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The sucking behavior of premature infants at 40 weeks of age is a significant, independent predictor of risk for future neuro-developmental delays, according to a Penn Nursing study that evaluated developmental outcomes at an earlier age than previous studies (12 vs. 18 months) and with a sample of infants who were considerably more premature (28 vs. 34 weeks).

“This precedent encourages the potential of a nutritive sucking assessment as part of a standardized early screen for developmental risk,” says Penn Nursing professor and lead author of the study, Barbara Medoff-Cooper, PhD, CRNP, RN, FAAN. 

The $3.2 million study, funded by the National Institute of Nursing Research, examined 105 preterm infants who had developmental outcomes measured at 6 or 12 months. All infants received a 5-minute sucking test at 34 and at 40 weeks postmenstrual age, PMA, with outcomes evaluated at 6 and/or 12 months corrected gestational age via the Bayley Scales of Infant Development. The 6- and 12-month values for the Psychomotor Developmental Index and Mental Developmental Index of the Bayley Scales of Infant Development were significantly below the normative levels established for infants delivered at term.

“Given the present lack of clinical guidelines for early identification of pre-term infants at greatest risk for developmental delays and the scale of the present ‘screening gap,’ it is important that all potentially useful approaches – analysis of neonatal feeding organization among them – be further explored,” explains Dr. Medoff-Cooper.

In the study, sucking organization was characterized by three parameters: number of sucks emitted, average number of sucks per burst, and the session-average of the sucking pressure peaks. The pattern of sucking was shown to be an even better predictor of developmental outcomes than perinatal cranial ultrasound and other neonatal measurements taken in the study.

The findings of the study were published in the Journal of Developmental & Behavioral Pediatrics.

Download the full article.

 

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This month, the U.S. Department of Health and Human Services’ “womenshealth.gov” website features an interview with Dr. Anne Teitelman. In the interview, Dr. Teitelman discusses her research about the impact of HIV on women and girls in the United States. Dr. Teitelman also talks about the links between dating violence and HIV, and offers advice for teens (and parents of teens) about the importance of HIV education and awareness.

The interview, which will be featured during the entire month of March, can be found here: http://www.4woman.gov/spotlight/2009/3.cfm

Photos of Dr. Teitelman are available upon request.

Page Content: Associate Professor Dr. Barbra Wall has received a 2008 Fichter Research Grant from the Association for the Sociology of Religion (ASR) for her study, "Clash and Compromise: Catholic Hospitals, Secularization, and the State in 20th Century America."

This study researches the history of women and religion by examining Catholic hospitals from 1925 to 2000 through the lens of five religious nursing congregations, with special emphasis on discovering how religious institutions such as hospitals attempt to shape healthcare and policy in a pluralistic environment. It will compare US Catholic hospitals from 1925 to 2000. The study is done at a time when religious organizations are in the forefront of the American healthcare scene. It will add to the secularization debate by enhancing our understanding of the role that religion plays in the United States, particularly as it applies to healthcare services. The end result will be a full-length book manuscript that will bring conceptual analyses from history, nursing, medicine, religion, gender, ethnicity, and sociology to the study of the American healthcare delivery system.

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Julie A. Sochalski, PhD, RN, FAAN, Associate Professor of Nursing, is co-investigator on an NIH/NHLBI R01 award, "Market competition and the quality of home health services," with Dr. Dan Polsky, PI, of the Division of General Internal Medicine from Penn School of Medicine.

In 2004 the federal government launched the Home Health Quality Initiative (HHQI) for reporting of quality information and incorporating “pay for performance.” The goal of this project is determine whether HHQI improves the quality of home health care, and whether HHQI is more likely to improve quality in more competitive markets.

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Female victims of sexual assault with dark skin are less likely than females with light skin to have their injuries identified, documented, and treated, leaving them disadvantaged in both the healthcare and criminal justice system, according to a new study published in the November issue of The American Journal of Emergency Medicine. 

 According to the National Crime Victimization Survey, black women have higher rape/sexual assault cases than white women, and one of the main reasons women do not report sexual victimization is "lack of [physical] proof" that an incident occurred.

 "This finding is novel and important with respect both to clinical assessment and the decisions made within the criminal justice process," said Penn Nursing professor Marilyn Sommers, PhD, RN, the principal investigator of the study.

 Dr. Sommers' study, in which 120 black and white volunteers underwent a forensic examination after consensual sexual intercourse, found:

• 55 percent of the sample suffered at least one, post-sex external genital injury (such as a tear, abrasion, redness, or swelling), with injuries identified 68 percent of the time in white women but only 43 percent of the time in black women. Significant disparities were only evident for external genitalia (as opposed to the internal genitalia or anus).
• Nearly three times the number of injuries to the external genitalia were identified in white women.
• The effects of race/ethnicity on injury detection became insignificant when skin color values were added to a model that predicts the occurrence of external genitalia injury, demonstrating the spurious relationship between race/ethnicity and injury prevalence.

 "The novel findings from this study have clinical ramifications for those performing forensic sexual assault exams," said Dr. Sommers. "Practitioners need to increase their vigilance when examining individuals with dark skin to ensure all injuries are identified, treated, and documented."

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Penn Nursing professor Mary Naylor, PhD, RN, FAAN, was featured on NOW on PBS in an episode that detailed the national nursing shortage. The video can be seen here. The full interview with Dr. Naylor, in which she details her transitional care model, can be seen on the PBS website, on the right hand column, under Video: Interview: Nursing from Hospital to Home.

 

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Adjunct assistant professor Deanna Gray-Miceli, PhD, APRN, FAANP, was featured in a New York Times front-page article on aging as an expert in geriatric falls.

The article discussed Dr. Gray-Miceli's research, which focuses on identifying the causes of falls, which might include treatable factors like changes in gait, low blood pressure, declining vision or heart arrhthmias, as well as conditions in the home.

Dr. Gray-Miceli is a former John A Hartford Foundation Post-Doctoral Fellow with our Hartford Center of Geriatric Nursing Excellence.

 

  

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Arlene D. Houldin, PhD, PMHCNS-BC, Associate Professor of Psychosocial Oncology Nursing, was approved for funding from the Veterans Health Administration, Comprehensive End-of-Life Care Initiative through a competitive RFP process.  The purpose over 3 years is to establish a new palliative care/hospice unit at PVAMC, to support staffing, and to measure quality outcomes, including nurse-sensitive patient outcomes.  The proposal was submitted by Jen Kapo, Palliative Care Medical Director at the PVAMC, and Dr. Houldin as Palliative Care Nursing Director, with strong support and commitment from Cindy Heidt and the PVAMC administration.   

The overall purpose of the funding is to ensure reliable access to quality end of life care to meet the needs of veterans with life limiting illness and their families, expanding the care of our veterans at PVAMC who are in need of palliative services.

Page Content: Dr. Linda Aiken has just been named an Ambassador for Global Health Research in the Paul G. Rogers Society of Research!America. Dr. Aiken was selected for this honor from among the nation’s best global health research leaders. As an Ambassador, she will conduct public outreach and advocacy for global health research through Research!America. She will meet with leaders and decision-makers and promote nursing research to non-scientific audiences through her presentations and dialogues, and she will be involved with several community-level activities to engage the public.

Dr. Aiken's global commitment to quality care through health outcomes research makes her an ideal candidate for this role and recipient of this major honor. She is the second Ambassador for Global Health Research from Penn Nursing. Marjorie Muecke, the assistant dean for Global Health Affairs, was selected as an Ambassador last year.

The late Paul G. Rogers was a former Florida Congressman who was world renowned for championing research to improve health. Research!America, the nation’s largest not-for-profit public education and advocacy alliance, launched this initiative last year in his honor. Research!America will provide advocacy leadership development to the Ambassadors and facilitate their public outreach and advocacy through speaking engagements and a range of community-level activities to connect with policy makers, opinion leaders, the media, and the public nationwide. 

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Associate Professor Cindy Connolly, PhD, RN, PNP, has had her newest book featured in the New England Journal of Medicine’s Review of Books. The book, Saving Sickly Children: The Tuberculosis Preventorium in American Life, 1909–1970, focuses on the history of Tuberculosis prevention in children in the United States as facilitated through preventoriums. The reviewer, Dr. C. Robert Horsburgh, Jr., of the Boston University School of Public Health, called the book “carefully researched and informative.”

“Connolly highlights many important features of tuberculosis, such as the centrality of good nursing to patient care as well as the oppressive stigma of the disease,” he writes in the January 1, 2009 issue. Although the tools to fight Tuberculosis have improved since the era of the preventorium, “we need to rekindle the energy and optimism […] for the struggle. Saving Sickly Children reminds us of how this can be done.”

Photos of Dr. Connolly are available upon request.

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Desiree Fleck, PhD(c), MSN, CRNP has received a grant for her dissertation funding from the Edna G. Kynett Memorial Foundation. Her mixed methods study (with a higher priority on quantitative data study) will investigate self-care in emerging adults (ages 18-25) with congenital heart disease. This is a first study of its kind in this patient population. The primary variable is self-care in congenital heart disease but will look at many variables including developmental stage, disease severity, depression, cognitive function, family function, and self-care confidence and knowledge and beliefs about self-care and adult care.

Founded in 1954 by Harold H. Kynett in memory of his wife, Edna, the primary purpose of the Kynett Memorial Foundation is to provide grants that further the "scientific study, prevention, early diagnosis and alleviation of diseases of the human heart and circulatory system."

 

Page Content: Connie M. Ulrich, PhD, RN, Assistant Professor of Bioethics and Nursing, has been invited by the National Heart Lung and Blood Institute at NIH to serve as the bioethicist for the NHLBI Data and Safety Monitoring Board (DSMB) for the Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation Trial. This is a major trial that has recently been funded by NIH and will involve approximately 3000 participants at 140 institutions.  Dr. Ulrich will serve with other scientists and will have responsibilities for assuring patient safety and the quality of the clinical study, including the benefits/risks of the proposed procedures and burden placed on the participants.

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Although it is one of the smaller top-ranked schools of nursing, the University of Pennsylvania School of Nursing rose to second place among all the schools receiving funding from the National Institutes of Health. The School received $7.7 million compared to nearly $9 million for top-ranked University of California San Francisco for the 2008 fiscal year. 

Despite difficulties for national Schools of Nursing to secure funding, the amount of funding going to support Penn’s researchers increased by 12 percent over the previous year.

“Our research program advancing nursing science is strong and growing despite increasing challenges in evidence-based quality care through developing and testing models of care,” said Penn Nursing Dean Afaf I. Meleis, PhD, RN, the Margaret Bond Simon Dean of Nursing. “Advancing knowledge to support the evidence for quality care and for decreasing disparities in healthcare requires support through federal funding. Therefore, we are gratified that our faculty are highly competitive.”

Penn is currently conducting major studies in the areas of transitional care from hospital to home, sleep research, effects of fatigue, prevalence of autism, nursing workforce issues, and managing children with critical illnesses.

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Dr. Rogers receives R21 award to test whether extending sleep will facilitate weight loss in obese adults

Associate Professor of Nursing Ann E. Rogers, PhD, RN, FAAN, has been awarded an NIH R21 for her project, “Extending Sleep in Obese Adults to Promote Weight Loss.”

It has been suggested--but never tested--that extending sleep will facilitate weight loss. Therefore, the goal is of this project is to lay the groundwork for a future clinical trial testing the hypothesis that healthy obese individuals who obtain at least 7.5 hours sleep per night will lose more weight than healthy obese adults obtaining 6.5 hours sleep per night.

 

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Linda H. Aiken, PhD, FRCN, RN, FAAN, is co-directing the largest workforce study ever conducted in Europe. The study, Nurse Forecasting: Human Resources Planning in Nursing (RN4CAST), involves a consortium of 15 partners that will address deficiencies in forecasting models and improve human resources planning in Europe.

RN4CAST will quantify in a sample of 11 European countries – Belgium, Finland, Germany, Greece, Ireland, Poland, Spain, Sweden, Switzerland, Netherlands, and the U.K. – important unmeasured factors in forecasting models, including how features of hospital work environments and qualifications of the nurse workforce impact on nurse recruitment and retention, productivity, and patient outcomes. Three partners outside Europe – China, South Africa, and Botswana – provide an added perspective. The study aims to add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe.

 

Page Content: Carla Clements, RN, MSN, under the mentorship of Marilyn (Lynn) S. Sommers, PhD, RN, FAAN, Lillian S. Brunner Professor of Medical-Surgical Nursing, Associate Director, Center for Health Disparities Research, is the recipient of a Diversity Supplement, “Understanding the Roles of Skin Hydration and Skin Color in Females” from the National Institute of Nursing Research under the American Recovery and Reinvestment Act (ARRA). 

The epidemic of sexual assault against females continues unabated. In Dr. Sommers’ previous work, funded by the National Institute of Nursing Research from 2002-2006, evidence was found that health disparities in the standard sexual assault examination may place women with dark skin at a disadvantage. Findings suggest that racial/ethnic differences in injury prevalence are likely explained by variation in injury visibility due to skin color. An alternative explanation is that the mechanical properties of the skin may be associated with either injurious or protective mechanisms across the continuum of skin color.  

The parent study for this work is Injury from Sexual Assault: Addressing Health Disparity (2R01NR05352, Sommers) and serves as the primary work related to the Diversity Supplement. The supplement has two primary goals: 1) To provide an opportunity for a post-master’s student (Carla Clements) interested in health-related research to spend two years engaged in a mentored experience in scientific inquiry and to develop research capabilities while considering doctoral study; 2) To foster knowledge development in the area of skin science and health disparities. The minority supplement will allow the Carla an opportunity to answer the question: Can the previous findings that genital injury prevalence varies by skin color be better understood because skin hydration also varies by skin color?