Risk behaviors of Dominican adolescents in their homeland and in the United States.

INTRODUCTION: Adolescence is a time of developmental change. The major task of adolescence is to become an independent individual capable of functioning as a contributing adult within culturally expected norms. It is often accompanied by frustration and difficulties with adjustments. One typical response of adolescents to these changes is engaging in high-risk behaviors. The purpose of this study was to compare self-reported high risk behaviors that may lead to unintentional and intentional injuries among adolescents living in the Dominican Republic and Dominican adolescents living in the United States. METHOD: This study used a cross-sectional, comparative design with data collection sites in Las Matas de Farfan, Dominican Republic, and Boston, MA, United States. Data were collected using the 99-item 1999 Youth Risk Behavior Survey. RESULTS: Findings indicated that adolescents in both groups reported similar risk behaviors in all areas; however, there were few differences between the two groups that did exist. DISCUSSION: To educate youth regarding outcomes of high-risk behaviors, it is necessary for providers to engage in discussion with adolescents regarding specific risk behaviors that are commonly practiced in their homeland or in their cultural groups.

Primary Care for the Underserved Conference: the evolution of an emerging professional culture.

This article presents the background of the Primary Care for the Underserved Conference and traces its evolutionary development over the past 13 years. Definitions of underserved are provided, and challenges in working with underserved populations are identified. The origin and purposes of the conference; geographic locations and conference themes; keynote, clinical, and research presentations; and extracurricular activities are highlighted. Conference sustainability in an era of limited funding for the underserved and conference outcomes are discussed. Future directions for the conference and the emerging culture of health care professionals who serve the underserved are offered.

The Perceived Effects of Condoms on Sexual Experience: A Comparison of Older Hispanic and Non-Hispanic Men.

Heterosexual transmission of HIV and other sexually transmitted diseases (STDs) is increasing in older adult populations around the world. This study compares Hispanic and non-Hispanic men ages 50 years and older currently using prescribed erectile dysfunction medications in relation to their perception of the effect of condoms on sexual experience. A sample of 86 men (40 Hispanic and 46 non-Hispanic men) ages 50-79 years completed the 10-item Effect on Sexual Experience (ESE) subscale. Although there was no difference between the 2 groups on the subscale mean score, t(84) = 1.449, p = .151, analysis of the subscale items found 1 item that was significantly different (p = .005) between the 2 groups, although this difference could have been related to different perceptions of the word disgusting. Hispanic men were also less concerned than non-Hispanic men about condom-related loss of erection. This study adds to the literature on HIV and STD prevention for older Hispanic/Latinos.

Attack on America: children's reactions and parents' responses.

INTRODUCTION: When disaster strikes, as it did September 11, 2001, children react to both the actual event and their parents' distress. The purpose of this study was to find out how children were affected by these recent events and how parents responded to their children's concerns. This study is a sequel to a previous study on parents' and children's perceptions to the President Clinton situation and the Starr Report. METHOD: Eighty-eight school-aged children and 51 parents were recruited for this descriptive, qualitative study that used community-based snowball sampling. Parents and children were asked a series of questions about the attacks on the World Trade Center and Pentagon, including how they heard about it and how it made them feel. RESULTS: Children's responses indicated feelings of fear about their safety and their future; wanting to take revenge; feeling sad and disappointed; and empathy for the victims. Parents realized they had to comfort their children in spite of their own feelings of dismay. Many parents reported difficulty in reacting to their child's concerns regarding fairness and justice. DISCUSSION: Pediatric nurse practitioners need to understand parents' and children's responses to such events in order to provide optimal health care, support, and counseling within the context of normal growth and development.

Gambling behaviors in Black older adults: perceived effects on health.

Gambling is a popular activity among older adults of multiple ethnic and cultural backgrounds, but gambling research has not focused on elderly individuals or on minority groups. Although most gambling is a social activity, it also could have health implications for older adults. Sixty-seven Black individuals, ages 50 to 88, completed the Massachusetts Gambling Screen and 20 Black older adults were interviewed about gambling behaviors and beliefs about gambling and health. Although participants in this study were low income, they were as active in gambling as the general population. One pathological gambler and two problem gamblers were identified. The correlation between reported overall health and beliefs about the effects of gambling on health was not significant. Researchers, educators, and nurses working with older adults can help define the health implications of gambling on this population.

Adult-health/medical-surgical nurses' perceptions of students' contributions to clinical agencies.

The nursing shortage and accompanying increase in nurses' workloads could suggest that the presence of nursing students on clinical units would further increase nurses' responsibilities. Counterbalancing this concern is the need to adequately prepare the next generation of dedicated and skilled nurses. The question arises as to whether nursing students are an asset or liability to clinical agencies.

Special delivery: when the pills "absolutely, positively" can't be delivered at home.

The practice of storing and dispensing medications by providers at an inner city neighborhood health center that serves predominantly ethnic minority clients was terminated due to accreditation regulations. This practice promoted adherence since many clients did not want to receive medications by mail at home due to confidentiality concerns or were unwilling to present to their local pharmacy due to fear of discrimination related to HIV status. The purpose of this paper is to describe an alternative means to access HIV medications in a safe and supportive environment for clients confronted with cultural and social barriers through a unique collaboration between an HIV specialty care program and HIV specialty pharmacy.

A Comparison of Substance Use Behaviors of Hispanic Men by Sexual Orientation.

BACKGROUND/SIGNIFICANCE: Substance use is a public health concern in the United States. Hispanic men in the United States experience disproportionate rates of substance use when compared to other ethnic groups. Previous research with the general population of Hispanic men has identified factors that are related and may contribute to substance use. In addition, Hispanic men who have sex with men (HMSM) may experience additional social factors that may result in substance use. Despite the body of research on substance use among Hispanic men, no study to date has compared the substance use behaviors of Hispanic men by sexual orientation. OBJECTIVES: The purpose of this study was to compare the substance use behaviors of Hispanic men by sexual orientation. METHODS: A cross-sectional descriptive design was used to collect data from 164 community-dwelling Hispanic men (i.e., 77 heterosexual men and 87 HMSM) who resided in the South Florida area. Participants completed standardized measures of substance use and demographic characteristics. RESULTS: Findings suggested that heterosexual men had higher rates of substance use when compared to MSM. No differences were found among the two groups of men in terms of alcohol intoxication. Religion, education, and income were not predictors of substance use. When health insurance status was controlled, MSM were less likely to report substance use. IMPLICATIONS: As a population, Hispanic men continue to experience health disparities in terms of substance use. Because substance use renders Hispanic men at risk for other health issues, more research is needed to understand the co-occurring health disparities experienced by Hispanic men who reside in the United States.

Condom attitudes of heterosexual men ages 50 and older using prescribed drugs (Viagra, Cialis, Levitra) to treat erectile dysfunction.

The purpose of this study was to explore attitudes about condoms that may affect condom use by heterosexual men ages 50 and older who were sexually active and currently using prescribed oral phosphodiesterase type 5 inhibitor medications (Viagra(®), Cialis(®), or Levitra(®)) for treatment of erectile dysfunction. The study was part of a larger study that explored the need for safer-sex health promotion and education for these men. Fifty men completed factor subscales of the Condom Attitude Scale. Subscales were scored and analyzed. Positive factors were found with regard to the Interpersonal Impact, Inhibition, Perceived Risk, Perceived Seriousness, and Global Attitudes subscales. Factors with negative or neutral responses included the Effect on Sexual Experience, Relationship Safety, and Promiscuity subscales. Independent t tests revealed no differences between married and nonmarried men for the mean score on any of the subscales, but there was a difference on the Global Attitude Scale, with younger men having a more positive global attitude than older men. Study findings can be used in the development of health promotion educational activities on condom use as a safer-sex practice.

SENORITAS: an HIV/sexually transmitted infection prevention project for Latina college students at a Hispanic-serving university.

Few HIV prevention projects have specifically targeted Latina college students. These young women may be at risk for HIV infection because of developmental issues, normative behaviors, gender roles, and cultural beliefs that affect their sexual practices. The SENORITAS project (an acronym for Student Education Needed in Order to Reduce Infection and Transmission of AIDS/HIV and STIs [sexually transmitted infections]) is an innovative program designed for Latina college students at an urban Hispanic-serving institution in South Florida. The project has two major aims: (a) to provide age-appropriate, gender-specific, and culturally tailored HIV/STI prevention education for Latina college students through the use of a theoretically based, single-session peer education program: and (b) to improve the competence, comfort level, and skills of multiethnic nursing students as HIV prevention educators. This article discusses project development and design using the information-motivation-behavioral skill model for HIV prevention, describes implementation with peer educators, and concludes with progress to date and future directions.

HAART to heart: HIV-related cardiomyopathy and other cardiovascular complications.

More than one million Americans have been diagnosed with human immunodeficiency virus (HIV). Advances in prevention and treatment of HIV have led to an increased life expectancy for patients with HIV infection. Due to their increased life span, HIV+ patients are now presenting to hospitals with an increased number of diverse late-stage complications, such as cardiomyopathy and other cardiovascular conditions. These complications are as a direct or indirect result of HIV disease, HIV treatment modalities, comorbid conditions, dietary and lifestyle factors, and unknown etiologies. Cardiac complications, particularly HIV-related dilated cardiomyopathy, are potentially life-threatening diagnoses, with symptoms that may be minimized with appropriate cardiac-specific assessments and treatments, patient teaching, and collaboration among nurses caring for the HIV-positive client with cardiac disease.