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In this paper the authors report the development and preliminary evaluation of the Rogerian-based Well-Being Picture Scale-Children's Version in a sample of 19 fourth and fifth grade students. Data was collected in conjunction with a larger study that examined childhood overweight and depression, and other measurements in the data set included the Child Depression Inventory. Scores on the Child Depression Inventory indicated that 20% of the children in the study were at risk for depression. A significant statistical inverse correlation (p < .05) was found between the post-test scores on the Well-Being Picture Scale-Children's Version and the Child Depression Inventory indicating that as depression scores increase well-being scores decrease.

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This pilot randomized-controlled trial was designed to evaluate the effectiveness of an over-the-counter multistep herbal smoking cessation regimen, SmokeRx, that employs four different herbal formulations taken at different times during the program. Twenty-two subjects were randomized to a placebo group and 20 to the SmokeRx program. The results show that the odds of reduced or validated cessation of smoking were not significantly different between the groups at any juncture over the 6 months of the trial but that there was a trend for higher odds in the SmokeRx group. Subjects were also more likely to drop out of the placebo group (p = .06), suggesting a possible positive effect of the SmokeRx regimen. Overall, early dropouts (at 2 week follow-up) appeared less motivated to quit smoking, as they were more likely to be younger, had smoked more than 5 years, had greater difficulty refraining from smoking in places where it is forbidden, had fewer previous quit attempts, did not intend to quit smoking in the next month, and exercised fewer hours per week. These results suggest that a larger trial of SmokeRx may be warranted and that more studies that assess the efficacy of herbal formulas are needed to provide valid data for non-nicotine smoking cessation options.

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BACKGROUND: It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly aging population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation profiled the incidence and risk of osteoporosis in adult women from a rural setting using ultrasonic bone scanning technology. METHODS: Between 2001 and 2005, adult female subjects (n = 323) in the age range of 40-87 were drawn from an independent, community dwelling, convenience sample. Bone mineral density T-scores were evaluated using heel ultrasonometry. Demographic and risk factor data, Merck Osteoporosis Evaluation SCORE questionnaire data, and the Osteoporosis Risk Assessment questionnaire data were analyzed. RESULTS: Results of these scans indicate that 25% of the total population had a T-score < or = -1.0, implying a 1.5- to 2.0-fold increase in risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause and weight had a positive correlation with T-scores. While the overall scores on the Merck SCORE questionnaire were inversely correlated to T-scores, no significant correlation was found between the Osteoporosis Risk Assessment questionnaire and T-score data. Additionally, women who had taken estrogen had significantly higher T-scores (p = 0.038) than those who had not. CONCLUSION: That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening in order to develop preventative awareness and provide education on bone health management. This finding has particularly important ramifications, since the sample was rural women, who typically have limited access to diagnostic bone density procedures.

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It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly elderly population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation aimed at profiling the incidence and risk of osteoporosis in adult women from a rural setting using ultrasonic bone scanning technology. Peri- and postmenopausal female subjects (n=234) were drawn from a convenience sample. After a non-radiative dual X-ray absorptiometric scanning, the bone mineral density was measured from the heel of the subjects using bone ultrasonometry, and their T-scores were recorded. Results of these scans indicate that in adult women in the age range of 32 and 87, 23.5% of the population had a heel ultrasonic T-score < or =1.0, implying a 1.5 to 2.0 fold increase in risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause was positively correlated with T-scores (p= 0.032); the higher the age at menopause, the higher the T scores. Additionally, women who had taken estrogen had significantly higher T-scores (p=0.038) than those who had not. That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening in order to develop awareness and provide education on bone health management.

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PURPOSE: To compare elders' self-ratings of the impact of their chronic conditions with healthcare providers' estimates of the impact of the same conditions on older adults. The effect of length of time in clinical practice and rural or urban clientele on healthcare providers' impact ratings was also explored. DATA SOURCES: A pen-and-paper survey was administered to 122 community-dwelling adults aged 55 years and older, attending health education or exercise programs held by a hospital in a city of approximately 60,000 people. Elders were asked to identify which of 11 common chronic conditions they had and then to rate the impact each condition had on their daily lives. A sample of 290 healthcare providers who are members of the Gerontological Society of America completed a mailed survey asking them to estimate the impact that each of the 11 conditions had on older adults. CONCLUSIONS: Healthcare providers consistently overestimated the impact that chronic health conditions had on older adults when compared with the elders' self-ratings of impact. Greater levels of experience were not significantly related to providers' impact ratings of chronic conditions. IMPLICATIONS FOR PRACTICE: Nurse practitioners, as primary care providers, must understand the impact of chronic conditions on older adults' daily lives in order to provide effective, efficient, and evidence-based health care. This study points to the need for more research to discover why older adults and healthcare providers have such different perspectives on the impact of chronic health conditions.

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