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Health-related quality of life (HRQOL) was explored in a sample of 119 custodial grandparents. A latent profile analysis identified three groups of grandparents along a continuum of good to poor HRQOL, with most custodial grandparents reporting Short Form-12 Health Survey (version 2) scores significantly below U.S. population means. Grandparent and grandchild characteristics that predicted grandparent HRQOL were identified. Grandchild health problems, number of grandchildren in custody, and grandparent education contributed to a moderate reduction in HRQOL. A large reduction in HRQOL was predicted by depression. Differences in depression were reported between groups, with grandparents with poor HRQOL also reporting clinically significant depression, grandparents with fair HRQOL reporting marginally clinically significant depression, and grandparents with good HRQOL reporting no depression. In a qualitative analysis, grandparent conceptualization of what they need to do to maintain and improve their health was explored for each group. Findings from the quantitative analysis indicate variation in grandparent health and mental health status and suggest that services should be tailored to address grandparent needs. The qualitative analysis highlights the importance of religion and spirituality to grandparents, the economic concerns of grandparents, and the need for transdisciplinary services. [ABSTRACT FROM AUTHOR]

Practice doctorate programs are developing rapidly to meet the American Association of Colleges of Nursing recommendation that advanced practice nurses will be prepared with a Doctor of Nursing Practice by 2015. Evaluation of nursing doctoral programs has focused almost exclusively on research doctorate programs. The authors examine formative evaluations from students enrolled in a practice doctorate program and summative evaluations provided by students at the time of and 1 year following graduation. Suggestions for nurse educators and administrators are presented. [ABSTRACT FROM AUTHOR]

Despite the focus on preventing toxic chemical exposures during pregnancy, the perinatal period, and childhood, health professionals have given little attention to the risks and effects of toxic chemical exposures on children with intellectual and developmental disabilities (DD). Children with DD may be at higher risk due to behaviors that persist past a developmentally appropriate age, communication skills, motor skills, nutrition issues, and health problems related to DD. This article examines exposure of children to lead, mercury, and environmental tobacco smoke, three toxicants known to affect children's health and development. The authors identify sources of these toxicants, examine research documenting their effects on children, consider strategies to prevent and manage exposure, identify characteristics and behaviors placing children with DD at increased risk of exposure, and discuss implications for health providers. [ABSTRACT FROM AUTHOR]

A structural equation model (SEM) examined interrelationships among psychosocial variables known to affect the health and development of well siblings and parents when a child with a chronic illness or disability is a member of the family. Using dyads of 252 well children and parents, socioeconomic status (SES) and family cohesion were associated with the parent-reported behavior of the well sibling. SES also influenced the mood of the mother that in turn influenced family cohesion. The well sibling's knowledge about the illness of the brother or sister, attitude toward the illness, mood, self-esteem, and feelings of social support were interrelated and related to the behavior of the well sibling. The SEM suggests that interventions may be directed at several points in these interactions including boosting knowledge levels of the well sibling, improving family cohesion, and assuring adequate 'income' support to the family through income transfers or in-kind services. [ABSTRACT FROM AUTHOR]