A graduate course on cultural diversity, based in constructivist theory and structured on the Process of Cultural Competence in the Delivery of Healthcare Services model, was developed and taught through classroom and online methods. The following research questions were explored: 1) Can an educational experience, built on constructivist learning theory tenets, change students' perceptions, attitudes, knowledge, and skills in the area of cultural competence? 2) Does the delivery method, online or traditional classroom, influence the degree of change? The study used a quasi-experimental, pretest-posttest control group design using the Inventory for Assessing the Process of Cultural Competence Among healthcare Professionals Revised. Findings showed significant changes (p<0.001) in cultural competence scores and subscores for all learners with both teaching modalities based on interval scale and in categories of cultural knowledge, skills, desire, and overall competence based on a nominal scale. The untaught construct of cultural desire showed the most significant improvement.

The ability to achieve return of spontaneous circulation with mechanical chest compression devices is significantly improved when compared with manual chest compressions. In the case of load-distributing band cardiopulmonary resuscitation, it was superior to manual cardiopulmonary resuscitation as the odds of return of spontaneous circulation were over 1.6 times greater. The robustness of these findings should be tested in large randomized clinical trials.

Four studies completed since 1995 have highlighted the importance of the relationship between the provider and the patient in enhancing adherence behavior. This study extends this work by comparing adherent and nonadherent clients in one high-volume HIV clinic in which the majority of care is provided by nursing staff. The sample comprised 130 clients (108 adherent and 22 nonadherent). Adherence status was determined by clinic staff using established procedures. The indicator of the patient-provider relationship was satisfaction with the care provider as measured within the Patient Satisfaction Questionnaire. Client groups differed significantly on perception of interpersonal manner of care provider (p =.018), care provider conduct total (p <.001), and quality total (p =.017). These findings are consistent with earlier work and underscore the potential importance of the patient-provider relationship as a focus of care for nurses.

The purposes of this study were to (a) identify behaviors that put adolescents at risk for HIV infection by retrospectively comparing a cohort of HIV positive and negative young adults and (b) determine gender-specific high-risk profiles. HIV-positive (n = 61) and HIV-negative (n = 124) individuals from two midwestern cities completed a survey tool prepared by the investigators examining six areas of behavior and activity identified in the literature as high risk. Alcohol use, drug use, and gang-related behaviors were not associated with HIV status in these young adults. Early, frequent, and unprotected sex with large numbers of partners were the predictive risk factors for HIV-seropositive status. Gender profiles, however, differed. Whereas the female profile suggested that early and unprotected sex were the only reliable predictors, HIV-positive male subjects had larger numbers of partners, engaged in more risky sexual behaviors, were more likely to have experienced sexual abuse before and during adolescence, and were more likely to have used cocaine during their adolescence. Conclusions include the confirmation of a resurgence of HIV among young males having sex with males and confirmation of females as the largest growing group of HIV-positive young adults.

In the face of significant stressors occasioned by the needs of people with chronic mental illness and the ideological structure at Fountain House, staff members at Fountain House, a psychiatric rehabilitation facility in New York, have long tenures and display fewer symptoms of burnout than other providers. This study identified staff methods for adapting to stress; methods for reframing stressors as positive features are presented. This study describes the processes generated by the ideological structure which create staff commitment to the model and to the mentally ill, and which produce a sense of personal accomplishment and satisfaction. Implications of these findings and needs for further research are discussed.