Research and Quality, 2001- 2006. Redman, R., Principal Investigator; Lynn, M., Co-Principal Investigator. Development of an Instrument to Assess Patient Expectations and Evaluation of Care Experiences. Program on Health Outcomes, University of North Carolina at Chapel Hill, 2002-2003. RESEARCH SYNTHESIS Sandelowski, M., Principal Investigator; Barroso, J., Co-Principal Investigator. Analytic Techniques for Qualitative Metasynthesis. National Institute of Nursing Research, National Institutes of Health, 2000-2005. Woodard, B., Principal Investigator; Sandelowski, M., & Barroso, J., Co-Investigators. A Pilot Study to Transform Qualitative Research Findings for Use in Evidence-based Practice. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2003-2004. RESEARCH TRAINING Mishel, M., Principal Investigator; Holditch-Davis, D., Co-Principal Investigator. Interventions for Preventing and Managing Chronic Illness. Institutional National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 1996-2006. SMOKING CESSATION Pletsch, P., Principal Investigator. Taste Changes and the Smoking Cessation Experience of Spontaneous Quitters: Informing the Next Generation of Cessation Interventions for Pregnant Women. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2002-2003. Pletsch, P., Co-Investigator. Testing Pharmacological Therapies for Pregnant Smokers. Duke University, National Cancer Institute, National Institutes of Health, 2003-2004. THERMOREGULATION Rowsey, P.J., Principal Investigator. Beneficial Effects of Exercise on Health and Disease. National Institute of Nursing Research, National Institutes of Health, 1999-2004. 22 CAROLINA NURSING RESEARCH CHRONICLE �� Major Research Project Sites July 2002 – June 2003 2002–2003 23 Barlow, J., Principal Investigator. Early Intervention for Hospitalized Children. The Duke Endowment, 2003-2005. Barlow, J., Principal Investigator. Community Pathways: Early Intervention for Hospitalized Children. NC Department of Health and Human Services, Division of Public Health, Women’s and Children’s Health Section, 2002-2003. Cockroft, M., & Foster, B., Co-Principal Investigators. Occupational Health Site Development for Undergraduate Nursing Students. AHEC Grant for Development of New Clinical Training Sites for Nursing, 2002-2003. Fishel, A., & Fogel. C., Faculty Liaisons. Curtis, P., Principal Investigator. Integrating CAM into Health Professions Education. National Institutes of Health, 2000-2005. Goeppinger, J., Principal Investigator. Sustainable Solutions to Economic Distress, Tobacco Dependence, Limited Health Care Access and the Nursing Shortage: Nursing Education for Golden LEAF Counties. Golden LEAF Foundation, 2003. Goeppinger, J., Project Director. Community-Oriented Primary Care for Rural Populations. Health Resources and Services Administration, Division of Nursing, 2000-2003. Henderson, M., Principal Investigator. Transitions: A New Model of Care for Frail Elderly Facing the Final Phase of Life, Warner Dannheisser Testamentary Trust, 2002-2004 Miles, M., Faculty Member. Ornstien, P., Director. Center for Developmental Science. National Institute of Mental Health, National Institutes of Health, 1998-2003. Educational and Professional Grants 2002–2003 Academic Year Miles, M., Co-Director; Elder, G., Director. Human Development: Interdisciplinary Research Training. National Institute of Child Health and Human Development, National Institutes of Health, 1998-2003 Miller, M., Project Director. Advanced education nurse traineeship. Bureau of Health Professions, Health Resources and Services Administration, 2002-2003. Pierce, S., Principal Investigator. Creating leaders in ethical deliberation. Helene Fuld Trust, 2001-2003. Rasin, J., Principal Investigator. Building capacity in the nursing workforce: Caring for diverse elders. John A. Hartford Foundation, 2001-2004. Redman, R., Principal Investigator; Moore, K., Co-Investigator. Ueltschi Service-Learning Course Development Grant. The University of North Carolina at Chapel Hill APPLES Service Learning Program, 2002-2004 . Alexander, G. Rumay, Clinical Assistant Professor Alexander, G. R. (2002). A mind for multicultural manage-ment. Nursing Management, 33(10), 30-33. Alexander, G. R. (2002). Legislation is the solution to the nursing shortage: The con side. Nursing Leadership Forum, 6(3), 65-8. Alexander, G. R. (2002). Let’s get busy diversifying! Nursing Management, 33(5), 16. Barroso, Julie, Assistant Professor Barroso, J., Carlson, J., & Meynell, J. (2003). Physiological and psychological markers associated with HIV-related fatigue. Clinical Nursing Research, 12(1), 49-68. Barroso, J., Gollop, C., Sandelowski, M., Meynell, J., Pearce, P., & Collins, L. (2003). The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing Research, 25, 153-178. Barroso, J., Preisser, J. S., Leserman, J., Gaynes, B. L., Golden, R. N., & Evans, D. L. (2002). Predicting fatigue and depression in HIV-positive gay men. Psychosomatics, 43(4), 317-325. Leserman, J., Petitto, J. M., Gu, H., Gaynes, B. N., Barroso, J., Golden, R. N., Perkins, D. O., Folds, J. D., & Evans, D. L. (2002). Progression to AIDS, a clinical AIDS con-dition, and mortality: Psychosocial and physiological predictors. Psychological Medicine, 32, 1059-1073. Randall, M., & Barroso, J. (2002). Delayed pursuit of health care among HIV-positive gay men enrolled in a longitudinal research study. Journal of the Association of Nurses in AIDS Care, 13(4), 7-15. Sandelowski, M., & Barroso, J. (2002). Finding the findings in qualitative studies. Journal of Nursing Scholarship, 34, 213-219. Sandelowski, M., & Barroso, J. (2003). Creating metasum-maries of qualitative findings. Nursing Research, 52, 226-233. Sandelowski, M., & Barroso, J. (2003). Toward a metasyn-thesis of qualitative findings on motherhood in HIV-positive women. Research in Nursing and Health, 26, 153-170. Sandelowski, M., & Barroso, J. (2003). Writing the proposal for a qualitative research methodology project. Qualitative Health Research, 13, 781-820. Beeber, Linda S., Professor Beeber, L. S. (2002). The pinks and the blues: Symptoms of chronic depression in mothers during their children’s first year. American Journal of Nursing, 102(11), 91-8. Beeber, L. S., & Miles, M. S. (2003). Maternal mental health and parenting in poverty. In J. J. Fitzpatrick (Series Ed.), M. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 303-331). New York: Springer. Belyea, Michael, Research Associate Professor Lai, Y. H., Dalton J. A., Belyea, M., Chen M. L., Tsai, L. Y., & Chen, S. C. (2003). Development and testing of the pain opioid analgesics beliefs scale in Taiwanese cancer patients. Journal of Pain & Symptom Management, 25(4), 376-385. Mishel, M. H., Germino, B., Belyea, M., Stewart, J., Bailey, D., Jr., Robertson, C., & Mohler, J. (2003). Moderators of an uncertainty management intervention for men with localized prostate cancer. Nursing Research 52(2), 89-97. Black, Beth, Clinical Associate Professor Black, B., & Miles, M. (2002). Calculating risks and bene-fits of disclosure in African American women with HIV. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(6), 688-697. Holditch-Davis, D., & Black, B. (2003). Care of preterm infants: Programs of research and their relationship to developmental science. In J. J. Fitzpatrick (Series Ed.), M. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 23-60). New York: Springer. Boyington, Alice, Assistant Professor Castina, S., Boyington, A. R., & Dougherty, M. C. (2002). Urinary incontinence: If we don’t ask, patients won’t tell. American Journal of Nursing, 10(8), 85, 87. Dougherty, M. C., Dwyer, J. W., Pendergast, J. F., Coward, R. T., Vogel, W. B., Duncan, R. P., Rooks, L., Tomlinson, B. U., & Boyington, A. R. (2002). A behavioral manage-ment for continence intervention reduced urinary incontinence symptoms in older rural women. Evidence-based Mental Health, 5, 79. Carlson, John, Research Associate Professor Barroso, J., Carlson, J., & Meynell, J. (2003). Physiological and psychological markers associated with HIV-related fatigue. Clinical Nursing Research, 12(1), 49-68. Carlson, J., Youngblood, R., Dalton, J. A., Blau, W., & Lindley, C. (2003). Is patient satisfaction a legitimate outcome of pain management? Journal of Pain and Symptom Management, 25(3), 264-275. Rowsey, P. J., Metzger, B. L., Carlson, J., & Gordon, C. J. (2003). Effect of exercise conditioning on thermoreg-ulatory responses to repeated administration of chlor-pyrifos. Environmental Research, 92, 27-34. Thoyre, S., & Carlson, J. (2003). Occurrence of oxygen desaturation events during preterm infant bottle feed-ing near discharge. Early Human Development, 72, 25-36. Cheek, Dennis, Assistant Professor Cheek, D., & Cesan, A. (2003). Genetic predictors of cardio-vascular disease: The use of chip technology. The Journal of Cardiovascular Nursing, 18(1), 50-56. Christian, Becky J., Associate Professor Christian, B. J. (2003). Growing up with chronic illness: Psychosocial adjustments of children and adolescents with cystic fibrosis. In J. J. Fitzpatrick (Series Ed.), M. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 151-172). New York: Springer. Cronenwett, Linda R., Professor and Dean Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. Journal of Nursing Administration, 33(2), 131-133. Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. (repeated in) Nurse Educator, 28(4), 153-155. Dalton, Jo Ann, Professor Carlson, J., Youngblood, R., Dalton, J. A., Blau, W., & Lindley, C. (2003). Is patient satisfaction a legitimate outcome of pain management? Journal of Pain and Symptom Management, 25(3), 264-275. Keefe, F., Ahles, T., Porter, L., Sutton, L., McBride, C., Pope, M., McKinstry, E., Furstenberg, C., Dalton, J. A., & Baucom, D. (May 2003). The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life. Pain, 103(1-2), 157-162. Lai, Y. H., Dalton J. A., Belyea, M., Chen M. L., Tsai, L. Y., & Chen, S. C. (2003). Development and testing of the pain opioid analgesics beliefs scale in Taiwanese can-cer patients. Journal of Pain & Symptom Management, 25(4), 376-385. Stephenson, N. L. & Dalton, J. A. (2003). Using reflexology for pain management: A review. Journal of Holistic Nursing, 21(2), 179-191. Dougherty, Molly C., Frances Hill Fox Distinguished Professor Castina, S., Boyington, A. R., & Dougherty, M. C. (2002). Urinary incontinence: If we don’t ask, patients won’t tell. American Journal of Nursing, 102(8), 85, 87. Dougherty, M. C. (2002). Progress: Editor’s web site and more. Nursing Research, 51, 4a. Dougherty, M. C., Dwyer, J. W., Pendergast, J. F., Coward, R. T., Vogel, W. B., Duncan, R. P., Rooks, L., Tomlinson, B. U., & Boyington, A. R. (2002). A behavioral manage-ment for continence intervention reduced urinary incontinence symptoms in older rural women. Evidence-based Mental Health, 5, 79. Lin, S-Y., & Dougherty, M. C. (2002). Incontinence impact, symptom distress and treatment-seeking behavior in women with involuntary urine loss in southern Taiwan. International Journal of Nursing Studies, 40, 227-234. Moore, K. N., Colling, J., & Dougherty, M. C. (2002). Nursing research and continence care. Urologic Nursing, 22(3), 183-187. Esposito, Noreen, Assistant Professor Esposito, N. (2002). St. John the Divine. Iris: The UNC Journal of Medicine, Literature & Visual Art, 3, 30-35. 24 CAROLINA NURSING RESEARCH CHRONICLE Faculty Publications 2002–2003 Academic Year 2002–2003 25 Fishel, Anne, Professor Fishel, A. (2002). Anxiety disorders. In N. Randolph (Ed.), Springhouse review for psychiatric and mental health nursing certification (pp.81-93). Philadelphia: Lippincott, Williams & Wilkins. Fogel, Catherine, Professor Fogel, C., & Moos, M-K. (2002). Family planning nurs-ing manual. Raleigh, NC: Women’s Health Section, Department of Health and Human Services. Fogel, C., & Moos, M-K. (2002). Maternal health nursing manual. Raleigh, NC: Women’s Health Section, Department of Health and Human Services. Fogel, C., Moos, M-K., & Flannigan, O. (2002). Orientation to women’s health care in local health departments workbook. Raleigh, NC: Women’s Health Section, Department of Health and Human Services. Fogel, C. (2003). Sexuality of women. In V. Lucas, & E. Breslin (Eds.), AWHONN’s core curriculum for women’s health (pp. 400-431). Philadelphia: W.B. Saunders. Fogel, C. (2003). Women and sexuality. In E. Q. Youngkin & M. S. Davis (Eds.), Women’s health: A primary care clinical guide (3rd ed., pp. 109-130). Stamford, CT: Appleton & Lange. Gingrich, P., & Fogel, C. (2003). Herbal therapy use by perimenopausal women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32(2), 181-189. Foley, Barbara Jo, Clinical Associate Professor Fry, S., Harvey, R., Hurley, A., & Foley, B. (2002). Development of a model of moral distress in military nursing. Nursing Ethics, 9(4), 373-387. Funk, Sandra G., Professor Funk, S. G. (2003). Experimental designs. In K.S. Oman, M. Krugman, & R. Fink (Eds.), Nursing research secrets (pp. 113-121). Philadelphia: Hanley & Belfus, Inc. Leeman, J., Goeppinger, J., Funk, S. G., & Roland, J. (2003). An enriched research experience for minority undergradu-ates: A step towards increasing the number of minority nurse researchers. Nursing Outlook, 51(1), 20-24. Germino, Barbara, Beerstecher Blackwell Distinguished Professor Mishel, M. H., Germino, B., Belyea, M., Stewart, J., Bailey, D., Jr., Robertson, C., & Mohler, J. (2003). Moderators of an uncertainty management intervention for men with local-ized prostate cancer. Nursing Research, 52(2), 89-97. Goeppinger, Jean, Professor Leeman, J., Goeppinger, J., Funk, S. G., & Roland, E.J. (2003). An enriched research experience for minority undergraduates: A step toward increasing the number of minority nurse researchers. Nursing Outlook, 51(1), 20-24. Halloran, Edward, Associate Professor Goldrick, B., & Halloran, E. (2003). Emerging infections: Life with SARS in Hong Kong. American Journal of Nursing, 103(7), 22-23. Halloran, E. (2002). Heroic medicine vs. disease prevention in the American Civil War, 1861-1865. In J. Raftery (Ed.), Then and now: collected papers of the seventh biennial conference of the Australian Society of the History of Medicine (pp. 112-122). Adelaide, Australia: Australian Society of the History of Medicine, Inc. Halloran, E. (2003). John D. Thompson. In W. D. White (Ed.), Compelled by data: John D. Thompson, nurse, health services researcher and health administration educator (pp. 19-28). New Haven, CT: Yale University, Department of Epidemiology and Public Health. Thorson, M., & Halloran, E. (2003). Henderson’s unique function of nurses. In J. Fitzpatrick, & A. Whall, Conceptual models of nursing (2nd ed). Upper Saddle River, NJ: Prentice-Hall. Harrell, Joanne S., Professor Gilmer, M. J., Harrell, J. S., Miles, M. S., & Hepworth, J. (2003). Factors influencing physical activity in young adolescents of parents with premature coronary heart disease. Journal of Pediatric Nursing, 18(3), 159-168. Harrell, J. S., Pearce, P. F., & Hayman, L. (2002). Fostering prevention in the pediatric population. Journal of Cardiovascular Nursing, 18(2), 144-149. Harrell, J. S., Pearce, P. F., Markland, E., Wilson, K., Bradley, C., & McMurray, R. G. (2003). Assessing physical activity in adolescents: The common activities of chil-dren in 6th - 8th grades. Journal of the American Academy of Nurse Practitioners, 15(4), 170-179. McMurray, R. G., Harrell, J. S., Bangdiwala, S., Deng, S., & Baggett, C. (2003). Factors contributing to the energy expenditure of youth during cycling and running. Pediatric Exercise Science, 15, 67-82. McMurray, R. G., Harrell, J. S., Bradley, C. B., Deng, S., & Bangdiwala, S. (2003). Gender and ethnic changes in physical work capacity from childhood through ado-lescents. Research Quarterly for Exercise and Sports, 74(2), 143-152. Henderson, Martha, Clinical Assistant Professor Henderson, M. L. (2003). Advance care planning: Nuts and bolts. FORUM N.C. Medical Board, 7(1), 8-13. Holditch-Davis, Diane, Professor Fitzpatrick, J. J., Miles, M. S., & Holditch-Davis, D. (Eds.) (2003). Annual review of nursing research: Vol. 21. Research on child health and pediatric issues. New York: Springer. Holditch-Davis, D. (2003). Distinguished researcher award. Identification of developmental risk in infants with medical problems: A program of research. Southern Connections, 17(1), 4. Holditch-Davis, D., Bartlett, T. R., Blickman, A., & Miles, M. S. (2003). Post-traumatic stress symptoms in mothers of premature infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32, 161-171. Holditch-Davis, D., & Black, B. (2003). Care of preterm infants: Programs of research and their relationship to developmental science. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 23-60). New York: Springer. Holditch-Davis, D., Blackburn, S., & Vandenberg, K. A. (2003). Newborn and infant neurobehavioral development. In C. Kenner & J. W. Lott (Eds.), Comprehensive neonatal nursing care: A physiologic perspective (3rd ed., pp. 236-284). Philadelphia: Saunders. Miles, M. S., & Holditch-Davis, D. (2003). Enhancing nurs-ing research with children and families using a devel-opmental science perspective. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 1-20). New York: Springer. Holoman, Elizabeth, Clinical Assistant Professor Holoman, E. (2002). Congenital pulmonary alveolar pro-teinosis: A case study. Neonatal Intensive Care, 15(6), 15-18. Hughes, Linda C., Research Associate Professor Frank-Stromborg, M., Ward, S., Hughes, L. C., Brown, K., Coleman, E. A., Grindel, C. G., & Miller-Murphy, C. (2002). Does certification status of the oncology nurse make a difference in patient outcomes? Oncology Nursing Forum, 29, 665-672. Hughes, L. C. (2002). Peer group caring interaction scale and organizational climate for caring questionnaire. In J. Watson (Ed.), Assessing and measuring caring in nursing and health science (pp. 151-156). New York: Springer. Hughes, L. C., Romick, P., Sandor, K., Phillips, C. A., Glaister, J., Levy, K., & Rock, J. (2003). Evaluation of an informal peer group experience on baccalaureate nursing students’ emotional well-being and profes-sional socialization. Journal of Professional Nursing, 19, 38-48. Jones, Cheryl B., Associate Professor Jones, C. B., & Lusk, S. L. (2002). Incorporating health services research into nursing doctoral programs. Nursing Outlook, 50(6), 225-231. Jones, C. B., & Thompson, K. T. (2002). Economics influ-ences in health care delivery. In M. Stanhope, & J. Lancaster (Eds.), Foundations of Community Health Nursing (pp. 105-126). St. Louis: Mosby. Kovner, C. T., Jones, C. B., Zahn, C., Gergen, P., & Basu, J. (2002). Nurse staffing and post surgical adverse events: An analysis of administrative data from a sam-ple of U.S. hospitals, 1990-1996. Health Services Research, 37(3), 611-629. Moody, L. E., Small, B. J., & Jones, C. B. (2002). Advance directives preferences of functionally and cognitively impaired nursing home residents in the United States. Journal of Applied Gerontology, 21(1), 103-118. Kjervik, Diane K., Professor Kjervik, D. K. (2002). APNs: Know your collaborators and their insurance policies. [Column]. Journal of Clinical Systems Management, 4(9), 6. Kjervik, D. K. (2002). APNs: Mental health nurses required to intervene. [Column]. Journal of Clinical Systems Management, 4(6), 8. Kjervik, D. K. (2002). APNs: States may regulate HMOs. [Column]. Journal of Clinical Systems Management, 4(12), 8. 26 CAROLINA NURSING RESEARCH CHRONICLE Kjervik, D. K. (2002). Bridging the law-reality gap. [Column]. Journal of Nursing Law, 8(3), 5. Kjervik, D. K. (2002). Legal protections at the end of life. [Column]. Journal of Clinical Systems Management, 4(7), 18. Kjervik, D. K. (2002). Physicians as experts on advanced practice nursing care. [Column]. Journal of Clinical Systems Management, 4(8), 10. Kjervik, D. K. (2002). Side rails as restraints? [Column]. Journal of Clinical Systems Management, 4(10), 6. Kjervik, D. K. (2002). Supervisory responsibility and profes-sional relationships. [Column]. Journal of Clinical Systems Management, 4(11), 8. Kjervik, D. K. (2002). The evolving nursing standard of care. [Column]. Journal of Nursing Law, 8(2), 5. Kjervik, D. K. (2002). TJ and nursing. Journal of Nursing Law, 8(4), 19-22. Kjervik, D. K. (2003). Negligent credentialing of APNs. [Column]. Journal of Clinical Systems Management, 5(1), 6. Kjervik, D. K. (2003). Psych nurse qualified to serve as an expert witness. [Column]. Journal of Clinical Systems Management, 5(2), 6. Leeman, Jennifer, Research Assistant Professor Leeman, J., Goeppinger, J., Funk, S. G., & Roland, J. (2003). An enriched research experience for minority undergraduates: A step towards increasing the number of minority nurse researchers. Nursing Outlook, 51(1), 20-24. Lowdermilk, Deitra, Clinical Professor Lowdermilk, D., & Perry. S. (Eds.). (2003). Maternity nursing (6th ed.). St Louis: Mosby. Lynn, Mary, Associate Professor Sloane, P., Mitchell, C. M., Weissman, G., Zimmerman, S. I., Long, K. M., Lynn, M., Calkins, M., Lawton, M. P., Teresi, J., Grant, L., Lindeman, D., & Montgomery, R. (2002). The therapeutic environment screening scale for nursing homes (TESS-NH): An observational instrument for assessing institutional environments for persons with dementia. Journal of Gerontology Series B – Psychological Sciences & Social Sciences, 57(2), S69-78. Mark, Barbara, Professor Mark, B., Salyer, J., & Harless, D. (2002). Factors influenc-ing perceptions of staffing adequacy. Journal of Nursing Administration, 32(5), 234-242. Mark, B., Salyer, J., & Wan, T.T.H. (2003). Professional nursing practice: Impact on organizational and patient outcomes. Journal of Nursing Administration, 33(4), 224-234. McCue, M., Mark, B., & Harless, D. (2003). Nurse staffing, quality and hospital financial performance. Journal of Health Care Financial Management, 29(4). 54-76. McQuiston, Christine M., Assistant Professor McQuiston, C. M., & Flaskerud, J. (2003). If they don’t ask about condoms, I just tell them: A descriptive case study of Latino lay health advisors’ helping activities. Health Education & Behavior, 30(1), 79-96. Miles, Margaret S., Professor Beeber, L. S., & Miles, M. S. (2003). Maternal mental health and parenting in poverty. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 303-331). New York: Springer. Black, B., & Miles, M. S. (2002). Calculating risks and ben-efits of disclosure in African American women with HIV. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(6), 688-697. Fitzpatrick, J. J., Miles, M. S., & Holditch-Davis D. (Eds.). (2003). Annual review of nursing research: Vol. 21. Research on child health and pediatric issues. New York: Springer. Gilmer, M. J., Harrell, J. S., Miles, M. S., & Hepworth, J. T. (2003). Factors influencing physical activity in young adolescents of parents with premature coronary heart disease. Journal of Pediatric Nursing 18(3), 159-168. Holditch-Davis, D., Bartlett, T. R., Blickman, A., & Miles, M. S. (2003). Post-traumatic stress symptoms in mothers of premature infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32, 161-171. Miles, M. S. (2003). Parents of children with chronic health problems: Programs of nursing research and their relationship to developmental science. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch- Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 247-277). New York: Springer. Miles, M. S. (2003). Support for parents during a child’s hospi-talization. American Journal of Nursing, 103(2), 62-64. Miles, M. S., & Holditch-Davis, D. (2003). Enhancing nurs-ing research with children and families using a devel-opmental science perspective. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual Review of Nursing Research: Vol. 21. Research on Child Health and Pediatric Issues (pp. 1-20). New York: Springer. Mishel, Merle H., Kenan Distinguished Professor Mishel, M. H., & Clayton, M. F. (2003). Uncertainty in ill-ness theories. In M. J. Smith & P. Liehr (Eds.), Middle range theory in advance practice nursing (pp. 25- 48). New York: Springer Publishing. Mishel, M. H., Germino, B., Belyea, M., Stewart, J., Bailey, D., Jr., Robertson, C., & Mohler, J. (2003). Moderators of an uncertainty management intervention for men with localized prostate cancer. Nursing Research, 52(2), 89-97. Palmer, Mary H., Umphlet Distinguished Professor Fonda, D., Benvenuti, F., Cottenden, A., DuBeau, C., Kirshner-Hermanns, R., Miller, K., Palmer, M. H., & Resnick, N. (2002). Urinary incontinence and bladder dysfunc-tion in older persons. In P. Abrams, L. Cardozo, S. Khoury, & A. Wein (Eds.), Incontinence. 2nd inter-national consultation on incontinence (2nd ed., pp. 625-695). Plymouth, UK: Health Publications Ltd. Newman, D., & Palmer, M. H. (Eds). (2003). State of the science on urinary incontinence. American Journal of Nursing, 3, 1-58. Palmer, M. H. (2003). The state of the science in urinary incontinence nursing research. [Guest editorial]. Journal of Wound, Ostomy and Continence Nursing, 30(2), 61. Palmer, M. H.(2003). Urinary incontinence. In V. Carrieri- Kohlman, A. Lindsey, & C. West (Eds.), Pathophysiological phenomena in nursing: Human responses to illness, (3rd ed., pp. 91-114). St. Louis: Saunders. Palmer, M. H., Baumgarten, M., Langenberg, P., & Carson, J. (2002). Risk factors for hospital-acquired inconti-nence in female hip fracture patients. Journal of Gerontology: Medical Sciences 57A(10), M672-M677. Palmer, M. H., Fogarty, L., Somerfield, M., & Powel, L. (2003). Incontinence after prostatectomy: Coping with incontinence after prostate cancer surgery. Oncology Nursing Forum, 30(2), 229-238. Palmer, M. H., & Fitzgerald, S. (2002). Urinary incontinence in working women: A comparison study. Journal of Women’s Health and Gender Based Medicine, 11(10), 879-888. Pletsch, Pamela K., Associate Professor Pletsch, P. K. (2002). Commentary on “Mexican Americans’ explanatory model of Type 2 diabetes.” Western Journal of Nursing Research, 24(8), 861-863. Pletsch, P. K., Morgan, S., & Pieper, A. (2003). Smoking cessation among low income African American preg-nant women: Context and beliefs about smoking and smoking cessation. American Journal of Maternal Child Nursing, 28(5), 1-7. Stevens, P. E., & Pletsch, P. K. (2002). Informed consent and the history of inclusion of women in clinical research. Health Care for Women International, 23(8), 809-819. Rasin, Joyce, Associate Professor Beck, C. K., Vogelpohl, T. S., Rasin, J., Uriri, J. T., O’Sullivan, P., Walls, R., Phillips, R., & Baldwin, B. (2002). A clinical trial of behavioral interventions to decrease disruptive behavior in demented nursing home residents. Nursing Research, 51(4), 219-228. Redman, Richard, Professor Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. Journal of Nursing Administration, 33(2), 131-133. Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. (repeated in) Nurse Educator, 28(4), 153-155. Redman, R. (2003). Practice environments. Research and Theory for Nursing Practice, 17(1), 87-88. Redman, R. (2003). Promoting safe environments for patient care delivery. Research and Theory for Nursing Practice, 17(2), 97-100. Redman, R. (2003). Instrumentation. In K. S. Oman, M. Krugman, & R. M. Fink (Eds.), Nursing Research Secrets (pp. 139-148). St. Louis: Hanley & Belfus, Inc. Redman, R., & Clark, L. (2002). Service-learning as a model for integrating social justice in the nursing curriculum. Journal of Nursing Education, 41(10), 446-449. Tzeng, H. M., Ketefian, S., & Redman, R. (2002). Relationship of staff nurses’ strength of organization-al culture, job satisfaction, and inpatient evaluation with nursing care. International Journal of Nursing Studies, 39(1), 79-84. 2002–2003 27 Rodgers, Shielda, Clinical Associate Professor Aucoin, J., & Rodgers, S. (2002). Health promotion in rural settings. In C. C. Clark (Ed.), Health promotion in communities: Holistic and wellness approaches. New York: Springer. Rowsey, Pamela J., Associate Professor Gordon, C. J., Rowsey, P. J., & Yang, Y. L. (2002). Effect of repeated nicotine exposure on core temperature and motor activity in male and female rats. Journal of Thermal Biology, 27(6), 485-492. Rowsey, P. J., Metzger, B. L., Carlson, J., & Gordon, C. J. (2003). Effects of exercise conditioning on thermoreg-ulatory responses to repeated administration of chlor-pyrifos. Environmental Research, 92, 27-34. Sandelowski, Margarete, Cary C. Boshamer Distinguished Professor Barroso, J., Gollop, C. J., Sandelowski, M., Meynell, J., Pearce, P., & Collins, L. J. (2003). The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing Research, 25, 153-178. Hamilton, J., & Sandelowski, M. (2003). Living the golden rule: Reciprocal exchanges among African Americans with cancer. Qualitative Health Research, 13, 656-674. Sandelowski, M. (2002). [Review of the book Say little, do much]. Bulletin of the History of Medicine, 76, 835-836. Sandelowski, M. (2003). Reality and representation in reproductive technologies. Review Essay: R. Davis- Floyd & J. Dumit (Eds.), Cyborg babies, E. A. Kaplan & S. Squier (Eds.), Playing Dolly, & A. R. Saetnan, N. Oudshoorn, & M. Kirejczyk (Eds.), Bodies of technolo-gy. Nursing History Review, 11, 187-189. Sandelowski, M. (2003). Tables or tableaux? Writing and reading mixed methods studies. In A. Tashakkori & C. Teddlie (Eds.), Handbook of mixed methods in social and behavioral research (pp. 321-350). Thousand Oaks, CA: Sage. Sandelowski, M. (2003). Taking things seriously: Studying the material culture of nursing. In J. Latimer (Ed.), Advanced qualitative research for nursing (pp. 185-210). Oxford, UK: Blackwell Science. Sandelowski, M., & Barroso, J. (2002). Finding the findings in qualitative studies. Journal of Nursing Scholarship, 34, 213-219. Sandelowski, M., & Barroso, J. (2003). Creating metasum-maries of qualitative findings. Nursing Research, 52, 226-233. Sandelowski, M., & Barroso, J. (2003). Toward a metasynthesis of qualitative findings on motherhood in HIV-positive women. Research in Nursing & Health, 26, 153-170. Sandelowski, M., & Barroso, J. (2003). Writing the proposal for a qualitative research methodology project. Qualitative Health Research, 13, 781-820. Schwartz, Todd, Research Instructor Adams, K. F., Jr., Gheorghiade, M., Uretsky, B. F., Patterson, J. H., Schwartz, T. A., & Young, J. B. (2002). Clinical benefits of low serum digoxin concentrations in heart failure. Journal of the American College of Cardiology, 39, 946-953. Gulledge, A. A., McShea, C., Schwartz, T., Koch, G., & Lord, S. (2003). Effects of hyperfibrinogenemia on the vas-culature of C57BL/6 mice with and without athero-genic diet. Arteriosclerosis, Thrombosis, and Vascular Biology, 23, 130-135. Raymond, R. J., Hinderliter, A. L., Willis, P. W., IV, Clarke, W. R., Ralph, D., Caldwell, E. J., Williams, W., Ettinger, N. A., Hill, N. S., Summer, W. R., de Boisblanc, B., Schwartz, T., Koch, G., Clayton, L.M., Jöbsis, M. M., Crow, J. W., & Long, W. (2002). Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. Journal of the American College of Cardiology, 39, 1214-1219. Skelly, Anne, Associate Professor Cagle, C., Appel, S., Skelly, A., & Carter-Edwards, L. (2002). Mid-life African American women with type 2 diabetes: Influence on work and the multicaregiver role. Ethnicity and Disease, 12(4), 555-566. Keyserling, T., Samuel-Hodge, C., Ammerman, A., Ainsworth, B., Henriquez-Roldan, C., Ingram, A., Elasy, T., Skelly, A., Johnston, L., & Bangdawala, S. (2002). A randomized trial of an intervention to improve self-care behaviors of African American women with type 2 diabetes: Impact on physical activity. Diabetes Care, 25(9), 1576-1583. Skelly, A. (2003). Diabetes self-management training: A Nursing Perspective. North Carolina Medical Journal, 64(1), 1-2. Thoyre, Suzanne, Assistant Professor Thoyre, S. (2003). Developmental transition from gavage to oral feeding in the preterm infant. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual Review of Nursing Research: Vol. 21. Research on Child Health and Pediatric Issues (pp. 61-92). New York: Springer. Thoyre, S., & Carlson, J. (2003). Occurrence of oxygen desaturation events during preterm infant bottle feeding near discharge. Early Human Development, 72, 25-36. Van Riper, Marcia, Associate Professor Van Riper, M. (2003). A change of plans: The birth of a child with Down syndrome. American Journal of Nursing, 103, 77-74. Van Riper, M. (2003). The sibling experience of living with chronic illness and disability. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual Review of Nursing Research: Vol. 21. Research on Child Health and Pediatric Issues (pp. 279-302). New York: Springer. Waldrop, Julee B., Clinical Assistant Professor Waldrop, J. B. (2002). Kidney disease on the rise. The Clinical Advisor, July/August, 120. Waldrop, J. B. (2002). Staying on top of the drug. The Clinical Advisor, September/October 25, 142. Waldrop, J. B. (2002). Email me in the morning. The Clinical Advisor, November/December, 128. Waldrop, J. B. (2003). Allergic Conjunctivitis. In Handbook of allergy and asthma (pp. 144-162). Philadelphia: Lippincott. Doctoral Student and Post-Doctoral Fellow Activities 2002–2003 Academic Year GRANTS Amoako, E., Principal Investigator; Mishel, M. H., Sponsor. Building Academic Geriatric Nursing Capacity. Predoctoral Fellowship, Joan A. Hartford Foundation, 2002-2004. Bond, S., Principal Investigator; Neelon, V., Sponsor. Differentiating Patterns of Delirium in Terminally Ill Cancer Patients. Predoctoral Fellowship, John A. Hartford Foundation, 2001-2003. Bond, S., Principal Investigator; Neelon, V., Sponsor. Differentiating Patterns of Delirium in Terminally Ill Cancer Patients. Predoctoral Fellowship, American Cancer Society, 2001-2003. Brunssen, S., Principal Investigator; Holditch-Davis, D., Sponsor. Effect of Perinatal Interleukin-6 Elevation on Neurodevelopment. National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 1999-2002. Clayton, M., Principal Investigator; Mishel, M. H., Sponsor. Factors Influencing Patient-Provider Communication Among Older Breast Cancer Survivors. Predoctoral Fellowship, Lineberger Comprehensive Cancer Center, 2002-2003. Lukkahatai, N., Principal Investigator; Dalton, J. A., Sponsor. The Thai Cancer Pain Experience: Relationship among Spiritual Beliefs, Pain Appraisal, Pain Coping, and Pain Perception and Outcomes. Doctoral Research Travel Award, University Center of International Study, University of North Carolina at Chapel Hill, 2003-2004. Pearce, P., Principal Investigator; Harrell, J. S., Sponsor. Designing with children, for children – computer-ized activity recall. National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 2002-2004. Stewart, J., Principal Investigator; Mishel, M. H., Sponsor. Test of a Model of Uncertainty in Children with Cancer, Oncology Nursing Society, 2002-2004. Stewart, J., Principal Investigator; Miles, M. H., Sponsor. Predoctoral Fellowship, Center for Developmental Science, University of North Carolina at Chapel Hill, 2002-2003. Wilde, M. H., Principal Investigator; Dougherty, M. C., Sponsor. Sensations of Urine Flow in People with Foley Catheters. National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 2002-2004. INSTITUTIONAL NRSA AWARD RECIPIENTS PREDOCTORAL STUDENTS Beacham, P. (Holditch-Davis, D., sponsor) Management of Neonatal Post-Operative Pain, 2002-2004. 28 CAROLINA NURSING RESEARCH CHRONICLE Brown, E. (Sandelowski, M., sponsor). Transition to Adulthood in Chronically Ill Adolescents, 2002-2003 Cho, J. (Holditch-Davis, D., sponsor). Effects of Gender upon the Interaction of Mother and Child with Chronic Health Problem, 2001-2003. Greene, N. (Harrell, J. S., & Skelly, A. sponsors) Prevention of Type 2 Diabetes in African American Families, 2002-2004 Jessup, A. (Harrell, J. S., sponsor). Prevention/Management of Obesity in Children, 2002-2004 Knobel, R. (Holditch-Davis, D., sponsor). Thermoregulation in Extremely Low Birthweight Infants, 2001-2003. Lambe, C. (Germino, B., sponsor) Complimentary Therapies, 2002-2004 Larson, K. (Sandelowski, M., sponsor) Sex Risk Behaviors in Latino Adolescents, 2001-2002. Rasmussen, S. (Dalton, J. A., sponsor). Pain Beliefs, Pain Description and Pain Relief Measures of Chronic Pain Patients, Family Members and Nurses, 2001-2003. POSTDOCTORAL FELLOWS Burns, D. (Mishel, M. H., & Skelly, A., sponsors). Factors that Influence Self-Care Management of African-Americans with Type II Diabetes, 2001-2003. Hughes, L. (Mark, B., sponsor). Discretion in Clinical Decision Making and Its Relationship to Patient Outcomes, 2001-2003. Kim, S. S. (Pletsch, P., sponsor). A Focus Group of Korean American Men: Personal and Sociocultural Factors Contributing to Smoking Cessation, 2002-2004. Enriquez, M. (Miles, M. S., sponsor). Readiness and Adherence: A Descriptive Study Examining the Index of Readiness” as a Predictor of Adherence in HIV Women Beginning a New Regimen of Anti-HIV Medications, 2002-2004. PUBLICATIONS Barroso, J., Gollop, C. J., Sandelowski, M., Meynell, J., Pearce, P. F., & Collins, L. (2003). The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing research, 25(2), 153-178. Frank-Stromborg, M., Ward, S., Hughes, L. C., Brown, K., Coleman, E. A., Grindel, C. G., & Miller-Murphy, C. (2002). Does certification status of the oncology nurse make a difference in patient outcomes? Oncology Nursing Forum, 29, 665-672. Harrell, J. S., Pearce, P. F., & Hayman, L. L., (2003). Fostering prevention in the pediatric population. Journal of Cardiovascular Nursing, 18(2), 144-149. Harrell, J. S., Pearce, P. F., Markland, E., Wilson, K., Bradley, C., & McMurray, R. G. (2003). Assessing phys-ical activity in adolescents: Common activities of chil-dren in 6th-8th grades. Journal of the American Academy of Nurse Practitioners, 15, 20-28. Holditch-Davis, D., Bartlett, T. R., Blickman, A. L., & Miles, M. S. (2003). Posttraumatic stress symptoms in mothers of premature infants. Journal of Gynecologic & Neonatal Nursing, 32, 161-171. Hughes, L. C. (2002). Peer group caring interaction scale and organizational climate for caring questionnaire. In J. Watson (Ed.), Assessing and measuring caring in nursing and health science (pp. 151-156). New York: Springer. Knobel, R. (2002). Congenital cutaneous candidiasis: A case presentation. Neonatal Network. 21(6), 9-12. Mishel, M.H. & Clayton, M.F. (2003). Uncertainty in ill-ness theories. In M. J. Smith & P. Liehr (Eds.), Middle range theory in advance practice nursing (pp. 25-48). New York: Springer. Olson, D. M. (2003). Ethical considerations. In S. Watson & B. Meier (Eds.), Invasive cardiology: A manual for cath lab personnel, 2nd Edition. Birmingham, MI: Physicians’ Press. Olson, D. M., Chioffi, S. M., Macy, G. E., Meek, L. G., Cook, H. A. (2003). The BIS monitor enhances patient care and decreases cost in the neurocritical care set-ting. Care Nurse. Olson, D. M., Meek, L. G., & Taylor, D. M. (2003). Best practice makes perfect. Advance for Nurses, 5(2), 13-14. Pribisko, A. (2003). Preventing perioperative adverse drug reactions. AORN, 77(1), 104-122. Stewart, J. L. (2003). “Getting used to it”: Children find-ing the ordinary and routine in the uncertain context of cancer. Qualitative Health Research, 13, 394-407. Therriault, R. E., & Cheek, D. (2002). Pharmacogenetic implications for practitioners. In L. Jameson & J. Evans (Eds.), Principles of molecular medicine, 2nd Edition Totowa, NJ: Human Press. Wilde, M. H. (2002). Understanding urinary catheter problems from the patient’s point of view. Home Healthcare Nurse, 20(7), 449-456. Wilde, M. H. (2002). Home care clinics: Long-term catheters. ADVANCE: For Providers of Post-Acute Care, 5(6), 22-4. Wilde, M. H. (2003). Meanings and practical knowledge of peole with long-term urinary catheters. With com-mentary by B. L. Cameron. Journal of Wound Ostomy Continence Nursing, 30(1), 33-43. University of North Carolina at Chapel Hill School of Nursing Annual Level of Extramural Research Funding (1993–present) January 2004 Nursing Update RN Refresher Course January 12–May 28 February 2004 History Taking and Physical Examination: February 3, 10, 17, 24 Sharpening Your Skills Diabetes Management in Children & Adolescents February 6 Nursing Administration Review Course February 19–20 Critical Care Update February 26 March 2004 Kemble Lecture featuring Dr. Betty Ferrell and reception March 1 honoring Dr. Jo Ann Dalton upon her retirement History Taking and Physical Examination: March 2, 16, 23, 30 Sharpening Your Skills Substance Abuse Update March 5 15th Annual PACU & Ambulatory Surgery Conference March 13 Survival Skills for Nurse Educators March 18 in Staff Development Roles Career Opportunities in Clinical Research: Understanding March 20–May 1 the Roles & Responsibilities of CRA and CRC April 2004 Cutting Edge: Hot Topics in Neurology & Neurosurgery April 2 Test Construction for Critical Thinking in Nursing Education April 3 ONS Chemotherapy and Biotherapy Course April 14–15 Certificate in Clinical Leadership April 19–23 Latino Culture & Language April 22 SON Foundation Board meeting April 22 Pediatric Nursing Review Course April 28–30 Distinguishes School of Nursing events from Continuing Education events Calendar of Events For more information on School events, contact the Office of Advancement. E-mail: sonalum@unc.edu Phone: (919) 966-4619 FAX: (919) 843-8241 www.unc.edu/depts/nursing For more information or to register for a Continuing Education program, contact the School of Nursing Office of Continuing Education. E-mail: nursing_ce@unc.edu Phone: (919) 966-3638 FAX: (919) 966-0870 www.unc.edu/depts/nursing/ lifelong/index.html Nonprofit Organization U.S. Postage PAID Permit No. 177 Chapel Hill, NC 27599-1110 School of Nursing The University of North Carolina at Chapel HIll CB# 7460 Carrington Hall Chapel Hill, NC 27599-7460
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Title | Carolina nursing |
Other Title | Milestones in the life of a school |
Date | 2003 |
Description | fall 2003 - Research chronicle 2002/2003 |
Digital Characteristics-A | 1054 KB; 32 p. |
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Pres File Name-M | pubs_serial_carolinanursing2003fall.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_borndigital\images_master\ |
Full Text | T H E U N I V E R S I T Y O F N O R T H C A R O L I N A A T C H A P E L H I L L S C H O O L O F N U R S I N G �� F a l l 2 0 0 3 Carolina NURSING Chronicle highlights several of the important research initiatives that are designed to improve the health of you and your fellow North Carolinians. From the tree-topped mountains of Buncombe County to the sandy beaches of New Hanover County, SON researchers are work-ing in your communities to learn how to better care for the health of North Carolinians. Examples high-lighted within these pages include studies to help Latina mothers suf-fering from depression learn how to deal with their symptoms; efforts to reduce the uncertainty that many cancer patients face with treatment and recovery; and work to empower those with arthritis to better care for themselves. Nearly 50 SON scientists were engaged in research projects from July 2002 to the end of the fiscal year this June, bringing in over $10 million in funding, $7.5 mil-lion from the National Institutes of Health alone. These funds support-ed a wide variety of new research initiatives, including the creation of the Center for Innovation in Health Disparities Research, an important collaborative initiative with North Carolina Central University and Winston-Salem State University to recruit and train a greater number of minority nurses, to conduct more culturally competent research and to develop innovative methodologies in health disparities research. Of course, our researchers could not do their work without your con-tinued support. On behalf of each scientist at the School of Nursing, I thank you for all that you do, from sharing your time and resources to representing the SON so well in our communities. I hope you enjoy this issue dedicated to the health of North Carolina and wish you and your family another healthy and happy year. Sincerely, Sandra G. Funk, PhD, FAAN Professor and Associate Dean for Research Dear Alumni and Friends, Many people know North Carolina as the home of the Outer Banks, the loblolly pine and the best barbecue and basketball around, yet do enough of us know that we’re among the top states in our nation for contracting diabetes and cardiovascular disease? Or that our Latino population, the nation’s largest minority group and the state’s fasting growing population, faces ongoing disparity in the avail-ability and quality of patient care right here in our own backyard? What exactly is the state of health for North Carolina’s nearly 8.3 mil-lion citizens, and what is your School of Nursing doing to improve it? This year’s issue of the Research FROM THE Associate Dean Carolina NURSING On the cover: Research assistant Brent Woodard tests blood samples from North Carolina schoolchildren for Dr. Joanne Harrell’s study on risk factors for cardiovascular disease and type 2 diabetes. 2 For the Health of North Carolina: How SON Researchers Are Improving the Well-Being of Our State 10 The Genetics Revolution at UNC: One Nurse’s View 12 From A Different Perspective: UNC’s International Nurse Researchers 14 Interdisciplinary Research: A Team-Based Approach to Improving Health 16 Centers of Activity: An Update on CRCI and CIHDR Projects 18 Research Space: The Next Frontier 19 In Brief 21 Faculty Research Activity 2002-2003 21 Faculty Research Grants 23 Education and Professional Grants 24 Faculty Publications 27 Doctoral Student and Post-Doctoral Fellow Activities Carolina Nursing is published by The University of North Carolina at Chapel Hill School of Nursing for the School’s alumni and friends. Dean Linda R. Cronenwett, PhD, RN, FAAN Executive Content Editor Sandra G. Funk, PhD, FAAN Professor and Associate Dean for Research Managing Editor Sunny Smith Nelson Contributing Writers Brittany Dunstan Jim Vickers Photography Janna Dieckmann, PhD, RN Brittany Dunstan Jean Goeppinger, PhD, RN, FAAN Norma Singleton Hawthorne Kabira Kirby Sunny Smith Nelson Anne Aldridge Webb Design and Production Alison Duncan Design Research Support Center Staff Dana Hunter Gregory Workman Office of Advancement Norma Singleton Hawthorne, Director Anne Aldridge Webb, Associate Director, Alumni Affairs and Annual Fund Sunny Smith Nelson, Associate Director, Public Relations and Communications Brittany Dunstan, Health Affairs Communications Intern School of Nursing The University of North Carolina at Chapel Hill Carrington Hall, CB# 7460 Chapel Hill, NC 27599-7460 (919) 966-4619 E-mail: sonalum@unc.edu http://nursing.unc.edu Research Chronicle Edition IN THIS EDITION 2 CAROLINA NURSING RESEARCH CHRONICLE How SON Researchers Are Improving the Well-Being of Our State NORTH CAROLINA IS A STATE OF MANY COMPLEXITIES. After many years as a state made up of small, scattered farms, half of its population is concentrated now in urban areas such as Charlotte, the Piedmont and the Triangle. The state is one of the biggest producers and consumers of tobac-co in the country, yet its governor, in a former post as the state’s attorney general, brought litigation against the nation’s major tobacco companies and won a multi-billion dollar suit. Nearly one-quarter of its population has earned a baccalaureate degree, yet nearly 13% still live in poverty. And then there’s the issue of the state’s health. Located in the area known as the nation’s “stroke belt,��� the state has serious problems with illnesses such as diabetes, heart disease, obesity and cancer. Yet the state is also home to sev-eral of the country’s preeminent health-care research institutions, includ-ing UNC and Duke University. What are these health-care providers doing to improve the health of the state, and what kind of impact is their research having on its 8.3 million residents? Here at the School of Nursing, researchers are touching the lives of premature babies, cancer survivors, the chronically ill and new immigrants through groundbreaking research projects. Highlighted here are a few examples of how the SON’s researchers are working for the health of North Carolina. For the Health of North Carolina by Sunny Smith Nelson Depression can be a serious and debilitating problem for many Hispanic mothers new to North Carolina. Many are unfamiliar with the language and culture; they may be struggling to make ends meet; and they have children to care for without their usual network of fam-ily and friends to help. Low-income Hispanic mothers are, in fact, at an increased risk for developing depression because of these com-bined social factors. Any form of depression that lasts at least six months at a time for a mother can have negative effects on her chil-dren, too. They may not get the attention and developmental stimu-lation they need to properly build healthy cognitive, emotional and social capabilities during the criti-cal years from birth to three years of age. This, in turn, places the children at increased risk for their own problems, including speech and attention disorders and their own form of depression. SON professor Dr. Linda Beeber recently began a study funded by the U.S. Department of Health and Human Services Administration for Children and Families to help these low-income Hispanic mothers bet-ter cope with their depression. The study, known as Alas, which is Spanish for “wings,” is the first to develop and test a home-based intervention specifically for non- English speaking Hispanic mothers with symptoms of depression. The intervention, conducted in Spanish and reflective of Hispanic cultural values, pairs non-Spanish speaking to the people of North Carolina since we rank first in the nation in the relative growth of newly immi-grated citizens who are of Hispanic origin,” says Beeber. “We believe it will contribute to the growing net-work of resources that will help our Latino community create a promis-ing future for their children. And while this is a test of an innovative model of intervention for depressive symptoms in Latina mothers, it can be replicated with other non- English speaking populations in need of mental health support. My hope is that people of many differ-ent cultures and origins can one day benefit from this work as well.” The Alas study is working to improve the mental and emotional well-being of low-income Latina mothers and their children. 2002–2003 3 psychiatric-mental health nurses and Early Head Start (EHS) bilin-gual staff members as a team to make home visits over 19 weeks to Hispanic mothers in Asheville and Chapel Hill. The team works with each mother on interpersonal problem areas that contribute to her depres-sive symptoms, such as her rela-tionships with those close to her and how they can affect how she feels. “By monitoring her feelings on a weekly basis, the mother can learn how to put her feelings into context,” says Beeber. “She finds that those feelings don’t come out of the blue, but are dependent on what is happening in her life.” Based on how the mother feels, the intervention team offers specific, repetitive coping skills for the mother to practice, from learning how to better manage conflict to better differentiating between good and bad comforts. Fathers are involved in the intervention, too. The team visits alternate with a “booster” session conducted by the nurse on call by cell phone. The intervention gives the mother the support she needs while empower-ing her to independently recognize and deal with her symptoms, explains Beeber. At the end of the intervention, the mother and inter-vention team create a list of her accomplishments during their time together and either secure further care for the mother or provide her with resources should a recurrence of symptoms occur. “This study is especially relevant For the Health of North Carolina WESTERN NC: Giving Mothers Their “Wings” to Fly 4 CAROLINA NURSING RESEARCH CHRONICLE to the aforementioned study in that its goal is to help those who have been diagnosed with cancer deal with the psychological effects of the disease; in this case, however, they are survivors who face enduring uncertainty about the possibility of recurrence and possible long-term health problems related to cancer treatment. Participants of this National Cancer Institute-funded study include older women who have been cancer-free for five years. They receive a self-delivered inter-vention consisting of a tape player and a set of audiotapes of cognitive strategies to help them deal with events that trigger feelings of uncer- Many cancer patients speak of uncertainty when talking about their disease—uncertainty in choosing a treatment option, uncertainty in how it will change their bodies, uncertainty in the face of recurrence. Often, in the back of their minds, are the doubts and dreads that nag. Doctors and nurses work hard to allay these fears, but is there one word, one course of action, that works better than another? Dr. Merle Mishel, Kenan distinguished professor at the SON, and Dr. Barbara Germino, the SON’s Beerstecher Blackwell profes-sor in thanatology, are working on two studies to learn how to help cancer patients and survivors better manage their uncertainty. In “Decision-Making Under Uncertainty Prostate Cancer,” Mishel and Germino are testing whether a patient education booklet and a videotape with vignettes of strategies for communicating with the doctor that they developed, supplemented with nurse contact to help patients use the materials, will be effective in helping both Caucasian and African American men diagnosed with localized prostate cancer become better informed and more active partici-pants in the decision-making process with their doctor. The study is funded by the National Institute of Nursing Research and the National Cancer Institute at the National Institutes of Health. Mishel and Germino believe the training is necessary because, although prostate cancer is the sec-ond most common type of cancer in American men, no universally recommended treatment exists for the disease and most men opt for the treatment their doctor special-izes in without fully considering all their options. “Our goals for the study are to see if the decision-making training can help men recently diagnosed with prostate cancer become more informed about the range of treat-ment options available to them,” says Mishel. “A second important goal is to see if the decision-making training enables men to more fully ask questions and get the informa-tion they want from their health-care providers.” “Managing Uncertainty in Older Breast Cancer Survivors” is similar For the Health of PIEDMONT: Learning to Live with the Uncertainty of Cancer 2002–2003 5 Drs. Barbara Germino and Merle Mishel (middle, left to right) work with research team members Sharon Coop (far left) and Gail Fuller (far right) on a study to help men suffering from prostate cancer become more active participants in the treatment decision-making process with their health-care providers. tainty about breast cancer recur-rence. They also receive a manual that contains information on how to manage long-term side effects from cancer treatment and resources for more assistance. Nurses make follow-up calls to help them learn the skills taught in the materials. At this point in the study, says Mishel, the research team has iden-tified significant gains in women who received the intervention as compared to those in the control group. Both Caucasian and African American women who received the intervention improved in their abil-ity to see their illness in a more positive light, they had more knowledge about the disease and they showed fewer symptoms of long-term side effects. They also improved in their ability to manage the triggers of uncertainty about recurrence by using coping self-statements and by engaging in less catastrophizing about negative out-comes. In addition, they reported significantly greater access to infor-mation and found the information more helpful. “Long-term survivors of breast cancer often face physical and emo-tional changes which can continue years after treatment is finished,” says Germino. “We are very pleased to find that this nursing interven-tion helps long-term cancer survivors manage their fears of recurrence and the long-term side effects of treatment.” North Carolina 6 CAROLINA NURSING RESEARCH CHRONICLE Odds are, if you grew up in a small, rural town in the South, you knew someone with type 2 diabetes. The disease is common among Southerners no matter their cultur-al heritage and is due, in part, to a diet heavy in fried and sugary foods and a sedentary lifestyle. With so much in the headlines nowadays about the importance of diet and exercise, why is it that the disease is so prevalent in the region, particu-larly among rural and low-income populations? According to Dr. Anne Skelly, an associate professor at the SON, no effective, culturally compe-tent interventions have been devel-oped to help these folks prevent the disease. That’s why she’s been spending so much time in a small, rural town in Chatham County, North Carolina lately. Skelly is the principal investiga-tor of “Type 2 Diabetes: Ethnic Variation in Knowledge and Belief,” a study funded by the National Institute of Nursing Research at the National Institutes of Health. She and her co-investigators, Drs. Will Gesler and Molly Dougherty of UNC and Dr. Thomas Arcury of Wake Forest University, are working with at-risk rural and low-income indi-viduals in Chatham County to study their knowledge levels and beliefs about the disease, and in particular where they are receiving this infor-mation. Around 120 European American, African American and Latino men and women between the ages of 30 and 60 are being followed to learn what they know about the causes of the disease, how it affects the body, how to treat it and where to turn in the communi-ty for information on the issue. Their sources for information on the disease are being mapped, which helps Skelly and her research team learn how this ethnically diverse community’s beliefs con-verge, differ and overlap. By better understanding the belief systems of these different populations, Skelly believes health-care researchers can better develop culturally appropri-ate, community-based strategies to prevent or delay the disease. “The exciting news in diabetes research is that we now have strong evidence that type 2 diabetes can be prevented or delayed with the use of modest lifestyle interventions such as diet and physical activity,” she says. “What are needed are effective, culturally-sensitive strategies to assist high-risk individuals in making these changes.” For the Health of Dr. Anne Skelly hopes she will be able to develop culturally appropriate, commu-nity- based prevention strategies for diabetes by learning what rural North Carolinians know about the dis-ease and where they get that information. PHOTO COURTESY OF APRIL SOWARD CENTRAL NC: Sweet Tea, Candied Yams and Fried Chicken: How Do You Beat Type 2 Diabetes in the South? 2002–2003 7 Ask a kid nowadays what his or her favorite game is, and you’ll probably get an answer like “Sony Playstation 2’s Grand Theft Auto” video game instead of hide and seek or kickball. Children and adoles-cents of the twenty-first century are far more sedentary than their par-ents or grandparents ever were, with the majority of their free time spent in front of a television or computer. This immobile form of fun is start-ing to take its toll on the health of today’s kids, as evidenced by the alarming rise in weight and type 2 diabetes that is showing up in youth under the age of 18. Dr. Joanne Harrell, a professor at the SON and the director of the Center for Research on Chronic Illness in Vulnerable People, is principal investigator of a study known as CHIC III, short for Cardiovascular Health in Children and Youth. The study, funded by the National Institute of Nursing Research at the National Institutes of Health, is an investigation of the childhood development of several risk factors for cardiovascular dis-ease and type 2 diabetes and the aggregation of those factors over time. CHIC III is following thou-sands of North Carolina elementary, middle and high school children across all stages of puberty, measur-ing such things as blood pressure, body mass index, body fat, waist circumference, insulin, glucose and lipid levels, eating habits, physical activity and smoking. Family histo-ries of cardiovascular disease and diabetes are taken from parents, and all the factors are added together and evaluated to determine if a child runs a high risk of devel-oping the diseases. From her research, Harrell has learned that school-based interven-tions, both in the classroom and on the playground, are very important. Kids need to get more health educa-tion and more exercise while in school. She has tested different interventions that feature combina-tions of these two components, try-ing to determine which is the best mix for today’s kids. Her results could impact how North Carolina’s schoolchildren exercise and play for years to come. “We have found that almost half of the children we are studying are obese or overweight,” says Harrell. “There is an urgent need to increase physical activity, decrease sedentary activities such as TV view-ing and computer games, and improve eating habits in our children. Families, schools, communities and legislators must work together to help combat this epidemic.” North Carolina Dr. Joanne Harrell and her research team are working with thousands of North Carolina school children to determine their risk for cardiovas-cular disease and diabetes. PHOTO COURTESY OF KABIRA KIRBY Healthier Hearts for Today’s “CHICs” 8 CAROLINA NURSING RESEARCH CHRONICLE African Americans with arthritis and other chronic health problems in eastern North Carolina now have 38 more trained advocates working in their communities to help them deal with their conditions thanks to the “Yes We Can!” project. Directed by Dr. Jean Goeppinger and imple-mented with community partners from Craven, Jones and Pamlico counties, the project recently trained 38 residents from the three counties to act as workshop leaders and community coordinators. As such, they will teach persons with arthritis and other chronic condi-tions like diabetes and heart disease how to deal with their symptoms, pain, and fatigue; plan and imple-ment an individualized exercise program; and manage other chal-lenges related to living a healthy life with chronic health problems. The workshop leaders and com-munity coordinators are part of a larger study funded by the U.S. Centers for Disease Control and Prevention to learn which of two community-based, disease self-management programs, the Arthritis Self-Help Course (ASHC) or the Chronic Disease Self- Management Program (CDSMP), is the most effective in helping per-sons with arthritis and other chron-ic conditions. The study is the first to compare the effectiveness of the two programs for persons with arthritis and to place a particular emphasis on studying their effectiveness among rural and African American populations. The community coordinators will publi-cize the disease-management work-shops in their communities and assist with participant recruitment and enrollment. “Arthritis is one of two leading causes of disability in the U.S. and the second most common co-mor-bid condition,” says Goeppinger, a professor who holds joint appoint-ments with the schools of nursing and public health. “People with chronic diseases such as arthritis live 24 hours a day, seven days a week with their diseases. They need to learn how to live well with their chronic diseases by becoming good self-managers. This study will determine which program is most helpful in accomplishing that goal.” PHOTO COURTESY OF DR. JEAN GOEPPINGER For the Health of EASTERN NC: “Yes We Can!” Project a Community Success Dr. Jean Goeppinger is working with several community partners in eastern North Carolina, including Stephanie Fisher, pictured here, to help those with arthritis learn to manage their symptoms better and to implement an exercise plan to improve their quality of life. 2002–2003 9 Childhood is by far the most definitive time in a person’s life developmentally. From learning to sit up or walk to recognizing social cues and acceptable behavior, the first few years of a child’s life can determine how they act, think and feel for the rest of their lives. As a parent, you want to give your child all the tools necessary to help them develop into happy, healthy adults. And as the parent of a premature infant, you would want to give them even more to make up for what Mother Nature was not able to give them. But what do you do if you are the parent of a premature infant and live in a rural area with-out access to all the necessary serv-ices? And what if you don’t really know what those necessary services are, or aren’t sure how you’d pay for them if you did? How do you deal with the stress of having a pre-mature child and all the challenges associated with it? Dr. Diane Holditch-Davis and Dr. Margaret Miles are working to help mothers with these concerns. Holditch-Davis and Miles are the lead researchers of “Nursing Support Intervention of Mothers with Prematures,” also called the MOMS Project, a National Institute of Nursing Research-funded study to examine the effectiveness of a culturally congruent intervention to support rural African American mothers of premature babies from the time the babies are receiving intermediate care to the age of 18 months. They hope that by improv-ing the psychological well-being of the mothers and helping them identify resources for their children, the mothers will improve their rela-tionships with their children and seek and prolong the use of child health developmental services. The infants ideally will gain by being in more developmentally supportive environments than they might have received without the intervention. Thus far, 212 mothers and their high-risk premature babies have been recruited for the study and are being followed until the children are at 24 months of age, corrected for prematurity. The mothers receive encouraging, instructive vis-its and phone calls from Holditch- Davis, Miles and the research team, and the mothers’ psychological well-being and the babies’ develop-mental status are measured using a series of tests. With the support of caring nurses, Holditch-Davis and Miles hope the mothers will be able to support themselves and their tiny children even better. “There is nothing harder for a mother than the critical illness of her child,” says Holditch-Davis. “The MOMS Project aims to help mothers deal with these feelings and find resources to help so they can better meet the needs of their pre-term infants.” North Carolina Research team members Shannon Wong and Jackie Fowler Pilgrim discuss the MOMS Project, a study by Drs. Diane Holditch-Davis and Margaret Miles to help African American mothers of premature babies find the resources they need to help their babies. Support In a Time of Need 10 CAROLINA NURSING RESEARCH CHRONICLE Van Riper, an associate professor at the School of Nursing, renders those judgments with the authority of one who was engaged in the research of genetic-related health problems a half decade before the gene-mapping project began in 1990. Her experiences as a graduate Van Riper, an associate professor at the School of Nursing, renders these judgements with the authority of one who was engaged in the research of genetic-related health problems a half decade before the gene-mapping project began in 1990. Her experiences as a graduate student, doctoral candidate and fac-ulty member with studies on fami-lies’ responses to testing for Down syndrome and the birth of children with the disorder all led to an epiphany, as she calls it. When attending a genetics summer insti-tute for nursing faculty, she realized the need to include genetic content in her research, teaching and prac-tice if she wanted to keep pace with the genetics revolution. It was, she says, the beginning of her life’s work. A successful proposal to the National Institute of Nursing Research for a three-year mentored research scientist development award entitled “Family Experience of Genetic Testing: Ethical Dimensions” followed in 2000, and Van Riper joined UNC’s faculty in 2001, transferring her research project and knowledge to the campus. UNC Chancellor James Moeser was working on genetics initiatives for UNC around that time as well. In February 2001, Moeser announced a new genomics center that would be funded by a public-private investment of more than $245 million over the next 10 years. The Carolina Center for Genome Sciences (CCGS) would involve fac-ulty from the College of Arts and Sciences and the Schools of Information and Library Science, Law, Medicine, Nursing, Public Health, Pharmacy and Dentistry. Dr. Terry Magnuson, an internationally respected geneticist, was chosen to lead the initiative. Recognizing Van Riper’s expertise, he asked her to help coordinate the Center’s efforts concerning the ethical, legal, and social implications (ELSI) of recent advances in genetics. As a result, Van Riper and colleagues from across campus will lead a class on ELSI this upcoming spring. A health affairs interdisciplinary grant is funding the course. “Recent advances in genetics made possible through the Human Genome Project have revolutionized the field of health care, and nurs-es are in an ideal position to help individuals and families maximize the benefits of the genetic revolution. But first, nurses need a working knowledge of human genetics, an awareness of recent advances in the field of genetics, and an understanding of the potential effects of genetic discoveries on individual and family well-being.” —MARCIA VAN RIPER, PHD, RN The Genetics Revolution at UNC: One Nurse’s View by Jim Vickers PHOTO COURTESY OF DR. MARCIA VAN RIPER “This course will give faculty and students from a wide variety of disciplines an opportunity to come together to discuss possible ways to address important ethical, legal, and social issues related to advances in genetics and genomics,” she notes. Even with a full work load as a CCGS member, associate professor and founding fellow of the UNC Institute of Arts and Humanities Ethics Program, Van Riper is in the process of finishing data collection for her study of how individuals and families define and manage ethical issues that emerge during four types of genetic testing — prenatal screening for Down syn-drome, carrier testing for cystic fibrosis (CF), BRCA 1 & 2 testing for families at high risk for breast cancer and mutation analysis for Huntington disease. She is using a mixed-method design to explore the experiences of more than 40 families using in-depth semi-struc-tured interviews and self-report measures. Preliminary findings underscore the need to use a family perspective when exploring the ethi-cal issues that emerge from genetic testing. Ethical issues encountered by families in the study include concerns about privacy, informed consent, freedom of choice in reproductive decisions, insurability, discrimination and stigmatization. “A number of family members have made a point of noting that the decision to undergo genetic testing is a very personal experience,” she says, “and no two individuals are affected by the experience in the same way.” Van Riper recently submitted a proposal for a pilot study to explore how families from diverse cultural backgrounds make sense of and use genetic testing results from four of the most widely performed genetic tests, including prenatal screening for Down syndrome, screening for sickle cell anemia, BRCA 1 & 2 test-ing and mutation analysis for the Factor V Leiden gene. If funded, the pilot study will move Van Riper’s research on the family experience of being tested for and living with a genetic condition further toward the prediction of individual and family outcomes following genetic testing. In addition, it will provide a basis for the development and testing of tailored, culturally sensitive individ-ual and family-centered interven-tions to improve the experience and outcomes for persons undergoing genetic testing. Quoting one of her mentor’s, Eric Juengst, the first chief of the Ethical, Legal and Social Implications Branch of the National Center for Human Genome Research at NIH, Van Riper says, “The promise of accessi-ble genetic information lies in its ability to allow individuals and families to identify, understand and sometimes control their inherited health risks. This promise puts the individual and families that receive genetic services at the moral center of the enterprise: if genetic assess-ment is to be judged a success, it must be from the recipient's point of view, in terms of their ability to use the information to enrich their lives. “The pace and enormity of recent genetic discoveries has made it virtually impossible for nurses not to be involved in some aspect of genetic health care. My goal is to get our students excited about genetics and help them see how they can make a critical differences in the lives of families being tested for and living with genetic conditions.” Dr. Marcia Van Riper is working with many families, including those of babies with Down syndrome, to better understand how families define and manage ethical issues that emerge during genetic testing. 2002–2003 11 PHOTO COURTESY OF DR. MARCIA VAN RIPER 12 CAROLINA NURSING RESEARCH CHRONICLE by Brittany Dunstan “Pain isn’t just a simple word,” says Nada Lukkahatai, a fourth-year doctoral nursing student at Carolina. “My time here at UNC has helped me learn that.” Lukkahatai has seen a great deal of pain in her time as a nurse in her native Thailand. She spent several years caring for cancer patients, helping them manage their pain through mental and spir-itual techniques. Medications are not as heavily relied upon in Thailand as they are in the United States, she explains, which was a surprising discovery for her when she came to the U.S. to study Western pain management. “For pain relief, Thai patients often rely on non-narcotic medica-tion and their ability to cope,” explains Lukkahatai. “Buddhism is the religion of the majority of the Thai people, and Buddhists believe in impermanence and non-self-hood and are more accepting of suffering because of their beliefs. According to Buddhist teachings, once a person learns to let go of one’s ‘self,’ he or she becomes free from suffering. In light of the importance of these beliefs, I won-dered if Thai cancer patients per-ceive pain differently from how Western studies have shown the majority of Western patients per-ceive pain. I wanted to know if cul- From a Different Perspective: UNC’s International Nurse Researchers tural influences, including religious and spiritual beliefs, affected how people responded to and coped with pain. I knew if this proved to be true that different, culturally informed strategies for pain man-agement should be explored.” Lukkahatai traveled back to her homeland to conduct her research, where cancer is the second leading cause of death. The cancer patients in her sample answered a series of questionnaires, and Lukkahatai says her preliminary results have been fairly on target with her expectations. “To achieve the most effective pain treatment, multidi-mensional strategies are required,” she says. “Knowledge about inte-grating biological, psychological and sociocultural factors of pain is essential. Understanding the influ-ence of culture on the cancer pain experience is one clinical challenge health-care professionals are facing worldwide in improving pain man-agement.” Lukkahatai graduates in December and will return to Thailand to teach and share her findings with other nurses who care for cancer patients. She eventually hopes to return to the U.S. to do further research as a post-doctoral student and would like to work again with her dissertation team comprised of Drs. Jo Ann Dalton, Barbara Germino, Michael Belyea, Julie Barroso and Frances Keefe, all “Medications are not as heavily relied upon in Thailand as they are in the United States…For pain relief, Thai patients often rely on non-narcotic medication and their ability to cope,” explains Lukkahatai. PHOTO COURTESY OF NADA LUKKAHATAI Nada Lukkahatai, a native of Thailand, is exploring the relation-ship between religiosity and pain management. seasoned researchers who she says helped her see pain from a different perspective. Hyekyun Rhee is on the opposite side of the tassel from Lukkahatai, having graduated from the SON’s PhD program in 2002. Originally from Korea, Rhee decided to stay in the US after her studies and cur-rently is serving as an assistant pro-fessor of nursing at the University of Virginia. Like Lukkahatai, her expe-rience as a UNC doctoral student was a formative one, where she learned to see nursing research in a new light. “My research interests focus on adolescent health,” she explains, “which is a matter of serendipity, really. When I was searching for a dissertation topic, my advisor, Dr. Margaret Miles, suggested I look at data from a newly available nation-al longitudinal study of adolescent health. From that database, I was able to do secondary data analyses that explored the prevalence of physical symptoms such as headache and abdominal pains in healthy adolescents and how these symptoms were related to ecological and developmental factors.” Her UNC research, found with a little luck and a helpful faculty member, has provided her with a solid base that is helping her now springboard into other areas of research she might not have con-sidered before, Rhee says. 2002–2003 13 Originally from Korea but now a faculty member at UVA’s nursing school, Hyekyun Rhee says UNC is where she first developed her nursing research interests. “I feel very blessed to work in such a sup-portive environment as UVA’s SON, and I am grateful to UNC mentors, particularly Dr. Miles, who helped me start my research career…” —HYEKYUN RHEE “I am still interested in researching adolescent health issues in the context of develop-mental science as I did at UNC, but now I’m becoming more interested in the health of adolescents with chronic conditions.” This summer, Rhee received intramural funding to support the development of a program of research on adolescents with asth-ma. She hopes to learn if a cogni-tive- behavioral intervention focus-ing on enhancing the quality of decision-making is effective in reducing risk behaviors in adoles-cents with asthma. In addition to her own study, Rhee has been involved as a co-investigator in a newly funded research project studying adoles-cents’ smoking behavior. “Being a brand-new faculty member, I’m spending a lot of time preparing lectures, writing manu-scripts for publication and submit-ting grant proposals,” she says. “I feel very blessed to work in such a supportive environment as UVA’s SON, and I am grateful to UNC mentors, particularly Dr. Miles, who helped me start my research career. Thanks to looking into an unex-pected research interest, I plan to continue to build my professional career as a competent educator and researcher by enhancing my expert-ise in this field.” PHOTO COURTESY OF HYEKYUN RHEE 14 CAROLINA NURSING RESEARCH CHRONICLE Not only are they leaders of research teams comprised of scien-tists from multiple disciplines, they are important contributors to other scientists’ work as well. The National Institutes of Health and other federal funding sources recognize the importance of this cross-pollination of sciences, favoring proposals that involve interdisciplinary collaborations to encourage scientists to learn methods and theoretical perspec-tives outside of their own fields. Carolina’s nurse researchers cer-tainly recognize the contributions the interdisciplinary approach can make to increase the knowledge base of nursing. More than a dozen current SON research projects involve researchers from other fields. In a study based in central North Carolina, principal investiga-tor Dr. Anne Skelly, a nurse sociolo-gist, and co-principal investigator Dr. Molly Dougherty, a nurse anthropologist, are studying 120 low-income African Americans, Latinos, and European Americans aged 30 to 60 to gather information necessary to create culturally appro-priate community-based strategies to prevent and delay the expression of type 2 diabetes. Both of these SON professors offer an important set of research skills and experi-ences from prior studies that enhance their current collabora-tion. Skelly is an associate professor of nursing who is known for her work on type 2 diabetes, particular-ly with minority communities, while Dougherty, the Frances Hill Fox professor of nursing, is a nationally recognized expert in women’s health, aging and com-munity- based interventions. A key feature of their research is precisely mapping the locations of the sources from which members of the different groups obtain infor-mation about diabetes. For authori-tative assistance they are collabo-rating with co-investigator Dr. Wilbert Gesler of the UNC Geography Department. Well-informed on the global positioning system and the co-author of Medical Geography, Gesler is an internationally recognized expert in a field originated by Dr. John Snow in the nineteenth century when he mapped the residences of cholera victims in London and thereby traced the source of the disease to a single water pump. Gesler’s most recent book, Healing Places, ana-lyzes the effects of environment on healing. “Interdisciplinary research enhances our understanding of the phenomena under study,” explains Skelly. “In our present work, look-ing at the knowledge and beliefs of individuals at high-risk for dia-betes, our team was able to use the-ories from the disciplines of nurs-ing, anthropology, sociology and Interdisciplinary Research: A Team-Based Approach to Improving Health Forget your ideas of nurse researchers in their starched white uniforms holding patients’ hands while taking notes on vital signs. Today’s nurse researchers are often experts in a variety of scientific specialties, from genetics to geography, and are skilled at integrating technology and theory to produce comprehensive approaches to treatment. by Jim Vickers Dr. Barbara Waag Carlson's research team features scientists from many different disciplines. Featured here are Carlson, Charles Leonard, a biochemistry and microbiology graduate student at North Carolina State University, and Sebrina Wiggins, a doctoral student in Pennsylvania State University's biobehavioral health department. medical geography to develop explanatory models of diabetes to guide the development of cultural-ly- sensitive, community-based diabetes prevention programs.” Collecting data from 106 adults aged 70 and greater, Dr. Barbara Waag Carlson and co-investigator Dr. Virginia Neelon are measuring respiratory periodicity (breathing patterns involving repetitive cycles of increased amplitude separated by intervals of either apnea or hypop-nea) and cerebral oxygenation dur-ing sleep to predict their effect on cognitive decline. Carlson, an asso-ciate professor, is trained in experi-mental psychology as well as biobe-havioral nursing and is well versed in measuring brain activities and the development of minimally intrusive research instruments. Neelon, the director of the SON’s Biobehavioral Lab, is a nurse physi-ologist and internationally respect-ed for her work with older adults, having developed the NEECHAM Confusion Scale for measuring acute confusion in elders. This is the fourth research project on which Dr. Marilyn Hartman of the UNC Department of Psychology and Dr. Sunil Dogra of the UNC School of Medicine have worked with Carlson and Neelon, and once again their specialized knowledge and abilities are crucial to a suc-cessful outcome. As a licensed clini-cal psychologist and an expert in age-associated memory and atten-tion changes, Hartman is oversee-ing the collection and interpreta-tion of cognitive data. As an anes-thesiologist specializing in the influence of states of arousal on pain thresholds, Dogra is reviewing health and functional assessments by a nurse practitioner and inter-preting sleep-structure data. Both assist Carlson in training assistants to administer the memory test and assess health functions. Dr. Chris McQuiston began studying sexually transmitted dis-eases and women in 1989 when she was teaching at the University of Akron. Shortly after her arrival in Chapel Hill in 1994, she expanded her program to include African Americans, European Americans and Hispanics. Then in 1997 she concentrated her focus on Mexican immigrants in the Triangle region. In her current study, “Gender, Migration, and HIV Risks among Mexicans,” she has enlisted as a co-investigator Dr. Emilio Parrado from the Department of Sociology at Duke University. Parrado has studied Mexican migration since 1991, gaining astute knowledge as a researcher and project manager 2002��2003 15 of the Mexican Migration Project (MMP) conducted at the University of Pennsylvania, during which he was intimately involved in conduct-ing “ethnosexual” surveys in Mexican and sister-American com-munities. McQuiston, an associate professor at the SON, is employing the MMP survey method and has benefited from Parrado’s experience in having conducted fieldwork in both countries and in having designed both the MMP questionnaire and data management programs. While these experts from other disciplines and campuses enhance SON research, SON researchers have been enriching projects in other UNC divisions and on other cam-puses. Among them, Kenan profes-sor and cancer expert Dr. Merle Mishel is the principal investigator in a study of men diagnosed with prostate cancer being conducted as part of a consortium by Dr. James Mohler of the UNC School of Medicine. Skelly, in addition to serving as principal investigator of her own study, serves as a co-inves-tigator of a study on rural elders’ diabetes self-management now underway at Wake Forest University and as a consultant to Dr. Sharon Utz’s University of Virginia-study of community-based care of African Americans. SON professor Dr. Jo Ann Dalton served as a consultant on pain management for Dr. Francis Keefe at Duke University in a recently completed study of spouse-guided pain management training and for a continuing study of assisted coping skills training for lung cancer patients. “We are pleased that so many School of Nursing researchers head interdisciplinary research teams and participate on teams from other disciplines,” notes Dr. Sandra Funk, associate dean for research. “Interdisciplinary collaboration is a hallmark of research at UNC-Chapel Hill. We are fortunate to have over 50 centers and institutes on campus, such as our Center for Research on Chronic Illness, that facilitate these collaborations, thereby strengthening the research conducted by all faculty.” Amanda DeWitt, also a research assistant in Carlson's study, is a junior studying both biology and psychology at UNC. According to Carlson, half of her research team comes from disciplines other than nursing. Centers of Activity: An Update on CRCI and CIHDR Projects Center for Research on Chronic Illness Purpose: To advance research on the prevention and management of chronic illness in vulnerable people by funding pilot studies, developing new investi-gators, providing research support and facilitating dissemination Established: 1994 Current studies: 25 Funding: National Institute of Nursing Research at the National Institutes of Health Center for Innovation in Health Disparities Research Purpose: A partnership among the schools of nursing at North Carolina Central University, Winston- Salem State University and UNC-Chapel Hill to increase the capacity for culturally competent nursing research by mentoring faculty and students, funding pilot studies and developing and implementing a series of workshops designed to promote innovative methodolo-gies in health disparities research Established: 2002 Current studies: 9 Funding: National Institute of Nursing Research and the National Center on Minority Health and Health Disparities at the National Institutes of Health EXPLORING SOLUTIONS to childhood obesity. Encouraging minority students to inves-tigate their community’s health issues. Recording the rich voices of nurses from previous eras. These are just a few of the projects supported by the School’s two main research centers, the Center for Research on Chronic Illness (CRCI) and the Center for Innovation in Health Disparities Research (CIHDR). These centers provide administrative, financial and outreach support for the majority of the School of Nursing’s research projects. A pictorial update of a few of these initiatives is featured on these pages. Nursing Care for the Chronically Ill: An Oral History of Nurses and Nursing Assistants, 1950-1970 Carrie Robinson, RN, pictured here on the left in her younger nursing days, and a fellow registered nurse, now retired, shown on the right with a grace that comes from time and experience, are both living examples of the importance of a good nurse. These women dedicated many years of their lives to caring for chronically ill patients in North Carolina, and now their stories will be saved for posterity thanks to a new project by Dr. Janna Dieckmann and history doctoral candidate Cristina Nelson. Dieckmann and Nelson traveled the highways and byways of North Carolina this year to record the stories of the state’s nurses and nursing assistants who cared for the chronically ill between 1950 and 1970. The study, funded as a pilot study by the CRCI, investigates patterns of caregiving for the chronically ill in order to broaden our understanding of caring for this group today. Additional project investigators include Dr. Jacqueline Hall and Beth Millwood, director and outreach coordinator of the Southern Oral History Program respectively, and Dr. Joyce Rasin, SON professor. “It is a privilege to be able to document the dignity and worth of these nurses who gave dedicated care to the long-term sick,” says Dieckmann. 16 CAROLINA NURSING RESEARCH CHRONICLE 2002–2003 17 REAP Abu Bangura (left) and Bisola Baruwa (right), nursing students at North Carolina Central University, are both interested in careers in nursing research. As members of the local African-American community, they are all too familiar with the figures on the state of minority health in N.C., which is why they have signed up to participate in REAP, formally known as the Research Enrichment and Apprenticeship Program. The program, a joint collaboration between UNC and NCCU funded by CIHDR, pairs minority nursing students with nurse scien-tists experienced in health disparities research. Students contribute to faculty research by collecting and analyzing data and conducting interventions, and they are given the opportunity to conduct their own original research on a related health disparity issue. This will be REAP’s third year, and program directors say they are seeing positive effects already. Several of the student participants have said they are prepared to pursue careers in minority health research as a result of the program. STOPP-T2D STOPP-T2D, the acronym for Dr. Joanne Harrell’s “Studies to Treat or Prevent Pediatric Type 2 Diabetes,” is testing a school-based intervention to increase physical activity, improve nutrition and prevent type 2 diabetes in children and adolescents. Type 2 diabetes has increased at alarming rates over the past decade in youth under 18. Thus far Harrell and her co-investigators Drs. Robert McMurray, John Buse, Allan Steckler, Anthony Hackney, Maihan Vu and Vivian West have worked with hundreds of middle school students in central and eastern North Carolina counties, piloting the Oral Glucose Tolerance Test, changing the PE curriculum to increase minutes of moder-ate to vigorous physical activity in each class, reducing fat and calorie content for school lunch entrees, snack bars and vending machines and increasing consumption of water by students. This National Institute of Diabetes and Digestive and Kidney Diseases-funded project may revolu-tionize the way adolescents eat and exercise at school once the results are made public upon completion in 2009. by Sunny Smith Nelson In 2003, the School of Nursing boasted 42 faculty members work-ing as principal investigators, co-principal investigators or co-investi-gators of large, extramurally fund-ed research grants. These researchers brought in over $10 million to fund their work and helped thousands of North Carolina citizens improve their health by involving them in their studies. What you won’t find on these scien-tists’ resumes is a skill they’ve per-fected while working at Carrington Hall: space utilization. Here’s how research space in the SON breaks down: there are approx-imately 4,800 square feet of space for funded research projects in Carrington Hall. Divide that among 42 researchers and their 75 to 100 research team members, and that’s around 34 square feet per person. In room dimensions, that’s about 5’ x 6’. Not much space to recruit study participants, hire and train research assistants, crunch data and write conclusive reports on your results. Yet SON researchers manage to do it everyday. There is a light at the end of the tunnel for these researchers, though. The new addition to Carrington Hall will more than double the amount of space dedi-cated to externally-funded projects at the SON. The majority of the new space will be housed on the second and third floors of the addition and will feature a climate-controlled archive room, a welcomed addition and a far cry from the Carrington attic where researchers currently store their data. The addition also will feature 45 new offices, provid-ing all research staff with a better 18 CAROLINA NURSING RESEARCH CHRONICLE working environment. The quality of research per-formed at the SON doesn’t rest with the faculty alone, however. Many of the School’s alumni have commit-ted to support research excellence at the SON. The Class of ’56, when thinking of ways they collectively could support the School, struck upon naming the Biobehavioral Laboratory Suite. “Nursing is a spe-cial field,” says Jane Sox Monroe (BSN ’56) who with her husband, Paul, named the Human Patient Simulator Laboratory for Critical Care Skills Development. “We believe strongly in the program of the School of Nursing and in the opportunities that the new addition will provide.” Margaret Ferguson Raynor (BSN ’67) and her husband, Dr. Bobby C. Raynor, chose to support the Biobehavioral Lab for Genomics. “The new building will allow us to stay at the top of the practice of nursing while providing a pleasing learning and working environment,” says Raynor. “Important new features include state-of-the-art technology and equipment to enable nursing stu-dents and faculty to remain on the cutting edge of the practice, thus ensuring their ability to provide North Carolina citizens with the best nursing care possible.” According to Dr. Maggie Miller, the assistant dean for student and faculty services, the new research space can only add to the quality of the research produced by the SON. “The new addition is a testa-ment to the School’s dedication to quality research,” she says. “It will provide an environment that will match the high caliber research performed here, and hopefully make the SON even more attractive to faculty with established research programs or those wanting to devel-op outstanding programs.” Several opportunities to help support SON research are available, from naming labs or suites to con-tributing to endowed professorships that will support nationally renowned faculty researchers. If you would like to learn more about these opportunities, contact Norma Hawthorne at (919) 966-4619 or norma_hawthorne@unc.edu. The SON’s researchers thank you from the bottom of their 5’ x 6’ research spaces. Research Space: The Next Frontier QUICK FACTS • 21 Funded project areas • Dedicated archiving space • Expanded space for the Research Support Center • 45 new offices NAMING OPPORTUNITIES TO SUPPORT SON RESEARCH Building Addition, to be named by donor ($4 million) Distinguished professorship ($500,000) Faculty Research Award ($250,000) Biobehavioral Laboratory Suite (A Gift of the Class of ’56) Research Support Center Suite ($200,000) Associate Dean for Research Office ($100,000) Biobehavioral Laboratory for Genomics Study (A Gift of Margaret Ferguson Raynor, BSN ’67, and Dr. Bobby C. Raynor) Biobehavioral Laboratory for Human Factors Study ($100,000) Biobehavioral Laboratory for Sleep Study ($100,000) Research Project Suites (20 available; $15,000 each) Two faculty members share this office originally intended to house one person. 2002–2003 19 The numbers are in, and the School of Nursing is once again in the top five in several national rankings. The National Institutes of Health released its research funding rankings this spring, and the SON placed fourth among nursing schools nationwide with $7.5 million received in fiscal year 2002 from the agency. That’s a one-year increase of nearly $1.25 million, enough to bump the SON up a spot in the national ranking from its fifth place spot in 2001. The University fared well overall, placing 13th nationwide in grants funded by the NIH, with the SON, School of Dentistry and School of Public Health all ranking in the top five. News of this ranking came fast on the heels on the U.S.News & World Report ranking of the nation’s best graduate schools. The SON maintained its excellent standing, ranking fifth nationwide for its master’s programs. The nursing service administration program was ranked third; the SON’s family nurse practitioner and psychiatric/mental health programs were both ranked seventh; and the adult nurse practitioner program was ranked ninth. “As I represent the School of Nursing at meetings across the state and nation, people come up to me and ask, 'How does UNC-Chapel Hill do it?'” says Dean Linda Cronenwett. “Indeed, the collective accomplishments of the faculty, staff and students are astounding, year after year. We aim for excel-lence and are proud to achieve recognition for our leadership.” I N B R I E F An estimated 20 million Americans are affected by urinary incontinence, making it a signifi-cant health concern in the United States. Nearly $5.2 billion is spent annually on supplies and services to treat the condition, but according to Dr. Mary H. Palmer, Umphlet dis-tinguished professor in aging at UNC, the responsibility for promot-ing continence and treating incon-tinence lies with health-care providers, particularly nurses. Palmer co-led a national con-ference, funded in part by a grant from the Agency for Healthcare Research and Quality, on preven-tion, detection and treatment options last year, with the recom-mendations from that conference appearing in a seminal document co-edited by Palmer and Diane K. Newman of the Penn Center for Continence and Pelvic Health in the Division of Urology at the University of Pennsylvania Medical Center. “State of the Science on Urinary Incontinence,” an American Journal of Nursing special supple-ment, was released this March with much fanfare, including video press conferences, press releases and interviews with national media. The recommendations reported by Palmer and Newman include improving public awareness and education on the issue; advocating for more education for nurses on the condition; improving clinical care guidelines and practices; increasing reimbursement for edu-cation, evaluation, management and behavioral interventions; and increasing research that compares various interventions, involves minorities and men, and can be implemented in clinical practice. An electronic, full-text version of the issue is available at www.NursingCenter.com/ui. Distinguished professor leads conference on UI, co-edits special AJN supplement on condition Dr. Mary H. Palmer co-led a national conference on incontinence with Dr. Diane K. Newman of the Penn Center for Continence and Pelvic Health and Dr. Diana Mason, editor-in-chief of the American Journal of Nursing. SON Ranks in Top Five—Again! University of Washington, Seattle University of California, San Francisco University of Illinois at Chicago University of North Carolina at Chapel Hill University of Pennsylvania $13,662,728 42 $10,663,305 41 $8,176,294 28 $7,535,184 21 $5,758,381 19 Total Amount Total Awards Top five nursing schools receiving NIH funding PHOTO COURTESY OF DR. MARY H. PALMER 20 CAROLINA NURSING RESEARCH CHRONICLE Depressive symptoms are more prevalent, severe and persistent in many low-income mothers, says Dr. Linda Beeber, SON professor, because of the complex life prob-lems they face with lean resources and poor social support. These symptoms can make it hard for mothers to get the education, job training or enrichment programs that can help break them out of poverty, and their children can suf-fer emotionally and mentally as their mothers sink deeper into depression with no hope of improv-ing the situation. A new study fund-ed by the National Institute of Mental Health that Beeber is lead-ing, “Reducing Depressive Symptoms in Low-Income Mothers,” will seek to help these mothers break the cycle during the first three years of their child’s life when development is so dependent on a mother’s energy. “Although awareness of postpartum depression has increased, maternal depressive symptoms that last more than six months at any time during the first three years of the child’s life can negatively affect development,” explains Beeber. Very similar to a study she also is conducting with low-income Hispanic mothers, this research will test a 5-month intervention to help African American and Caucasian mothers effectively function with their symptoms, manage life issues, utilize social support available through public programs and better parent their children. The study will work with Early Head Start (EHS) programs in Orange, Guilford and McDowell counties, North Carolina; Asheville, North Carolina; and Onondaga County, New York. Beeber and her fellow researchers will recruit 226 depressed mothers of children between six weeks and 30 months enrolled in EHS pro-grams in order to study them at baseline and 14, 22 and 26 weeks later to test how effective the intervention is. “Few controlled interventions with high-risk mothers such as these have been done to date,” says Beeber. “This study will address this gap by bringing an intervention specifically for depressive symptoms alongside of an already existing early child intervention program. By helping these mothers better utilize EHS resources, the positive benefits of the intervention can be maintained and thus result in lasting benefits for the child as well as the mother.” Helping Low-Income Mothers with Depressive Symptoms Help Themselves I N B R I E F More than 84,000 female inmates are being held now in state and federal prisons, and many are at an increased risk for contracting HIV due to histories of promiscuity, prostitution or exchange of sex for drugs. Dr. Cathie Fogel, a professor at the SON, wants to help them reduce their risk. Expanding upon her efforts to improve the health of incarcerated women, Fogel this year began her new study, “Helping Women Prisoners Reduce HIV Risk After Release.” The study, funded by the National Institute of Mental Health, will continue for five years and test a primary prevention women-cen-tered risk reduction intervention with incarcerated women. The intervention is designed to help pre-vent HIV infection by reducing sex-ual risk behaviors and promoting sexual protective practices upon release from prison. If successful, the proposed inter-vention will serve as a model for HIV prevention efforts in women’s prisons and may be translated for broader application. “I am excited to be able to offer this program to a population of vulnerable women who are often forgotten and whose risks are many,” says Fogel. “It is my hope that through our work we will be able to improve the health of the women and, by extension, their families and communities.” Reducing the Risk of HIV in Female Prisoners ARTHRITIS Goeppinger, J., Principal Investigator; Schwartz, T., Statistician. Comparing ASHC and CDSMP Outcomes in Arthritis. Association of Schools of Public Health, Centers for Disease Control, 2002-2004. CANCER Mishel, M., Principal Investigator; Germino, B., Co- Principal Investigator; Gil, K., Carlton-LaNey, I., & Belyea, M., Co-Investigators. Managing Uncertainty in Older Breast Cancer Survivors. National Cancer Institute, National Institutes of Health, 1999-2004. Mishel, M., Principal Investigator; Germino, B., Co- Principal Investigator; Beeber, L., Belyea, M., Gollop, C., Mohler, J., Co-Investigators. Decision Making Under Uncertainty in Prostate Cancer. National Institute of Nursing Research, National Institutes of Health, 2002-2006. CARDIOVASCULAR DISEASE Brown, D., Principal Investigator. Perceived Stress, Cortisol and Cardiovascular Responses During Sleep in Black Women. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2003-2004. Fleury, J., Principal Investigator; Bunker, B., Co- Investigator; Carlson, J., Statistician. Community-based Intervention to Promote Cardiovascular Health. American Heart Association, 1999-2002. Harrell, J., Principal Investigator; McMurray, R., Bangdiwala, S., & Davenport, M., Co-Investigators. Cardiovascular Health in Children and Youth (CHIC III). National Institute of Nursing Research, National Institutes of Health, 2000-2004. Harrell, J., Principal Investigator; McMurray, R., Co- Principal Investigator; Bangdiwala, S., Co- Investigator. Energy Expenditures of Physical Activities in Youth (EEPAY). National Institute of Nursing Research, National Institutes of Health, 1998-2002. CAREGIVING Rasin, J., Principal Investigator. Caregiving Stress in Family Care Homes. Junior Faculty Development Award, The University of North Carolina at Chapel Hill, 2002. Rasin, J., Principal Investigator. Caregiving Stress in Family Care Homes. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2001-2002. CHRONIC ILLNESS Dieckmann, J., Principal Investigator. Caring for the Chronically Ill in North Carolina and Two Neighboring States, 1930-1940. Junior Faculty Development Award, The University of North Carolina at Chapel Hill, 2002. Dieckmann, J., Principal Investigator; Hall, J., & Rasin, J., Co-Investigators. Nursing Care for the Chronically Ill: An Oral History of Nurses and Nursing Assistants, 1950-1970. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2002-2003. Goeppinger, J., Operations Committee Member; Cross, A., Principal Investigator. Prevention Research Centers Program. Centers for Disease Control, 2000-2003. Harrell, J., Principal Investigator; Funk, S., Co-Principal Investigator; Leeman, J., Co-Investigator; Holditch- Davis, D., Mishel, M., & Dougherty, M., Core Directors. Center for Preventing/Managing Chronic Illness in Vulnerable People. National Institute of Nursing Research, National Institutes of Health, 1994-2004. CYSTIC FIBROSIS Christian, B., Principal Investigator; D’Auria, J., Co- Principal Investigator; Retsch-Bogart, G., & Belyea, M., Co-Investigators; Holditch-Davis, D., Senior Research Consultant. Building Life Skills in Children with Cystic Fibrosis. National Institute of Nursing Research, National Institutes of Health, 1998-2002. DEPRESSION Beeber, L., Principal Investigator; Holditch-Davis, D., Perreira, K., Belyea, M., Co-Investigators. EHS Latino Mothers: Reducing Depression and Improving Infant/Toddler Mental Health. Department of Health and Human Services – Administration for Children, Youth, and Families, 2002-2006. Beeber, L., Principal Investigator; Canuso, R., Holditch- Davis, D., Mishel, M., Belyea, M., Co-Investigator. Reducing Depressive Symptoms in Low-Income Mothers. National Institute of Mental Health, National Institutes of Health, 2003-2008. DIABETES Harrell, J., Principal Investigator; McMurray, R., Bangdiwala, S., Hackney, A., & Chapman, J., Co- Investigators. Physical Activity in Youth-Preventing Type 2 Diabetes. National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, 2002-2009. Skelly, A., Site Principal Investigator & Co-Investigator; Quandt, S., Principal Investigator. Rural Elders’ Diabetes Self-Management: Ethnic Variations. Wake Forest University, National Institute on Aging, National Institutes of Health, 2001-2005. Skelly, A., Principal Investigator; Dougherty, M., Arcury, T., Cravey, A., & Gesler, W., Co-Investigators. Type 2 Diabetes: Ethnic Variation in Knowledge and Beliefs. National Institute of Nursing Research, National Institutes of Health, 2000-2004. ELDERS Carlson, B., Principal Investigator; Neelon, V., Hartman, M., Dogra, S., & Carlson, J., Co-Investigators. Respiratory Periodicity and Cognitive Decline in Elders. National Institute of Nursing Research, National Institutes of Health, 2002-2006. Carlson, B., Principal Investigator; Neelon, V., Carlson, J., & Rowsey, P., Co-Investigators. Core Body Temperature Rhythm, Cytokines and Respiratory Periodicity During Sleep in Older Adults with and Without Age-Associated Memory Impairment. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2002-2003. Hudson, M., Principal Investigator; Carlson, J., Co- Investigator; Belyea, M., Psychometric Consultant; Fishel, A., Field Tester. Elder Abuse: A Screening Protocol. National Institute on Aging, National Institutes of Health, 1997-2002. Palmer, M., Subcontract Principal Investigator and Study Co-Investigator; Baumgarten, M., Principal Investigator. Locus of Care and Pressure Ulcers After Hip Fracture. University of Maryland, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 2002. GENETICS Thoyre, S., Co-Principal Investigator; Van Riper, M., Co- Principal Investigator; Brackett, K., Co-Investigator. Feeding Issues for Young Children with Down Syndrome and Their Families. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill, National Institute of Nursing Research, National Institutes of Health, 2002-2003. Van Riper, M., Principal Investigator; Knafl, K., Magnuson, T., Juengst, E., Grabowski, G., & Gregory, P., Mentors. Family Experience of Genetic Testing: Ethical Dimensions. National Institute of Nursing Research, National Institutes of Health, 2001-2003. HEALTH DISPARITIES McQuiston, C., Principal Investigator; Dennis, B., Flack, S., Co-Principal Investigators; Leeman, J., Co- Investigator and Project Director; Miles, M., Rowsey, P., Goeppinger, J., & Eaves, Y., Core Directors. Center for Innovation in Health Disparities Research. National Institute of Nursing Research, National Institutes of Health, 2002-2007. Faculty Research Grants 2002–2003 Academic Year 2002–2003 21 HIV/AIDS Barroso, J., Co-Investigator; Leserman, J., Site Principal Investigator. HIV: Neuropsychiatric and Psychoimmune Relationships. University of Pennsylvania, National Institutes of Health, 2001-2004. Fogel, C., Principal Investigator. The Experiences of HIV-Infected Women Following Incarceration. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill, National Institute of Nursing Research, National Institutes of Health, 2002-2004. McQuiston, C., Principal Investigator; Parrado, E., Co- Investigator; Flippen, C., Project Manager. Gender, Migration, and HIV Risks Among Mexicans. National Institute of Nursing Research, National Institutes of Health, 2001-2005. Pletsch, P., Co-investigator; Stevens, P., Principal Investigator; Keigher, S., Co-Investigator. In-Depth Longitudinal Study of HIV-Infected Women. University of Wisconsin at Milwaukee, National Institute of Nursing Research, National Institutes of Health, 2000-2003. INCONTINENCE Boyington, A., Principal Investigator; Dougherty, M., Sponsor. A Knowledge-Based System for Continence. National Institute of Nursing Research, National Institutes of Health, 1999-2003. Boyington, A., Principal Investigator. Enhanced Recruitment for Phase 3: A Knowledge-Based System for Continence. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2001-2002. Kincade, J., Principal Investigator; Dougherty, M., Co-Principal Investigator; Carlson, J., Co-Investigator and Statistician; Busby-Whitehead, J., & Wells, E., Co-Investigators. Efficacy of Biofeedback to Treat UI in Women. National Institute of Nursing Research, National Institutes of Health, 2000-2004. Kincade, J., Principal Investigator; Dougherty, M., Co- Principal Investigator; Carlson, J., Co-Investigator and Statistician; Busby-Whitehead, Co-Investigator. Effectiveness of Self-Monitoring to Treat UI in Women. National Institute of Nursing Research, National Institutes of Health, 2001-2004. Palmer, M., Principal Investigator. Urinary Incontinence Research, Practice & Policy Issues. Agency for Healthcare Research and Quality, 2002-2003. INFANTS AND CHILDREN Holditch-Davis, D., Principal Investigator; Scher, M., Miles, M., Schwartz, T., & Hack, M., Co- Investigators. Assessment of Biological And Social Risk In Preterm Infants. National Institute of Nursing Research, National Institutes of Health, 1998-2003. Holditch-Davis, D., Principal Investigator; Miles, M., Co- Principal Investigator; Beeber, L., & Thoyre, S., Co- Investigators; Belyea, M., Statistical Investigator; Pedersen, C., & Biddle, A., Consulting Investigators; Black, B., Project Manager; Hubbard, C., & Wereszczak, J., Clinical Investigators; Nursing Support Intervention for Mothers of Prematures. National Institute of Nursing Research, National Institutes of Health, 2001-2006. Thoyre, S., Principal Investigator; Holditch-Davis, D., Sponsor; Carlson, J., Statistical Investigator; Veness- Meehan, K., Consulting Investigator. Contingent Feeding of Preterms to Reduce Hypoxemia. National Institute of Nursing Research, National Institutes of Health, 2002-2005. Thoyre, S., Principal Investigator. Decreasing the Effect of Variability in a Test of Contingent Feeding for Preterm Infants. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2002-2003. NURSING SYSTEMS AND OUTCOMES Cronenwett, L. R., Steering Committee Member; Roper, W., Principal Investigator. Program on Health Outcomes, School of Public Health, The University of North Carolina at Chapel Hill, Glaxo-Wellcome Foundation, 1999-2003. Esposito, N., Principal Investigator; Beeber, L., Psychiatric Nurse; Schwartz, T., Statistician. Women Drug Abusers and Post Sexual Assault Care. National Institute on Drug Abuse, National Institutes of Health, 2001-2002. Foley, B., Principal Investigator; Bingham, M., Kee, C., Minick, P, & Harvey, S., Co-Investigators; Schwartz, T., Statistician. Nursing Processes and Patient Outcomes in U.S. Army Hospitals, Triservice Nursing Research Program, 2002-2004 Jones, C., Principal Investigator. Calculating the Costs of Nursing Turnover in Hospitals. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2001-2004. Jones, C., Principal Investigator. Differential Nursing Employment Patterns: Racial and Geographic Characteristics. Junior Faculty Development Award, The University of North Carolina at Chapel Hill, 2002. Lynn, M., Principal Investigator; Mark, B., Nursing Systems Analyst; Bollen, K., SEM Analyst; Morgan, J., Data Analyst. Testing a Model of Quality Care in Home Health. National Institute of Nursing Research, National Institutes of Health, 2002-2007. Lynn, M., Principal Investigator; Redman, R., Co- Principal Investigator. Canaries in the Coalmine: A View of the Nursing Shortage from the Trenches. Faculty Research Opportunity Grant, School of Nursing, The University of North Carolina at Chapel Hill, 2003-2004. Mark, B., Principal Investigator. Nurse Staffing, Financial Performance, and Quality Care. Agency for Healthcare Research and Quality, 1999-2005. Mark, B., Principal Investigator; Jones, C., Eck, S., & Belyea, M., Investigators. A Model of Patient and Nursing Administration Outcomes. National Institute of Nursing Research, National Institutes of Health, 1995-2007. Mark, B., Co-Sponsor; Radwin, L., Principal Investigator. Testing the Quality Health Outcomes Model in Cancer Care. University of Massachusetts at Boston, Agency for Healthcare Research and Quality, 2001- 2006. Redman, R., Principal Investigator; Lynn, M., Co-Principal Investigator. Development of an Instrument to Assess Patient Expectations and Evaluation of Care Experiences. Program on Health Outcomes, University of North Carolina at Chapel Hill, 2002-2003. RESEARCH SYNTHESIS Sandelowski, M., Principal Investigator; Barroso, J., Co-Principal Investigator. Analytic Techniques for Qualitative Metasynthesis. National Institute of Nursing Research, National Institutes of Health, 2000-2005. Woodard, B., Principal Investigator; Sandelowski, M., & Barroso, J., Co-Investigators. A Pilot Study to Transform Qualitative Research Findings for Use in Evidence-based Practice. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2003-2004. RESEARCH TRAINING Mishel, M., Principal Investigator; Holditch-Davis, D., Co-Principal Investigator. Interventions for Preventing and Managing Chronic Illness. Institutional National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 1996-2006. SMOKING CESSATION Pletsch, P., Principal Investigator. Taste Changes and the Smoking Cessation Experience of Spontaneous Quitters: Informing the Next Generation of Cessation Interventions for Pregnant Women. Center for Research on Preventing/Managing Chronic Illness in Vulnerable People, School of Nursing, The University of North Carolina at Chapel Hill. National Institute of Nursing Research, National Institutes of Health, 2002-2003. Pletsch, P., Co-Investigator. Testing Pharmacological Therapies for Pregnant Smokers. Duke University, National Cancer Institute, National Institutes of Health, 2003-2004. THERMOREGULATION Rowsey, P.J., Principal Investigator. Beneficial Effects of Exercise on Health and Disease. National Institute of Nursing Research, National Institutes of Health, 1999-2004. 22 CAROLINA NURSING RESEARCH CHRONICLE �� Major Research Project Sites July 2002 – June 2003 2002–2003 23 Barlow, J., Principal Investigator. Early Intervention for Hospitalized Children. The Duke Endowment, 2003-2005. Barlow, J., Principal Investigator. Community Pathways: Early Intervention for Hospitalized Children. NC Department of Health and Human Services, Division of Public Health, Women’s and Children’s Health Section, 2002-2003. Cockroft, M., & Foster, B., Co-Principal Investigators. Occupational Health Site Development for Undergraduate Nursing Students. AHEC Grant for Development of New Clinical Training Sites for Nursing, 2002-2003. Fishel, A., & Fogel. C., Faculty Liaisons. Curtis, P., Principal Investigator. Integrating CAM into Health Professions Education. National Institutes of Health, 2000-2005. Goeppinger, J., Principal Investigator. Sustainable Solutions to Economic Distress, Tobacco Dependence, Limited Health Care Access and the Nursing Shortage: Nursing Education for Golden LEAF Counties. Golden LEAF Foundation, 2003. Goeppinger, J., Project Director. Community-Oriented Primary Care for Rural Populations. Health Resources and Services Administration, Division of Nursing, 2000-2003. Henderson, M., Principal Investigator. Transitions: A New Model of Care for Frail Elderly Facing the Final Phase of Life, Warner Dannheisser Testamentary Trust, 2002-2004 Miles, M., Faculty Member. Ornstien, P., Director. Center for Developmental Science. National Institute of Mental Health, National Institutes of Health, 1998-2003. Educational and Professional Grants 2002–2003 Academic Year Miles, M., Co-Director; Elder, G., Director. Human Development: Interdisciplinary Research Training. National Institute of Child Health and Human Development, National Institutes of Health, 1998-2003 Miller, M., Project Director. Advanced education nurse traineeship. Bureau of Health Professions, Health Resources and Services Administration, 2002-2003. Pierce, S., Principal Investigator. Creating leaders in ethical deliberation. Helene Fuld Trust, 2001-2003. Rasin, J., Principal Investigator. Building capacity in the nursing workforce: Caring for diverse elders. John A. Hartford Foundation, 2001-2004. Redman, R., Principal Investigator; Moore, K., Co-Investigator. Ueltschi Service-Learning Course Development Grant. The University of North Carolina at Chapel Hill APPLES Service Learning Program, 2002-2004 . Alexander, G. Rumay, Clinical Assistant Professor Alexander, G. R. (2002). A mind for multicultural manage-ment. Nursing Management, 33(10), 30-33. Alexander, G. R. (2002). Legislation is the solution to the nursing shortage: The con side. Nursing Leadership Forum, 6(3), 65-8. Alexander, G. R. (2002). Let’s get busy diversifying! Nursing Management, 33(5), 16. Barroso, Julie, Assistant Professor Barroso, J., Carlson, J., & Meynell, J. (2003). Physiological and psychological markers associated with HIV-related fatigue. Clinical Nursing Research, 12(1), 49-68. Barroso, J., Gollop, C., Sandelowski, M., Meynell, J., Pearce, P., & Collins, L. (2003). The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing Research, 25, 153-178. Barroso, J., Preisser, J. S., Leserman, J., Gaynes, B. L., Golden, R. N., & Evans, D. L. (2002). Predicting fatigue and depression in HIV-positive gay men. Psychosomatics, 43(4), 317-325. Leserman, J., Petitto, J. M., Gu, H., Gaynes, B. N., Barroso, J., Golden, R. N., Perkins, D. O., Folds, J. D., & Evans, D. L. (2002). Progression to AIDS, a clinical AIDS con-dition, and mortality: Psychosocial and physiological predictors. Psychological Medicine, 32, 1059-1073. Randall, M., & Barroso, J. (2002). Delayed pursuit of health care among HIV-positive gay men enrolled in a longitudinal research study. Journal of the Association of Nurses in AIDS Care, 13(4), 7-15. Sandelowski, M., & Barroso, J. (2002). Finding the findings in qualitative studies. Journal of Nursing Scholarship, 34, 213-219. Sandelowski, M., & Barroso, J. (2003). Creating metasum-maries of qualitative findings. Nursing Research, 52, 226-233. Sandelowski, M., & Barroso, J. (2003). Toward a metasyn-thesis of qualitative findings on motherhood in HIV-positive women. Research in Nursing and Health, 26, 153-170. Sandelowski, M., & Barroso, J. (2003). Writing the proposal for a qualitative research methodology project. Qualitative Health Research, 13, 781-820. Beeber, Linda S., Professor Beeber, L. S. (2002). The pinks and the blues: Symptoms of chronic depression in mothers during their children’s first year. American Journal of Nursing, 102(11), 91-8. Beeber, L. S., & Miles, M. S. (2003). Maternal mental health and parenting in poverty. In J. J. Fitzpatrick (Series Ed.), M. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 303-331). New York: Springer. Belyea, Michael, Research Associate Professor Lai, Y. H., Dalton J. A., Belyea, M., Chen M. L., Tsai, L. Y., & Chen, S. C. (2003). Development and testing of the pain opioid analgesics beliefs scale in Taiwanese cancer patients. Journal of Pain & Symptom Management, 25(4), 376-385. Mishel, M. H., Germino, B., Belyea, M., Stewart, J., Bailey, D., Jr., Robertson, C., & Mohler, J. (2003). Moderators of an uncertainty management intervention for men with localized prostate cancer. Nursing Research 52(2), 89-97. Black, Beth, Clinical Associate Professor Black, B., & Miles, M. (2002). Calculating risks and bene-fits of disclosure in African American women with HIV. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(6), 688-697. Holditch-Davis, D., & Black, B. (2003). Care of preterm infants: Programs of research and their relationship to developmental science. In J. J. Fitzpatrick (Series Ed.), M. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 23-60). New York: Springer. Boyington, Alice, Assistant Professor Castina, S., Boyington, A. R., & Dougherty, M. C. (2002). Urinary incontinence: If we don’t ask, patients won’t tell. American Journal of Nursing, 10(8), 85, 87. Dougherty, M. C., Dwyer, J. W., Pendergast, J. F., Coward, R. T., Vogel, W. B., Duncan, R. P., Rooks, L., Tomlinson, B. U., & Boyington, A. R. (2002). A behavioral manage-ment for continence intervention reduced urinary incontinence symptoms in older rural women. Evidence-based Mental Health, 5, 79. Carlson, John, Research Associate Professor Barroso, J., Carlson, J., & Meynell, J. (2003). Physiological and psychological markers associated with HIV-related fatigue. Clinical Nursing Research, 12(1), 49-68. Carlson, J., Youngblood, R., Dalton, J. A., Blau, W., & Lindley, C. (2003). Is patient satisfaction a legitimate outcome of pain management? Journal of Pain and Symptom Management, 25(3), 264-275. Rowsey, P. J., Metzger, B. L., Carlson, J., & Gordon, C. J. (2003). Effect of exercise conditioning on thermoreg-ulatory responses to repeated administration of chlor-pyrifos. Environmental Research, 92, 27-34. Thoyre, S., & Carlson, J. (2003). Occurrence of oxygen desaturation events during preterm infant bottle feed-ing near discharge. Early Human Development, 72, 25-36. Cheek, Dennis, Assistant Professor Cheek, D., & Cesan, A. (2003). Genetic predictors of cardio-vascular disease: The use of chip technology. The Journal of Cardiovascular Nursing, 18(1), 50-56. Christian, Becky J., Associate Professor Christian, B. J. (2003). Growing up with chronic illness: Psychosocial adjustments of children and adolescents with cystic fibrosis. In J. J. Fitzpatrick (Series Ed.), M. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 151-172). New York: Springer. Cronenwett, Linda R., Professor and Dean Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. Journal of Nursing Administration, 33(2), 131-133. Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. (repeated in) Nurse Educator, 28(4), 153-155. Dalton, Jo Ann, Professor Carlson, J., Youngblood, R., Dalton, J. A., Blau, W., & Lindley, C. (2003). Is patient satisfaction a legitimate outcome of pain management? Journal of Pain and Symptom Management, 25(3), 264-275. Keefe, F., Ahles, T., Porter, L., Sutton, L., McBride, C., Pope, M., McKinstry, E., Furstenberg, C., Dalton, J. A., & Baucom, D. (May 2003). The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life. Pain, 103(1-2), 157-162. Lai, Y. H., Dalton J. A., Belyea, M., Chen M. L., Tsai, L. Y., & Chen, S. C. (2003). Development and testing of the pain opioid analgesics beliefs scale in Taiwanese can-cer patients. Journal of Pain & Symptom Management, 25(4), 376-385. Stephenson, N. L. & Dalton, J. A. (2003). Using reflexology for pain management: A review. Journal of Holistic Nursing, 21(2), 179-191. Dougherty, Molly C., Frances Hill Fox Distinguished Professor Castina, S., Boyington, A. R., & Dougherty, M. C. (2002). Urinary incontinence: If we don’t ask, patients won’t tell. American Journal of Nursing, 102(8), 85, 87. Dougherty, M. C. (2002). Progress: Editor’s web site and more. Nursing Research, 51, 4a. Dougherty, M. C., Dwyer, J. W., Pendergast, J. F., Coward, R. T., Vogel, W. B., Duncan, R. P., Rooks, L., Tomlinson, B. U., & Boyington, A. R. (2002). A behavioral manage-ment for continence intervention reduced urinary incontinence symptoms in older rural women. Evidence-based Mental Health, 5, 79. Lin, S-Y., & Dougherty, M. C. (2002). Incontinence impact, symptom distress and treatment-seeking behavior in women with involuntary urine loss in southern Taiwan. International Journal of Nursing Studies, 40, 227-234. Moore, K. N., Colling, J., & Dougherty, M. C. (2002). Nursing research and continence care. Urologic Nursing, 22(3), 183-187. Esposito, Noreen, Assistant Professor Esposito, N. (2002). St. John the Divine. Iris: The UNC Journal of Medicine, Literature & Visual Art, 3, 30-35. 24 CAROLINA NURSING RESEARCH CHRONICLE Faculty Publications 2002–2003 Academic Year 2002–2003 25 Fishel, Anne, Professor Fishel, A. (2002). Anxiety disorders. In N. Randolph (Ed.), Springhouse review for psychiatric and mental health nursing certification (pp.81-93). Philadelphia: Lippincott, Williams & Wilkins. Fogel, Catherine, Professor Fogel, C., & Moos, M-K. (2002). Family planning nurs-ing manual. Raleigh, NC: Women’s Health Section, Department of Health and Human Services. Fogel, C., & Moos, M-K. (2002). Maternal health nursing manual. Raleigh, NC: Women’s Health Section, Department of Health and Human Services. Fogel, C., Moos, M-K., & Flannigan, O. (2002). Orientation to women’s health care in local health departments workbook. Raleigh, NC: Women’s Health Section, Department of Health and Human Services. Fogel, C. (2003). Sexuality of women. In V. Lucas, & E. Breslin (Eds.), AWHONN’s core curriculum for women’s health (pp. 400-431). Philadelphia: W.B. Saunders. Fogel, C. (2003). Women and sexuality. In E. Q. Youngkin & M. S. Davis (Eds.), Women’s health: A primary care clinical guide (3rd ed., pp. 109-130). Stamford, CT: Appleton & Lange. Gingrich, P., & Fogel, C. (2003). Herbal therapy use by perimenopausal women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32(2), 181-189. Foley, Barbara Jo, Clinical Associate Professor Fry, S., Harvey, R., Hurley, A., & Foley, B. (2002). Development of a model of moral distress in military nursing. Nursing Ethics, 9(4), 373-387. Funk, Sandra G., Professor Funk, S. G. (2003). Experimental designs. In K.S. Oman, M. Krugman, & R. Fink (Eds.), Nursing research secrets (pp. 113-121). Philadelphia: Hanley & Belfus, Inc. Leeman, J., Goeppinger, J., Funk, S. G., & Roland, J. (2003). An enriched research experience for minority undergradu-ates: A step towards increasing the number of minority nurse researchers. Nursing Outlook, 51(1), 20-24. Germino, Barbara, Beerstecher Blackwell Distinguished Professor Mishel, M. H., Germino, B., Belyea, M., Stewart, J., Bailey, D., Jr., Robertson, C., & Mohler, J. (2003). Moderators of an uncertainty management intervention for men with local-ized prostate cancer. Nursing Research, 52(2), 89-97. Goeppinger, Jean, Professor Leeman, J., Goeppinger, J., Funk, S. G., & Roland, E.J. (2003). An enriched research experience for minority undergraduates: A step toward increasing the number of minority nurse researchers. Nursing Outlook, 51(1), 20-24. Halloran, Edward, Associate Professor Goldrick, B., & Halloran, E. (2003). Emerging infections: Life with SARS in Hong Kong. American Journal of Nursing, 103(7), 22-23. Halloran, E. (2002). Heroic medicine vs. disease prevention in the American Civil War, 1861-1865. In J. Raftery (Ed.), Then and now: collected papers of the seventh biennial conference of the Australian Society of the History of Medicine (pp. 112-122). Adelaide, Australia: Australian Society of the History of Medicine, Inc. Halloran, E. (2003). John D. Thompson. In W. D. White (Ed.), Compelled by data: John D. Thompson, nurse, health services researcher and health administration educator (pp. 19-28). New Haven, CT: Yale University, Department of Epidemiology and Public Health. Thorson, M., & Halloran, E. (2003). Henderson’s unique function of nurses. In J. Fitzpatrick, & A. Whall, Conceptual models of nursing (2nd ed). Upper Saddle River, NJ: Prentice-Hall. Harrell, Joanne S., Professor Gilmer, M. J., Harrell, J. S., Miles, M. S., & Hepworth, J. (2003). Factors influencing physical activity in young adolescents of parents with premature coronary heart disease. Journal of Pediatric Nursing, 18(3), 159-168. Harrell, J. S., Pearce, P. F., & Hayman, L. (2002). Fostering prevention in the pediatric population. Journal of Cardiovascular Nursing, 18(2), 144-149. Harrell, J. S., Pearce, P. F., Markland, E., Wilson, K., Bradley, C., & McMurray, R. G. (2003). Assessing physical activity in adolescents: The common activities of chil-dren in 6th - 8th grades. Journal of the American Academy of Nurse Practitioners, 15(4), 170-179. McMurray, R. G., Harrell, J. S., Bangdiwala, S., Deng, S., & Baggett, C. (2003). Factors contributing to the energy expenditure of youth during cycling and running. Pediatric Exercise Science, 15, 67-82. McMurray, R. G., Harrell, J. S., Bradley, C. B., Deng, S., & Bangdiwala, S. (2003). Gender and ethnic changes in physical work capacity from childhood through ado-lescents. Research Quarterly for Exercise and Sports, 74(2), 143-152. Henderson, Martha, Clinical Assistant Professor Henderson, M. L. (2003). Advance care planning: Nuts and bolts. FORUM N.C. Medical Board, 7(1), 8-13. Holditch-Davis, Diane, Professor Fitzpatrick, J. J., Miles, M. S., & Holditch-Davis, D. (Eds.) (2003). Annual review of nursing research: Vol. 21. Research on child health and pediatric issues. New York: Springer. Holditch-Davis, D. (2003). Distinguished researcher award. Identification of developmental risk in infants with medical problems: A program of research. Southern Connections, 17(1), 4. Holditch-Davis, D., Bartlett, T. R., Blickman, A., & Miles, M. S. (2003). Post-traumatic stress symptoms in mothers of premature infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32, 161-171. Holditch-Davis, D., & Black, B. (2003). Care of preterm infants: Programs of research and their relationship to developmental science. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 23-60). New York: Springer. Holditch-Davis, D., Blackburn, S., & Vandenberg, K. A. (2003). Newborn and infant neurobehavioral development. In C. Kenner & J. W. Lott (Eds.), Comprehensive neonatal nursing care: A physiologic perspective (3rd ed., pp. 236-284). Philadelphia: Saunders. Miles, M. S., & Holditch-Davis, D. (2003). Enhancing nurs-ing research with children and families using a devel-opmental science perspective. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 1-20). New York: Springer. Holoman, Elizabeth, Clinical Assistant Professor Holoman, E. (2002). Congenital pulmonary alveolar pro-teinosis: A case study. Neonatal Intensive Care, 15(6), 15-18. Hughes, Linda C., Research Associate Professor Frank-Stromborg, M., Ward, S., Hughes, L. C., Brown, K., Coleman, E. A., Grindel, C. G., & Miller-Murphy, C. (2002). Does certification status of the oncology nurse make a difference in patient outcomes? Oncology Nursing Forum, 29, 665-672. Hughes, L. C. (2002). Peer group caring interaction scale and organizational climate for caring questionnaire. In J. Watson (Ed.), Assessing and measuring caring in nursing and health science (pp. 151-156). New York: Springer. Hughes, L. C., Romick, P., Sandor, K., Phillips, C. A., Glaister, J., Levy, K., & Rock, J. (2003). Evaluation of an informal peer group experience on baccalaureate nursing students’ emotional well-being and profes-sional socialization. Journal of Professional Nursing, 19, 38-48. Jones, Cheryl B., Associate Professor Jones, C. B., & Lusk, S. L. (2002). Incorporating health services research into nursing doctoral programs. Nursing Outlook, 50(6), 225-231. Jones, C. B., & Thompson, K. T. (2002). Economics influ-ences in health care delivery. In M. Stanhope, & J. Lancaster (Eds.), Foundations of Community Health Nursing (pp. 105-126). St. Louis: Mosby. Kovner, C. T., Jones, C. B., Zahn, C., Gergen, P., & Basu, J. (2002). Nurse staffing and post surgical adverse events: An analysis of administrative data from a sam-ple of U.S. hospitals, 1990-1996. Health Services Research, 37(3), 611-629. Moody, L. E., Small, B. J., & Jones, C. B. (2002). Advance directives preferences of functionally and cognitively impaired nursing home residents in the United States. Journal of Applied Gerontology, 21(1), 103-118. Kjervik, Diane K., Professor Kjervik, D. K. (2002). APNs: Know your collaborators and their insurance policies. [Column]. Journal of Clinical Systems Management, 4(9), 6. Kjervik, D. K. (2002). APNs: Mental health nurses required to intervene. [Column]. Journal of Clinical Systems Management, 4(6), 8. Kjervik, D. K. (2002). APNs: States may regulate HMOs. [Column]. Journal of Clinical Systems Management, 4(12), 8. 26 CAROLINA NURSING RESEARCH CHRONICLE Kjervik, D. K. (2002). Bridging the law-reality gap. [Column]. Journal of Nursing Law, 8(3), 5. Kjervik, D. K. (2002). Legal protections at the end of life. [Column]. Journal of Clinical Systems Management, 4(7), 18. Kjervik, D. K. (2002). Physicians as experts on advanced practice nursing care. [Column]. Journal of Clinical Systems Management, 4(8), 10. Kjervik, D. K. (2002). Side rails as restraints? [Column]. Journal of Clinical Systems Management, 4(10), 6. Kjervik, D. K. (2002). Supervisory responsibility and profes-sional relationships. [Column]. Journal of Clinical Systems Management, 4(11), 8. Kjervik, D. K. (2002). The evolving nursing standard of care. [Column]. Journal of Nursing Law, 8(2), 5. Kjervik, D. K. (2002). TJ and nursing. Journal of Nursing Law, 8(4), 19-22. Kjervik, D. K. (2003). Negligent credentialing of APNs. [Column]. Journal of Clinical Systems Management, 5(1), 6. Kjervik, D. K. (2003). Psych nurse qualified to serve as an expert witness. [Column]. Journal of Clinical Systems Management, 5(2), 6. Leeman, Jennifer, Research Assistant Professor Leeman, J., Goeppinger, J., Funk, S. G., & Roland, J. (2003). An enriched research experience for minority undergraduates: A step towards increasing the number of minority nurse researchers. Nursing Outlook, 51(1), 20-24. Lowdermilk, Deitra, Clinical Professor Lowdermilk, D., & Perry. S. (Eds.). (2003). Maternity nursing (6th ed.). St Louis: Mosby. Lynn, Mary, Associate Professor Sloane, P., Mitchell, C. M., Weissman, G., Zimmerman, S. I., Long, K. M., Lynn, M., Calkins, M., Lawton, M. P., Teresi, J., Grant, L., Lindeman, D., & Montgomery, R. (2002). The therapeutic environment screening scale for nursing homes (TESS-NH): An observational instrument for assessing institutional environments for persons with dementia. Journal of Gerontology Series B – Psychological Sciences & Social Sciences, 57(2), S69-78. Mark, Barbara, Professor Mark, B., Salyer, J., & Harless, D. (2002). Factors influenc-ing perceptions of staffing adequacy. Journal of Nursing Administration, 32(5), 234-242. Mark, B., Salyer, J., & Wan, T.T.H. (2003). Professional nursing practice: Impact on organizational and patient outcomes. Journal of Nursing Administration, 33(4), 224-234. McCue, M., Mark, B., & Harless, D. (2003). Nurse staffing, quality and hospital financial performance. Journal of Health Care Financial Management, 29(4). 54-76. McQuiston, Christine M., Assistant Professor McQuiston, C. M., & Flaskerud, J. (2003). If they don’t ask about condoms, I just tell them: A descriptive case study of Latino lay health advisors’ helping activities. Health Education & Behavior, 30(1), 79-96. Miles, Margaret S., Professor Beeber, L. S., & Miles, M. S. (2003). Maternal mental health and parenting in poverty. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 303-331). New York: Springer. Black, B., & Miles, M. S. (2002). Calculating risks and ben-efits of disclosure in African American women with HIV. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(6), 688-697. Fitzpatrick, J. J., Miles, M. S., & Holditch-Davis D. (Eds.). (2003). Annual review of nursing research: Vol. 21. Research on child health and pediatric issues. New York: Springer. Gilmer, M. J., Harrell, J. S., Miles, M. S., & Hepworth, J. T. (2003). Factors influencing physical activity in young adolescents of parents with premature coronary heart disease. Journal of Pediatric Nursing 18(3), 159-168. Holditch-Davis, D., Bartlett, T. R., Blickman, A., & Miles, M. S. (2003). Post-traumatic stress symptoms in mothers of premature infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32, 161-171. Miles, M. S. (2003). Parents of children with chronic health problems: Programs of nursing research and their relationship to developmental science. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch- Davis (Vol. Eds.), Annual review of nursing research: Vol. 21. Research on child health and pediatric issues (pp. 247-277). New York: Springer. Miles, M. S. (2003). Support for parents during a child’s hospi-talization. American Journal of Nursing, 103(2), 62-64. Miles, M. S., & Holditch-Davis, D. (2003). Enhancing nurs-ing research with children and families using a devel-opmental science perspective. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual Review of Nursing Research: Vol. 21. Research on Child Health and Pediatric Issues (pp. 1-20). New York: Springer. Mishel, Merle H., Kenan Distinguished Professor Mishel, M. H., & Clayton, M. F. (2003). Uncertainty in ill-ness theories. In M. J. Smith & P. Liehr (Eds.), Middle range theory in advance practice nursing (pp. 25- 48). New York: Springer Publishing. Mishel, M. H., Germino, B., Belyea, M., Stewart, J., Bailey, D., Jr., Robertson, C., & Mohler, J. (2003). Moderators of an uncertainty management intervention for men with localized prostate cancer. Nursing Research, 52(2), 89-97. Palmer, Mary H., Umphlet Distinguished Professor Fonda, D., Benvenuti, F., Cottenden, A., DuBeau, C., Kirshner-Hermanns, R., Miller, K., Palmer, M. H., & Resnick, N. (2002). Urinary incontinence and bladder dysfunc-tion in older persons. In P. Abrams, L. Cardozo, S. Khoury, & A. Wein (Eds.), Incontinence. 2nd inter-national consultation on incontinence (2nd ed., pp. 625-695). Plymouth, UK: Health Publications Ltd. Newman, D., & Palmer, M. H. (Eds). (2003). State of the science on urinary incontinence. American Journal of Nursing, 3, 1-58. Palmer, M. H. (2003). The state of the science in urinary incontinence nursing research. [Guest editorial]. Journal of Wound, Ostomy and Continence Nursing, 30(2), 61. Palmer, M. H.(2003). Urinary incontinence. In V. Carrieri- Kohlman, A. Lindsey, & C. West (Eds.), Pathophysiological phenomena in nursing: Human responses to illness, (3rd ed., pp. 91-114). St. Louis: Saunders. Palmer, M. H., Baumgarten, M., Langenberg, P., & Carson, J. (2002). Risk factors for hospital-acquired inconti-nence in female hip fracture patients. Journal of Gerontology: Medical Sciences 57A(10), M672-M677. Palmer, M. H., Fogarty, L., Somerfield, M., & Powel, L. (2003). Incontinence after prostatectomy: Coping with incontinence after prostate cancer surgery. Oncology Nursing Forum, 30(2), 229-238. Palmer, M. H., & Fitzgerald, S. (2002). Urinary incontinence in working women: A comparison study. Journal of Women’s Health and Gender Based Medicine, 11(10), 879-888. Pletsch, Pamela K., Associate Professor Pletsch, P. K. (2002). Commentary on “Mexican Americans’ explanatory model of Type 2 diabetes.” Western Journal of Nursing Research, 24(8), 861-863. Pletsch, P. K., Morgan, S., & Pieper, A. (2003). Smoking cessation among low income African American preg-nant women: Context and beliefs about smoking and smoking cessation. American Journal of Maternal Child Nursing, 28(5), 1-7. Stevens, P. E., & Pletsch, P. K. (2002). Informed consent and the history of inclusion of women in clinical research. Health Care for Women International, 23(8), 809-819. Rasin, Joyce, Associate Professor Beck, C. K., Vogelpohl, T. S., Rasin, J., Uriri, J. T., O’Sullivan, P., Walls, R., Phillips, R., & Baldwin, B. (2002). A clinical trial of behavioral interventions to decrease disruptive behavior in demented nursing home residents. Nursing Research, 51(4), 219-228. Redman, Richard, Professor Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. Journal of Nursing Administration, 33(2), 131-133. Cronenwett, L. R., & Redman, R. (2003). Partners in action: Nursing education and nursing practice. (repeated in) Nurse Educator, 28(4), 153-155. Redman, R. (2003). Practice environments. Research and Theory for Nursing Practice, 17(1), 87-88. Redman, R. (2003). Promoting safe environments for patient care delivery. Research and Theory for Nursing Practice, 17(2), 97-100. Redman, R. (2003). Instrumentation. In K. S. Oman, M. Krugman, & R. M. Fink (Eds.), Nursing Research Secrets (pp. 139-148). St. Louis: Hanley & Belfus, Inc. Redman, R., & Clark, L. (2002). Service-learning as a model for integrating social justice in the nursing curriculum. Journal of Nursing Education, 41(10), 446-449. Tzeng, H. M., Ketefian, S., & Redman, R. (2002). Relationship of staff nurses’ strength of organization-al culture, job satisfaction, and inpatient evaluation with nursing care. International Journal of Nursing Studies, 39(1), 79-84. 2002–2003 27 Rodgers, Shielda, Clinical Associate Professor Aucoin, J., & Rodgers, S. (2002). Health promotion in rural settings. In C. C. Clark (Ed.), Health promotion in communities: Holistic and wellness approaches. New York: Springer. Rowsey, Pamela J., Associate Professor Gordon, C. J., Rowsey, P. J., & Yang, Y. L. (2002). Effect of repeated nicotine exposure on core temperature and motor activity in male and female rats. Journal of Thermal Biology, 27(6), 485-492. Rowsey, P. J., Metzger, B. L., Carlson, J., & Gordon, C. J. (2003). Effects of exercise conditioning on thermoreg-ulatory responses to repeated administration of chlor-pyrifos. Environmental Research, 92, 27-34. Sandelowski, Margarete, Cary C. Boshamer Distinguished Professor Barroso, J., Gollop, C. J., Sandelowski, M., Meynell, J., Pearce, P., & Collins, L. J. (2003). The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing Research, 25, 153-178. Hamilton, J., & Sandelowski, M. (2003). Living the golden rule: Reciprocal exchanges among African Americans with cancer. Qualitative Health Research, 13, 656-674. Sandelowski, M. (2002). [Review of the book Say little, do much]. Bulletin of the History of Medicine, 76, 835-836. Sandelowski, M. (2003). Reality and representation in reproductive technologies. Review Essay: R. Davis- Floyd & J. Dumit (Eds.), Cyborg babies, E. A. Kaplan & S. Squier (Eds.), Playing Dolly, & A. R. Saetnan, N. Oudshoorn, & M. Kirejczyk (Eds.), Bodies of technolo-gy. Nursing History Review, 11, 187-189. Sandelowski, M. (2003). Tables or tableaux? Writing and reading mixed methods studies. In A. Tashakkori & C. Teddlie (Eds.), Handbook of mixed methods in social and behavioral research (pp. 321-350). Thousand Oaks, CA: Sage. Sandelowski, M. (2003). Taking things seriously: Studying the material culture of nursing. In J. Latimer (Ed.), Advanced qualitative research for nursing (pp. 185-210). Oxford, UK: Blackwell Science. Sandelowski, M., & Barroso, J. (2002). Finding the findings in qualitative studies. Journal of Nursing Scholarship, 34, 213-219. Sandelowski, M., & Barroso, J. (2003). Creating metasum-maries of qualitative findings. Nursing Research, 52, 226-233. Sandelowski, M., & Barroso, J. (2003). Toward a metasynthesis of qualitative findings on motherhood in HIV-positive women. Research in Nursing & Health, 26, 153-170. Sandelowski, M., & Barroso, J. (2003). Writing the proposal for a qualitative research methodology project. Qualitative Health Research, 13, 781-820. Schwartz, Todd, Research Instructor Adams, K. F., Jr., Gheorghiade, M., Uretsky, B. F., Patterson, J. H., Schwartz, T. A., & Young, J. B. (2002). Clinical benefits of low serum digoxin concentrations in heart failure. Journal of the American College of Cardiology, 39, 946-953. Gulledge, A. A., McShea, C., Schwartz, T., Koch, G., & Lord, S. (2003). Effects of hyperfibrinogenemia on the vas-culature of C57BL/6 mice with and without athero-genic diet. Arteriosclerosis, Thrombosis, and Vascular Biology, 23, 130-135. Raymond, R. J., Hinderliter, A. L., Willis, P. W., IV, Clarke, W. R., Ralph, D., Caldwell, E. J., Williams, W., Ettinger, N. A., Hill, N. S., Summer, W. R., de Boisblanc, B., Schwartz, T., Koch, G., Clayton, L.M., Jöbsis, M. M., Crow, J. W., & Long, W. (2002). Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. Journal of the American College of Cardiology, 39, 1214-1219. Skelly, Anne, Associate Professor Cagle, C., Appel, S., Skelly, A., & Carter-Edwards, L. (2002). Mid-life African American women with type 2 diabetes: Influence on work and the multicaregiver role. Ethnicity and Disease, 12(4), 555-566. Keyserling, T., Samuel-Hodge, C., Ammerman, A., Ainsworth, B., Henriquez-Roldan, C., Ingram, A., Elasy, T., Skelly, A., Johnston, L., & Bangdawala, S. (2002). A randomized trial of an intervention to improve self-care behaviors of African American women with type 2 diabetes: Impact on physical activity. Diabetes Care, 25(9), 1576-1583. Skelly, A. (2003). Diabetes self-management training: A Nursing Perspective. North Carolina Medical Journal, 64(1), 1-2. Thoyre, Suzanne, Assistant Professor Thoyre, S. (2003). Developmental transition from gavage to oral feeding in the preterm infant. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual Review of Nursing Research: Vol. 21. Research on Child Health and Pediatric Issues (pp. 61-92). New York: Springer. Thoyre, S., & Carlson, J. (2003). Occurrence of oxygen desaturation events during preterm infant bottle feeding near discharge. Early Human Development, 72, 25-36. Van Riper, Marcia, Associate Professor Van Riper, M. (2003). A change of plans: The birth of a child with Down syndrome. American Journal of Nursing, 103, 77-74. Van Riper, M. (2003). The sibling experience of living with chronic illness and disability. In J. J. Fitzpatrick (Series Ed.), M. S. Miles & D. Holditch-Davis (Vol. Eds.), Annual Review of Nursing Research: Vol. 21. Research on Child Health and Pediatric Issues (pp. 279-302). New York: Springer. Waldrop, Julee B., Clinical Assistant Professor Waldrop, J. B. (2002). Kidney disease on the rise. The Clinical Advisor, July/August, 120. Waldrop, J. B. (2002). Staying on top of the drug. The Clinical Advisor, September/October 25, 142. Waldrop, J. B. (2002). Email me in the morning. The Clinical Advisor, November/December, 128. Waldrop, J. B. (2003). Allergic Conjunctivitis. In Handbook of allergy and asthma (pp. 144-162). Philadelphia: Lippincott. Doctoral Student and Post-Doctoral Fellow Activities 2002–2003 Academic Year GRANTS Amoako, E., Principal Investigator; Mishel, M. H., Sponsor. Building Academic Geriatric Nursing Capacity. Predoctoral Fellowship, Joan A. Hartford Foundation, 2002-2004. Bond, S., Principal Investigator; Neelon, V., Sponsor. Differentiating Patterns of Delirium in Terminally Ill Cancer Patients. Predoctoral Fellowship, John A. Hartford Foundation, 2001-2003. Bond, S., Principal Investigator; Neelon, V., Sponsor. Differentiating Patterns of Delirium in Terminally Ill Cancer Patients. Predoctoral Fellowship, American Cancer Society, 2001-2003. Brunssen, S., Principal Investigator; Holditch-Davis, D., Sponsor. Effect of Perinatal Interleukin-6 Elevation on Neurodevelopment. National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 1999-2002. Clayton, M., Principal Investigator; Mishel, M. H., Sponsor. Factors Influencing Patient-Provider Communication Among Older Breast Cancer Survivors. Predoctoral Fellowship, Lineberger Comprehensive Cancer Center, 2002-2003. Lukkahatai, N., Principal Investigator; Dalton, J. A., Sponsor. The Thai Cancer Pain Experience: Relationship among Spiritual Beliefs, Pain Appraisal, Pain Coping, and Pain Perception and Outcomes. Doctoral Research Travel Award, University Center of International Study, University of North Carolina at Chapel Hill, 2003-2004. Pearce, P., Principal Investigator; Harrell, J. S., Sponsor. Designing with children, for children – computer-ized activity recall. National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 2002-2004. Stewart, J., Principal Investigator; Mishel, M. H., Sponsor. Test of a Model of Uncertainty in Children with Cancer, Oncology Nursing Society, 2002-2004. Stewart, J., Principal Investigator; Miles, M. H., Sponsor. Predoctoral Fellowship, Center for Developmental Science, University of North Carolina at Chapel Hill, 2002-2003. Wilde, M. H., Principal Investigator; Dougherty, M. C., Sponsor. Sensations of Urine Flow in People with Foley Catheters. National Research Service Award, National Institute of Nursing Research, National Institutes of Health, 2002-2004. INSTITUTIONAL NRSA AWARD RECIPIENTS PREDOCTORAL STUDENTS Beacham, P. (Holditch-Davis, D., sponsor) Management of Neonatal Post-Operative Pain, 2002-2004. 28 CAROLINA NURSING RESEARCH CHRONICLE Brown, E. (Sandelowski, M., sponsor). Transition to Adulthood in Chronically Ill Adolescents, 2002-2003 Cho, J. (Holditch-Davis, D., sponsor). Effects of Gender upon the Interaction of Mother and Child with Chronic Health Problem, 2001-2003. Greene, N. (Harrell, J. S., & Skelly, A. sponsors) Prevention of Type 2 Diabetes in African American Families, 2002-2004 Jessup, A. (Harrell, J. S., sponsor). Prevention/Management of Obesity in Children, 2002-2004 Knobel, R. (Holditch-Davis, D., sponsor). Thermoregulation in Extremely Low Birthweight Infants, 2001-2003. Lambe, C. (Germino, B., sponsor) Complimentary Therapies, 2002-2004 Larson, K. (Sandelowski, M., sponsor) Sex Risk Behaviors in Latino Adolescents, 2001-2002. Rasmussen, S. (Dalton, J. A., sponsor). Pain Beliefs, Pain Description and Pain Relief Measures of Chronic Pain Patients, Family Members and Nurses, 2001-2003. POSTDOCTORAL FELLOWS Burns, D. (Mishel, M. H., & Skelly, A., sponsors). Factors that Influence Self-Care Management of African-Americans with Type II Diabetes, 2001-2003. Hughes, L. (Mark, B., sponsor). Discretion in Clinical Decision Making and Its Relationship to Patient Outcomes, 2001-2003. Kim, S. S. (Pletsch, P., sponsor). A Focus Group of Korean American Men: Personal and Sociocultural Factors Contributing to Smoking Cessation, 2002-2004. Enriquez, M. (Miles, M. S., sponsor). Readiness and Adherence: A Descriptive Study Examining the Index of Readiness” as a Predictor of Adherence in HIV Women Beginning a New Regimen of Anti-HIV Medications, 2002-2004. PUBLICATIONS Barroso, J., Gollop, C. J., Sandelowski, M., Meynell, J., Pearce, P. F., & Collins, L. (2003). The challenges of searching for and retrieving qualitative studies. Western Journal of Nursing research, 25(2), 153-178. Frank-Stromborg, M., Ward, S., Hughes, L. C., Brown, K., Coleman, E. A., Grindel, C. G., & Miller-Murphy, C. (2002). Does certification status of the oncology nurse make a difference in patient outcomes? Oncology Nursing Forum, 29, 665-672. Harrell, J. S., Pearce, P. F., & Hayman, L. L., (2003). Fostering prevention in the pediatric population. Journal of Cardiovascular Nursing, 18(2), 144-149. Harrell, J. S., Pearce, P. F., Markland, E., Wilson, K., Bradley, C., & McMurray, R. G. (2003). Assessing phys-ical activity in adolescents: Common activities of chil-dren in 6th-8th grades. Journal of the American Academy of Nurse Practitioners, 15, 20-28. Holditch-Davis, D., Bartlett, T. R., Blickman, A. L., & Miles, M. S. (2003). Posttraumatic stress symptoms in mothers of premature infants. Journal of Gynecologic & Neonatal Nursing, 32, 161-171. Hughes, L. C. (2002). Peer group caring interaction scale and organizational climate for caring questionnaire. In J. Watson (Ed.), Assessing and measuring caring in nursing and health science (pp. 151-156). New York: Springer. Knobel, R. (2002). Congenital cutaneous candidiasis: A case presentation. Neonatal Network. 21(6), 9-12. Mishel, M.H. & Clayton, M.F. (2003). Uncertainty in ill-ness theories. In M. J. Smith & P. Liehr (Eds.), Middle range theory in advance practice nursing (pp. 25-48). New York: Springer. Olson, D. M. (2003). Ethical considerations. In S. Watson & B. Meier (Eds.), Invasive cardiology: A manual for cath lab personnel, 2nd Edition. Birmingham, MI: Physicians’ Press. Olson, D. M., Chioffi, S. M., Macy, G. E., Meek, L. G., Cook, H. A. (2003). The BIS monitor enhances patient care and decreases cost in the neurocritical care set-ting. Care Nurse. Olson, D. M., Meek, L. G., & Taylor, D. M. (2003). Best practice makes perfect. Advance for Nurses, 5(2), 13-14. Pribisko, A. (2003). Preventing perioperative adverse drug reactions. AORN, 77(1), 104-122. Stewart, J. L. (2003). “Getting used to it”: Children find-ing the ordinary and routine in the uncertain context of cancer. Qualitative Health Research, 13, 394-407. Therriault, R. E., & Cheek, D. (2002). Pharmacogenetic implications for practitioners. In L. Jameson & J. Evans (Eds.), Principles of molecular medicine, 2nd Edition Totowa, NJ: Human Press. Wilde, M. H. (2002). Understanding urinary catheter problems from the patient’s point of view. Home Healthcare Nurse, 20(7), 449-456. Wilde, M. H. (2002). Home care clinics: Long-term catheters. ADVANCE: For Providers of Post-Acute Care, 5(6), 22-4. Wilde, M. H. (2003). Meanings and practical knowledge of peole with long-term urinary catheters. With com-mentary by B. L. Cameron. Journal of Wound Ostomy Continence Nursing, 30(1), 33-43. University of North Carolina at Chapel Hill School of Nursing Annual Level of Extramural Research Funding (1993–present) January 2004 Nursing Update RN Refresher Course January 12–May 28 February 2004 History Taking and Physical Examination: February 3, 10, 17, 24 Sharpening Your Skills Diabetes Management in Children & Adolescents February 6 Nursing Administration Review Course February 19–20 Critical Care Update February 26 March 2004 Kemble Lecture featuring Dr. Betty Ferrell and reception March 1 honoring Dr. Jo Ann Dalton upon her retirement History Taking and Physical Examination: March 2, 16, 23, 30 Sharpening Your Skills Substance Abuse Update March 5 15th Annual PACU & Ambulatory Surgery Conference March 13 Survival Skills for Nurse Educators March 18 in Staff Development Roles Career Opportunities in Clinical Research: Understanding March 20–May 1 the Roles & Responsibilities of CRA and CRC April 2004 Cutting Edge: Hot Topics in Neurology & Neurosurgery April 2 Test Construction for Critical Thinking in Nursing Education April 3 ONS Chemotherapy and Biotherapy Course April 14–15 Certificate in Clinical Leadership April 19–23 Latino Culture & Language April 22 SON Foundation Board meeting April 22 Pediatric Nursing Review Course April 28–30 Distinguishes School of Nursing events from Continuing Education events Calendar of Events For more information on School events, contact the Office of Advancement. E-mail: sonalum@unc.edu Phone: (919) 966-4619 FAX: (919) 843-8241 www.unc.edu/depts/nursing For more information or to register for a Continuing Education program, contact the School of Nursing Office of Continuing Education. E-mail: nursing_ce@unc.edu Phone: (919) 966-3638 FAX: (919) 966-0870 www.unc.edu/depts/nursing/ lifelong/index.html Nonprofit Organization U.S. Postage PAID Permit No. 177 Chapel Hill, NC 27599-1110 School of Nursing The University of North Carolina at Chapel HIll CB# 7460 Carrington Hall Chapel Hill, NC 27599-7460 |
OCLC number | 44489549 |