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Richard SL, Renn BN, Tran DMT, Kim J, Feng D. Metabolic Syndrome, Modifiable Lifestyle Factors, and Sleep-Disordered Breathing: The Hispanic Community Health Study. Ann Behav Med 2024; 58:179-191. [PMID: 38175927 PMCID: PMC10858308 DOI: 10.1093/abm/kaad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND US Hispanics/Latinos are disproportionately susceptible to metabolic syndrome (MetS), attributed in part to systemic inequities related to health and lifestyle factors such as low physical activity (PA) levels, diet quality, alcohol use, tobacco use, and sleep disorder. Gender and heritage group differences are vastly understudied and need to be examined in this heterogeneous population. PURPOSE To examine the relationships between select health and lifestyle factors and MetS among Hispanic gender and heritage subgroups (Hypothesis 1) and determine whether gender and heritage moderate those relationships (Hypothesis 2). METHODS Participants included 14,155 Hispanic Americans aged 18-76 (59% female, mean age 45.92 ± 13.97) from seven heritage subgroups. This secondary analysis of cross-sectional data from the observational Hispanic Community Health Study/Study of Latinos (HCHS/SOL) dataset used hierarchical multinomial logistic regression to test Hypothesis 1; the dependent variable, MetS, included three categories delineating absence of MetS and presence of MetS with or without related medication use. Hayes' PROCESS macro tested Hypothesis 2. RESULTS Low PA and sleep-disordered breathing (SDB) each had significant (p < .001) predictive value of MetS group membership, whereas both low and high alcohol use (p < .001) were associated with decreased MetS risk. Cigarette pack-years were not significantly associated with MetS outcomes. Gender moderated the association between MetS and alcohol use (p < .001), cigarette pack-years (p < .001), and SDB (p < .001) such that the effects on MetS were higher in females than males. The association between MetS and diet quality (p < .001) was stronger among males than in females. CONCLUSIONS Gender and heritage differences were prominent among study variables.
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Affiliation(s)
- Shannon L Richard
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Brenna N Renn
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Dieu-My T Tran
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Jinyoung Kim
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Du Feng
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
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Tran DMT, Cross CL, Navalta JW. A Randomized Controlled Trial, Non-Nutrition Based mHealth Program: The Potential Impact on Dietary Intake in College Students. Clin Nurs Res 2024; 33:34-39. [PMID: 37649306 DOI: 10.1177/10547738231197864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The aims of this study were to (1) explore this sample's pre- and post-intervention dietary intake, specifically the macro- and micronutrients, and their eating habits related to location of consumption and use of electronic devices, and (2) compare this sample's nutritional measures to the current Dietary Guidelines 2020 to 2025. Twenty-eight participants were included in the secondary data analysis. Participants reported a total of 822 items consumed during this study. Most items were consumed at home (n = 629, 76.5%). We found significant differences in the intake of energy, protein, total fat, carbohydrates, total vegetables, total grains, and total meat in different locations. For most of these measures, consumption at home and/or restaurants resulted in a greater magnitude of consumption than at other locations (e.g., car, daycare). Participants reported consuming most of their energy and nutrients while either using electronic devices alone (n = 365, 44.4%) or using no devices (n = 346, 42.1%). Significant differences were found among three measures including energy, total fat, and total fiber. The majority of the macronutrients (total fiber, fruits, vegetables, meat, and dairy) consumed by our sample were under the threshold recommended in the 2020 to 2025 Dietary Guidelines.
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Tran DMT, Martinez I, Cross CL, Earley YF. MOBILE Intervention Pilot Study in College Students With Elevated Blood Pressure. J Cardiovasc Nurs 2023; 38:256-261. [PMID: 37027130 PMCID: PMC9579215 DOI: 10.1097/jcn.0000000000000917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hypertension is typically recognized in middle-aged and older adults but often overlooked in younger populations. OBJECTIVE We evaluated a mobile intervention for reducing blood pressure (BP) in college-age students for 28 days. METHODS Students with elevated BP or undiagnosed hypertension were assigned to an intervention or control group. All subjects completed baseline questionnaires and attended an educational session. For 28 days, intervention subjects sent their BP and motivation levels to the research team and completed assigned BP-reducing tasks. After 28 days, all subjects completed an exit interview. RESULTS We found a statistically significant decrease in BP in the intervention group only ( P = .001) but no statistical difference in sodium intake for either group. Mean hypertension knowledge increased in both groups but was only significant for the control group ( P = .001). CONCLUSIONS The results provide preliminary data on BP reduction with greater impact on the intervention group.
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Affiliation(s)
- Dieu-My T. Tran
- University of Nevada, Las Vegas – School of Nursing, Las Vegas, Nevada, USA
| | - Iris Martinez
- University of Nevada, Las Vegas – School of Nursing, Las Vegas, Nevada, USA
| | - Chad L. Cross
- University of Nevada, Las Vegas – School of Public Health, Las Vegas, Nevada, USA
| | - Yumei Feng Earley
- University of Nevada, Reno – School of Medicine, Reno, Nevada, USA
- University of Nevada, Reno – Center for Molecular and Cellular Signal Transduction in the Cardiovascular System, Reno, Nevada, USA
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Richard SL, Renn BN, Kim J, Tran DMT, Feng D. Mental health is related to metabolic syndrome: The Hispanic community health study/ study of Latinos. Psychoneuroendocrinology 2023; 152:106085. [PMID: 36989563 DOI: 10.1016/j.psyneuen.2023.106085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/28/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Metabolic syndrome (MetS) is associated with common mental health conditions. Using cross-sectional data from the observational Hispanic Community Health Study / Study of Latinos (HCHS/SOL), this study examined the relationship between MetS and depression and anxiety in addition to testing moderating effects of gender and Hispanic heritage subgroups. METHODS Participants included 13,496 Hispanic Americans aged 18-74 (59% women, mean age 46.59 ± 13.65) from seven heritage subgroups. Depression was measured using the Center for Epidemiologic Studies Depression 10-item scale, and anxiety was assessed using the State-Trait Anxiety Inventory 10-item scale. A 3-level categorical variable was developed to assess the combined influence of depression and anxiety. The dependent variable is dichotomous, delineating the presence or absence of MetS as defined by the National Cholesterol Education Program Third Adult Treatment Panel. Logistic regression and Hayes' PROCESS macro assessed these relationships and the moderating effects of gender-heritage subgroups. RESULTS Results suggest depression (p < .001) and anxiety (p < .001) were associated with an increased likelihood of MetS. Puerto Ricans had the highest, and South Americans had the lowest, levels of depression and anxiety. Gender moderated the relationship between mental health and MetS, with women having a significant increase in the probability of MetS with depression (p < .001), anxiety (p < .001), or both (p < .001). CONCLUSION Elevated symptoms of depression and anxiety are associated with the presence of MetS in US Hispanic subgroups. Gender-heritage differences are present among the study variables. Strategies to manage psychological well-being must be employed to optimize cardiometabolic health in US Hispanics.
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Affiliation(s)
| | | | | | | | - Du Feng
- 4505 S Maryland Pky, Las Vegas, NV 89154, USA
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Richard SL, Feng D, Kim J, Tran DMT, Renn BN. Electrocardiogram Abnormalities Associated With Metabolic Syndrome: The Hispanic Community Health Study/Study of Latinos. Biol Res Nurs 2023:10998004231152849. [PMID: 36653902 DOI: 10.1177/10998004231152849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a prognostic cluster of physiologic risk factors that may develop into cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Electrocardiogram abnormalities (ECGA) can be instrumental in identifying the early stages of disease and may be associated with MetS in Hispanic Americans. OBJECTIVE To explore the relationships between MetS and major and minor ECGA in the Hispanic population (Hypothesis 1) and determine whether gender-ethnic subgroups moderate these relationships (Hypothesis 2). METHODS This secondary data analysis was conducted using large-scale data from the cohort study Hispanic Community Health Study/Study of Latinos (N = 13,628; 59% women and 41% men). Major ECGA encompassed 9 abnormalities including pathologic Q waves and left ventricular hypertrophy. Minor ECGA were tested independently of major ECGA. MetS was classified into 4 categories delineating metabolic abnormalities and related medication use. Multinomial logistic regression and Hayes' PROCESS macro were used for statistical analysis. RESULTS Major ECGA were significantly associated with the presence of MetS and/or related medication use, whereas minor ECGA abnormalities were associated with MetS for participants who also took MetS-related medications only. Gender moderated the association between MetS and minor ECGA such that women with minor ECGA had a higher likelihood of MetS when compared to men. CONCLUSIONS Findings suggest that early recognition and associated treatment of major and minor ECGA can be important to prevent MetS and further morbidities in the Hispanic population.
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Affiliation(s)
| | - Du Feng
- 14722University of Nevada, Las Vegas, NV, USA
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Tran DMT, Silvestri-Elmore A, Sojobi A. Lifestyle Choices and Risk of Developing Cardiovascular Disease in College Students. Int J Exerc Sci 2022; 15:808-819. [PMID: 35992186 PMCID: PMC9362881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of the study was to examine and evaluate the cardiovascular risk factors in college students including their nutritional and social choices and how those choices related to their cardiovascular health. A descriptive, cross-sectional study of 148 college students, obtaining their blood pressure, body mass index, fasting lipid panel, fasting glucose, hemoglobin A1c, serum cotinine levels, physical activity, alcohol consumption, and dietary habits. A high prevalence of cardiovascular disease risk factors was found: 23.8% were current or past smokers with more male than female smokers (p = .009); 65.5% consumed alcoholic beverages; 13.5% had elevated blood pressure; 25.7% had hypertension stage I; 3.4% had hypertension stage II; 36.5% were overweight while 19.9% were obese; 14.2% had prediabetes and 2% had diabetes; and 40.5% had borderline high cholesterol levels while 3.4% had hyperlipidemia. Elevated blood pressure and hypertension were most prevalent between the ages of 18 and 23 years and among males (p = .001). The top three risk factor co-occurrences were overweight and drinking alcohol (33.78%), followed by family history of heart disease and drinks alcohol (27.70%), and overweight and history of heart disease (25.68%). Of the 148 participants, 108 of them had at least two cardiovascular risk factors. The results of this study indicate that college students participate in risky behaviors that predispose them to develop CVD in the future.
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Affiliation(s)
- Dieu-My T Tran
- School of Nursing, University of Nevada-Las Vegas, Las Vegas, NV, USA
| | | | - Angela Sojobi
- School of Nursing, University of Nevada-Las Vegas, Las Vegas, NV, USA
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Abstract
BACKGROUND/AIMS To review the literature on college students' healthcare-seeking behaviours to uncover the current evidence and promote better healthcare-seeking behaviours and essentially better health outcomes in young adults. METHODS The researchers conducted an extensive literature review using CINAHL, Cochrane, PubMed, EBSCOhost and Google Scholar in the years 2018 and 2019. The search was limited to the past 18 years (2000-2018) and to studies reported in the English language focused on the general healthcare-seeking behaviour of college students. The search was also extended to young adults (aged 18-39 years). RESULTS A total of 56 articles were identified for abstract review and only 28 articles met the inclusion criteria for the final review. The following themes emerged to organise our findings: healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviours and barriers to accessing care among college students. CONCLUSIONS This review summarises the current body of knowledge related to healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviour and barriers to accessing care among this population. Important measures further to address the health needs and interventions for addressing these needs among the college student population are discussed.
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Affiliation(s)
- Dieu-My T Tran
- Assistant Professor, School of Nursing, University of Nevada Las Vegas, USA
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Abstract
Many young adults are at risk for cardiovascular disease related to their behavioral choices. Irresponsible alcohol consumption, tobacco smoking, sedentary lifestyle, poor dietary habits, and excessive weight gain are some of the behaviors that put young adults at risk. The Centers for Disease Control and Prevention identified that 15% of young adults are diagnosed with chronic illnesses related to their behavioral choices. The purpose of this review is to identify, in the literature, interventions that are currently available to young adults and evaluate the adequacy and effectiveness of those interventions. An extensive electronic search was conducted using CINAHL, EBSCOhost, Cochrane, PubMed, and Google Scholar. A total of 130 articles were identified and 28 articles met the inclusion criteria. Three main interventions were identified for young adults: personalized interventions, technology-based interventions, and educational/behavioral interventions. The interventions were all effective to different degrees and interventions were most effective when they were combined. This review impacts in what manner nurses and health care providers deliver health promotion, prevention, and management of cardiovascular risk factors in young adults; in particular, nurses play a key role in lifestyle modifications including diet and exercise.
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Affiliation(s)
| | - Angela Sojobi
- University of Nevada, Las Vegas, Nevada, United States
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Tran DMT, Dingley C, Arenas R. Perception and Beliefs Regarding Cardiovascular Risk Factors and Lifestyle Modifications Among High-Risk College Students. Can J Nurs Res 2020; 53:94-106. [PMID: 31918566 DOI: 10.1177/0844562119899310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Studying risk factors and corresponding behavior in young adults is important as atherosclerotic plaque begins to form in early adulthood, resulting in cardiovascular disease (CVD) later in life. The purpose of this study was to explore the perceptions and beliefs regarding cardiovascular risk and lifestyle modification among high-risk college students (based on Framingham 30-year risk score). METHODS Semistructured qualitative interviews were conducted and analyzed using qualitative content analysis. RESULTS Risk factors included overweight/obesity, alcohol consumption, elevated blood pressure, family history, and smoking. Qualitative interviews revealed six themes: (a) recognizing risk, (b) lifestyle trajectories, (c) factors influencing lifestyles, (d) ideal healthy lifestyle modifications, (e) perceived benefits of healthy lifestyles, and (f) integrating technology and health apps. Participants demonstrated a lack of understanding of how the various factors contributed to CV risk. Influencing factors to a healthy lifestyle were categorized as environmental, relational, financial, work/life/school balance, and internal/intrinsic motivation. CONCLUSIONS Understanding high-risk college students' beliefs and perceptions regarding CVD risk factors and lifestyle modification is the first step to assessing the problem facilitating early intervention in the young adult population. Clinicians should assess, develop, and implement risk reduction programs that are tailored to individuals who need it the most, those at high risk.
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Affiliation(s)
- Dieu-My T Tran
- School of Nursing, University of Nevada, Las Vegas, NV, USA
| | | | - Rogelio Arenas
- Department of Anthropology, University of Nevada, Las Vegas, NV, USA
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Abstract
PURPOSE This study was designed to identify underlying cardiovascular risk factors among college students including lifestyle characteristics, health behaviors and knowledge, and perception of the risk factors. METHOD College students (N = 293), aged 19-36 years, enrolled at either a Midwestern or a Southwestern University in the United States, responded to three questionnaires: sociodemographic, knowledge of cardiovascular risk factors, and perception of cardiovascular risk factors. Anthropometric measures collected included blood pressure (BP), glucose, lipid panel, height, weight, and body mass index (BMI). RESULTS There were significant regional and gender differences in cardiovascular disease (CVD) risk among Southwestern and Midwestern college students. Students from the Southwest had a higher risk of developing CVD in 30 years compared to those in the Midwest; they also had a higher perceived risk. Males were more at risk of developing CVD than females but had a lower perceived risk than females. Dietary habits were similar between the two populations, and we found no significant differences in BMI. The two regions varied in BP levels, but the Midwestern students had significantly higher prevalence of elevated BP and Stage 2 hypertension. CONCLUSION Our data suggest that college students are a high-risk population and tend to underestimate and misperceive their risk for developing CVD.
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Affiliation(s)
| | - Dieu-My T Tran
- 2 School of Nursing, University of Nevada, Las Vegas, NV, USA
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Tran DMT, Kupzyk KA, Zimmerman LM. Using Cluster Analysis to Identify Subgroups of College Students at Increased Risk for Cardiovascular Disease. J Nurs Meas 2018; 26:470-482. [PMID: 30593573 DOI: 10.1891/1061-3749.26.3.470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE To examine the co-occurrence of cardiovascular risk factors and cluster subgroups of college students for cardiovascular risks. METHODS A cross sectional descriptive study was conducted using co-occurrence patterns and hierarchical clustering analysis in 158 college students. RESULTS The top co-occurring cardiovascular risk factors were overweight/obese and hypertension (10.8%, n = 17). Of the total 34 risk factors that co-occurred, 30 of them involved being overweight/obese. A six-cluster-solution was obtained, two clusters displayed elevated levels of lifetime and 30-year cardiovascular disease risks. CONCLUSIONS The hierarchical cluster analysis identified that single White males with a family history of heart disease, overweight/obese, hypertensive or diabetes, and occasionally (weekly) consumed red meat, take antihypertensive medication, and hyperlipidemia were considered the higher risk group compared to other subgroups.
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Affiliation(s)
- Dieu-My T Tran
- University of Nevada, Las Vegas School of Nursing, Las Vegas, Nevada
| | - Kevin A Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | - Lani M Zimmerman
- University of Nebraska Medical Center College of Nursing, Lincoln, Nebraska
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Tran DMT, Zimmerman LM, Kupzyk KA, Shurmur SW, Pullen CH, Yates BC. Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment. J Am Coll Health 2017; 65:158-167. [PMID: 27911653 DOI: 10.1080/07448481.2016.1266638] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. PARTICIPANTS The final sample that responded to recruitment consisted of 158 college students from a midwestern university. METHODS A cross-sectional, descriptive study was performed using convenience sampling. RESULTS College students were knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease (CVD). Knowledge of cardiovascular risk factors was correlated with the lifetime risk estimates (ρ = .17, p = .048), and perception of cardiovascular risk was positively associated with 30-year CVD risk estimates (ρ = .16, p = .048). More than 50% of the participants had 1 or more cardiovascular risk factors. CONCLUSIONS High knowledge level of cardiovascular risk factors was not sufficient to lower cardiovascular risks within this study population, but changing perception of cardiovascular risk factors may play a bigger role in reducing long-term cardiovascular risks.
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Affiliation(s)
- Dieu-My T Tran
- a School of Nursing , University of Nevada , Las Vegas , Las Vegas , Nevada , USA
| | - Lani M Zimmerman
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Kevin A Kupzyk
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Scott W Shurmur
- c School of Medicine , Texas Tech University Health Sciences Center , Lubbock , Texas , USA
| | - Carol H Pullen
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Bernice C Yates
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
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