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Biomedical subjects

Rosanne C Harrigan

Publications and source records attributed to Rosanne C Harrigan.

16 recordsLinked to original sources
PubMed2006

Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial.

CONTEXT: Observational studies and polyp recurrence trials are not conclusive regarding the effects of a low-fat dietary pattern on risk of colorectal cancer, necessitating a primary prevention trial. OBJECTIVE: To evaluate the effects of a low-fat eating pattern on risk of colorectal cancer in postmenopausal women. DESIGN, SETTING, AND PARTICIPANTS: The Women's Health Initiative Dietary Modification Trial, a randomized controlled trial conducted in 48,835 postmenopausal women aged 50 to 79 years recruited between 1993 and 1998 from 40 clinical centers throughout the United States. INTERVENTIONS: Participants were randomly assigned to the dietary modification intervention (n = 19,541; 40%) or the comparison group (n = 29,294; 60%). The intensive behavioral modification program aimed to motivate and support reductions in dietary fat, to increase consumption of vegetables and fruits, and to increase grain servings by using group sessions, self-monitoring techniques, and other tailored and targeted strategies. Women in the comparison group continued their usual eating pattern. MAIN OUTCOME MEASURE: Invasive colorectal cancer incidence. RESULTS: A total of 480 incident cases of invasive colorectal cancer occurred during a mean follow-up of 8.1 (SD, 1.7) years. Intervention group participants significantly reduced their percentage of energy from fat by 10.7% more than did the comparison group at 1 year, and this difference between groups was mostly maintained (8.1% at year 6). Statistically significant increases in vegetable, fruit, and grain servings were also made. Despite these dietary changes, there was no evidence that the intervention reduced the risk of invasive colorectal cancer during the follow-up period. There were 201 women with invasive colorectal cancer (0.13% per year) in the intervention group and 279 (0.12% per year) in the comparison group (hazard ratio, 1.08; 95% confidence interval, 0.90-1.29). Secondary analyses suggested potential interactions with baseline aspirin use and combined estrogen-progestin use status (P = .01 for each). Colorectal examination rates, although not protocol defined, were comparable between the intervention and comparison groups. Similar results were seen in analyses adjusting for adherence to the intervention. CONCLUSION: In this study, a low-fat dietary pattern intervention did not reduce the risk of colorectal cancer in postmenopausal women during 8.1 years of follow-up. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov Identifier: NCT00000611.

Adenoma↗
PubMed2006

A collaborative approach to developing a validated competence-based curriculum for health professions students.

PROBLEM: Curricula are developed to educate health professions students to provide efficient and effective health services. In addition to learning their disciplinary perspective, today's students must master the concepts of multidisciplinary team care. Traditionally, curriculum was developed based primarily on the perspectives of the discipline faculty, administration and accrediting agencies. However, now there are multiple groups (other academic educators, consumers and employers of health care providers) who may hold differing perspectives about outcomes expected from these programs. PURPOSE: The purpose of this investigation was to use an innovative methodology to generate and validate a curriculum for health professions students from multiple disciplines. METHOD: A multi-phased method using focus groups, surveys, dissemination and affirmation was presented to identify the concepts and best practices that should be included. RESULTS: Several performance-based themes evolved during the interviews and a questionnaire was generated. Academic educators, consumers and employers of health care providers indicated agreement that the components on the survey were realistic and important for health professions students to achieve. Thus, outcomes for a curriculum were validated. The faculty rated several components of the curriculum as less realistic for students to achieve than did the consumers and employers. This investigation suggests it may be necessary for faculty to assist providers and parents in developing more realistic expectations about what students can achieve during their educational program. The approach used in this current project moves the field of the health professions curriculum development to a different level when compared with the traditional curriculum development approaches and should be used by others concerned with multi-professional education to assure the validity of the curricula.

Cooperative Behavior↗
PubMed2006

Anti-tumor effects of herbal medicines on endometrial carcinomas via estrogen receptor-alpha-related mechanism.

This study was performed to examine the relationship between the anti-tumor effects of herbal medicine and endometrial carcinoma with ER-related mechanisms. An endometrial cancer cell line (Ishikawa) was used for this study. The cell viability and expression of estrogen receptors (ER) were determined by MTT and RT-PCR. A dose-dependent decrease of viability and apoptosis of the cancer cells was generated by exposure to the herbal medicines, Juzen-taiho-to or Shimotsu-to. The expression of ER-alpha mRNA, but not ER-beta mRNA was suppressed by Juzen-taiho-to or Shimotsu-to in an endometrial cancer cell line. The anti-tumor effect of these herbal medicines against endometrial carcinoma might be correlated to the ER-alpha related mechanism.

Antineoplastic Agents↗
PubMed2006

A literature review on Complementary and Alternative Medicine for the treatment of breast cancer: Hawai'i.

The purpose of this literature review is to survey the scholarly work done in the field of Complementary and Alternative Medicine (CAM) as it relates to breast cancer treatment, accenting studies done on diverse ethnicities of Hawai'i. This study reviews articles published in biomedical literature from 1999-2005 that report findings related to the themes recognized in this area of study.

Breast Neoplasms↗
PubMed2006

The use of Complementary and Alternative Medicine by Asian women of Hawai'i in the treatment of breast cancer.

This qualitative investigation examined complementary and alternative medicine (CAM) by Hawai'i Asian women breast cancer survivors. The majority of participants felt that the conventional treatment they received was adequate in treating their cancer but was impersonal in nature leaving them feeling abandoned. Many sought CAM to improve their quality of life. Additional research on CAM and the patient-physician relationship is urgently needed.

Adult↗
PubMed2005

Growth in clinical research productivity and funding at the University of Hawaii's John A. Burns School of Medicine: the past 10 years.

Over the last ten years, faculty at the John A. Burns School of Medicine (JABSOM) and the University of Hawaii (UH) have been actively engaged in ongoing efforts to increase the quantity and improve the quality of biomedical research in the State of Hawaii. JABSOM's Clinical Research Center (CRC), funded in 1995 by the National Center for Research Resources (NCRR) and the Research Centers in Minority Institutions (RCMI) of the National Institutes of Health, has provided research infrastructure that has been essential to these efforts. The CRC and other JABSOM departments and affiliated programs have collaborated with public and private entities within the community, particularly in the area of health, related to diverse racial and ethnic populations. This paper sets forth a number of the significant indicators of research progress, as illustrated primarily through CRC support for various research activities conducted at JABSOM.

Efficiency↗
PubMed2005

Improving Hawaiian and Filipino involvement in clinical research opportunities: qualitative findings from Hawai'i.

OBJECTIVE: Investigate the barriers to participation in medical research that involves Asian and Pacific Islander (API) populations in Hawai'i. PARTICIPANTS: Fifty people (27 Filipinos, 23 Hawaiian/Pacific Islanders) in five different communities on Oahu. DESIGN: Nine focus groups with an ethnically matched moderator were held to explore people's feelings, problems, and recommendations regarding medical research. Sessions were audiotaped, transcribed, and qualitatively analyzed with the constant comparison method. RESULTS: Only 12% of study participants said that they absolutely would not participate in a clinical study. Most agreed that research is vital. Filipino participants were more optimistic about the safety and value of joining in medical research. Hawaiian groups were more hesitant and fearful. Reasons for nonparticipation included negative feelings about the purpose and intent of clinical trials and language and cultural barriers. Suggestions on how to encourage API populations to participate in research investigations included improving peoples' understanding of the benefits to family and community. Hawaiian and Filipino groups differed only slightly in their assessments of the type of research needed in their communities. CONCLUSIONS: Recruitment campaigns must improve people's awareness of the process of informed consent, research safeguards, and benefits to family and community. Attention should focus on K-12 health education to use members of the younger generations to access and educate elders, involving persons with medical research experience as a recruitment resource, returning results to study participants, and increasing the number of healthcare professionals and researchers that are culturally and linguistically matched to the community.

Biomedical Research↗
PubMed2005

Oral health disparities and periodontal disease in Asian and Pacific Island populations.

INTRODUCTION: While oral health disparities exist in many ethnic groups in Hawaii, the challenge of developing research and intervention programs is hampered by the lack of a dental school and adequate state resources. OBJECTIVE: To use a collaboration model to establish a mentoring relationship with a research-intensive school of dentistry to reduce oral health disparities in Hawaii. METHODS: Collaborative interactions with the University of Hawaii School of Medicine (UH) and the University of North Carolina School of Dentistry at Chapel Hill (UNC) included bimonthly teleconferences, on-site planning and mentoring sessions, yearly conferences in Hawaii open to the community using UNC faculty, and on-site skills training sessions. The community was asked to participate in determining priorities for research through focus-group interactions. Two pilot investigations were also conducted. RESULTS: Both universities have been awarded grants to fund activities to support the combined intellectual and physical resources of multiple private, public, and community organizations to achieve the goal of improving the oral health status of the people of Hawaii. As a result of initial planning, two related grants have been submitted (one approved, one disapproved) to fund pilot studies on the oral health status of mothers and their babies in a rural community. These studies include both UH and UNC investigators. CONCLUSIONS: Health disparities occur among diverse ethnic groups in Hawaii, and links between general health and oral health continue to emerge. In spite of obstacles to designing effective research and intervention programs in Hawaii, UH fostered a collaborative relationship with a premiere dental research institution to develop competence in clinical research, conduct pilot studies, and obtain extramural funding for comprehensive studies. Direct involvement of community representatives in the research process is integral to the success of such studies and will continue to serve as the foundation of our community-based participatory research. The network partners have accomplished their primary goal of developing culturally appropriate methods for assessing determinants of oral health, oral health-related quality of life, and health outcomes in Asians and Pacific Islanders.

Adult↗
PubMed2004

Voicing the strengths of Pacific Island parent caregivers of children who are medically fragile.

Research is deficient regarding the strengths of Pacific Island parents of children who are medically fragile. The purpose of this qualitative ethnographic study was to explore the strengths of Pacific Island parents of these children. Audiotaped interviews were analyzed using Text Smart and peer review. The core theme reflecting strength was positive energy. Participants believed that parents needed to have the ability to handle emotional feelings, solve problems, connect with their spirituality, find meaning, take care of themselves, use family support, use community support, use a positive attitude, be resourceful, meet a challenge, interact with nature, and focus on the present. Themes were affirmed by the literature with the exception of interacting with nature, which may be indigenous to the population's cultural orientation.

Adaptation, Psychological↗
PubMed2002

Child-rearing practices of primary caregivers of HIV-infected children: An integrative review of the literature.

The number of human immunodeficiency virus (HIV)-infected children has increased because of the HIV and acquired immunodeficiency syndrome epidemic. Yet little is known about the child-rearing practices of these children's primary caregivers. The purpose of this article is to describe what is known about the child-rearing practices of primary caregivers of HIV-infected children. The review covers a 10-year period from 1990 to 2000. Three electronic bibliographic databases (MEDLINE, CINAHL, and AIDSLINE) were explored. Key words used were HIV-positive children, caregivers, and child-rearing. A total of 50 papers were examined. Using the Matrix Method, each paper was evaluated according to five frames of reference: journal, purpose, sample, method, and findings. Content analysis was used to identity salient themes. Themes that emerged were: caregiver, child, and interactions or child-rearing practices. These findings affirm the parent-child interaction model generated by Kathryn E. Barnard and support this framework as a tool for investigating the relationships between these children and their caregivers.

Adaptation, Psychological↗
PubMedDate not supplied

Barriers to increasing native Hawaiian, Samoan, and Filipino nursing students: perceptions of students and their families.

This article presents the results of an innovative approach to increase the numbers of native Hawaiian, Samoan, and Filipino students who enroll in and complete the bachelor of nursing in science degree. The approach used 2 methods to obtain input. The first was a series of focus groups comprising current and potential students in the nursing program. The second method was a survey of community elders, parents, and high school students in schools with large enrollments of native Hawaiians, Samoans, and Filipinos. The results made clear that Asian Pacific Islanders are composed of distinct groups that have many diverse concerns that need to be addressed in the recruitment and retention phases. One surprise was the low interest in incorporating traditional healing into the curriculum. It was clear that high school students should be given information on nursing early and effectively because this is a key component of their interest in a nursing career.

Attitude↗
PubMedDate not supplied

Medically fragile children: an integrative review of the literature and recommendations for future research.

The literature related to medically fragile children (MFC) is analyzed, and a model is generated to improve quality of care and cost effectiveness. The sources of stress for families include home care professionals, respite care, financial concerns, and limited community resources. Children cared for in hospitals often experience less than desirable quality outcomes. Community-based pediatric extended care facilities may be a means of reducing family stress, improving physiologic and developmental outcomes, and reducing cost. Case management may significantly reduce parental stress and improve the quality of life for these children. Additional systematic study of care options for MFC is essential.

Child↗
PubMedDate not supplied

Stress in families with medically fragile children.

The literature related to the stress experienced by families who care for medically fragile children is analyzed. A model is generated from themes identified in the research literature. Four core themes were identified under which most of the stressors identified in the literature could be grouped. These are role conflict, financial burden, care burden, and independence. These are in turn arranged as a matrix in which the family, the child, the care professional, and health care system interact dynamically with the four core themes. The Family Stress/Task Matrix has the potential for facilitating research related to models that include a family-centered view among health professional and systems.

Child↗
PubMedDate not supplied

Beliefs of mothers in Asian countries and among Hmong in the United States about the causes, treatments, and outcomes of acute illnesses: an integrated review of the literature.

An understanding of mothers' beliefs regarding the causes of illness, treatment, and outcome is an important component of culturally competent care. However, little is known about the beliefs of Asian parents related to acute illnesses. The purpose of our article is to synthesize what is known about the beliefs of mothers regarding the causes, treatment, and outcome of acute illnesses in Asian countries and Hmong in the United States. The literature review covers the period from 1990-2000. The electronic bibliographic databases explored included Pub Med, MEDLINE, HealthSTAR, CINAHL, and PsycINFO. Keywords used were beliefs, health beliefs, mothers or parents, cause of illness or etiology, treatment, diarrhea, acute respiratory infection, measles, Asia, and Hmong. A total of 15 articles were retrieved and examined. Using the matrix method, each article was evaluated according to five frames of reference: journal, purpose, sample, method, and findings. Content analysis was used to generate themes. Expressions of belief related to the causes of illnesses among mothers from Asian countries and Hmong who have emigrated from Laos to the United States of America were found to be quite similar. Beliefs about practices were primarily related to feeding and home care. The majority of mothers first provided treatment for their children using traditional practices. When the child did not recover, the mother sought medical advice.

Acute Disease↗
PubMedDate not supplied

Parent participation in the care of hospitalized child in Thai and Western cultures.

This integrated literature review provides state-of-the-science information regarding parent participation in the care of hospitalized child. The database search revealed only 12 articles on this subject published between 1996-2002. Ganong's (1987) integrative research review process guided this study, and the matrix method of Garrard (1999) was modified to develop the data collection tool. The rules of inference for data analysis and interpretation were identified. Research outcomes were systematically analyzed and reported using a qualitative descriptive approach. Three major themes emerged from the investigation: parents, nurses, and child care interactions. As there were both similar and different findings between Thai and Western cultures, cultural differences regarding parent participation in the care of hospitalized child must be considered in future investigations. Because cultural competence in parent participation has not been well addressed in the literature, further research is needed to delineate the cultural underpinnings of parent participation in the care of hospitalized child.

Adolescent↗