bluuebunny/crossref_metadata_2025 huggingface dataset:
The stability of osumilite in metapelitic granulites
Authors: CARRINGTON D. P. , HARLEY S. L.
Published: May 2007

Abstract
A petrogenetic grid and related diagrams derived from KFMASH‐system experiments demonstrate that osumilite is stable in relatively magnesian bulk rock compositions (XMg > 0.6) at temperatures in excess of 875° C and pressures less than 11 kbar. The experiments, involving the dehydration melting of biotite in synthetic metapelites, were conducted in the range 850–1000° C. Both the mineral assemblages and phase compositions reported from well‐documented natural examples of osumilite‐bearing rocks are reproduced by the experiments at P‐T conditions similar to those previously estimated for these occurrences. Peak metamorphic P‐T conditions can be reliably inferred from distinctive osumilite‐bearing assemblages identified in the phase diagrams, thereby avoiding the problems of diffusional re‐equilibration that often prohibits conventional geothermobarometry from recovering peak conditions. Integration of the experimental data with recent independent experiments, after correcting the latter for an underestimated friction correction, allows extension of the petrogenetic grid to higher temperatures. The extended grid is applied to assess and refine the metamorphic history of the Napier Complex, East Antarctica: the high‐P stability limit for osumilite in the Napier Complex is 9–10 kbar, the prograde P‐T‐t path is not necessarily anticlockwise and isobaric cooling in the Scott and Tula mountains occurred, respectively, at pressures greater and less than reactions in the range 8–9 kbar. The stability range for osumilite predicted by the KFMASH‐system petrogenetic grid overlaps many more metamorphic terranes than osumilite is found in. Whilst osumilite is not distinctive in thin section and is prone to retrogression, it is possible that carbon dioxide present in the natural system stabilizes cordierite at the expense of osumilite.
Conditions of contact metamorphism, Papoose Flat Pluton, eastern California, USA: implications for cooling and strain histories
Authors: NYMAN M. W. , LAW R. D. , MORGAN S. S.
Published: May 2007

Abstract
Petrological study of highly strained carbonate and pelitic rocks within the contact aureole surrounding the western part of the Papoose Flat pluton yields thermal profiles (plots of metamorphic temperature versus distance) across the aureole that show temperature gradients which are relatively flat and narrow (<100m). The gradients occur close to the contact and indicate a slight decrease in temperature from 500–550°C at the pluton/wall rock contact to 450–500°C at the outer margin of the aureole. One thermal profile across low‐strain metasedimentary rocks located in the southern part of the aureole shows that thermal effects from emplacement extend no further than 600 m from the contact. Coexistence of andalusite and cordierite in pelitic rocks of the aureole constrain pressures to <4 kbar. Thermal modelling using an analytical solution of the conductive heat flow equation for a rectangular‐shaped pluton reproduces the observed thermal maxima and profile shape. Conductive rather than convective cooling also is supported by isotopic and field evidence for limited fluid flow along the strongly deformed margin of the pluton. Simple thermal models coupled with observed high‐temperature deformation features and a measured 90% attenuation of stratigraphic units in the plastically deformed western part of the pluton's aureole indicate that strain rates may have been of the order of 10‐12s‐1. Evidence for episodic heating, such as two distinct generations of andalusite growth in pelites from the aureole, alternatively may indicate a longer heating event and, therefore, slower strain rates. Thermal models also indicate that parts of the pluton still may have been above the solidus during deformation of the pluton margin and aureole.
Retrograde metamorphic reactions in deforming granites and the origin of flame perthite
Authors: PRYER L. L. , ROBIN P.‐Y. F.
Published: May 2007

AbstractMicroprobe analyses of feldspars in granite mylonites containing flame perthite give compositions that invariably plot as three distinct clusters on a ternary feldspar diagram: orthoclase (Or92–97), albite and oligoclase‐andesine. The albite occurs as grains in the matrix, as flame‐shaped lamellae in orthoclase, and in patches within plagioclase grains.

We present a metamorphic model for albite flame growth in the K‐feldspar in these rocks that is related to reactions in plagioclase, rather than alkali feldspar exsolution. Flame growth is attributed to replacement and results from a combination of two retrograde reactions and one exchange reaction under greenschist facies conditions. Reaction 1 is a continuous or discontinuous (across the peristerite solvus) reaction in plagioclase, in which the An component forms epidote or zoisite. Most of the albite component liberated by Reaction 1 stays to form albite in the host plagioclase, but some Na migrates to form the flames within the K‐feldspar. Reaction 2 is the exchange of K for Na in K‐feldspar. Reaction 3 is the retrograde formation of muscovite (as ‘sericite’) and has all of the chemical components of a hydration reaction of K‐feldspar. The Si and Al made available in the plagioclase from Reaction 1 are combined with the K liberated from the K‐feldspar, to produce muscovite in Reaction 3. The muscovite forms in the plagioclase, rather than the K‐feldspar, as a result of the greater mobility of K relative to Al. The composition of the albite flames is controlled by both the peristerite and the alkali feldspar miscibility gaps and depends on the position of these solvi at the pressure and temperature that existed during the reaction. Using an initial plagioclase composition of An20, the total reaction can be summarized as:

20 oligoclase + 1 K‐feldspar + 2 H2O = 2 zoisite + muscovite + 2 quartz + 15 albiteplagioclase+ 1 albiteflame.

This model does not require that any additional feldspar framework be accreted at replacement sites: Na and K are the only components that must migrate a significant distance (e.g. from one grain to the next), allowing Al to remain within the altering plagioclase grain. The resulting saussuritization is isovolumetric.

The temperature and extent of replacement depends on when, and how much, water infiltrates the rock. The fugacity of the water, and therefore the pressure of the fluid, may have been significantly lower than lithostatic during flame growth.
Evolution of fluid pressure and fracture propagation during contact metamorphism
Authors: DUTROW B. , NORTON D.
Published: May 2007

Abstract
Rock fracture enhances permeability and provides pathways through which fluids migrate. During contact metamorphism, fluids contained in isolated pores and fractures expand in response to temperature increases caused by the dissipation of heat from magmas. Heat transport calculations and thermomechanical properties of water‐rich fluids demonstrate (1) that thermal energy is a viable mechanism to produce and maintain pore fluid pressure (Pf) in a contact metamorphic aureole; (2) that the magnitude of Pf generated is sufficient to propagate fractures during the prograde thermal history (cause hydrofracture) and enhance permeability; and (3) that Pf‐driven fracture propagation is episodic with time‐scales ranging from years to thousands of years. Because Pf dissipation is orders of magnitude faster than P, f buildup, Pf oscillations and cyclical behaviour are generated as thermal heating continues. The Pf cycle amplitude depends on the initial fracture length, geometry and the rock's resistance to failure whereas the frequency of fracture depends on the rate of heating. Consequently, oscillation frequency also varies spatially with distance from the heat source.

Time series of fluid pressures caused by this process suggest that cyclical fracture events are restricted to an early time period of the prograde thermal event near the intrusive contact. In the far field, however, individual fracture events have a lower frequency but continue to occur over a longer time interval. Numerous fracture cycles are possible within a single thermal event. This provides a provisional explanation for multiple generations of veins observed in outcrop.

P
f cycling and oscillations may explain several petrological features. If pore fluids are trapped at various positions along a pressure cycle, the large amplitude of Pf variations for small fractures may account for different pressures recorded by fluid inclusions analysed from a single sample. Pf oscillations, during a single thermal episode, also drive chemical reactions which can produce complex mineral textures and assemblages for discontinuous reactions and/or zoning patterns for continuous reactions. These can mimic polymetamorphic or disequilibrium features.

Temporal aspects of fracture propagation and permeability enhancement also constrain the likely timing of fluid flow and fluid‐mineral interactions. These data suggest that fluid flow and fluid‐mineral reactions are likely to be restricted to an early period in the prograde thermal history, characterized by high Pf coincident with relatively high temperatures, fracture propagation and consequent increases in permeability. This early prograde hydration event is followed by diffusional peak metamorphic reactions. This relationship is evident in the complex mineralogical textures common in some metamorphosed rocks.
Phase petrology and P‐T conditions of mafic blueschists from the Meliata unit, West Carpathians, Slovakia
Authors: FARYAD S. W.
Published: May 2007

Abstract
Blueschists occurring as layers in calcite marbles of the Meliata unit occur along the so‐called Roznava tectonic line situated in the southern part of the Gemericum, Slovakia. Mineral assemblages and compositions from seven blueschists localities and one occurrence of amphibolite facies rocks overprinted by blueschist metamorphism were investigated. The most common minerals in the blueschists are blue amphibole, epidote and albite. Some Fe2+‐ and Al‐rich rocks also contain garnet and chloritoid, respectively. Na‐pyroxene with a maximum 50% jadeite component was also found. The blue amphiboles correspond mostly to crossite and also to glaucophane and ferroglaucophane in some samples. Almandine‐ and spessartine‐rich garnet has very low MgO content (<3 wt%). The Si content in phengite ranges between 3.3 and 3.5 pfu calculated on the basis of 11 oxygens. The zoning patterns of blue amphibole, garnet and chloritoid suggest their formation during a prograde stage of metamorphism. The P‐T conditions of metamorphism are estimated to be about 380–460° C and 10–13 kbar. Pressures of 7.5–8.5 kbar and temperatures of 350–370° C were obtained for some actinolite‐ and aegirine‐rich rocks. Apart from chlorite, other mafic minerals formed during retrograde metamorphism are biotite and occasionally also actinolite.
Post‐entrapment modification of fluid inclusions due to overpressure: evidence from natural samples
Authors: BARKER A. J.
Published: May 2007

Abstract
Effects of post‐entrapment fluid‐inclusion modification are examined with reference to retrogression‐related quartz veins from the Caledonian, Øse Thrust, northern Norway. The inclusions occur in secondary trails, and contain high‐density hypersaline aqueous fluids. On morphological characteristics, they are subdivided into, Type A: elongate, ellipsoidal and/or irregular inclusions, and Type B: more equant, regular, and/or negative crystal form. With reference to previous research on post‐entrapment modification of inclusions in quartz it is proposed that Type A inclusions experienced little or no post‐entrapment modification, whereas Type B inclusions show features characteristic of post‐entrapment permanent inelastic stretching and/or leakage. This produces increased homogenization temperatures (Th), associated with increased inclusion volume and lowering of density, whilst maintaining constant salinity. The similarity of data for degree of fill and salinity between Type A and Type B inclusions indicates that Type B inclusions have primarily modified by stretch rather than leakage. However, the spread towards slightly larger volume of vapour in Type B inclusions suggests that some leakage has also occurred. Because stretched and/or partially leaked inclusions have increased Th, isochore projections significantly underestimate trapping pressure (Pt) relative to unmodified inclusions. Therefore, recognition of post‐entrapment inclusion modification due to overpressure is crucial to avoid misinterpretation of data, but has considerable potential for constraining the detail of P‐T trajectories of individual rocks. On this basis, rocks from the Øse Thrust zone, north Norway, are shown to have experienced rapid uplift on a ‘clockwise’P‐T‐t path during the final stages of Caledonian (Scandian) orogenesis.
Community Health Diagnosis in Nursing
Authors: Muecke Marjorie A.
Published: May 2007

A review of the historical evolution of the concept of community health diagnosis in nursing identifies sources of ambiguity that have impeded making the goals and values of community health nursing operational. Refinements of meaning in the conceptualization of the community health diagnosis that focus upon the community as the primary level of analysis are suggested. Implications of this reconceptualization of the practice of community health nursing are considered in guidelines for developing community health diagnoses and in an example of the diagnosis of a Mien refugee community's responses to health problems.
The Development of Mental Health Consultation to a Foster Care Placement Agency
Authors: Pearson Geraldine Sanner
Published: May 2007

This paper describes the demographic data of latency‐aged foster children and the reasons for their placement away from birth parents. It also discusses the particular behavior and psychiatric problems that might precipitate referral to a mental health clinic. It then details a program developed to assess and treat those children having minimal involvement of foster or birth parents in their therapy. A consultation/collaboration model theorized by Caplan is applied to the program that developed. A case example is given and the roles of caseworker and mental health clinician are examined.
PRIMARY HEALTH CARE AN ANSWER TO THE DILEMMAS OF COMMUNITY NURSING?
Authors: Goeppinger Jean
Published: May 2007

Some issues that are salient to contemporary community nursing practice, including goals, levels of practice, roles, and settings are presented. Different positions on each issue are discussed. The opportunities offered for resolution of these issues by the construct of primary health care, as defined by the World Health Organization (Director‐General's Report, 1975), are emphasized.
The Importance of Influencing Nursing Students' Attitudes Toward Older Adults
Authors: Rose Molly A.
Published: May 2007

The purpose of this quasi‐experimental study was to determine if a course in gerontology would improve baccalaureate senior nursing students' attitudes toward older adults and increase their interest in working with older persons as clients. The course concentrated on aging as a positive experience. Clinical experience involved health assessment and health promotion with well older people in their homes and in senior citizen centers. Attitudes of students who were enrolled in the course were compared to those of fellow classmates who were not. As predicted, those who participated in the gerontologic course scored significantly higher on a “facts on aging” quiz and showed a more positive net bias toward older adults than the control group. Their interest in working with older people also increased. More emphasis must be placed on decreasing stereotype attitudes of nurses. Those who view the older adult in a more positive image will be increasingly likely to become involved in program planning and research in the area of health promotion and disease prevention for the older population.
Networking
Authors: Puetz Belinda E.
Published: May 2007

Networking involves establishing and using contacts for information, support, and other assistance in order to achieve career goals. Public health nurses must understand the concept, process, and techniques of networking. There are do's and don'ts for effective networking, as well as methods of organizing nurses' networking efforts. The basics of this enjoyable and practical way to get ahead in the profession and to help others at the same time are presented.
Gerontologic Primary Care: A Community‐Centered Experience for Nursing Students
Authors: Hudson Margaret F.
Published: May 2007

The mismatch between the American health care system and the health care needs of our older adults is well documented (Butler, 1975; Schwab, 1977). All too often, available services are oriented to acute care, fragmented, poorly coordinated, and not readily accessible. Meeting the complex health care needs of our older adults is a major challenge to our ingenuity and resourcefulness, especially in light of the fact that American health care expenditures have reached 10 percent of our gross national product. This article tells of one approach to help alleviate this problem.
The Poor: A Population at Risk
Authors: Pesznecker Betty L.
Published: May 2007

This paper formulates an updated, multidimensional model of poverty and discusses nursing research and practice implications based on the model. The older, traditional cultural and structural models of poverty are compared and contrasted with special attention to the perpetuating impact of stigmatization. From analysis of the older views of poverty, an updated model is proposed that emphasizes investigation of inter‐relationships among environmental, individual/group, and mediating factors. Drawing from concepts of social learning theory, maladaptive and adaptive responses to the situational environments of the poor are explored. There is a focus on the major emotional responses to poverty such as depression, anomie, feelings of powerlessness, and low self‐efficacy. Finally, specific nursing interventions for the client as well as at higher political levels are assessed.
Use of an Ecologic Model to Identify Children at Risk for Infection and to Quantify the Expected Impact of the Risk Factors
Authors: McFarlane Judith
Published: May 2007

Infection and malnutrition and the effects of their interaction account for the majority of childhood deaths and chronic deficits in growth and development in Latin America. To promote child heath, the determinants of infection and malnutrition must be identified and cost‐effective interventions applied.

Medical examinations of 988 children (age 2 weeks to 14 years) living at three altitudes in northem Chile revealed that 393 (40%) of the youngsters harbored one or more infections. When sorted by region and ethnicity, indigenous children of the highlands had infection rates 50 percent higher than those of Spanish descent living near the coast.

An ecologic model was used as an organizing framework to illustrate the relationships among variables. Measurement of these variables revealed that health, age, and education of the mother were statistically significant predictors of child health, as were the child's nutrient intake and medical history. Traditional measurements of child health (weight, height, family wealth, and paternal occupation) did not differentiate between well and infected children.

Policy implications are suggested for further validation. To focus on selected child health needs, such as feeding programs or immunization campaigns, without simultaneously attending to the environment from which the needs arise could be an inappropriate use of time, personnel, and money.
A Community ‐Based Support Group for Families and Patients After Acute Coronary Disease
Authors: Mallick M. Joan
Published: May 2007

A community‐based support group has been organized for patients with coronary disease and their families. Participants differed from those in other groups because an extensive amount of time had elapsed between their first coronary event and their becoming active in the group. While many of the issues raised resembled those addressed by similar groups described elsewhere, the support patterns used by participants were also different. Of most significance was the fact that the patients were able to support their spouses and relieve long‐standing anxiety. Implications for public health nursing include the development of groups for these chronically ill patients, focusing on the needs of the spouses, and structuring groups to encourage mutual support.
Social Resources, Health Resources, and Preventive Health Behavior: Patterns and Predictions
Authors: Kulbok Pamela Porter
Published: May 2007

This study was designed to test the resource model of preventive health behavior (PHB) that incorporates social and health resources as causes of good health habits. The findings were based on survey data collected in 1979 on a national probability sample of 3,025 adults. Factor analysis was used to construct indexes of PHB and of health. Five PHB factors were regressed on education and income; on three health factors; and on control variables age, sex, and race. The model predicted dental and fitness factors. Higher education and the health factor of better health comparison consistently predicted the PHB factors. It was concluded that several types of PHBs are unrelated to one another and that the causes of these specific PHBs do vary.
Nursing and Medicine: Complementary Modes of Thought and Action
Authors: Pridham Karen F. , Hansen M. F.
Published: May 2007

This paper explores collaborative practice by examining the modes of thought and action that nursing and medicine use in dinical problem solving. The characteristics that define and differentiate nursing and medicine establish the perspectives of the professions, and these perspectives contribute to and limit the two different ways of interpreting reality. In collaborative practice, the set of problems defined by a specific client and by each discipline becomes part of the context of clinical problem solving for both nurses and physicians. Means are suggested to clarify the process of nursing assessment or diagnosis and its relationship to corresponding processes in medicine. Such analysis helps to define the contributions that nursing makes to health care.
Public Health Nursing for America's Children
Authors: Berkseth Janet Kempf
Published: May 2007

By history, public health nursing and child health have been closely connected With current health problems of children and the need for childhood prevention of adult problems, the need for this connection continues. The Minnesota model for public health nursing can be applied to conceptualize the needed education and practice.
Establishing Mutual‐Help Groups for Family‐Member Care Givers: A New Role for Community Health Nurses
Authors: Pesznecker Betty L. , Zahlis Ellen
Published: May 2007

Today, an ever increasing percentage of the population is becoming elderly. As a result, the number of families becoming involved in caring for an elderly relative is also increasing. These family care givers are at risk for developing emotional and physical problems brought about by stresses and strains inherent in this role. Community health nurses are in a unique position to support these persons by creating mutual‐help groups. Such groups help to supply care givers with a forum for continuing problem solving and inform them of resources available within the community.
Practicing Autonomously: A Comparison of Nurses
Authors: Wood Joan E. , Tiedje Linda Beth , Abraham Ivo L.
Published: May 2007

Forty‐five subjects including community health nurses with baccalaureate nursing degrees, senior‐level generic nursing students, and registered nurses in a baccalaureate nursing program were compared on age, years of employment in nursing, and three variables of professional autonomy: nurses' rights and responsibilities, the nurse‐patient relationship, and nurses' role in health care delivery. It was predicted that nurses from baccalaureate programs and those practicing in community health nursing would perceive themselves as more autonomous and that age and years of employment in nursing would not appreciably alter perceptions of autonomy. An analysis of variance confirmed the initial prediction at the 0.01 level of significance or better for nurses' rights and responsibilities and their role in health care delivery. A significant negative correlation was obtained between age and nurses' rights and responsibilities for the community health nurses; a significant positive correlation was obtained between years of work experience and nurses' rights and responsibilities for only the registered nurses. This study is perceived as an initial step in a lengthy process aimed at identifying factors that influence nurses' perceptions about professional autonomy.
An Evaluation of Consistency in Baccalaureate Public Health Nursing Education
Authors: Blank Jacqueline J. , McElmurry Beverly J.
Published: May 2007

A national study was conducted to determine the public health nursing content and clinical experiences faculty include in the baccalaureate preparation of nurses and the degree of consistency that exists among these programs. The concept of professionalism provided a framework for determining standardization in educational preparation. Data were collected using a mailed questionnaire distributed to all National League for Nursing‐accredited baccalaureate programs and completed by the person responsible for the public health nursing curriculum. The questionnaire obtained information related to theory and practice objectives. A response rate of 82 percent (n= 275) was obtained after follow‐up mailings and telephone calls. Content analyses of responses allowed us to identify curricular components most and least emphasized in baccalaureate public health nursing education as well as a core curriculum in public health nursing. Overall, the nursing educators were more consistent in the emphasis placed on areas of clinical competence than on public health nursing concepts. Public health nursing educators are encouraged to consider what constitutes the theoretical base for public health nursing practice.
Life with a New Baby: Stressors, Supports, and Maternal Experience
Authors: Pridham Karen F. , Egan Kathleen Batato , Chang Audrey S. , Hansen Marc F.
Published: May 2007

The context in which mothers of new infants solve problems of infant care tasks includes day‐to‐day stressors and supports. Both may be a function of maternal experience in the form of parity or time since the infant's birth. Our short‐term (90‐day) longitudinal study explored the nature of the stressors and supports that mothers report in the infant's first three months, and examined their relationship to maternal experience. It was organized as six 15‐day periods to explore change over time.

The stressors and supports recorded in the daily log that 62 mothers kept were coded in seven classes structured by the mothers' own language. In addition, they were coded using a second scheme as either existential (conditions, activities, or events of being) or social. Supports were almost equivalent in mean frequency to stressors throughout the 90 days. Four of the seven classes were more likely to be reported as stressors than supports. For both stressors and supports, the existential type was more frequent than the social type. Although overall, stressors and supports decreased significantly across the six periods, three support classes (activities/plans, behavior of self and others, and conditions) and three stressor classes (tasks/responsibilities, conditions, and events) did not change significantly. For all six periods, the relationship of stressors and supports, over all classes, was strong and positive.
The Family as the Unit of Care in Nursing: A Historical Review
Authors: Whall Ann L.
Published: May 2007

Current discussions of nursing theory identify the metaparadigm of nursing as focused upon person, environment, health, and nursing. Literature was reviewed to determine if historical and current sources supported the understanding that the family as recipient of care was a continuing nursing focus. The review supported the contention that the family unit has been an early, continuing, and ever increasing focus of nursing care. Public health nursing was the first clinical area to emphasize service to families, and this continuing emphasis is evident for this practice area. The conclusion is drawn that if the family is now deemphasized as a unit of analysis and care, an historically important focus will be abandoned.
Migrant Farm Workers' Perceptions of Support Persons in a Descriptive Community Survey
Authors: Smith Linda Schoonover , Gentry David
Published: May 2007

This descriptive study was designed to identify those people North American black migrant farmworkers in eastern North Carolina considered to be supportive. The sample included 96 black male and female migrant workers between 18 and 60 years of age. Face to face interviews were conducted by seven interviewers in migrant camps in three rural counties and one migrant health center. The questionnaire consisted of 23 multiple choice questions and described supportive persons sought out by farmworkers to consult about concerns over personal or health problems. The majority of the farmworkers perceived that the crewleader was the one person in the camp that farmworkers turned to for help. The nursing implications of this dependent relationship are discussed, and strategies to strengthen supportive relationships for farmworkers are described.
The Health of Teenagers: A Focused Ethnographic Study
Authors: Magilvy Joan K. , McMahon Marty , Bachman Marty , Roark Susan , Evenson Christine
Published: May 2007

This study, a focused community analysis, was conducted to determine the health needs and status of the aggregate of school‐aged adolescents (13–18 years) using a method combining an epidemiologic approach with an ethnographic field method. Health was defined broadly, assumed to be interrelated with environmental, economic, social, educational, and cultural variables influencing adolescent life. The research involved five steps: collection of available secondary epidemiologic and census data; interviews with key informants, such as teachers, parents, school nurses, and other adults working with teenagers; participant observation and ethnographic interviews with primary informants, that is, teenagers from a variety of backgrounds; and finally, analysis and reporting of secondary and ethnographic data. Of the many themes generated in the data collection, four are reported here: lifestyle, health, pregnancy, and substance abuse. Findings included a typology of subgroups of the adolescent population that influenced lifestyles and led to different attitudes toward health, pregnancy, and substance abuse. The ethnographic approach facilitated an understanding of the health needs and attitudes of teenagers, implying a need for altered interventions and approaches by adults teaching and caring for them.
Construct Validity of a Clinical‐performance‐evaluation Tool in Community Health Nursing
Authors: Rudolph Elizabeth , Kaiser Katherine A. , Corrigan Marjorie J.
Published: May 2007

An evaluative research study was conducted to examine the construct validity and applicability of a selected clinical‐performance‐evaluation tool. The tool was designed for baccalaureate students in a community health nursing course. Eighteen senior students functioning in two urban clinical agencies participated in the study. Data were collected at two evaluation points over one semester. Results indicated strong support for construct validity of the tool. This finding suggests a high level of correlation between theoretical concepts and clinical practice. Recommendations for use of the clinical performance evaluation tool are discussed.
Public Health Nursing Model for Contact Follow‐up of Patients with Pulmonary Tuberculosis
Authors: Kellogg Bonnie , Dye Charlene , Cox Karen , Rosenow Greta
Published: May 2007

Contact follow‐up for patients with pulmonary tuberculosis is an important component in the control of this communicable disease. In two recent cases, district public health nurses used a model that resulted in 100 percent compliance in the initial screening of industrial contacts to contagious pulmonary tuberculosis. Seven factors are believed to have contributed to this success rate. This approach to case management seems valuable, since compliance in follow‐up is a major obstacle in the control of the disease.
Urinary Incontinence in Women
Authors: Brink Carol A. , Wells Thelma J. , Diokno Ananias C.
Published: May 2007

The majority of 200 women in community living between the ages of 55 and 90 described themselves as having some degree of uncontrolled urine loss. They reported severe wetting (63%) on a daily basis (69%), and most (56%) had had the problem for more than five years. These women completed the diagnostic phase of a treatment‐evaluation program currently in process.
Community Health Assessment and Program Planning in the Nurse Practitioner Curriculum: Evaluation of a Guided Design Learning Module
Authors: Selby Maija L. , Tuttle Dorothy M.
Published: May 2007

A 14‐hour learning module based on the Guided Design method was developed to teach community health assessment and program‐planning skills to nurse practitioner students. The module was developed because students in the program, part of a master's‐level community health nursing major, viewed community skills as irrelevant to their role. The module was implemented for two consecutive classes (n= 19) and was evaluated through a quasi‐experimental design that measured changes in (1) students' attitudes toward community health assessment and program planning as part of the nurse practitioner role, and (2) their ability to conduct community health assessment and program planning. Upon completion of the Guided Design module, all students satisfactorily assessed a real community and planned a health program to meet a community need, and they reported highly significant (P< 0.001) improvements in their attitudes toward these aspects of the nurse practitioner role.
Nursing in Cuba: Population‐focused Practice
Authors: Swanson Janice M.
Published: May 2007

Cuba, faced with an inadequate health care system at the time of its 1959 revolution, has brought about major health care reforms. Marked change in health status has occurred through the evolution of broader social change and the geographic distribution of health care to the entire population. The country was recently recognized as already having met the World Health Organization's mandate of “health for all by the year 2000,” and community health nursing has played a major role in achieving this goal. Cuba has implemented population‐focused community health nursing practice, an approach to improve the health of the entire community.
Long‐term Approaches to End Homelessness
Authors: Francis Marion B.
Published: May 2007

Using an epidemiologic framework, this article discusses the reports of two national conferences and the literature to describe homelessness as a consequence of poverty, alcoholism, mental illness, and family turmoil; power‐lessness; and an unsupportive, hostile environment, where the demand for affordable housing exceeds the supply. Nurses are urged to advocate for legislation to create more affordable housing as the first priority of public policy, and also address other long‐term approaches to end homelessness.
Characteristics of Medicare‐Eligible Home Care Clients
Authors: Pasquale Debra K.
Published: May 2007

Abstract Providers, consumers, and legislators seem to agree that today's home care population is older and sicker; however, very few data are available on what characterizes today's Medicare home care clients. This descriptive study was designed to identify the characteristics of Medicare‐eligible home care clients, and define the scope and complexity of health‐related problems in this group. Data were collected by retrospective review of 100 randomly selected clinical records from a large not‐for‐profit home care agency. Findings showed that chronic health care problems predominated, that over half of the sample had at least moderate functional impairment, the female recipients tended to be older and rely on informal caregivers, that females were usually more functionally impaired than males, and that wives usually provided care to male clients. The findings demonstrate that the Medicare home care population is not monolithic, but a diverse aggregate that may have age and gender variants.
Reliability and Validity Testing of a Home Health Patient Classification System
Authors: Churness Vivian Hayes , Kleffel Dorothy , Onodera Marlene L. , Jacobson Joan
Published: May 2007

Abstract Home health agency nurses are caring for greater numbers of acutely ill patients than ever. Because patient requirements are so diverse, it has become difficult to predict the amounts and types of nursing care specific patients must have. To meet the need for a means of quantifying nursing care requirements in a home health setting, a patient‐classification system was developed by the authors. The purpose of the present study was to test the reliability and validity of the system in actual use. Staff nurses in the Visiting Nurse Association of Los Angeles, Inc, completed patient classification forms for 408 home visits. Seventy‐five of these visits were then scored by a second nurse who used patients' medical records as a data source. Agreement between raters ranged from 35 to 100 percent for specific instrument items. When patients were classified into one of five groups, 69 percent of the visits were accurately predicted. Using this information, the instrument was revised and is currently undergoing further field testing in the agency.
Role Supplementation as a Nursing Intervention for Alzheimer's Disease: A Case Study
Authors: Kelley Lisa Skemp , Lakin Jean A.
Published: May 2007

Abstract With a long‐term chronic illness, family structure and functioning often become impaired. Family members require assistance in understanding the nature and progression of the illness, and in assuming new roles to preserve the stability of the family unit. This case study describes how a community health nurse used role supplementation to assist one family effectively to cope with the changes associated with Alzheimer's disease.
Mothers' Perceptions and Use of Community Health Services During the Postpartum
Authors: Rovers Ria , Isenor Liz
Published: May 2007

Abstract This exploratory study examined the perceptions and use of services provided by community health nurses (CHNs) for two groups of rural mothers sampled one year apart. The stratified samples (30 primiparas, 20 multiparas in each group) consisted of mothers who had normally delivered a healthy, full‐term infant in a small regional hospital. A short‐term, longitudinal design was used to determine mothers' pre‐discharge perceptions of the need for services provided by CHNs; perceptions and use of services at one week postdis‐charge and six weeks' postpartum; and variables related to mothers' willingness to initiate seeking information/support from CHNs. All but two mothers had received at least one CHN visit by six weeks' postpartum. The majority were positive about these visits. Most identified a general checkup of the baby or a check of the weight or cord as the most useful services. Only 32 and 26 percent of the women, respectively, had initiated contact with their CHN during this time, and active information seeking was not significantly related to their reports of problems during the postpartum. Mothers tended to rely more on their traditional family networks and reading, and less on their doctors and the CHN for informational support during the postpartum. Mothers' degree of familiarity with CHNs was an important variable in initiating contact. These and related findings suggest the importance of clarifying the role of CHNs to the public, and of recognizing the importance of the interpersonal dimension of that role.
Novice Home Visitors Teaching/Learning Needs
Authors: Davis Janet Haggerty , Deitrick Emily Posey
Published: May 2007

Abstract The objective of this study was to identify the perceptions of novice home visitors of their initial home visits to families in the community. Thirty‐four senior‐level public health nursing students completed a 16‐item questionnaire on previsit expectations and postvisit evaluations. Content analysis revealed that most students were anxious about making their first visit and felt insecure in the home visitor role. In general, they perceived the visit as successful if therapeutic rapport was established with a family. Social learning theory was used to explain students' teaching/learning needs related to the sequential nature of mastering the home visitor role. The results suggest that novice home visitors would benefit from structured preparation strategies derived from social learning theory.
The Fit of Elder Abuse with the Family Violence Paradigm, and the Implications of a Paradigm Shift for Clinical Practice
Authors: Phillips Linda R.
Published: May 2007

Abstract Elder abuse is one of the most complex, difficult, and frustrating problems that practicing public health nurses face. In part this frustration is related to the lack of fit between the family violence paradigm (the explanatory base most commonly used to guide case identification and intervention) and the types of abuse most commonly encountered. Several issues are raised when this paradigm serves as the exclusive basis for concepts about elder abuse. A more comprehensive view is possible when this problem is placed in the context of a family caregiving paradigm.
Home Care Nursing: A View From the Field
Authors: Myers Margaret B.
Published: May 2007

Editor's Note A year ago Public Health Nursing published special content on home health care (4:2, June 1987). This past year has seen the crisis in home care escalate. Medicare claims denials are soaring. This year there are fewer home care agencies than there were a year ago, particularly voluntary agencies. This means patients, especially those without a payment source, are going without needed care. A recent conversation with a colleague gave rise to the following editorial. It is an eloquent, powerful statement about home care nursing as seen through the eyes of a practicing home care nurse. This guest editorial is adapted from Margaret Myers's “Report to the Subcommittee on Workplace and Salaries of the Governor's Task Force on the Nursing Shortage” for Connecticut. Its message is universal. I invite readers to respond through letters, which might comprise a special section in a future issue.

S.L.S.
Cultural Relativity and Poverty
Authors: Martin Miriam E. , Henry Marshelle
Published: May 2007

The nurse who practices from a perspective of cultural relativity attempts to understand client behaviors within the context of the clients’culture. Viewing customs (behaviors) as a reflection of client beliefs and values can enhance the nurse's effectiveness with clients in poverty. This paper presents a case study in which a culturally relativistic perspective was used to assess and intervene with a family living in poverty.
College Students' Knowledge About AIDS and Attitudes Toward Condom Use
Authors: Strader Marlene K. , Beaman Margaret L.
Published: May 2007

College students were surveyed to determine their knowledge about AIDS and attitudes toward condom use. Overall scores were high, with a mean of 22.5 on the 28‐item true‐false questionnaire. Of the 81 percent of respondents who indicated they were presently or had been sexually active, only 40 percent reported using condoms; 87 percent expressed an intention to have vaginal intercourse and 18 percent to have rectal intercourse. From the open‐ended questions about condoms, 37 beliefs were elicited and the 10 most frequently mentioned were identified. The majority of subjects reported protection against sexually transmitted diseases and preventing pregnancy as the most important reasons for using condoms. Forty‐seven percent also believed condoms important for preventing AIDS. Other significant beliefs about condom use included that they cause less worry, interfere with spontaneous sexual response, decrease pleasure for self and/or partner, are inconvenient and uncomfortable, and decrease feeling. The most significant referents for deciding about condom use were mothers in younger subjects and sexual partners for older subjects. These results indicate the need for influencing attitudes and normative beliefs to change condom use behavior.
Measuring Physical Activity in Midlife Women
Authors: Wilbur JoEllen , Miller Arlene , Dan Alice J. , Holm Karyn
Published: May 2007

Women's risks for osteoporosis and cardiovascular disease are increasing. Although it is known that these risks decline with physical activity, it is difficult to associate specific risk levels with specific activity levels. Measuring activity levels is complex and problematic, especially in women. The present study explored the validity of a particular measure, the retrospective survey questionnaire, used with a female population to gauge physical activity, both occupational and leisure. To measure construct validity, four retrospective measures were administered to a sample of 43 middle‐aged women representing three occupational groups (teachers, clerical workers, nurses) known to differ in activity levels. In addition, measurement approaches were triangulated by including a prospective measure, a beeper‐cued record kept by subjects. A significant difference was noted among the groups on retrospective and prospective occupational activity measures, with clerical workers having the lowest levels of energy expenditure. The retrospective occupational measure correlated positively and significantly with the beeper‐cued record kept during work; however, no correlation was found between the retrospective leisure measure and the beeper‐cued record. These data suggest that the retrospective measure is appropriate for measuring the occupational dimension of physical activity. Additional study is required to identify women's leisure pursuits and the dimension of their household activities.
The Role of Black Churches in Supporting Compliance with Antihypertension Regimens
Authors: Smith Eva D.
Published: May 2007

Although considerable gains have been made in hypertension control in the United States, the rate of control in blacks is lower than in whites. It has been asserted that this low control rate in blacks is due to lack of compliance. Using previously tested and new measures, as well as chart audit, this pilot study evaluated the specific role and effectiveness of the black church in promoting compliance with antihypertension regimens. A sample of 63 hypertensive subjects from two inner‐city black churches participated; 33 were from a church that had a hypertension screening project and 30 were from one that did not. Clients from the church with the project did not score higher on a self‐report compliance measure than those from the church without the project. Furthermore, no relationship was found between support and compliance and blood pressure control, although relationships were seen between age and compliance scores, and between following a doctor's advice and compliance scores. The church without a screening program was viewed by clients as more supportive than the one with the program.