How Do Risky Behaviors and Mental Health Differ Among Students Based on Undergraduate Class Status?

OBJECTIVE

The purpose of this study was to examine the relationships among undergraduate class status, risky behaviors (i.e., alcohol and marijuana use, sexual activity), life satisfaction, and ability to cope.

METHODS

Undergraduate students (N = 2,961) completed an electronic survey to assess for mental health status and risky behaviors.

RESULTS

Compared with others, first-year students reported fewer days of having at least one alcoholic drink, fewer days of having five or more alcoholic drinks in a row, and less frequency of marijuana use. First-year students reported fewer sexual partners and less frequency of sexual activity compared with others. First-year students were more likely to report greater life satisfaction, being able to cope with difficult situations, and greater self-worth, compared with others.

CONCLUSIONS

As undergraduate students progress through their academic career, they are more likely to engage in risky behaviors and experience life dissatisfaction.

Associations of early life stress with leptin and ghrelin in healthy young adults

BACKGROUND

Childhood adversity is a major risk factor for cardiometabolic health problems. Stress-related changes in diet suggest a role for endocrine factors that influence dietary intake, such as leptin and ghrelin. These hormones influence metabolism and may contribute to the relationship of early adversity, mental, and cardiometabolic health. This study examined levels of leptin and ghrelin in a sample of young adults with and without early life stress (ELS).

METHODS

Young adults ages 18-40 (N = 200; 68.5% female) were recruited from the community. Participants with ELS (N = 118) had childhood maltreatment, and a subset, n = 92 (78.0%) also had parental loss, and n = 65 (55.1%) also had a current psychiatric disorder. Control participants (N = 82) had no maltreatment, parental loss, or psychiatric disorders. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Exclusion criteria included medical conditions and current medications other than hormonal contraceptives. Body Mass Index (BMI) and other anthropometrics were measured, and fasting plasma was assayed for total ghrelin and leptin with the Bio-Plex Pro Human Diabetes Panel.

RESULTS

While ELS was significantly associated with greater leptin (r = .16, p = .025), a finding which held when adjusted for age and sex (F(3196)= 28.32, p = .011), this relationship was abolished when accounting for BMI (p = .44). Participants with ELS also had significantly lower total ghrelin (r = .21, p = .004), which held adjusting for age and sex (p = .002) and was attenuated (p = .045) when the model included BMI (F=46.82, p < .001). Current psychiatric disorder was also a significant predictor of greater leptin (r = .28, p < .001) and lower ghrelin (r = .29, p = .003). In the model with ELS and covariates, psychiatric disorder remained significant (F=7.26, p = .008) and ELS was no longer significant (p = .87). Associations with severity and recent perceived stress were also examined.

CONCLUSION

The relationship of ELS and leptin was no longer significant when accounting for BMI, suggesting potential avenues for intervention. Ghrelin findings persisted after correction for BMI, which may be secondary to physiological differences in the regulation of these hormones (leptin is produced by adipocytes, whereas ghrelin is produced primarily in the GI tract). Lastly, these findings suggest that psychiatric functioning may be a key component contributing to the relationship of lower total ghrelin and childhood adversity.

Influence of COVID-19 on the next generation of nurses in the United States

AIMS/OBJECTIVES

Examine the affective state (anxiety, depression), life satisfaction, stress and worry, media consumption and perceptions of pursuing a career in nursing amidst the COVID-19 pandemic.

BACKGROUND

Nursing students worldwide have reported increased stress, fear and anxiety amidst challenges and risks associated with COVID-19. It remains unclear what impact COVID-19 will have on nursing students in the United States (US) as they prepare to enter the workforce.

DESIGN

Cross-sectional study of undergraduate nursing students at one university in the Northeastern United States.

METHODS

Students (N = 161) completed an online survey (July 2020) about health and life satisfaction, affective state (depression, anxiety), stress and interest in pursuing nursing. Descriptive statistical analysis described sample and quantitative data. Linear regression was used to examine whether media consumption, stress, affective states predicted interest in pursuing a nursing career. Qualitative thematic analysis was applied to the open-ended question, 'How has COVID-19 influenced your interest in pursuing a nursing career?'. The Standards for Reporting Qualitative Research (SRQR) checklist was used to evaluate methodological quality.

RESULTS

Mean stress score was 56.6 (range 0-100), 55.6% of respondents felt unsettled about the future, and 68.2% reported feeling overwhelmed. 18.7% of students reported moderate to severe anxiety, 19.8% reported moderate to severe depression and 54.4% reported that COVID-19 influenced their interest in nursing. Six themes emerged from qualitative analysis: no change, reaffirming/confirmatory, importance of nursing, reality check, positive influence and negative influence.

CONCLUSIONS

Universities/colleges and nursing faculty should prioritise universal mental health assessment for nursing students and enhance mental health services to support and monitor this population.

RELEVANCE TO CLINICAL PRACTICE

Mental health services to support nursing students are warranted in the wake of the COVID-19 pandemic. Reduction in nursing workforce may have significant impacts on staffing ratios, patient outcomes, nurse burn-out and other aspects of clinical care.

Developing Motivational Interviewing Skills Among Undergraduate Nursing Students

The current study evaluated changes in undergraduate nursing students' knowledge and self-efficacy in motivational interviewing. Fourth-year undergraduate nursing students completed a hybrid, online curriculum. Changes in knowledge and self-efficacy were assessed using a pretest/posttest design. Repeated measures analysis of variance was used to determine differences between knowledge and self-efficacy mean scores. Of the 144 students who participated in the study, 88.2% were female, 96.5% were non-Hispanic/Latino, 88.9% were White, and mean age was 21.3 years. There were significant increases in knowledge and self-efficacy mean scores between pre-survey and post-survey 1 and 2. There were no differences between post-surveys 1 and 2 scores. A hybrid, online curriculum using asynchronous modules and synchronous simulation training can facilitate nursing students' learning experiences and enhance knowledge and self-efficacy about motivational interviewing. [Journal of Psychosocial Nursing and Mental Health Services, 61(5), 17-24.].

Lessons From the Field: Strategies for Success in Obtaining Grant Funding

OBJECTIVE

To summarize a preconference workshop that focused on how to be successful in obtaining funding by making one's scholarship innovative and significant.

METHOD

In 2021, at the annual American Psychiatric Nurses Association (APNA) Conference, a panel of nurse scholars reflected on and discussed how to make grant proposals innovative and significant. Two moderators posed questions to five panelists at different stages in their research trajectories about four key research concepts: idea conception, framing for the funding agency, significance, and innovation.

RESULTS

Conceptualizing an innovative, scholarly idea starts with a passion for the topic, a team of experts and scholarly community, and time to think and delve into the literature. For funding opportunities, start small, read the funding announcements thoroughly and carefully, and make sure it is the right fit. Strategies to illustrate significance include avoiding generalizations, maintaining objectivity, being clear about impact, and using strength-based language. Contemplate the many facets of innovation as well as balance innovation and feasibility.

CONCLUSIONS

Inclusion of challenges in composing significance and innovation sections of grant proposals offers knowledge for psychiatric nurse researchers to add to their toolkits as they seek funding and conduct research and scholarship.

Reporting racial and ethnic diversity in eating disorder research over the past 20 years

OBJECTIVE

Recent public awareness of racial and ethnic disparities has again brought to light issues of diversity, equity, and inclusion in the eating disorders field. However, empirical information on racial and ethnic representation in eating disorders research is limited, making it difficult to understand where improvements are needed.

METHOD

This study reviewed all studies including human participants published in the International Journal of Eating Disorders in 2000, 2010, and 2020. Differences in likelihood of reporting race and ethnicity were calculated based on study year, location, and diagnostic categories.

RESULTS

Out of 377 manuscripts, 45.2% reported information on the race and ethnicity of study participants. Studies conducted in the United States were more likely to report (128/173), and those conducted in Europe were less likely to report (5/61) on race and ethnicity than those conducted outside of those regions. Rates of reporting increased from 2000 to 2020. White participants made up approximately 70% of the samples that reported race and ethnicity data. Hispanic participants made up approximately 10% of samples reporting race and ethnicity. Participants from all other races and ethnicities made up less than 5% each.

DISCUSSION

Although rates of reporting race and ethnicity increased over time, most participants were White. Rates of reporting also differed by the geographical region, which may reflect variability in how information on race and ethnicity is collected across countries. More attention toward capturing the cultural background of research participants and more inclusivity in research are needed in the eating disorders field.

Accountability in promoting representation of historically marginalized racial and ethnic populations in the eating disorders field: A call to action

Promoting representation of historically marginalized racial and ethnic populations in the eating disorders (EDs) field among professionals and the populations studied and served has long been discussed, with limited progress. This may be due to a reinforcing feedback loop in which individuals from dominant cultures conduct research and deliver treatment, participate in research, and receive diagnoses and treatment. This insularity maintains underrepresentation: EDs in historically marginalized populations are understudied, undetected, and undertreated. An Early Career Investigators Workshop generated recommendations for change that were not inherently novel but made apparent that accountability is missing. This paper serves as a call to action to spearhead a paradigm shift from equality to equity in the ED field. We provide a theoretical framework, suggest ways to disrupt the feedback loop, and summarize actionable steps to increase accountability in ED leadership and research toward enhancing racial/ethnic justice, equity, diversity, and inclusion (JEDI). These actionable steps are outlined in the service of challenging our field to reflect the diversity of our global community. We must develop and implement measurable metrics to assess our progress toward increasing diversity of underrepresented racial/ethnic groups and to address JEDI issues in our providers, patients, and research participants.

Do measures of healthy eating differ in survivors of early adversity?

Early life adversity has been linked to poor health, including obesity. Understanding the role of unhealthy food intake, may elucidate the importance of self-soothing behaviors in explaining the association between early life adversity and poor health in adulthood. The purpose of this study was to assess the association between early life adversity and dietary quality in a sample of adults from the Lifestyle Influences of Family Environment study. Early life adversity, demographic, and dietary data were obtained for 145 participants using formal interviews and two days of interviewer-administered 24-h recalls. Dietary quality was measured using the 2015 Healthy Eating Index (HEI) scoring algorithm to compute total and component scores. The association between early life adversity and dietary quality was assessed through linear regression and in models adjusted for age and sex. The mean ± SD HEI score for all participants was 54.6 ± 12.8. Individuals with early life adversity had a 4.51 lower overall HEI score when compared to those without early life adversity, 95% CI (0.35, 8.68). After adjusting for age and sex, early life adversity was associated with a 4.6 lower HEI score, 95% CI (0.45, 8.73). HEI component scores indicated that individuals with early life adversity were significantly more likely to have lower whole grain (0.7 versus 2.4) and total dairy (4.3 versus 6.1) scores compared to those without early life adversity. ELA was associated with lower measures of dietary quality. Results warrant future research on dietary and behavioral factors that underly the association between early life adversity and poor health outcomes.

Workforce Diversity in Eating Disorders: A Multi-Methods Study

Despite growing recognition of the importance of workforce diversity in health care, limited research has explored diversity among eating disorder (ED) professionals globally. This multi-methods study examined diversity across demographic and professional variables. Participants were recruited from ED and discipline-specific professional organizations. Participants' (n = 512) mean age was 41.1 years (SD = 12.5); 89.6% (n=459) of participants identified as women, 84.1% (n = 419) as heterosexual/straight, and 73.0% (n = 365) as White. Mean years working in EDs was 10.7 years (SD = 9.2). Qualitative analysis revealed three themes resulting in a theoretical framework to address barriers to increasing diversity. Perceived barriers were the following: "stigma, bias, stereotypes, myths"; "field of eating disorders pipeline"; and "homogeneity of the existing field." Findings suggest limited workforce diversity within and across nations. The theoretical model suggests a need for focused attention to the educational pipeline, workforce homogeneity, and false assumptions about EDs, and it should be tested to evaluate its utility within the EDs field.

Treating Individuals With Eating Disorders: Part 1

According to the American Psychiatric Association, eating disorders (EDs) are characterized by a persistent disturbance of eating or eating-related behaviors that result in altered consumption or absorption of food and that significantly impair physical health and/or psychosocial functioning. EDs are chronic psychiatric illnesses and are notoriously difficult to treat. The etiology of eating disorders is unknown and thought to be a complex interplay among biological predisposition, environmental and sociocultural factors, neurobiological influences, and psychological factors. Moreover, prevalence of eating disorders is increasing despite variation in prevalence estimates across studies. Nurses are well-positioned to implement appropriate screening for and comprehensive assessment of EDs as well as offer patient-centered treatment options including referrals when indicated. As the first in a two-part series, this article provides an overview of the clinical characteristics of EDs and key areas for assessment and diagnostic considerations. The follow-up article in this series will focus on pharmacological treatment strategies. [Journal of Psychosocial Nursing and Mental Health Services, 58(3), 7-13.].

Molecular cloning and expression of human leukotriene-C4 synthase

Leukotriene-C4 synthase (LTC4S; EC 2.5.1.37) catalyzes the committed step in the biosynthesis of the peptidoleukotrienes, which are important in the pathogenesis of asthma. Antibodies were generated to a synthetic peptide based on the partial amino acid sequence previously reported for human LTC4S [Nicholson, D.W., Ali, A., Vaillancourt, J.P., Calaycay, J.R., Mumford, R.A., Zamboni, R.J. & Ford-Hutchinson, A. W. (1993) Proc. Natl. Acad. Sci. USA 90, 2015-2019] and specifically bound detergent-solubilized LTC4S obtained from THP-1 cells, confirming that the published sequence is associated with enzyme activity. Inosine-containing oligonucleotides based on the partial protein sequence were used to isolate a 679-bp cDNA for LTC4S from THP-1 cells. The cDNA contains an open reading frame that encodes a 150-amino acid protein (M(r) = 16,568) that has a calculated pI value of 11.1. The deduced protein sequence is composed predominantly of hydrophobic amino acids; hydropathy analysis predicts three transmembrane domains connected by two hydrophilic loops. Analysis of the deduced sequence identified two potential protein kinase C phosphorylation sites and a potential N-linked glycosylation site. The amino acid sequence for human LTC4S is unique and shows no homology to other glutathione S-transferases. LTC4S was found to be most similar to 5-lipoxygenase activating protein (31% identity, 53% similarity), another protein involved in leukotriene biosynthesis. Active enzyme was expressed in bacterial, insect, and mammalian cells as shown by the biosynthesis of LTC4 in incubation mixtures containing LTA4 and reduced glutathione. The cloning and expression of human LTC4S provide the basis for a better understanding of this key enzyme in peptidoleukotriene biosynthesis.

Secretion of active kringle-2-serine protease in Escherichia coli

Active human tissue plasminogen activator variant kringle-2-serine protease (K2 + SP domains; referred to as MB1004) was synthesized as a secreted protein in Escherichia coli, isolated, and characterized. MB1004 is a relatively large and complex protein, approximately 38 kDa in size and containing nine disulfide bonds. MB1004 without a pro region was secreted into the periplasm of E. coli by fusing the protein to the PhoA leader peptide expressed from the tac promoter. Approximately 1% (20 micrograms/L broth) of the secreted MB1004 was purified from E. coli homogenates as a soluble, active enzyme by using a combination of lysine and Erythrina inhibitor affinity chromatography. Purified MB1004 was monomeric and single-chain, and the N-terminus was identical with the predicted amino acid sequence. The specific activity of purified MB1004 from E. coli was compared against the equivalent recombinant material purified from mammalian cells that was naturally glycosylated (MB1004G) or deglycosylated after treatment with N-glycanase (MB1004N). Results from four different in vitro assays showed that MB1004 and MB1004N had similar activities. Both exhibited 4-12-fold higher specific activity than MB1004G in plasminogen activation assays. These results suggest that an inaccurate picture of specific activity can be obtained if the effects of glycosylation are not considered. By utilization of secretion in E. coli, nonglycosylated MB1004 was purified without in vitro refolding and was shown to be suitable for structure-function studies.

Expression of secreted insulin-like growth factor-1 in Escherichia coli

The synthesis, processing and secretion of insulin-like growth factor-1 (IGF-1 or somatomedin-C) fused to LamB and OmpF secretion leader sequences in Escherichia coli have been investigated. Expression and secretion of IGF-1 was achieved. The major portion of this secreted IGF-1 accumulated in the periplasmic space as insoluble aggregates. A small amount of IGF-1 was found folded in its native conformation in the medium. The lamB and ompF signal sequences were fused to the 5' coding sequence of IGF-1. Fusion of the lamB signal sequence directly to IGF-1 (lamB-IGF-1) resulted in accumulation of 16-20 micrograms/A550/ml of correctly processed IGF-1 in the periplasmic space. The processing efficiency of LamB-IGF-1 and OmpF-IGF-1 was enhanced in an E. coli strain bearing a prlA4 mutation. Amino acid sequence analysis of IGF-1 secreted into the periplasm and exported into the medium confirmed the precise removal of the LamB or OmpF signal sequence. IGF-1 synthesized in E. coli was demonstrated to be active in a cell proliferation bioassay.

Mistranslation in IGF-1 during over-expression of the protein in Escherichia coli using a synthetic gene containing low frequency codons

Partial misincorporation of Lys for Arg has been observed for the Arg residues of IGF-1 when the molecule is expressed in Escherichia coli using a synthetic gene with the low frequency AGA codon encoding all six Arg residues and yeast preferred codons encoding the remaining residues. The Lys for Arg substitution at these residues could not be detected when a gene containing E. coli preferred codons, with the codon CGT coding for all Arg residues, was used for the expression of the protein. Similarly, no misincorporation of Lys for Arg could be detected when a gene containing Escherichia coli preferred codons at all positions, except for an AGA codon at Arg (36), was utilized.