arthralgia; complementary and alternative medicine; juvenile idiopathic arthritis.
|
|
- Jemimah Hodges
- 5 years ago
- Views:
Transcription
1 Brief Report: Use of Complementary and Alternative Medicine and Psychological Functioning in Latino Children with Juvenile Idiopathic Arthritis or Arthralgia Kathy Zebracki, 1,2 PHD, Katherine Holzman, 1 Kathyrn J. Bitter, 2 BA, Kelly Feehan, 2 BS, and Michael L. Miller, 2 MD 1 Loyola University Chicago and 2 Feinberg School of Medicine, Northwestern University Introduction Objective To describe the use of complementary and alternative medicine (CAM) and its relationship to symptoms of anxiety, depression, and dysthymia in Latino children with juvenile idiopathic arthritis (JIA) or arthralgia. Methods Parents of 36 children between the ages of 6 and 16 years with either JIA (n ¼ 17) or arthralgia (n ¼ 19) completed questionnaires during routine pediatric rheumatology clinic visits assessing use of CAM and psychological functioning. Results CAM was used by the majority of children primarily to treat pain episodes. The most common modalities were prayer and massage therapy. CAM use was associated with decreased symptoms of anxiety and dysthymia in children with arthralgia, but not in children with JIA. Conclusion Preliminary findings suggest that CAM use is associated with improved psychological functioning in children with arthralgia. Healthcare providers are encouraged to routinely screen for CAM usage and to educate families about the potential benefits and limitations of CAM. Key words arthralgia; complementary and alternative medicine; juvenile idiopathic arthritis. Complementary and alternative medicine (CAM) consists of healthcare approaches currently not considered to be standard medical practice. CAM modalities such as massage and herbal preparations are often utilized as a supplement to traditional medical treatments. The incidence of CAM use is notably rising among adults and children with chronic health conditions, such as arthritis (Feldman et al., 2004; Hagen, Schneider, Stephens, Modrusan, & Feldman, 2003; Southwood, Malleson, Roberts-Thomson, & Mahy, 1990), and within adult ethnic minority groups with rheumatological conditions (Herman, Dente, Allen, & Hunt, 2006). Less is known, however, about ethnic preferences of CAM use in children with chronic health conditions. Juvenile idiopathic arthritis (JIA) is comprised of a heterogeneous group of chronic diseases (e.g., oligoarthritis, polyarthritis, systemic arthritis) characterized by joint inflammation with onset at or before 16 years of age. Estimates of JIA in children vary from 80,000 to 285,000 [Centers for Disease Control and Prevention (CDC), 2005]. Children with arthralgia, which occurs more commonly than arthritis, experience joint pain without signs of inflammation. Although JIA is considered a chronic health condition, whereas arthralgia is considered a symptom, both youth with JIA and those with arthralgia may experience acute and chronic pain, stiffness, decreased mobility, and functional disabilities. Latino individuals in particular experience disproportionate rates of impairment secondary to arthritis as compared to Caucasian individuals (CDC, 2005). Youth with JIA are also at an increased risk for experiencing psychological symptomatology, especially internalizing symptoms (LeBovidge, Lavigne, Donenberg, & Miller, 2003). To our knowledge, there are no data concerning psychological functioning in children with arthralgia. Standard medical management for JIA and arthralgia involves a variety of therapies (e.g., nonsteroidal antiinflammatory drugs, physical therapy); however, conventional treatment alone may not meet the needs of some patients with chronic rheumatic diseases. Studies suggest All correspondence concerning this article should be addressed to Kathy Zebracki, PhD., Loyola University Chicago, Department of Psychology, 6525 N. Sheridan Road, Chicago, IL kzebrac@luc.edu. Journal of Pediatric Psychology 32(8) pp , 2007 doi: /jpepsy/jsm033 Advance Access publication July 11, 2007 Journal of Pediatric Psychology vol. 32 no. 8 ß The Author Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please journals.permissions@oxfordjournals.org
2 Use of CAM and Psychological Functioning 1007 that some families with children with rheumatic disease seek CAM therapies in addition or as an alternative to conventional treatment due to concerns about medication side effects and a perception that the child s health condition is not improving (Rosenberg, 1996). CAM utilization is better documented in the adult population than in children with rheumatic disease; however, of the few studies examining use in pediatric patients, CAM use was found to be common (Feldman et al., 2004; Hagen et al., 2003). Canadian studies have noted that 34 64% of pediatric rheumatology patients use at least one form of CAM (Feldman et al., 2004; Hagen et al., 2003). Furthermore, a study assessing CAM use in children attending an arthritis camp in either Australia or Canada found that 70% of children use CAM (Southwood et al., 1990). To our knowledge, there are no data regarding CAM use in children with arthralgia. In an effort to address these gaps in the literature and to advance the understanding of CAM use in Latino children with rheumatic disease, the purpose of this study was 3- fold. First, the study described the prevalence, type, and reason for CAM use in Latino children with JIA or arthralgia. Consistent with previous pediatric rheumatology studies (Feldman et al., 2004; Hagen et al., 2003), we hypothesized that CAM usage would be common, with frequency of use associated with increased identification with culture of origin. Second, we assessed the relationship between CAM use and psychological functioning. Based on findings from a pediatric oncology sample (Post-White, 2006), we hypothesized that CAM use would be associated with decreased symptoms of anxiety, depression, and dysthymia. Finally, we provided preliminary data regarding potential group differences that exist between children with JIA and children with arthralgia regarding CAM use and psychological functioning. Due to the chronic nature of JIA and previous research (LeBovidge et al., 2003), we hypothesized that children with JIA would be more likely to use CAM to reduce symptoms than children with arthralgia. Methods Participants The study was approved by the local institutional review board. Families were recruited from the rheumatology clinic at a Midwest tertiary care children s hospital and invited to participate by their pediatric rheumatologist, using an interpreter when necessary, if children were (a) between the age of 6 and 16, (b) had a diagnosis of JIA as defined by the Durban classification criteria (Petty et al., 1998) or symptoms of arthralgia (i.e., joint pain without inflammation, no diagnosis of arthritis or other rheumatic condition), (c) were of Latino origin (i.e., at least one parent has a Latin American background), and (d) did not have significant cognitive impairments. Of the 39 children who met the eligibility requirements, 36 (92%) agreed to participate. Three families declined participation due to a preference to share private health information only for the purposes of receiving medical care. Informed consent was obtained. Measures Data collection occurred during routine clinic visits and was conducted by trained Spanish-speaking research assistants. English and Spanish versions for consent forms and measures were available. Demographic and Illness Questionnaire Parents completed a brief questionnaire that included questions about disease-related and demographic information. The pediatric rheumatologist completed a form indicating current illness characteristics. CAM Questionnaire Parents completed a questionnaire assessing frequency of CAM use, CAM type(s), perceived benefit of CAM (i.e., very, somewhat, or not helpful), and reason(s) for seeking such therapies (i.e., cure arthritis, manage fatigue, manage pain, overall well-being, symptoms unrelated to arthritis, or other). CAM use was defined as utilizing at least one type of CAM in conjunction with conventional medical treatment. The questionnaire also included an item assessing the child s pain intensity on a scale from 0 (no pain) to 10 (severe pain). Functional Ability The 30-item Childhood Health Assessment Questionnaire (CHAQ; Singh, Athreya, Fries, & Goldsmith, 1994) assessed children s performance over the past week in eight areas of daily functioning and yielded an overall Disability Index score. Higher scores indicated worse functioning. The CHAQ has demonstrated good reliability and validity in children with all subtypes of juvenile arthritis (Singh et al., 1994). Level of Acculturation The Acculturation Rating Scale for Mexican Americans-II (ARSMA-II; Cuellar, Arnold, & Maldonado, 1995) was used to assess acculturation and orientation (i.e., language, ethnic identity, cultural heritage, and ethnic interaction) toward the Mexican/Latino and Anglo cultures. The measure has been adapted for use with all Latino groups and Cronbach s alpha for the scales ranged from.83 to.88.
3 1008 Zebracki, Holzman, Bitter, Feehan, and Miller Table I. Descriptive Characteristics [M (SD) orn (%)] Characteristic Total (n ¼ 36) JIA (n ¼ 17) Arthralgia (n ¼ 19) Child s Age (3.06) (2.59) 9.05 (2.64) Child s Gender (Female) 20 (55.6%) 12 (70.6%) 8 (42.1%) Country of Origin Mexico 26 (72.2%) 11 (64.7%) 16 (84.2%) Puerto Rico 5 (13.9%) 3 (17.6%) 2 (10.5%) Other (Guatemala, Cuba) 4 (11.1%) 3 (17.6%) 1 (5.3%) Parents marital status a Married 23 (63.9%) 10 (58.8%) 13 (68.4%) Primary caregiver s education a <High school 6 (16.7%) 3 (17.6%) 3 (15.8%) High school/ged 24 (66.7%) 11 (64.7%) 12 (63.2%) Household Income a $24, (44.4%) 7 (41.2%) 9 (47.4%) $25, (33.3%) 6 (35.3%) 6 (31.6%) Illness Characteristics Illness duration (years) 3.50 (3.33) 4.83 (3.93) 2.30 (2.15) Pain severity 5.46 (2.41) 4.74 (2.46) 6.14 (2.22) Disability Index 0.84 (.75) 0.90 (.72) 0.78 (.79) Note. JIA ¼ juvenile idiopathic arthritis, a Does not equal 100% due to missing data. Groups differed significantly (p <.05); Groups differed significantly (p <.001). Psychological Functioning The Child and Adolescent Symptoms Inventories- 4 (CSI and ASI; Gadow & Sprafkin, 2002) are rating scales that assessed the behavioral and psychological functioning of the child (ages 5 12) and adolescent (ages 12 18). Severity scores for anxiety, depression, and dysthymia were used. Normative data are available for both English and Spanish versions of the measure. The instruments have demonstrated satisfactory test retest reliability and predictive and concurrent validity. Results Descriptive characteristics of each illness group and the sample are summarized in Table I. Parents reported moderate levels of child s pain severity and limited impairment in functional ability. Independent samples t-tests revealed significant differences between the two groups. Children with JIA were older [t (34) ¼ 3.71, p ¼.001] and had the diagnosis longer [t (24) ¼ 2.36, p <.05] than children with arthralgia, which is consistent with the chronic nature of arthritis and typical age of diagnosis. CAM Use Consistent with our hypothesis, the majority of families (56%) used at least one CAM therapy in conjunction with conventional medical treatment. The most common modalities were prayer (56%), massage therapy (50%), meditation/relaxation (30%), salve/skin creams (30%), aromatherapy (25%), touch therapy (20%), and herbal medicine (20%). CAM was used to manage pain (90%) or improve overall well-being (20%) and found to be somewhat helpful according to parent report (80%). Almost half of the families (45%) indicated that their physician was not aware of their CAM use. Contrary to our hypothesis, CAM was used equally by both children with JIA (n ¼ 10) and children with arthralgia (n ¼ 10). Demographic and illness characteristics (i.e., disease duration, pain, functional ability) were not associated with CAM use. Level of Acculturation Mean level of acculturation (M ¼.29, SD ¼ 1.52) fell into the Latino-oriented range. Families were typical traditional Latino to high bicultural types. Contrary to our hypothesis, level of acculturation was not associated with CAM use. Psychological Functioning Mean parent-report scores for the child s symptoms of anxiety (M ¼ 54.53, SD ¼ 8.69) and depression (M ¼ 58.00, SD ¼ 10.98) were within normal limits, while mean scores for symptoms of dysthymia
4 Use of CAM and Psychological Functioning 1009 (M ¼ 61.03, SD ¼ 11.15) fell in the at-risk range. Scores were similar between children with JIA and children with arthralgia. Contrary to our hypothesis, CAM use was not associated with psychological functioning for the overall sample; however, between-group differences emerged. Using hierarchical linear regressions, after controlling for child s age and gender, CAM use predicted symptoms of anxiety (F ¼ 11.66, p <.01) and dysthymia (F ¼ 4.64, p <.05) in children with arthralgia but not in children with JIA; use was associated with decreased symptoms. A significant relationship between use and symptoms of depression was not found for either group. Discussion The use of CAM in this sample, particularly prayer and massage therapy, was common, which is consistent with previous studies (e.g., Feldman et al., 2004; Hagen et al., 2003; Southwood et al., 1990). Families sought CAM therapies primarily for relief of child s pain. CAM was viewed by parents as somewhat helpful in minimizing symptoms and sequelae of JIA or arthralgia. Despite perceived CAM effectiveness, 45% of families did not share their CAM use with the child s pediatric rheumatologist. This rate is lower than those in previous adult and pediatric studies, which found nondisclosure rates as high as 66 77% (Cincotta et al., 2006; Robinson & McFrail, 2004). Reasons for nondisclosure may include a maladaptive belief that physicians may not need to know about CAM usage or may respond negatively to the use. Level of acculturation was not associated with CAM use, which may suggest that the decision to use CAM is motivated by concerns about the child s health and current symptoms, independent of the family s cultural background. It is also possible, however, that differing levels of acculturation are associated with different types of CAM usage, which our study did not assess. CAM use was associated with lower levels of anxiety and dysthymia symptoms in children with arthralgia, but not in children with JIA. One potential reason for this finding is that increased disease severity in children with JIA may minimize improvement in perceived psychological functioning and overall well-being. Moreover, children with JIA typically have persisting stressors related to inflammation and its sequelae, which may offset potential benefits from CAM therapies. Furthermore, it is possible that psychological symptoms did improve over time (e.g., children with JIA initially had higher levels of anxiety and dysthymia); however, the small sample size and cross-sectional nature of the study limited the ability to test this hypothesis. Pediatric healthcare providers are encouraged to inquire about CAM use as part of their routine medical assessment of the child. As the efficacy and potential contraindications of CAM therapies are not well established (Hagen et al., 2003; Post-White, 2006), physicians are encouraged to provide families with reliable information concerning CAM use and to coordinate use with standard medical treatment not only to monitor for medicinal interaction, but also to enhance its utility to the child s well-being. Furthermore, increased awareness and communication between families and the child s physician can reconcile misconceptions of conventional medicine and facilitate the provision of culturally sensitive healthcare. Findings and limitations of the present study suggest potential directions for future study. First, the sample size was small and consequently, findings need to be confirmed by a larger and more heterogeneous sample (e.g., a variety of ethnic groups). Second, as parent report may be discrepant with children s perceptions and behaviors (Palermo, Zebracki, Newman, & Singer, 2004), future data should be collected from multiple informants using multiple methods. Third, as this study was cross-sectional in nature implications regarding the causation of findings cannot be made. Therefore, a longitudinal study is warranted. Finally, to augment this study s preliminary findings, future research should assess reasons for nondisclosure of CAM use and examine what CAM treatment factors (e.g., frequency, type, duration) differentially affect the child s medical and psychological status and contribute to a positive outcome and optimal overall functioning. Received October 23, 2006; revisions received and accepted April 15, 2007 References Center for Disease Control and Prevention. (2005). Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis: United States, Morbidity & Mortality Weekly Report, 54, Cincotta, D., Crawford, N., Lim, A., Cranswick, N., Skull, S., South, M., et al. (2006). Comparison of complementary and alternative medicine use: Reasons and motivations between two tertiary children s hospitals. Archives of Disease in Childhood, 91(2),
5 1010 Zebracki, Holzman, Bitter, Feehan, and Miller Cuéllar, I., Arnold, B., & Maldonado, R. (1995). The Acculturation Rating Scale for Mexican Americans-II: A revision of the original ARSMA scale. Latino Journal of Behavioral Sciences, 17(3), Feldman, D., Duffy, C., De Civita, M., Malleson, P., Philibert, L., Gibbon, M., et al. (2004). Factors associated with the use of complementary and alternative medicine in juvenile idiopathic arthritis. Arthritis & Rheumatism, 51(4), Gadow, K., & Sprafkin, J. (2002). Childhood Symptom Inventory-4 screening and norms manual. Stony Brook, NY: Checkmate Plus. Hagen, L., Schneider, R., Stephens, D., Modrusan, D., & Feldman, B. (2003). Use of complementary and alternative medicine by pediatric rheumatology patients. Arthritis & Rheumatism, 49(1), 3 6. Herman, C. J., Dente, J. M., Allen, P., & Hunt, W. C. (2006). Ethnic differences in the use of complementary and alternative therapies among adults with osteoarthritis. Preventing Chronic Disease: Public Health Research, Practice and Policy, 3(3), A80. LeBovidge, J., Lavigne, J., Donenberg, G., & Miller, M. (2003). Psychological adjustment of children and adolescents with chronic arthritis: A metaanalytic review. Journal of Pediatric Psychology, 28(1), Palermo, T., Zebracki, K., Newman, A., & Singer, N. (2004). Juvenile idiopathic arthritis: Predictors of parent-child discrepancy on reports of pain and disability. Journal of Rheumatology, 31(9), Petty, R., Southwood, T., Baum, J. Bhettay, E., Glass, D., Manners, P., et al. (1998). Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban. Journal of Rheumatology, 25, Post-White, J. (2006). Complementary and alternative medicine in pediatric oncology. Journal of Pediatric Oncology Nursing, 23(5), Robinson, A., & McGrail, M. (2004). Disclosure of CAM use to medical practitioners: A review of qualitative and quantitative studies. Complementary Therapies in Medicine, 12(2,3), Rosenberg, A. (1996). Treatment of juvenile rheumatoid arthritis: Approach to patients who fail standard therapy. Journal of Rheumatology, 23, Singh, G., Athreya, B., Fries, J., & Goldsmith, D. (1994). Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis & Rheumatism, 37(12), Southwood, T., Malleson, P., Roberts-Thomson, P., & Mahy, M. (1990). Unconventional remedies used for patients with juvenile arthritis. Pediatrics, 85(2),
Factors Associated With the Use of Complementary and Alternative Medicine in Juvenile Idiopathic Arthritis
Arthritis & Rheumatism (Arthritis Care & Research) Vol. 51, No. 4, August 15, 2004, 527 532 DOI 10.1002/art.20536 2004, American College of Rheumatology ORIGINAL ARTICLE Factors Associated With the Use
More informationDiscordance between physician s and parent s global assessments in juvenile idiopathic arthritis
Rheumatology 2007;46:141 145 Advance Access publication 16 June 2006 Discordance between physician s and parent s global assessments in juvenile idiopathic arthritis doi:10.1093/rheumatology/kel201 F.
More informationAcknowledgements. Ethnic Disparities in Asthma. Health Disparities in Asthma
CAM Use in Childhood : The Role of Culture & LCAP Research Team Kimberly Arcoleo, PhD, MPH Associate Professor Director, Center for Promoting Health in Infants, Children, Adolescents & Women Acknowledgements
More informationBackground on the issue Previous study with adolescents and adults: Current NIH R03 study examining ADI-R for Spanish speaking Latinos
Sandy Magaña Background on the issue Previous study with adolescents and adults: brief description of study examining comparison between whites and Latinos in on the ADI-R Current NIH R03 study examining
More informationEthnic Identity Statuses and Latino/a Mental Health Outcomes
Marquette University e-publications@marquette Maria Dittman Library Research Competition: Student Award Winners Library (Raynor Memorial Libraries) 1-1-2017 Ethnic Identity Statuses and Latino/a Mental
More informationValidation of the Russian version of the Quality of Life-Rheumatoid Arthritis Scale (QOL-RA Scale)
Advances in Medical Sciences Vol. 54(1) 2009 pp 27-31 DOI: 10.2478/v10039-009-0012-9 Medical University of Bialystok, Poland Validation of the Russian version of the Quality of Life-Rheumatoid Arthritis
More informationPaediatric rheumatology. The Dutch translation of the revised Childhood Health Assessment Questionnaire: a prelimary study of score distribution
Paediatric rheumatology The Dutch translation of the revised Childhood Health Assessment Questionnaire: a prelimary study of score distribution M. Van Dijk 1, W. Groen 2, S. Moors 3, P. Bekkering 4, A.
More informationMeasures of Self-Efficacy
Arthritis Care & Research Vol. 63, No. S11, November 2011, pp S473 S485 DOI 10.1002/acr.20567 2011, American College of Rheumatology PSYCHOLOGICAL MEASURES Measures of Self-Efficacy Arthritis Self-Efficacy
More informationPatterns of Union Formation Among Urban Minority Youth in the United States
Archives of Sexual Behavior, Vol. 29, No. 2, 2000 Patterns of Union Formation Among Urban Minority Youth in the United States Kathleen Ford, Ph.D. 1 and Anne Norris, Ph.D., RN 2 Since 1990, several large
More informationAnxiety and Depression Association of America 34 th Annual Conference March 27-30, 2014
Anxiety and Depression Association of America 34 th Annual Conference March 27-30, 2014 Inger E. Burnett-Zeigler, Ph.D. Assistant Professor Asher Center for the Study and Treatment of Depressive Disorders
More informationCOMPARISON OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE IN PEDIATRIC PATIENTS WITH CHRONIC DISEASES VERSUS HEALTHY PRE- SURGICAL PEDIATRIC PATIENTS
COMPARISON OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE IN PEDIATRIC PATIENTS WITH CHRONIC DISEASES VERSUS HEALTHY PRE- SURGICAL PEDIATRIC PATIENTS Phung, Vivien University of California, Irvine Department
More informationKarine Toupin April Sabrina Cavallo Debbie Ehrmann Feldman Andy Ni
DOI 10.1007/s11136-011-0033-2 The associations among economic hardship, caregiver psychological distress, disease activity, and health-related quality of life in children with juvenile idiopathic arthritis
More informationStress and Adaptation in Mothers of Children With Cerebral Palsy
Stress and Adaptation in Mothers of Children With Cerebral Palsy Janeen Manuel, PhD, Michelle J. Naughton, PhD, MPH, Rajesh Balkrishnan, PhD, Beth Paterson Smith, PhD, and L. Andrew Koman, MD Wake Forest
More informationAvoidant Coping Moderates the Association between Anxiety and Physical Functioning in Patients with Chronic Heart Failure
Avoidant Coping Moderates the Association between Anxiety and Physical Functioning in Patients with Chronic Heart Failure Eisenberg SA 1, Shen BJ 1, Singh K 1, Schwarz ER 2, Mallon SM 3 1 University of
More informationAverage length/number of sessions: 50
Treatment Description Acronym (abbreviation) for intervention: CPP Average length/number of sessions: 50 Aspects of culture or group experiences that are addressed (e.g., faith/spiritual component, transportation
More informationIncremental Clinical Utility of ADHD Assessment Measures with Latino Families
Marquette University e-publications@marquette Master's Theses (2009 -) Dissertations, Theses, and Professional Projects Incremental Clinical Utility of ADHD Assessment Measures with Latino Families Margaret
More informationChapter 3 - Does Low Well-being Modify the Effects of
Chapter 3 - Does Low Well-being Modify the Effects of PRISMA (Dutch DESMOND), a Structured Selfmanagement-education Program for People with Type 2 Diabetes? Published as: van Vugt M, de Wit M, Bader S,
More informationCIBMTR Center Number: CIBMTR Recipient ID: RETIRED. Today s Date: Date of HSCT for which this form is being completed:
Juvenile Idiopathic Arthritis Pre-HSCT Data Sequence Number: Date Received: Registry Use Only Today s Date: Date of HSCT for which this form is being completed: HSCT type: autologous allogeneic, allogeneic,
More informationERROR CORRECTION FORM
Juvenile Idiopathic Arthritis Pre-HSCT Data Sequence Number: Registry Use Only Date of HSCT for which this form is being completed: HSCT type: autologous allogeneic, allogeneic, syngeneic unrelated related
More informationSpirituality and Religiosity as an Approach to Coping for Adolescents Living with Sickle Cell Disease: A Review of the Literature
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationInformation about the Critically Appraised Topic (CAT) Series
Information about the Critically Appraised Topic (CAT) Series The objective of the Doctor of Nursing Practice (DNP) program at George Mason University is to prepare graduates for the highest level of nursing
More informationChild: care, health and development
bs_bs_banner Child: care, health and development Original Article doi:10.1111/j.1365-2214.2012.01386.x Children with juvenile idiopathic arthritis: are health outcomes better for those diagnosed younger?cch_1386
More information11/04/2018. Background. Background
RESEARCH INSTITUTE Practitioner perspectives on barriers and facilitators to culturally competent services Viviane Grandpierre RESEARCH INSTITUTE Background Increasing diversity in North America can create
More informationDevelopment of a New Fear of Hypoglycemia Scale: Preliminary Results
Development of a New Fear of Hypoglycemia Scale: Preliminary Results Jodi L. Kamps, 1 PHD, Michael C. Roberts, 2 PHD, ABPP, and R. Enrique Varela, 3 PHD 1 Children s Hospital of New Orleans, 2 University
More informationMeasuring Perceived Social Support in Mexican American Youth: Psychometric Properties of the Multidimensional Scale of Perceived Social Support
Marquette University e-publications@marquette College of Education Faculty Research and Publications Education, College of 5-1-2004 Measuring Perceived Social Support in Mexican American Youth: Psychometric
More informationEditorial: An Author s Checklist for Measure Development and Validation Manuscripts
Journal of Pediatric Psychology Advance Access published May 31, 2009 Editorial: An Author s Checklist for Measure Development and Validation Manuscripts Grayson N. Holmbeck and Katie A. Devine Loyola
More informationHong Huang School of Information, University of South Florida, Tampa, FL, USA. ABSTRACT
SOCIOECONOMIC STATUS, ATTITUDES ON USE OF HEALTH INFORMATION, PREVENTIVE BEHAVIORS, AND COMPLEMENTARY AND ALTERNATIVE MEDICAL THERAPIES: USING A U.S. NATIONAL REPRESENTATIVE SAMPLE Yiu Ming Chan Department
More informationHorizon Scanning Technology Summary. Adalimumab (Humira) for juvenile idiopathic arthritis. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Adalimumab (Humira) for juvenile idiopathic arthritis June 2007 This technology summary is based on information available at the time
More informationDr Sylvie Lambert, RN, PhD
Is it the most frequent unmet supportive care needs that predict caregivers anxiety and depression? Results from Australia s Partners and Caregivers Longitudinal Well-being Study Dr Sylvie Lambert, RN,
More informationCurriculum Planning: A Needs Assessment for Complementary and Alternative Medicine Education in Residency
190 March 2007 Family Medicine Curriculum Planning: A Needs Assessment for Complementary and Alternative Medicine Education in Residency Sarita H. Prajapati, MD, MPH; Ronald F. Kahn, MD; Tracy Stecker,
More informationResearch Article The Relationship of Allergy Severity to Depressive and Anxious Symptomatology: The Role of Attitude toward Illness
International Scholarly Research Network ISRN Allergy Volume 2011, Article ID 765309, 4 pages doi:10.5402/2011/765309 Research Article The Relationship of Allergy Severity to Depressive and Anxious Symptomatology:
More informationFindings Report: Humboldt Park Community Nutrition & Physical Activity Survey
Findings Report: 2013 Humboldt Park Community Nutrition & Physical Activity Survey 1 Introduction In summer 2005 and again in summer 2009, with assistance from SUHI, CO-OP Humboldt Park and the Consortium
More informationKey words children; maternal posttraumatic stress symptoms; pediatric injury; posttraumatic
Brief Report: The Impact of Maternal Posttraumatic Stress Disorder Symptoms and Child Gender on Risk for Persistent Posttraumatic Stress Disorder Symptoms in Child Trauma Victims Sarah A. Ostrowski, 1
More informationSikha Naik Mark Vosvick, Ph.D, Chwee-Lye Chng, Ph.D, and John Ridings, A.A. Center for Psychosocial Health
Sikha Naik Mark Vosvick, Ph.D, Chwee-Lye Chng, Ph.D, and John Ridings, A.A. Subhrasikha Naik Senior Study and research chronic diseases Participate in gathering data for Project Cope, which is focused
More informationPSYCHOPATHOLOGY AND DEVELOPMENT: TRAJECTORIES OF PSYCHOPATHOLOGY FROM EARLY ADOLESCENCE THROUGH YOUNG ADULTHOOD
Psychopathology and Develoment, 1 PSYCHOPATHOLOGY AND DEVELOPMENT: TRAJECTORIES OF PSYCHOPATHOLOGY FROM EARLY ADOLESCENCE THROUGH YOUNG ADULTHOOD Marc S. Schulz*, Stuart T. Hauser**, Joseph P. Allen***,
More informationAddressing Arthritis Treatment Disparities Among Different Patient Populations
Addressing Arthritis Treatment Disparities Among Different Patient Populations Lori Aylor, BSN CRRN In September 2010 I attended "Movement Is Life : A National Dialogue on Musculoskeletal Health Disparities
More informationUsing the WHO 5 Well-Being Index to Identify College Students at Risk for Mental Health Problems
Using the WHO 5 Well-Being Index to Identify College Students at Risk for Mental Health Problems Andrew Downs, Laura A. Boucher, Duncan G. Campbell, Anita Polyakov Journal of College Student Development,
More informationEstimates of the Reliability and Criterion Validity of the Adolescent SASSI-A2
Estimates of the Reliability and Criterion Validity of the Adolescent SASSI-A 01 Camelot Lane Springville, IN 4746 800-76-056 www.sassi.com In 013, the SASSI Profile Sheets were updated to reflect changes
More informationChapter V Depression and Women with Spinal Cord Injury
1 Chapter V Depression and Women with Spinal Cord Injury L ike all women with disabilities, women with spinal cord injury (SCI) may be at an elevated risk for depression due to the double jeopardy of being
More informationCreating a New Dialogue. Anaheim, CA September 30, 2010 Leticia Villarreal Sosa, Dominican University Rebeca Davila, St.
Creating a New Dialogue Anaheim, CA September 30, 2010 Leticia Villarreal Sosa, Dominican University Rebeca Davila, St. Augustine College Introductions Current Paradigm of Care Latinos and Mental Health
More informationMyths, Heart Disease and the Latino Population. Maria T. Vivaldi MD MGH Women s Heart Health Program. Hispanics constitute 16.3 % of US population!
Myths, Heart Disease and the Latino Population Maria T. Vivaldi MD MGH Women s Heart Health Program Hispanics constitute 16.3 % of US population! 1 LEADING CAUSES OF DEATH IN LATINOS Heart disease is the
More informationBreast cancer: Relationship between acculturation and barriers to breast cancer screening in Southwest Florida Latinas
University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 2006 Breast cancer: Relationship between acculturation and barriers to breast cancer screening in Southwest
More informationPsychiatric Morbidity, Stressors, Impact, and Burden in Juvenile Idiopathic Arthritis
J HEALTH POPUL NUTR 2005 Xxx;23(0):000-000 2005 ICDDR,B: Centre for Health and Population Research ISSN 1606-0997 $ 5.00+0.20 Psychiatric Morbidity, Stressors, Impact, and Burden in Juvenile Idiopathic
More informationDenial, Daily Hassles and Distress in HIV Positive Individuals
Denial, Daily Hassles and Distress in HIV Positive Individuals Brooke Gomez, Thomas DeSena M.A., James Miller M.A., Kyle Deaton B.A., & John Ridings B.A., Mark Vosvick PhD University of North Texas BACKGROUND
More informationBy Lora A. Connor B.A., 2008, California State University, Long Beach
By Lora A. Connor B.A., 2008, California State University, Long Beach A Thesis Proposal December 2014 Committee Members: James Amirkhan, Ph.D. (Chair) Courtney Ahrens, Ph.D. Young-Hee Cho, Ph.D. Agenda
More informationA Cross-Cultural Study of Psychological Well-being Among British and Malaysian Fire Fighters
A Cross-Cultural Study of Psychological Well-being Among British and Malaysian Fire Fighters Mohd. Dahlan Hj. A. Malek, Ida Shafinaz Mohd Universiti Malaysia Sabah Abstract Psychological consideration
More informationTransition: From Pediatric and Adult Care
Transition: From Pediatric and Adult Care Simone Appenzeller MD, PhD Associate Professor Rheumatology Unit State University of Campinas Clique para editar o estilo do subtítulo mestre PReS Latin American
More informationApplication of Rasch analysis to the parent adherence report questionnaire in juvenile idiopathic arthritis
Toupin April et al. Pediatric Rheumatology (2016) 14:45 DOI 10.1186/s12969-016-0105-5 RESEARCH ARTICLE Open Access Application of Rasch analysis to the parent adherence report questionnaire in juvenile
More informationImplicit Theories Relate to Youth Psychopathology, But How? A Longitudinal Test of Two Predictive Models
Child Psychiatry Hum Dev (2016) 47:603 617 DOI 10.1007/s10578-015-0595-2 ORIGINAL ARTICLE Implicit Theories Relate to Youth Psychopathology, But How? A Longitudinal Test of Two Predictive Models Jessica
More informationIAPAC 11 th International Conference on HIV Treatment and Prevention Adherence Fort Lauderdale, FL May 11, 2016
Nonadherence and Unsuppressed Viral Load Across Stages of Adolescent Development in US Youth with Perinatally Acquired HIV in the Pediatric HIV/AIDS Cohort Study: A Longitudinal Analysis Deborah Kacanek,
More informationASSESSMENT OF THE RELIABILITY AND VALIDITY OF THE ARTHRITIS IMPACT MEASUREMENT SCALES FOR CHILDREN WITH JUVENILE ARTHRITIS
819.~ BRIEF REPORT ASSESSMENT OF THE RELIABILITY AND VALIDITY OF THE ARTHRITIS IMPACT MEASUREMENT SCALES FOR CHILDREN WITH JUVENILE ARTHRITIS CLAUDIA J. COULTON, ELIZABETH ZBOROWSKY, JUDITH LIPTON. and
More informationA Survey on Knowledge, Attitudes and Usage of Complementary and Alternative Medicine in Singapore by Hwee-Ling Koh, Hui-Ling Ng & Hsiao-Huei Teo
A Survey on Knowledge, Attitudes and Usage of Complementary and Alternative Medicine in Singapore by Hwee-Ling Koh, Hui-Ling Ng & Hsiao-Huei Teo Introduction Complementary and Alternative Medicine (CAM)
More informationAsian American Midlife Women s Sleep Related Symptoms and Physical Activity
Asian American Midlife Women s Sleep Related Symptoms and Physical Activity A Secondary Analysis Yaelim Lee, PhD, MSN, RN 1 ; Helen Teng, MSN, CRNP 2 ; Ok Kyung Ham, PhD, MCHES, RN 3 ; Youjeong Kang, PhD,
More information2/23/18. Disclosures. Rheumatic Diseases of Childhood. Making Room for Rheumatology. I have nothing to disclose. James J.
Making Room for Rheumatology James J. Nocton, MD Disclosures I have nothing to disclose Rheumatic Diseases of Childhood Juvenile Idiopathic Arthritis (JIA) Systemic Lupus Erythematosus (SLE) Juvenile Dermatomyositis
More informationHIV Interventions along the US-Mexico Border: The Southern California Border HIV/AIDS Project
HIV Interventions along the US-Mexico Border: The Southern California Border HIV/AIDS Project Institute of Medicine Roundtable on Health Literacy January 26, 2006 Rosana Scolari Director of HIV Services
More informationCongruence of Perception of Asthma Control Between Parents, Children, and Clinicians The Ohio State University College of Nursing Honors Research
1 Congruence of Perception of Asthma Control Between Parents, Children, and Clinicians The Ohio State University College of Nursing Honors Research Thesis Student: Britain Somple Mentor: Dr. Kimberly Arcoleo,
More informationBreast cancer and self-examination knowledge among Tanzanian women: implications for breast cancer health education
64 Breast cancer and self-examination knowledge among Tanzanian women: implications for breast cancer health education T.A. NGOMA & M. NGOMA Ocean Road Cancer Institute, Dar es Salaam, Tanzania Abstract:
More informationPerceived parental attachment and achievement motivation
Western University Scholarship@Western Psychology Psychology 12-1-2011 Perceived parental attachment and achievement motivation Mena Bal Imants Barušs King's University College, baruss@uwo.ca Follow this
More informationSadie Wickwar 1, Katrin Buerkle 1, Hayley McBain 1,2, Sabina Ciciriello 4, Richard H Osborne 5, Lucy R Wedderburn 3 and Stanton P Newman 1*
Wickwar et al. Pediatric Rheumatology 2013, 11:27 RESEARCH Open Access Adaptation of the methotrexate in rheumatoid arthritis knowledge questionnaire (MiRAK) for use with parents of children with juvenile
More informationCHAPTER- III RESEARCH METHODOLOGY
CHAPTER- III RESEARCH METHODOLOGY 3.1 Introduction 3.2 Statement of the Problem 3.3 Objectives 3.4 Hypotheses 3.5 Variables 3.6 Operational Definitions of Variables 3.7 Selection of the Sample 3.8 Research
More informationMental and Physical Health of Youth in Clinical and Community Settings
Mental and Physical Health of Youth in Clinical and Community Settings Teresa L. Kramer, Ph.D. Martha M. Phillips, Ph.D. Terri L. Miller, Ph.D. Relationships Between Depression and Obesity in Adolescents
More informationhealth-related quality of life; juvenile arthritis; outcomes.
The Impact on Health-Related Quality of Life from Non-Steroidal Anti-Inflammatory Drugs, Methotrexate, or Steroids in Treatment for Juvenile Idiopathic Arthritis Russ Riddle, 1 MS, Christina N. Ryser,
More informationTHE INFLUENCE OF PSYCHOSOCIAL AND TREATMENT-RELATED VARIABLES ON ADHERENCE AND METABOLIC CONTROL IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
THE INFLUENCE OF PSYCHOSOCIAL AND TREATMENT-RELATED VARIABLES ON ADHERENCE AND METABOLIC CONTROL IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS Lene J. Kristensen, Niels H. Birkebaek, Anne H. Mose, Morten
More informationCreating a Child Self-Report Measure of Adverse Events Related to Cancer Treatment; Providing a Voice for the Child
Creating a Child Self-Report Measure of Adverse Events Related to Cancer Treatment; Providing a Voice for the Child Casey Hooke, PhD, RN, PCNS, CPON University of Minnesota School of Nursing Pamela Hinds,
More information2010 Community Health Needs Assessment Final Report
2010 Community Health Needs Assessment Final Report April 2011 TABLE OF CONTENTS A. BACKGROUND 3 B. DEMOGRAPHICS 4 C. GENERAL HEALTH STATUS 10 D. ACCESS TO CARE 11 E. DIABETES 12 F. HYPERTENSION AWARENESS
More informationQUALITY OF REFERRAL LETTERS TO PEDIATRIC RHEUMATOLOGY. Alexandra Rydz, General Pediatrics PGY-4 WCHRI Research Day October 24, 2018
QUALITY OF REFERRAL LETTERS TO PEDIATRIC RHEUMATOLOGY Alexandra Rydz, General Pediatrics PGY-4 WCHRI Research Day October 24, 2018 Background: the problem Arthritis Alliance of Canada recommendations:
More informationACCULTURATION LEVEL, GENERATIONAL STATUS, AND GENDER: THEIR ROLES IN ACCULTURATIVE STRESS IN YOUNG ADOLESCENT MEXICAN AMERICANS
ACCULTURATION LEVEL, GENERATIONAL STATUS, AND GENDER: THEIR ROLES IN ACCULTURATIVE STRESS IN YOUNG ADOLESCENT MEXICAN AMERICANS Suzanne C. Manning, M.S. Dissertation Prepared for the Degree of DOCTOR OF
More informationEarly Childhood Measurement and Evaluation Tool Review
Early Childhood Measurement and Evaluation Tool Review Early Childhood Measurement and Evaluation (ECME), a portfolio within CUP, produces Early Childhood Measurement Tool Reviews as a resource for those
More informationQuality of Life Among Adults with Attention Deficit Hyperactivity Disorder (ADHD): Comparative Study Between the Three Presentations of ADHD
University of Kentucky UKnowledge Theses and Dissertations--Early Childhood, Special Education, and Rehabilitation Counseling Early Childhood, Special Education, and Rehabilitation Counseling 2015 Quality
More informationMood Disorders Society of Canada Mental Health Care System Study Summary Report
Mood Disorders Society of Canada Mental Health Care System Study Summary Report July 2015 Prepared for the Mood Disorders Society of Canada by: Objectives and Methodology 2 The primary objective of the
More informationCRITICALLY APPRAISED PAPER (CAP)
CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What are the observed effects on pain and fatigue when comparing two occupational therapy activity-pacing interventions in adults with osteoarthritis?
More informationInterviewer Ratings of Caregiver Respondent and Home Environment LONGSCAN 1991
Interviewer Ratings of Caregiver Respondent and Home Environment LONGSCAN 1991 Description of Measure Purpose To assess the interviewer s impression of the interview, the respondent, the respondent s home,
More informationReview of Various Instruments Used with an Adolescent Population. Michael J. Lambert
Review of Various Instruments Used with an Adolescent Population Michael J. Lambert Population. This analysis will focus on a population of adolescent youth between the ages of 11 and 20 years old. This
More informationdiagnosis and initial treatment at one of the 27 collaborating CCSS institutions;
Peer-delivered smoking counseling for childhood cancer survivors increases rate of cessation: the Partnership for Health Study Emmons K M, Puleo E, Park E, Gritz E R, Butterfield R M, Weeks J C, Mertens
More informationDiscrimination and the Health of Asian Americans
Discrimination and the Health of Asian Americans 13 th Annual Summer Public Health Research Videoconference on Minority Health Gilbert C. Gee, Ph.D. University of Michigan Health Behavior & Health Education
More informationSelf Perceived Oral Health Status, Untreated Decay, and Utilization of Dental Services Among Dentate Adults in the United States: NHANES
Self Perceived Oral Health Status, Untreated Decay, and Utilization of Dental Services Among Dentate Adults in the United States: NHANES 2011 2012 Sayo Adunola, D.D.S., M.P.H. Dental Public Health Resident
More informationBaptistHealth_FEB2014 1
Hispanic Health Disparities in Diabetes: Implications for CVD Prevention Neil Schneiderman University of Miami Baptist Health South Florida 12 th Annual CVD Prevention Symposium Miami Beach, Florida February
More informationPerceived Discrimination and Depression as it Relates to Nativity Status of students from Immigrant Backgrounds
City University of New York (CUNY) CUNY Academic Works Master's Theses City College of New York 2012 Perceived Discrimination and Depression as it Relates to Nativity Status of students from Immigrant
More informationAIMS2 USER'S GUIDE BOSTON UNIVERSITY ARTHRITIS CENTER
AIMS2 USER'S GUIDE BOSTON UNIVERSITY ARTHRITIS CENTER The second version of the Arthritis Impact Measurement Scales (AIMS2) is an improvement on an evaluation instrument that was developed to measure patient
More informationHealth Behavioral Patterns Associated with Psychologic Distress Among Middle-Aged Korean Women
ORIGINAL ARTICLE Health Behavioral Patterns Associated with Psychologic Distress Among Middle-Aged Korean Women Hye-Sook Shin 1, PhD, RN, Jia Lee 2 *, PhD, RN, Kyung-Hee Lee 3, PhD, RN, Young-A Song 4,
More informationIntegrative Medicine Group Visits: A New Model of Care for Managing Health and Well-Being Katherine Gergen Barnett, MD Diane Rogers June 25, 2015
+ Integrative Medicine Group Visits: A New Model of Care for Managing Health and Well-Being Katherine Gergen Barnett, MD Diane Rogers June 25, 2015 Safety net hospital for Boston and surrounding communities;
More informationHorizon Scanning Technology Summary. Abatacept (Orencia) for juvenile idiopathic arthritis. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Abatacept (Orencia) for juvenile idiopathic arthritis June 2007 This technology summary is based on information available at the time
More informationRunning head: ASSESSMENT EVALUATION OF THE EATING 1
Running head: ASSESSMENT EVALUATION OF THE EATING 1 Assessment Evaluation of The Eating Disorder Inventory-3 Miss Luvz T. Study Johns Hopkins University ASSESSMENT EVAULATION OF THE EATING 2 Assessment
More informationA Comparison of Control Populations in Quebec Using the Short Musculoskeletal Function Assessment
94 MJM 2002 6: 94-99 Copyright 2002 by MJM ORIGINAL ARTICLE A Comparison of Control Populations in Quebec Using the Short Musculoskeletal Function Assessment Craig Lomita, BA* ABSTRACT The Short Musculoskeletal
More informationFederation of State Boards of Physical Therapy Minimum Data Set Questionnaire
Federation of State Boards of Physical Therapy Minimum Data Set Questionnaire Purpose: Understanding the current United States Health Workforce enables Federal and State Governments and Health Professional
More informationTHE SELF STIGMA OF MENTAL ILLNESS: IMPLICATIONS FOR SELF ESTEEM AND SELF EFFICACY
CORRIGAN SELF STIGMA ET AL. Journal of Social and Clinical Psychology, Vol. 25, No. 9, 2006, pp. 875-884 THE SELF STIGMA OF MENTAL ILLNESS: IMPLICATIONS FOR SELF ESTEEM AND SELF EFFICACY PATRICK W. CORRIGAN,
More information5/22/12. First Preventive Dental Exam: Disparities in Need Cost + Behavioral Insights! Mini-tour of Milwaukee! Acknowledgements!
First Preventive Dental Exam: Disparities in Need Cost + Behavioral Insights Peter Damiano* Raymond Kuthy* Donald Chi@ Natoshia Askelson* University of Iowa -Public Policy Center* -College of Dentistry
More informationTransition of the Adolescent Patient with Rheumatic Disease: Issues to Consider
Pediatr Clin N Am 52 (2005) 641 652 Transition of the Adolescent Patient with Rheumatic Disease: Issues to Consider Lori B. Tucker, MD*, David A. Cabral, MBBS Division of Pediatric Rheumatology, Centre
More informationText-based Document. Using Guided Imagery to Reduce Pain and Anxiety. Authors Cole, Linda C. Downloaded 3-May :29:51
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationAuthor's response to reviews
Author's response to reviews Title:The association between lean mass and bone mineral content in the high disease activity group of adult patients with juvenile idiopathic arthritis Authors: Kristyna Brabnikova
More informationArthritis Rheumatism Psoriasis
Arthritis Rheumatism Psoriasis 1 / 6 2 / 6 3 / 6 Arthritis Rheumatism Psoriasis You may think that arthritis is a single condition, but there are many forms of arthritis. Each type can be caused by different
More informationCírculo de Cuidado (Circle of Care):
Assess Group Círculo de Cuidado (Circle of Care): A Randomized Controlled Trial to Assess the Benefits of a Cognitive Behavioral Group Intervention for Latino Families Coping with Dementia Judith G. Gonyea,
More informationSleep evaluation scales and questionnaires (Lomeli, H.A. et al, 2008) Abstract
PMSIG Research: Abstracts, Articles and Reviews November 2017 Topic : Pain and Sleep Topics Every other month, the Pain Management Special Interest Group will be providing with some updates on new topics,
More informationPain Management in Patients with Fibromyalgia
University of Central Florida Honors in the Major Theses Open Access Pain Management in Patients with Fibromyalgia 2017 Linsey Fischer University of Central Florida Find similar works at: http://stars.library.ucf.edu/honorstheses
More informationInsulin Perceptions of Adult Type 2 Diabetes Patients at Eastwood Health Center. Nancy Castillo El Centro de Corazon Houston, TX
Insulin Perceptions of Adult Type 2 Diabetes Patients at Eastwood Health Center Nancy Castillo El Centro de Corazon Houston, TX Introduction CDC: 29.1 million people with diabetes in US Texas: 1.8 million
More informationProspective Psychological Evaluation of Pediatric Heart and Heart Lung Recipients
Prospective Psychological Evaluation of Pediatric Heart and Heart Lung Recipients Jo Wray, PHD, and Rosemary Radley-Smith, FRCP Department of Paediatrics, Harefield Hospital Objective To study psychological
More informationSocial Support as a Mediator of the Relationship Between Self-esteem and Positive Health Practices: Implications for Practice
15 JOURNAL OF NURSING PRACTICE APPLICATIONS & REVIEWS OF RESEARCH Social Support as a Mediator of the Relationship Between Self-esteem and Positive Health Practices: Implications for Practice Cynthia G.
More informationBarriers to Formal Diagnosis of Autism Spectrum Disorder in Adults. Laura Foran Lewis, RN, PhD University of Vermont
Barriers to Formal Diagnosis of Autism Spectrum Disorder in Adults Laura Foran Lewis, RN, PhD University of Vermont AUTISM SPECTRUM DISORDER (ASD) Diagnostic and Statistical Manual of Mental Disorders
More informationStage-Based Educational Interventions for Promoting Early Screening Mammography Use among Korean-American Women
Stage-Based Educational Interventions for Promoting Early Screening Mammography Use among Korean-American Women Jin H. Kim, PhD. RN Associate Professor Chamberlain College of Nursing Funded by NIH/NINR
More information