Aligning Forces for Quality: Engaging Healthcare Consumers Through Social Media: Maine Alliance Case Study

Reviews the planning, activities, outcomes, lessons, and future plans of the social media campaign conducted as part of Maine AF4Q's consumer outreach efforts. Outlines the need for stakeholder buy-in, detailed planning, and dedicated staff and resources

Mapping the Road from Childhood Trauma to Adult Somatization: The Role of Attachment

Objective: This study tested whether insecure attachment mediates the link between childhood trauma and adult somatization. Methods: A community sample of 101 couples completed self-report measures including the Relationship Scales Questionnaire, the Childhood Trauma Questionnaire, the Somatic Symptom Inventory, the Beck Depression Inventory, and the Conflict Tactics Scale. Results: Childhood trauma was associated with higher levels of somatization and insecure attachment. Insecure attachment style was also associated with higher levels of somatization. Controlling for age, income, and recent intimate partner violence, analyses showed that fearful attachment fully mediated the link between childhood trauma and somatization for women. For men there was no such mediation, but both childhood trauma and insecure attachment styles made independent contributions to predicting levels of somatization. Conclusions: Findings are consistent with the hypothesis that, for women, childhood trauma influences adult levels of somatization by fostering insecure adult attachment. For men, findings suggest that trauma and attachment are both important independent predictors of adult somatization. Study results support the idea that childhood trauma shapes patients’ styles of relating to others in times of need and these styles in turn influence the somatization process and how patients respond to providers. Screening for attachment style may provide information that could allow health care providers to tailor treatment more effectively. Key words: Attachment style, somatization, childhood trauma, interpersonal models. Abbreviations: CTQ = Childhood Trauma Questionnaire; CTS2 = Conflict Tactics Scale version 2; SSI = Somatic Symptom Inventory; RSQ = Relationship Scales Questionnaire; BDI = Beck Depression Inventory

Mapping the Road from Childhood Trauma to Adult Somatization: The Role of Attachment

Objective: This study tested whether insecure attachment mediates the link between childhood trauma and adult somatization. Methods: A community sample of 101 couples completed self-report measures including the Relationship Scales Questionnaire, the Childhood Trauma Questionnaire, the Somatic Symptom Inventory, the Beck Depression Inventory, and the Conflict Tactics Scale. Results: Childhood trauma was associated with higher levels of somatization and insecure attachment. Insecure attachment style was also associated with higher levels of somatization. Controlling for age, income, and recent intimate partner violence, analyses showed that fearful attachment fully mediated the link between childhood trauma and somatization for women. For men there was no such mediation, but both childhood trauma and insecure attachment styles made independent contributions to predicting levels of somatization. Conclusions: Findings are consistent with the hypothesis that, for women, childhood trauma influences adult levels of somatization by fostering insecure adult attachment. For men, findings suggest that trauma and attachment are both important independent predictors of adult somatization. Study results support the idea that childhood trauma shapes patients’ styles of relating to others in times of need and these styles in turn influence the somatization process and how patients respond to providers. Screening for attachment style may provide information that could allow health care providers to tailor treatment more effectively. Key words: Attachment style, somatization, childhood trauma, interpersonal models. Abbreviations: CTQ = Childhood Trauma Questionnaire; CTS2 = Conflict Tactics Scale version 2; SSI = Somatic Symptom Inventory; RSQ = Relationship Scales Questionnaire; BDI = Beck Depression Inventory

Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review

Introduction: Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia. Methods: This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937–present), Emcare on Ovid (1995–present), Scopus (1969–present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946–present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings. Results: From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles. Conclusion: The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories

Probable Cigarette Dependence, PTSD, and Depression after an Urban Disaster: Results from a Population Survey of New York City Residents 4 Months after September 11, 2001

Disaster exposure may exacerbate psychopathology and substance–related disorders. Four months after September 11, 2001, using random–digit dialing to contact a representative sample of adults (N = 2001) living in New York City, we assessed cigarette smoking and symptoms of probable cigarette dependence using measures from the National Survey on Drug Use and Health.Atotal of 36.8% of smokers reported increased cigarette use; 10.4% of respondents reported three or more symptoms of cigarette dependence and were considered cases of probable cigarette dependence based on DSM–IV criteria. Cases were more likely to report an increase in cigarette use since September 11 than non–cases (69.4% among cases vs. 2.2% among non–cases, p < 0.001). Cases were more likely to have probable posttraumatic stress disorder (PTSD) and depression than non–cases (18.1% vs. 5.7% for PTSD, p < 0.001; 23.6% vs. 6.0% for depression, p < 0.001). Increased cigarette use since September 11 was associated with probable PTSD among cases (23.4% vs. 6.4%, p = 0.011) and non–cases (15.1% vs. 5.5%, p = 0.034) but was associated with probable depression only among cases of probable cigarette dependence (28.3% vs. 13.3%, p = 0.027). This study showed the co–occurrence of probable cigarette dependence with increased cigarette use and the co–occurrence of probable cigarette dependence with probable PTSD and depression after September 11.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40293/2/Nandi_Probable Cigarette Dependence, PTSD, and Depression_2005.pd

The Landscape of Connected Cancer Symptom Management in Rural America: A Narrative Review of Opportunities for Launching Connected Health Interventions

Background: The 2016 President’s Cancer Panel called for projects focusing on improving cancer symptom management using connected health technologies (broadband and telecommunications). However, rural communities, like those in Appalachia, may experience a “double burden” of high cancer rates and lower rates of broadband access and adoption necessary for connected health solutions. Purpose: To better understand the current landscape of connected health in the management of cancer symptoms in rural America. Methods: A literature search was conducted using four academic databases (PubMed, CINAHL, MEDLINE, and PsycINFO) to locate articles published from 2010 to 2019 relevant to connected cancer symptom management in rural America. Text screening was conducted to identify relevant publications. Results: Among 17 reviewed studies, four were conducted using a randomized controlled trial; the remainder were formative in design or small pilot projects. Five studies engaged stakeholders from rural communities in designing solutions. Most commonly studied symptoms were psychological/emotional symptoms, followed by physical symptoms, particularly pain. Technologies used were primarily telephone-based; few were Internet-enabled video conferencing or web-based. Advanced mobile and Internet-based approaches were generally in the development phase. Overall, both rural patients and healthcare providers reported high acceptance, usage, and satisfaction of connected health technologies. Ten of the 17 studies reported improved symptom management outcomes. Methodological challenges that limited the interpretation of the findings were summarized. Implications: The review identified a need to engage rural stakeholders to develop and test connected cancer symptom management solutions that are based on advanced mobile and broadband Internet technologies

Service evaluation of weight outcomes as a function of initial BMI in 34,271 adults referred to a primary care/commercial weight management partnership scheme

Peer reviewedPublisher PD

What explains the association between neighborhood-level income inequality and the risk of fatal overdose in New York City?

Accidental drug overdose is a substantial cause of mortality for drug users. Using a multilevel case-control study we previously have shown that neighborhood-level income inequality may be an important determinant of overdose death independent of individual-level factors. Here we hypothesized that the level of environmental disorder, the level of police activity, and the quality of the built environment in a neighborhood mediate this association. Data from the New York City (NYC) Mayor’s Management Report, the NYC Police Department, and the NYC Housing and Vacancy Survey were used to define constructs for the level of environmental disorder, the level of police activity and the quality of the built environment, respectively. In multivariable models the odds of death due to drug overdose in neighborhoods in the top decile of income inequality compared to the most equitable neighborhoods decreased from 1.63 to 1.12 when adjusting for the three potential mediators. Path analyses show that the association between income inequality and the rate of drug overdose mortality was primarily explained by an indirect effect through the level of environmental disorder and the quality of the built environment in a neighborhood. Implications of these findings for the reduction of drug overdose mortality associated with the distribution of income are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40292/2/Nandi_What Explains the Association Between Neighborhood-Level_2006.pd

Job Loss, Unemployment, Work Stress, Job Satisfaction, and the Persistence of Posttraumatic Stress Disorder One Year After the September 11 Attacks

The influence of unemployment and adverse work conditions on the course of psychopathology after a mass disaster is unclear. We recruited a representative sample of adults living in the New York City metropolitan area six months after the September 11 attacks and completed follow-up interviews on 71% of the baseline sample six months later (N = 1939). At follow-up, posttraumatic stress disorder (PTSD) persisted in 42.7% of the 149 cases with PTSD at baseline. In multivariable models, unemployment at any time since baseline predicted PTSD persistence in the entire cohort (P = 0.02) and among persons employed at follow-up (P = 0.02). High levels of perceived work stress predicted PTSD persistence among persons employed at follow-up (P = 0.02). Persons unemployed in the aftermath of a disaster may be at risk for poor mental health in the long-term.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40294/2/Nandi_Job Loss, Unemploymet, Work Stress, Job Satisfation_2004.pd