Connecting Nursing Students and Older Adults: An Intergenerational Service-Learning Experience.

Background: Aging populations have an increased need for health care services. Nursing students are often introduced to care of older adults through a clinical experience in a skilled nursing facility, which can negatively bias a student's attitudes toward this population.

Purpose: The purpose of this quality improvement project was to improve the attitudes of undergraduate nursing students toward older adults.

The Support, Education, and Advocacy (SEA) Program of Care for Women With Metastatic Breast Cancer: A Nurse-Led Palliative Care Demonstration Program.

Background: Women with metastatic breast cancer (MBC) experience unique symptom management and psychosocial needs due to aggressive, yet palliative treatment with a progressive, chronic illness.

Objective: This article describes the effect of a quality improvement project for coordination of supportive care in MBC. Program evaluations included referral rates for supportive services, patient-reported outcomes of symptom distress, generalized anxiety, and overall well-being.

Allostasis and the development of internalizing and externalizing problems: changing relations with physiological systems across adolescence.

Allostasis, or the maintenance of stability through physiological change, refers to the process by which individuals adjust to the continually changing demands that are put upon somatic activity by salient events. Bauer and colleagues proposed that allostasis could be detected through patterns of the joint reactivity of the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis system under stressful conditions. We examined the associations between ANS and HPA reactivity and the development of externalizing and internalizing problems over 2 years in a sample of 215 adolescents.

Dysregulated coherence of subjective and cardiac emotional activation in adolescents with internalizing and externalizing problems.

Background: Effective emotion regulation should be reflected in greater coherence between physiological and subjective aspects of emotional responses.

Method: Youths with normative to clinical levels of internalizing problems (IP) and externalizing problems (EP) watched emotionally evocative film-clips while having heart rate (HR) recorded, and reported subjective feelings.

Results: Hierarchical linear modeling revealed weaker coherence between HR and negative feelings in youths, especially boys, with more EP.

An exploratory study of spiritual care at the end of life.

Purpose: Although spiritual care is a core element of palliative care, it remains unclear how this care is perceived and delivered at the end of life. We explored how clinicians and other health care workers understand and view spiritual care provided to dying patients and their family members.

Methods: Our study was based on qualitative research using key informant interviews and editing analysis with 12 clinicians and other health care workers nominated as spiritual caregivers by dying patients and their family members.

Providers and types of spiritual care during serious illness.

Objective: Patients and palliative care experts endorse the importance of spiritual care for seriously ill patients and their families. However, little is known about spiritual care during serious illness, and whether it satisfies patients' and families' needs. The objective of this study was to describe spiritual care received by patients and families during serious illness, and test whether the provider and the type of care is associated with satisfaction with care.

Clinical and economic impact of palliative care consultation.

Palliative care consultation is the most common model of hospital-based services in the United States, but few studies examine the impact of this model. In a prospective study, we describe the impact of palliative care consultation on symptoms, treatment, and hospital costs. Patients receiving interdisciplinary palliative care consultations from 2002 to 2004 were approached for enrollment; 304 of 395 (77%) patients participated.

Young children's representations of conflict and distress: a longitudinal study of boys and girls with disruptive behavior problems.

We investigated narratives, symbolic play, and emotions in children who varied in severity of disruptive behavior problems. Children's representations of hypothetical situations of conflict and distress were assessed at 4-5 and 7 years. Behavior problems also were assessed then and again at 9 years.

Validation of the palliative performance scale in the acute tertiary care hospital setting.

Background: Physicians are often asked to prognosticate patient survival. However, prediction of survival is difficult, particularly with critically ill and dying patients within the hospitals. The Palliative Performance Scale (PPS) was designed to assess functional status and measure progressive decline in palliative care patients, yet it has not been validated within hospital health care settings.

Palliative care benchmarks from academic medical centers.

Introduction: Palliative care is growing in the United States but little is known about the quality of care delivered.

Objective: To benchmark the quality of palliative care in academic hospitals.

Design: Multicenter, cross-sectional, retrospective chart review conducted between October 1, 2002 and September 30, 2003.

Salivary testosterone diurnal variation and psychopathology in adolescent males and females: individual differences and developmental effects.

Individual differences in salivary testosterone were examined in 213 adolescents (106 boys, 107 girls; mean age = 13.66 years) in relation to externalizing and internalizing psychopathology. Self- and parent-report measures of behavior problems and psychiatric symptoms were obtained.

The development of concern for others in children with behavior problems.

The development of concern for others and externalizing problems were examined in young children with normative, subclinical, or clinical levels of behavior problems. There were no group differences in observable concern for others at 4-5 years of age. Children with clinical behavior problems decreased significantly in their concern by 6-7 years of age and were reported to have less concern at 6-7 years by mothers, teachers, and the children themselves, relative to other groups.