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Science in Action: Archive
Pediatrics
Posted February 2010

New growth curves for infants reflect racial diversity in U.S.

The infant growth chart used for decades by doctors, dietitians and hospitals to determine the healthy weight of infants may be incorrect for use today, says a new study from a University of Pennsylvania School of Nursing professor, whose latest research provides new healthy weights that reflect the racial diversity of U.S. births. “The currently used curves may not represent the U.S. population,” says lead author Irene Olsen, PhD, RD, LDN, who developed a new set of weight, length, and head circumference-for-age growth curves to assess preterm infants in NICUs. The new growth curves were published in the February issue of Pediatrics, The American Academy of Pediatrics’ journal.  Dr. Olsen created a new set of growth curves to represent an estimate of optimal growth that was based on national data of more than 257,000 infants, aged 22 to 42 weeks....
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Sex Education
Posted February 2010

Abstinence-only education delays sex in tweens

A new study weighs in on the controversy over sex education, finding that an abstinence-only intervention for pre-teens was more successful in delaying the onset of sexual activity than a health-promotion control intervention. After two years, one-third of the abstinence-only group reported having sex, compared to one-half of the control group. The study by researchers at the University of Pennsylvania appears in the February 1 edition of the Archives of Pediatrics & Adolescent Medicine. While abstinence-only intervention did not eliminate sexual activity all together, this is the first randomized controlled study to demonstrate that an abstinence-only intervention reduced the percentage of adolescents who reported any sexual intercourse for a long period, in this case two years, following the intervention. “It is extremely important to find an ...

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Staffing Levels
Posted April 2010

California nurse ratios could prevent thousands of deaths nationwide

In the first comprehensive evaluation of California’s landmark nurse staffing legislation mandating the maximum number of patients in a nurse’s hospital workload, researchers at the University of Pennsylvania have determined that the law prevents deaths from common surgeries, with the potential to save thousands of lives nationally. The researchers compared deaths from common surgeries in California from 2005 to 2006, following enactment of the legislation, to surgical deaths in two states without legally mandated patient-to-nurse ratios during that same period, finding that there would have been 13.9 percent fewer surgical deaths in New Jersey and 10.6 percent fewer surgical deaths in Pennsylvania in 2006 if hospitals in these states had been staffed at the same levels set in California hospitals. The study, which involved surveys completed by 22,33...
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Staffing Levels
Posted May 2010

NPs could solve primary care shortage

As the healthcare system braces to absorb 32 million more Americans as a result of reform legislation and the nation faces a shortage of primary care physicians, nurse practitioners (NPs) are the best resource to bridge the gap—but substantial barriers restrict nurse practitioners and other advanced practice registered nurses from filling this void , according to University of Pennsylvania School of Nursing research published  in the current issue of Health Affairs. “The growth of the chronically ill and elderly populations, gaps in health care quality, and increases in health care spending will intensify the demand for high quality primary care services at the same time that supply of primary care physicians is expected to shrink,” said nursing professor Mary D. Naylor, PhD, RN, who conducted a multi-year review of all studies conducted on ...

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Mental Health
Posted August 2010

The psychological effects of injury

When Therese Richmond was a young trauma unit nurse in Washington, DC, she became interested in what the physical injuries she was seeing were doing to the patients’ emotional and mental health.  “Every day, I would take care of people who had catastrophic injuries and I saw the impact that had with those people and their families,” said Richmond.  “You start wondering: How can we improve how well they do psychologically after the injury, and how can we prevent it in the first place.”  For the last several decades, then, Richmond has concentrated her research in two areas: First, the psychological effects of physical injury, and how to improve those psychological effects after the people have been injured.  Second, Richmond has studied violent injury.  “Gun violence or stabbing...
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Pediatrics
Posted August 2010

Research examines whether babies feel and remember pain

Early in her career, Linda Hatfield was troubled by the assumption on the part of the medical community that babies did not feel pain in the same way older children and adults did.  She has made research into early pediatric pain a specialty ever since.   “When I was trained, we believed that babies didn’t experience pain, and if they did, they didn’t remember it.  Both of those statements are incorrect,” said Dr. Hatfield, assistant professor of evidence-based practice in the School of Nursing and director of research and evidence-based practice at Pennsylvania Hospital.  Dr. Hatfield said those incorrect assumptions were based on the belief that babies’ nervous systems were not sufficiently myelinated – the myelin being the sheath that increases proper nerve function.  Without sufficient myelination, the theory went, babies couldn’t f...

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Dementia
Posted August 2010

Researcher focuses on early-stage dementia

Valerie Cotter is among the first to study the early stages of dementia and how it affects the lives of older adults.  “I feel it is important to understand how hope, social support, self-esteem and family relationships allow people to cope with the disease and its diagnosis,” said Cotter, the director of the Adult Health Nurse Practitioner Program at the University of Pennsylvania School of Nursing. Cotter said that advances in medical technology have made it possible to diagnose the early stages of dementia, and thus give nurses more ability to help those afflicted. Cotter worked with the Alzheimer’s Association of the Delaware Valley in 2005 to start the first specialized support group for people with early-stage dementia. Since dementia can be caused by or associated with so many other diseases and conditions, and because people...
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Pediatrics
Posted June 2010

Are infant growth charts misleading?

  Since the 1960s, pediatrics has relied on growth statistics derived by Dr. Lula Lubchenco, known familiarly as the “Lula Gram” or the “Lubchenco Curves.”  But Irene Olsen, Adjunct Assistant Professor in the School of Nursing, whose specialty is the growth assessment of premature infants, decided there needed to be a more up-to-date method of determining where especially premature infants should be in terms of growth.  “You measure and weigh these infants each day and measure their intakes and outputs.  What they receive for nutrition is primarily through tubes,” said Olsen.  Thus, she said, knowing what is “normal” size for a premature baby at each age is vital to knowing how to guide its nutrition and support healthy growth and development.  Olsen’s research has expanded far beyond the 5,000 nearly all-white babies Lubchenco measured in Denver ...

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Cardiac Health
Posted August 2010

Stem cells and heart health

When Joseph Libonati was doing a post-doctoral fellowship at the Boston University School of Medicine, he studied the heart functions of superior athletes – from collegians to the Boston Celtics.  “As you would imagine, these young people had great heart function,” said Dr. Libonati.  “My question was, well, why?  And how can we relate that to the average person.”  Dr. Libonati’s expertise is in heart function and how to keep the heart in its best shape – and how to get that information out to the public.  His cardio-vascular research with rodents has shown that even those with high blood-pressure who exercise regularly increase the number of intrinsic endogenous stem cells in their hearts.  “Stem cells are a big item in medicine these days,” said Dr. Libonati.  “In this case, stem cells get into the heart and make more young ‘healthy cells’...
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Cancer
Posted June 2010

Life During and After Cancer

There seems hardly a facet of life after cancer and cancer screening that Dr. Deborah Bruner has not researched. Her work spans cancer related screening behaviors, decision-making related to screening and treatment, quality of life in prostate, gynecologic, brain, and head and neck cancers and gender differences in treatment outcomes.  She has been a pioneer in measuring the patient experience in cancer clinical trials.  One of her major studies has been on the reaction of spouses to prostate cancer screening and treatment.  Wives, she noted, tend to want doctors to take more aggressive options than their husbands do. Husbands, Dr. Bruner has found, initially say they want to preserve their quality of life, rather than extending their lives when interviewed alone; but when the husband hears th...

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Self-Management of Chronic Diseases
Posted August 2010

Lack of sensitivity in treating minority asthma patients

As a young nurse in urban settings, Maureen George became disturbed by the continued visits to the hospital by poor minority asthma patients.  After all, she thought, there were good treatments for asthma and it should be easy for patients to keep up with them on their own.   “The hospital staff kept blaming the patients for their asthma getting worse, but I thought there was something more that could be done,” said George, an Assistant Professor of Family and Community Health  in the Center for Health Equity Research.  So she started interviewing the patients to see how they were handling the disease.  Eventually, she found that the minority and poor patients tended to self-manage their disease independent of what the doctors might tell them beyond the predictable barriers posed ...
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Prevention
Posted August 2010

Professor seeks ways to prevent illness for a healthier society

Karen Glanz’s research, as a behavioral epidemiologist, cuts across many disciplines, yet her particular interest is not in understanding disease causation, but how communities get their members to use that science effectively.   “We have cancer screenings, but how do you get people to obtain their colonoscopies according to guidelines?” said Glanz, the George A. Weiss University Professor and a Professor of Epidemiology and Nursing.  “Obese people know they should eat healthier foods, but what is it we can do to encourage them do so?”  Glanz’s work has been varied, but almost always touches on several areas, be they anthropology or psychology or social systems.  For the last decade, she has studied skin cancer prevention.  She has tried to educate swimming pool managers, for instance, to do such b...

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Trauma
Posted August 2010

Being trauma nurse sparked research choices

Two major areas of Nursing School Professor Marilyn Sommers’ research come from a trauma-nurse standpoint – the injuries that come in the course of rape, sexual assault and domestic abuse, and how to stop the near-epidemic of automobile-related injuries and death, especially among teen and young adult drivers.  Unfortunately, said Sommers, prosecution of sexual assault cases often do not go forward unless the victim has an injury.  “Even though a woman can be brutally raped, she can come out of that without visible injuries,” said Sommers; thus it is important to identify even the smallest injuries in a sexual assault victim.  Her research has discovered that injuries are more detectable on lighter-skinned women than on darker-skinned women, irrespective of race, using the curren...
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Cardiac Health
Posted August 2010

Heart health and fending off hospital readmissions

Barbara Riegel, professor of cardiovascular nursing, said that people recovering from heart surgery or other cardiovascular issues run into problems when high quality self-care is not a priority. She said home care falls into the realm of responsibility held by nurses to make sure recovering patients are safe and are doing the right things at home to take care of themselves. "Medical therapy happens in the office or the hospital, and that is about one percent of the patients’ time,” Riegel said. “Most of the time they are home taking care of themselves, but there is a lot to do over that period of time.”  Her research over the last 20 years with the heart-failure population, she said, is an effort to make sure that time at home is properly spent. Riegel said that people with heart problems are admitted to – and re-admitted to – hospital...

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Patricia D'Antonio
History of Nursing
Posted August 2010

Nursing from a historical perspective

While nursing has certainly gone through an upsurge of prestige in recent decades, said Patricia D’Antonio, it has always been true that nurses have had more education, money and status than others in their respective ethnic or social groups. D’Antonio, an Associate Professor at the School of Nursing and the Associate Director of the Barbara Bates Center for the History of Nursing, said that it has always required an enormous amount of time and money to become a nurse, and that nurses have always sought more education – something that certainly continues today. “The late 19th century begins the modern age of nursing,” said D’Antonio, who has also done research into psychiatric nursing, her clinical field.  “When there started to be standardization, registration of nurses, a defined body of knowledge – things that started primarily with Florence N...
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Nancy Hanrahan
Psychiatric/Mental Health
Posted August 2010

Research concentrates on how to use nurses to better care for mental-health patients

Nancy Hanrahan does not advocate going back to the old-style mental health asylum system, but in some ways, she said, her research shows that there are at least some things that can be learned there for the future of psychiatric nursing. “Mental health nurses were quite involved then, and there was a lot of work done by nurses when those with mental health problems went back into the community,” said Hanrahan, the Dr. Lenore H. Kurlowicz Term Assistant Professor of Nursing.  Hanrahan’s research concentrates on how to use nurses to better care for mental-health patients – extending also into their physical health – especially when they leave the hospital setting. “We are facing major problems,” said Hanrahan.  “These people have cardiac disease, metabolic syndromes, obesity, diabetes -- mainly because of lack of attention to their...

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Pediatrics
Posted August 2010

New set of growth curves created and validated in study

Since the 1960s, pediatrics has relied on growth statistics derived by Dr. Lula Lubchenco, known familiarly as the “Lula Gram” or the “Lubchenco Curves.”  But Irene Olsen, Adjunct Assistant Professor in the School of Nursing, whose specialty is the growth assessment of premature infants, decided there needed to be a more up-to-date method of determining where especially premature infants should be in terms of growth. “You measure and weigh these infants each day and measure their intakes and outputs.  What they receive for nutrition is primarily through tubes,” said Olsen.  Thus, she said, knowing what is “normal” size for a premature baby at each age is vital to knowing how to guide its nutrition and support healthy growth and development. Olsen’s research has expanded far beyond the 5,000 nearly all-white babies Lubchenco measured in Denver at mid-Centu...
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HIV/AIDS
Posted August 2010

Developing HIV/abuse interventions for girls

“Safe sex saves lives” has been the mantra of the movement to protect against HIV infection. But for teen girls – and especially for young African-American women, who are among the fastest growing population of new HIV cases in the United States – research has found the conversation on safe sex should essentially begin with a discussion of healthy versus abusive partner relationships. “Those who are sexually active are at the highest risk for intimate partner abuse,” said Dr. Anne Teitelman, a professor with Penn School of Nursing’s Center for Health Equities Research. “For teens to practice safe sex, they need to first understand the different types of partner abuse and how abuse undermines safe sex practices.” As a nurse practitioner working in an adolescent health center, Dr. Teitelman, said she began to wonder what was ...

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Gerontology
Posted December 2010

Naylor's transitional care model reduces hospital readmissions

Dr. Mary Naylor's Transitional Care Model is profiled in the June 9, 2010 issue of the Agency for Healthcare Research and Quality (AHRQ). The Transitional Care Model is an intensive, nurse-led care management program provided to high-risk seniors during and after hospitalization. A transitional care nurse with geriatric experience assesses inpatient and family needs, conducts discharge planning, implements the discharge plan through home visits and telephone communication, facilitates and encourages patient self-care, and serves as a liaison with community-based clinicians and services. Dr. Naylor, PhD, FAAN, RN is the Marian S. Ware Professor in Gerontology; Director of New Courtland Center for Transitions and Health. Her intensive research is designed to improve outcomes and reduce costs of care for vulner...
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Gerontology
Posted August 2010

Dr. Bradway's research on continence care featured on MedScape

Dr. Christine Bradway's extensive research on continence care for obese nursing home residents is featured as the first choice on the most recent Medscape Today, from WebMD.  Finding of her latest study, published first in Urologic Nursing, aimed to describe demographic characteristics and co-morbid conditions of obese nursing home residents, current nursing care practices related to continence care in obese nursing home residents, licensed and unlicensed nursing caregivers' reports of continence care issues they experience with obese nursing home residents, and continence care issues reported by obese nursing home residents.  Dr. Bradway PhD, CRNP is the Assistant Professor of Gerontological Nursing, Clinical Educator and Program Director of the Gerontology Nurse Practitioner Program.  For m...

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Awards
Posted August 2010

Dr. Deborah Watkins Bruner Accomplishes A First

  Dr. Deborah Watkins Bruner has been awarded a U10 grant from the National Cancer Institute (NCI) as Principal Investigator (PI) of the Radiation Therapy Oncology Group (RTOG) Community Clinical Oncology Program (CCOP). Dr. Bruner, the Independence Professor of Nursing Education at the University of Pennsylvania and co-program leader of the Cancer Control Program at the Abramson Cancer Center, is the first woman and first nurse to be awarded PI of a NCI sponsored cancer clinical trials cooperative group. The RTOG CCOP is the only CCOP research base focused solely on providing radiation (RT) and combination therapy-related symptom amelioration trials, and state-of-the-art RT treatment trials to the CCOP community, accruing close to 2000 patients over the last five years. The...
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HIV/AIDS
Posted November 2010

Penn Study Focuses on Sexual Behaviors

A school-based, six-session program targeting sexual risk behaviors has proven effective in reducing rates of self-reported unprotected sex and sex with multiple partners among South African sixth-graders, according to a report in the October issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.  Loretta S. Jemmott, PhD, RN, the van Amerigen professor of Psychiatric Mental Health Nursing and her husband John B. Jemmott III, PhD, professor of Communication in Psychiatry and the Kenneth B. Clark Professor of Communication at the University of Pennsylvania's School of Medicine and Annenberg School for Communication conducted the study with colleagues at the U.S. Centers for Disease Control and Prevention and the University of Fort Hare in South Africa, among others.  Researchers tested a school-based p...

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Other
Posted November 2010

Penn Nursing Charges Latin America

For the fourth year, faculty members Mamie Guidera, CNM, MSN and Dawn Durain, CNM, MPH led a course-related trip to Honduras with 12 second degree BSN students, graduate MSN students and one traditional BSN student. The aim of the course is to provide students with a socio-political and cultural perspective on health and health care delivery in Latin America through service learning. Students learn about the culture, health and health care by working side by side, or shoulder to shoulder with people in Santa Lucia and Concepcion Honduras. The students were responsible for the creation of multiple health education lesson plans throughout the semester. Using popular education techniques, these lessons focused on a wide variety of health promotion subjects, and were presented while in Honduras during trainin...
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Staffing Levels
Posted December 2010

Penn Nursing in The New England Journal of Medicine

The increased numbers of advanced practice nurses needed to provide primary care to the 32 million currently uninsured Americans to be covered under healthcare reform will require far-reaching changes including national uniformity in how nurses are allowed to practice, and how they are educated, such as moving the minimum educational requirement for nurses to the bachelor’s degree, write two Penn Nursing professors in today’s issue of The New England Journal of Medicine in separate articles. “Between 3 and 12 nurse practitioners can be educated for the price of producing one physician, and this can be accomplished more quickly than traditional medical education,” writes nursing professor Julie Fairman, PhD, RN with former Health and Human Secretary Donna Shalala, PhD, now president of the University of Miami urging states to adopt uniform scope of  ...

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