The number of studies demonstrating a relationship between religiosity and spirituality and physical and psychological health have increased rapidly during the past decade. There are significant disputes in the literature regarding the methodological quality of research in this area. Despite nursing scholars' interest in this area, no thorough review of the methodological critiques is available. The purpose of this study is to review areas of methodological difficulty in the study of religiosity and spirituality by identifying contemporary methodological critiques, critically evaluating the critiques and the underlying issues, and making suggestions for methodological advancement in the field. Three main areas of methodological critique exist: construct measurement, study design, and data analysis. Research in this area should aim for conceptual clarity, deliberate design, and appropriate analysis. Considerations of these critiques are instructive for nursing research done in the area of religiosity and spirituality.

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Background: Up to 4 million people in Tanzania are at risk for the parasitic disease onchocerciasis. A treatment program, Community-Directed Treatment with Ivermectin (CDTI), has made significant gains in prevention and treatment. Understanding factors affecting participation could help boost treatment coverage and sustain gains made in controlling onchocerciasis in endemic areas. Purpose: To explore community-perceived factors related to participation in and sustainability of the CDTI program in southwest Tanzania. Methods: Multilevel triangulation design using surveys, focus group discussions (FGDs), and semistructured interviews to collect data in two villages in the Morogoro Rural District of Tanzania. In total, 456 villagers participated in the survey and 42 in FDGs. Five community-directed distributors (CDDs) and three community health workers were interviewed. Findings: High levels of awareness of onchocerciasis (90%) and methods of prevention and treatment (95%) were reported. Over 75% of participants knew how ivermectin was distributed and 74% have taken the drug. Over 90% of villagers knew that distribution of the drug was for treatment and prevention. Only 43% knew the cause of onchocerciasis. Through FGDs, villagers reported barriers to participation, including lack of comprehensive understanding of the disease, fears of medication, distrust of the method determining dose, lack of health education materials, insufficient CDD-resident communication, and inflexible drug distribution mechanisms. Conclusions: Sustaining programs without supporting growth of CDDs and reinforcing education of communities could lead to a decrease in treatment and an increase in the public health threat. This research uncovered a need for more effective community education and sensitization. Clinical Relevance: Understanding barriers to participation in communitybased programs can assist public health and community health nurses and key stakeholders including Ministries of Health and local and regional health systems in the development of education and support materials to enhance health literacy and encourage program participation.

The aim of this study was to conduct a longitudinal test of an explanatory model of depression, where religiosity and/or spirituality (R/S) represents a potentially protective factor in college students in the USA. A Web-based survey was administered monthly to 214 students from religious and public colleges. At 1 month and 6 months, the measures of R/S, depression, stress, and cognitive vulnerability were administered. Between 2 and 5 months, only the measures of stress and depression were administered. The data were analyzed to test the hypothesis that R/S buffers the effect of stress on depression over time in the context of cognitive vulnerability. The results supported a direct and protective effect over time between R/S and depression, but a buffering effect on the relationship between stress and depression was not found. Although all aspects of R/S were demonstrated to protect the participants from depression, it did not appear that the relationship between R/S and stress or R/S and cognitive vulnerability explains this relationship. Nurses who are working with college students should take holistic approaches to their emotional difficulties, realizing the potentially beneficial effects of students' religiousness or spirituality.

Depression during the transition from late adolescence to young adulthood is a major mental health concern. Developmental theories addressing this transition, also called emerging adulthood, are few, and fewer yet are theories addressing mental health or psychopathology during this period. This article establishes the legitimacy of emerging adulthood as a unique developmental period and attempts to generate directions for theory development by merging theories of depression and development at the point of emerging adulthood. This article concludes with a theoretical discussion and application of this process in research and practice.

Spirituality is salient to persons nearing the end of life (EOL). Unfortunately, researchers have not been able to agree on a universal definition of spirituality reducing the effectiveness of spiritual research. To advance spiritual knowledge and build an evidence base, researchers must develop creative ways to describe spirituality as it cannot be explicitly defined. A literature review was conducted to determine the common attributes that comprise the essence of spirituality, thereby creating a common ground on which to base spiritual research. Forty original research articles (2002 to 2012) focusing on EOL and including spiritual definitions/descriptions were reviewed. Analysis identified five attributes that most commonly described the essence of spirituality, including meaning, beliefs, connecting, self-transcendence, and value.

Minority religious groups continue to grow in the United States, and traditional religious groups are becoming more diverse. The purpose of this paper is to detail the methodology of the measure adaptation and psychometric phase of an ongoing study that is designed to describe the relationship between R/S, emotional extremes, and risk behaviors in Christian, Jewish, and Muslim high school students as they transition to college. Unique challenges associated with measurement, recruitment, and research team dynamics were encountered. These challenges and possible solutions are discussed in the context of conducting research that focuses on religious minority groups.

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