bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Masculine and Feminine Speech Patterns in Proposal Acceptance
Authors: Lituchy Terri R. , Wiswall Wendy J.
Published: March 2007

Women with feminine speech patterns (i.e., use of tag questions, modals, intensifiers, and numeral approximations) are seen as less confident, less assertive, and less believable than women with masculine speech patterns. The present study examined how masculine and feminine speech patterns affect the acceptance by superiors of decisions made by male and female subordinates. Seventy-nine male and female students listened to a tape recording of a subordinate's proposal for a new electronic game. The results demonstrated that the proposals of subordinates with masculine speech patterns were more likely to be accepted by male listeners, whereas female listeners were not influenced by the speech patterns.
Information Usefulness and Acquisition During Organizational Encounter
Authors: Morrison Elizabeth Wolfe
Published: March 2007

The assimilation literature suggests that newcomers need several types of information to reduce the uncertainty surrounding organizational entry. One hundred seventeen newcomers were surveyed to assess the perceived usefulness of seven types of information and the extent to which they had actively and passively obtained them. In general, newcomers obtained more information actively than passively and more through monitoring than through inquiry. Appraisal information and technical information were seen as the most useful types and were actively sought more than the others. Although newcomers rated organizational information relatively low on usefulness, they passively received it more than any other type. The results provide new insight into the information that newcomers obtain during organizational encounter.
Designing Discourse
Authors: Markham Annette
Published: March 2007

This article provides a critical ethnographic account of how the members of a small design company experienced a work environment riddled with ambiguous communication. I present the organization's official philosophies as well as the discourse of the members to illustrate how ambiguous communication was strategically applied and how members responded and made sense of it. Although management's goal in providing vague goals and objectives was intended to spark freedom and creativity, the employees experienced this work environment as paradoxical and constraining. I contend that the members' responses to this system demonstrate how the interplay of ambiguous discourse and organizational power can construct complex structures of control. Even when organizational members were aware of contradictory and ambiguous communication practices by management, they were largely unaware of the extent to which their responses to this situation naturalized, reproduced, and strengthened a painfully experienced organizational system of control.
Leader-Member Exchange, the "Pelz Effect," and Cooperative Communication between Group Members
Authors: Lee Jaesub
Published: March 2007

This study explored effects of differential quality of leader-member exchange on cooperative communication among members of work groups. Findings suggest that the nature of an individual's own exchange with his or her leader and his or her leader's upward leader-member exchange have significant impact on perceived use of cooperative communication among coworkers. Furthermore, results of this study provide evidence of a tight linkage between vertical dyads and horizontal relationships with respect to cooperative communication.
The Discourses of Corporate Spiritualism and Evangelical Capitalism
Authors: Nadesan Majia Holmer
Published: March 2007

“Should your company save your soul?” asks Fortune magazine in 1991. This article explores the growth of literature proposing corporate spirituality as a means of motivating employees. Critical analysis of this literature suggests that it articulates and advocates two entrepreneurial views of subjecthood (i.e., personal identity) that obscure contemporary corporate power by centering the individual as an autonomous agent, fully responsible for shaping his or her destiny. They either strip individuals of all social positioning or elevate a masculine ideal to which women cannot aspire. Although these discourses reinforce social hierarchies of power and privilege, they also provide grounds for critiquing and transforming the contemporary workplace.
Feeling Understood: A Melody of Human Becoming
Authors: Jonas-Simpson Christine M.
Published: March 2007

This phenomenological-hermeneutic study centered on the phenomenon of feeling understood, which was conceptualized by the researcher as a melody of human becoming significant to quality of life. For the first time the Parse research method was used with music as part of the dialogical engagement. The study was conducted with 10 women living with an enduring health situation who volunteered to be in tape-recorded dialogue with the researcher to discuss feeling understood and to create a musical expression of this phenomenon. The finding of this study, which is the structure of the lived experience of feeling understood, surfaced from the dialogues and musical expressions: Feeling understood is an unburdening quietude with triumphant bliss arising with the attentive reverence of nurturing engagements, while fortifying integrity emerges amid potential disregard.
Quality of Life from a Transcultural Nursing Perspective
Authors: Leininger Madeleine
Published: March 2007

The author presents research findings derived from Leininger's theory of culture care diversity and universality bearing upon quality of life. She holds that since quality of life is culturally constituted and patterned, it needs to be studied and understood from a transcultural nursing perspective in order to advance nursing as a discipline and profession. Five major cultures are presented to illustrate culturally constituted dominant care patterns related to quality of life. These comparative data reflect more diversity than universality among the cultures. The author encourages nurse researchers to move beyond present-day overemphasis on individualism and to discover dominant transcultural care values and patterns of emic and etic knowledge focused on quality of life, health, and well-being.
Orem's Self-Care Deficit Theory: Research with Pregnant Women
Authors: Hart Marcella A.
Published: March 2007

A causal model of relationships among self-care agency, basic prenatal care actions, foundations for dependent-care agency, and selected pregnancy outcomes was investigated. This cross-sectional correlational study was conducted on a random sample of 127 women at least 30 weeks pregnant. Path analysis was used to analyze the data. Self-care agency was significantly and directly related to basic prenatal care actions and foundations for dependent-care agency, which in turn were directly related to infant birth weight. Findings lend support to Orem's theory and offer implications for maternity nursing practice and research.
Parse's Theory in Practice with a Group in the Community
Authors: Kelley Lois S.
Published: March 2007

The author, a nurse guided by Parse's theory of human becoming, describes one way to focus on quality of life in person-centered practice with a group in the community, in contrast to traditional nursing practice with groups in which the focus is on problems, learning, and socially-defined responsibility. The author describes living true presence over a 10-week period in accord with Parse's practice method with a group of persons with genital herpes. Emerging patterns of health of the group are reported along with a loose agenda for community-based practice.
Orem's Nursing Theory and Positive Mental Health: Practical Considerations
Authors: Orem Dorothea E. , Vardiman Evelyn M.
Published: March 2007

The impetus for the authors' development of this article was their growing awareness of the failure of some nurses to recognize positive mental health behaviors of patients. The authors also were aware of the absence of readily applicable criterion measures of positive mental health. This awareness led to the formulation and investigation of two questions: What human behaviors constitute adequate crterion measures of positive mental health of adults? Do adult persons in health care, including nursing situations, reveal evidence of positive mental health?
A Review of the Power as Knowing Participation in Change Literature
Authors: Caroselli Cynthia , Barrett Elizabeth Ann Manhart
Published: March 2007

In the 15 years since the introduction of Barrett's theory of power as knowing participation in change and its accompanying measurement instrument, a rapidly growing number of research studies have been conducted using the theory and instrument. This article presents a critical review of this literature, as well as recommendations for further research.
Korean Adolescents' Experiences of Smoking Cessation: A Prelude to Research with the Human Becoming Perspective
Authors: Kim Moon Sil , Shin Kyung Rim , Shin Sung Rae
Published: March 2007

Smoking cessation has been identified as an important factor for health and quality of life in Korean society. This article explicates Korean adolescents' experiences of smoking cessation from the perspective of Parse's human becoming theory, as a prelude to conducting research. A nurse was truly present with individual students as they shared their experiences of trying to stop smoking. Interpreted through the principles and concepts of Parse's theory, the experience of quitting smoking is elucidated as a struggle of choosing one's value priorities amid the opportunities and limitations inherent in this decision, while moving with unique patterns of relating. Staying with the commitment to stop smoking is changing one's health and quality of life. The authors briefly discuss the implications of this perspective for nursing practice, and identify struggling to change as a phenomenon for future research.
The Relationship of Self-Concept and Self-Care in Children with Cancer
Authors: Mosher Revonda B. , Moore Jean Burley
Published: March 2007

The purposes of this descriptive study were to examine the relationships between self-concept and (a) self-care, (b) dependent-care, and (c) basic conditioning factors for children with cancer, and to compare the self-concept of children on- and off-therapy. The theoretical framework was Orem's self-care deficit theory of nursing. The sample consisted of 74 children with cancer and their mothers. Results showed small but significant correlations between variables, providing some evidence that if children had higher self-concept scores they performed more self-care activities and received more dependent-care from their mothers. The self-concept scores of the on- and off-therapy groups were not significantly different. This study supports Orem's theory and reinforces the need to promote positive self-concept
School Choice and School Stratification: Shortcomings of the Stratification Critique and Recommendations for Theory and Research
Authors: Archbald Douglas A.
Published: March 2007

This article analyzes the stratification critique of school choice. The stratification critique consists of several key claims, some supporting evidence, and a loose set of assumptions and inferences usually left implicit. Limitations of the critique include rarely treating stratification as a complex multidimensional phenomenon; insufficient recognition that stratification is widespread in school districts, whether or not they have school choice; and the idea that from a policy standpoint, the decision is not between school choice and an ideal nonstratified state. One must weigh the stratification consequences of different policies, and these consequences must be viewed in relation to other policy goals and values. This article argues for clearer terminology, better indexes, and more explicit comparative frames of references in theory and research on school choice and stratification.
Forgotten Voices of Black Educators: Critical Race Perspectives on the Implementation of a Desegregation Plan
Authors: Morris Jerome E.
Published: March 2007

The conceptualization and implementation of desegregation educational policies are incomplete when they ignore the voices of Black educators. Through in-depth interviews with 21 African American educators in St. Louis, this article highlights how elements of what is being defined today as critical race theory were embedded in these educators' analyses of a 1983 court settlement that resulted in a 16-year desegregation plan. Through rich and detailed accounts, these educators illustrate how the desegregation plan ultimately protected the overall interests of Whites. Their analyses of the plan-seemingly pessimistic-were realistic. The ending of the plan in 1999 continued to place the onus on Black people to rectify the inequitable education in the city. Suggested is the need for courts and policy makers to begin listening to the voices of African American educators when framing educational policies' intent on improving the education of African American students.
Planning for Choice: The Educational Sociotechnological Challenge of the Future
Authors: Inbar Dan E.
Published: March 2007

The purpose of this discussion is to show through an examination of five trends -socioeducational demands, local political empowerment, technological options, economic trends, and nonlinear planning-how the theme of choice is emphasized. The common denominator of these trends is the weakening of the authoritative status of the school and the strengthening of the notion of choice. Planning for choice becomes an attribute of future educational policy-making and planning. Because planning is a structuring process and choice is a loosening one, the idea of planning for choice contains inherent dialectic tension. The discussion offers a conceptual framework for educational policy-making and planning strategies that will respond to these trends and tensions.
Program Equity for all Children: Meaningful Goal or Impossible Dream?
Authors: Berne Robert
Published: March 2007

After a decade of neglect, equity issues are once again at the core of educational policy debates, but the nature of equity in the 1990s is different from in the past, especially with its inclusion of outcomes. This article explores some of these differences from two perspectives. First, although we know that many elements of outcome equity are feasible, there are significant implementation issues including outcome measurement, the quid pro quo between account ability for outcomes and governance, resource implications, the need for integrated services for children, the necessary role changes for teachers and principals, and the need for parents as partners. Second, the article summarizes the recommendations of a New York State Equity Study Group, which focused on the following three questions: (a) Can we develop definitions of educational outcomes and outcome equity? (b) Can we identify the alternative policies and programs that are aimed at redressing outcome inequities? (c) What actions are needed to allocate resources to support policies and programs that produce outcome equity?
Program Equity and Adequacy: Issues from the Field
Authors: Goertz Margaret E.
Published: March 2007

The latest wave of school finance litigation has raised issues of educational adequacy as well as issues of funding equity in many states. This article explores the following philosophical, conceptual, technical, and political questions that state policymakers face as they struggle to address issues of adequacy and equity simultaneously. Do traditional equity issues go away if some equality of outcomes is achieved? What ought standards of adequacy look like? How does one design a school finance system based on adequacy? Can we define the production function(s) that will yield the desired outcomes? Is the political system ready to accept the additional costs (and possible redistributive effects) of a funding system linked to educational adequacy?
Equity or Adequacy of School Funding
Authors: Rossmiller Richard A.
Published: March 2007

Definitions of equal educational opportunity have evolved over the past 200 years, from access to schooling, to equal spending per pupil, to variable spending per pupil depending upon their individual educational needs. Existing arrangements for financing public K-12 education generally employ state subventions to narrow the disparities in funding that result from heavy reliance on local property taxes as the primary source of public school revenue. Although the quest for equity in school funding has dominated legal and political actions in recent years, in this article I argue that adequacy of school funding deserves far greater attention than it has thus far received and that single-minded pursuit of equity may lead to equality of funding at a level inadequate to provide the programs and services children need if they are to compete successfully in adult life.
Using Research to Inform Practice in Urban Schools: 10 Key Strategies for Success
Authors: Hodges Helené L. B.
Published: March 2007

To develop schools that are self-renewing learning organizations, we must ensure that teaching staffs are properly prepared and trained by making a commitment to provide professional development opportunities reflecting the best we can offer from the knowledge base. Similarly, if we are to affect sustained school improvement efforts, practitioners and researchers must continuously share and exchange this knowledge base with one another. How is this shared language best developed? Hodges offers 10 strategies: implementing school-based staff development programs; cooperatively planning and supporting staff development programs; ensuring that staff development programs contain effective training components; offering cooperative/collaborative training experiences; designing research-based staff development programs focused on improved student performance; maintaining high expectations and standards; committing to long-term training efforts; establishing ways to support and recognize transfer of new learnings; assessing staff development program effectiveness on significant measures; and linking research to teacher preparation programs.
Politics of Accountability within a School-to-Career Initiative: Implementation, Representation, and Evaluation
Authors: Danzig Arnold , Cobb R. Brian , Davies Timothy Gray , Mantle-Bromley Corinne , Miser Ann B.
Published: March 2007

This article reports on the politics of accountability in one state's school-to-career initiative. School-to-career systems are defined to include educational and work-related curricula and vocational guidance for all students. Historical contexts of school-to-career initiatives are presented. Perspectives of the federal government, state agencies, local partnerships, and a university evaluation team on what it means to implement school-to-career programs are discussed and differences explored. The article considers influences on program design, outcomes, and systems change efforts. This discussion focuses on three areas: (a) the politics of implementation-dilemmas faced in balancing constituent interests, (b) the politics of representation-how representation on a state management team affects partnership efforts, and (c) the politics of evaluation-ways in which accountability and standards reflect beliefs and alter practices in education settings. The article concludes with considerations and recommendations for policy makers.
The Educational Accountability of Schools in England and Wales
Authors: Ouston Janet , Fidler Brian , Earley Peter
Published: March 2007

This article reviews the requirements of English and Welsh schools to ensure accountability to stakeholders within the education system. It is argued that although there are many demands for accountability, few of them are rigorously imposed. The most powerful accountabilities operate through the educational "marketplace " that has been created by the introduction of site-based management and open enrollment. Although many of these accountabilities are not directly imposed, they have had a major impact on educational aims, practices, and values.
The Politics of Research-Information Use in the Education Policy Arena
Authors: Johnson Bob L.
Published: March 2007

Once research results have been produced, how are they used? This article examines the politics of using information generated by research. The value-laden nature of any research provides policy makers with an important resource to further their political agendas. Information can be subject to numerous interpretations. Those policy makers who are skillful in using research information can frame the issues and solutions in ways that are compatible with their interests. In terms of influencing public policy, how policy makers use research findings may be as important as the findings themselves.
Taking a Stand against Accidental Childhood Poisoning: The Founding of the Nation's First Poison Control Center in Chicago
Authors: Burda Anthony M. , Burda Natalie M.
Published: March 2007

Prior to the 1950s, there existed no formal system for poison prevention or treatment in the United States. Estimates place the number of pediatric poisoning fatalities at over 400 per year at that time. After World War II, urbanization and modern technological methods brought forth over 250,000 different brand name products on the market. Health care professionals presented with cases of acute poisoning usually had little knowledge of what ingredients were contained in these new products making it difficult, if not impossible, to treat these patients. In the 1930s, decades before the creation of the Chicago Poisoning Control Program, pharmacist Louis Gdalman had already established a poison information service at St. Luke's Hospital. Because of Mr. Gdalman's training in pharmacy and chemistry, physicians throughout the city of Chicago and from around the United States called on him around the clock in search of his assistance. In the late 1940s, Mr. Gdalman began recording information on small cards and developed a standard data collection form. By the 1950s he had established an extensive library on the management of acute and chronic poisoning. The first poison control center in Chicago was described as nothing more than a desk, chair, and a telephone located in the inpatient pharmacy. Reluctance by hospital administrators to designate space, resources, and funds were problems confronted by the first poison control center. Poison centers of the 1990s still experience these same difficulties.
Pharmacy Preparedness for Incidents Involving Weapons of Mass Destruction
Authors: Burda Anthony M. , Sigg Todd
Published: March 2007

Recent worldwide terrorist acts and hoaxes have heightened awareness that incidents involving weapons of mass destruction (WMD) may occur in the United States. With federal funding assistance, local domestic preparedness programs have been initiated to train and equip emergency services and emergency department personnel in the management of large numbers of casualties exposed to nuclear, biological, or chemical (NBC) agents. Hospital pharmacies will be required to provide antidotes, antibiotics, antitoxins, and other pharmaceuticals in large amounts and/or have the capability for prompt procurement. Pharmacists should become knowledgeable in drug therapy of NBC threats with respect to nerve agents, cyanide, pulmonary irritants, radionucleotides, anthrax, botulism, and other possible WMD.
Acute Cocaine Toxicity: Pharmacology and Clinical Presentations in Adult and Pediatric Populations
Authors: Lipton Jack W. , Mangan Kile P. , Silvestri Jean M.
Published: March 2007

Cocaine remains the most prevalent drug responsible for emergency department (ED) visits. A majority of acute cocaine toxicity cases involve young, habitual, adult cocaine users and often present with a range of cardiac, neurologic, gastrointestinal (GI) or renal symptoms. In addition, atypical populations (neonates, infants, toddlers, young children and adolescents) are presenting in EDs with varying symptoms that are unknowingly associated with cocaine exposure. Unfortunately, juvenile presentations are generally anecdotal in nature, and while enlightening, are difficult to quantify epidemiologically. Outlining the types of symptom presentation in these young populations may assist healthcare providers in expediting proper treatment for such demographic groups. Therefore, this review examines the current knowledge regarding cocaine's pharmacologic activity as it relates to its potential toxicity, and outlines the clinical manifestations of cocaine exposure and toxicity in adult and pediatric populations. We conclude from the available clinical reports that there must be a higher index of suspicion in the pediatric population to identify exposed infants and children. Improved recognition and identification in both typical and atypical populations will result in better characterization of acute cocaine toxicity.
Documentation of Pharmaceutical Care Activities in Community Pharmacies by Doctor of Pharmacy Students
Authors: Anderson Robert J. , Nykamp Diane , Miyahara Randell K.
Published: March 2007

The practice of pharmacy is evolving from a product-related focus to one that is more patient-oriented and outcome-directed. This new focus can reduce the cost and/or improve the quality of care. Pharmacists often detect and resolve medication-related problems, though few reimbursement incentives exist for the amount of time and effort it takes. With statutory restrictions on the total use of pharmacy technicians and state-mandated OBRA patient counseling and prospective drug utilization review, community pharmacists are pressed for time more than their hospital colleagues to document their daily interventions for improving drug therapy for their patients. PharmD students can assist the community pharmacist in documenting these medication-related problems. Documentation of these "cognitive" or "value-added services," including their outcome on cost and care, is critically necessary for future reimbursement consideration by third-party payers. Copyright © 1995 by W.B. Saunders Company
Clinical Intervention: Positive Outcome Based on Improved Communication with Physicians in a Community Hospital
Authors: Vohra Saifi , Fox Joann
Published: March 2007

Establishment of a clinical intervention program and standardized drug information system in a community hospital is explained. The establishment of the program increased better communication among pharmacists, medical staff, and other health care professionals. An effective and consistent interaction with the physicians with respect to patient's drug therapy was developed. Medication misadventures are diminished in a positive communications environment. The total number of interventions increased to 4,275 in first year of program in 1992 and 6,700 in 1993. The first six months of 1994 yielded similar improvements with a total of 3,390 interventions. Before 1991, no documentation of interventions existed. This intervention program resulted in a great cost savings to the pharmacy department. An estimated $96,000 cost savings was observed in 1992 and $87,000 in 1993. In the first six months of 1994, a cost savings of $48,000 was observed. This program decreased drug inventory to the lowest level recorded at this institution over this 30 month period. Significant improvement in several intervention categories such as adverse drug reaction (ADR), conversion from parenteral to oral therapy, aminoglycoside and vancomycin monitoring were observed. Statistical analysis showed significant improvement in the intervention program over a three-year period with P value ranging from 0.00 to 0.012.
Integrating Pharmaceutical Care into an HIV Clinic
Authors: Olson Kimberly
Published: March 2007

The purpose of this article is to describe the integration of clinical pharmacy services into an already exist ing HIV clinic. Ambulatory care pharmacy services were the only discipline not represented in the hospi tal based HIV clinic. With the move toward ambulatory care, the introduction of the new class of HIV drugs called the protease inhibitors, and the strong physician support of inpatient pharmacy services, the tim ing for pharmacy integration into the clinic was optimal. This article describes our goals for the clinic, the need for justification of pharmacy services through documentation, and the preparation steps made which established permanent pharmacy services in the HIV clinic. Daily procedures, interventions, statis tics of the pharmacy service, and barriers to success are also described. Patient information materials and examples of the documentation forms used by the clinic pharmacists are provided. This article is meant to aid other pharmacists who wish to integrate pharmacy services into an ambulatory HIV clinic setting.
Infection in Solid Organ Transplantation: Prophylactic Regimens, Clinical Manifestations, and Empiric Therapy
Authors: Maudlin Joanna K.
Published: March 2007

Solid organ transplantation has become an established practice for end-organ disease. Transplantation has inherent risks for infection which can be minimized by appropriate prophylactic, preemptive, and empiric antibiotic regimens. Proper vaccination and appropriate perioperative antibiotic use are of utmost importance in an immunocompromised patient. When immunosuppression is high, further prophylactic regimens against some pathogens, such as cytomegalovirus, are necessary. Empiric antibiotic therapy should be targeted to the most likely pathogens. However, certain antimicrobials may interact with immunosuppressant agents resulting in enhanced toxicity or decreasing immunosuppression. Appropriate monitoring parameters and protective measures should be taken.
Itraconazole Pulse Therapy for Onychomycosis
Authors: Matuszewski Karl , Park Janet
Published: March 2007

Itraconazole (Sporanox by Janssen) is a triazole antifungal agent. In September 1995, it was approved for the treatment of onychomycosis caused by dermatophytes of the toenail with or without fingernail involvement. FDA-labeled itraconazole therapy for onychomycosis consists of 200 mg by mouth daily for twelve consecutive weeks, with reported mycological cure rates of 54 percent. Pulse therapy, defined as a three- or four-month cycles of 200 mg of itraconazole twice daily for one week, followed by three weeks off the drug, has been shown to be a promising treatment option that deserves consideration. Cure rates have been as good, or better than the standard therapy. Recurrence has not been a problem and adverse drug effects have been few and mild. Decreased drug treatment cost are incurred with pulse therapy.
Epidemiology of Asthma
Authors: Letassy Nancy A.
Published: March 2007

Epidemiology of asthma is discussed in terms of the prevalence, risk factors associated with increasing morbidity and mortality, impact on life-style, long-term prognosis, and economic impact. Those most at risk for development of asthma are young children, African Americans, and those in lower economic status and inner-city communities. The primary contributing factor to increasing morbidity and mortality is undertreatment. Contributing factors may be restricted access to continuing medical care, unstable family situations, cultural and language barriers, failure to recognize severity of the disease, and inability to afford care.
The Lived Experience of College Student Lesbians’ Encounters with Health Care Providers
Authors: Williams-Barnard Carol L. , Mendoza Deanna C. , Shippee-Rice Raelene V.
Published: March 2007

The purpose of this preliminary study was to explore the lived experience of four self-identified college student lesbians coming out and their encounters with health care providers. This study used a qualitative method of phenomenology for data collection and analysis. Results of the study revealed a phenomenological model that embodied the core theme of navigating self-disclosure. Two major themes stemming from the core theme were also uncovered. Navigating self-disclosure in homophobic waters and navigating self-disclosure encounters with health care providers unveiled a continuum of self-disclosure to nondisclosure experiences encountered by lesbians. Strategies are offered to enhance interactions between lesbians and health care providers in primary and acute care settings.
The Use of Human Touch to Improve the Well-Being of Older Adults
Authors: Bush Elizabeth
Published: March 2007

Touch and massage are viable nursing modalities that are both underutilized and understudied. This underuse of touch is especially noted in settings aimed at improving the well-being of older adults. A number of studies suggest that the appropriate use of touch by nurses has the potential to significantly improve the health status of older adults. In particular, touch can be useful with cognitively impaired, institutionalized, or hospitalized older adults. Likewise, touch can be useful for improving comfort and communication among terminally ill older adults and their loved ones. This article synthesizes some of the available literature on the subject while suggesting avenues for nursing practice and education aimed at using touch as a viable and cost-effective holistic gerontological nursing intervention.
A Not-so-Silent Cry for Help
Authors: Carter Patricia A.
Published: March 2007

Cancer family caregivers face uncertainty every day. The holistic health care practitioner is in a unique position to alleviate some of this uncertainty by providing information. Although this may appear to be straightforward, unfortunately, more often than not, information is not provided or is provided in such a way that it is more harmful than helpful. This article presents findings from a qualitative study conducted with 21 older female caregivers of persons with advanced-stage cancer. Six areas of concern or need arose from the data and are presented with caregiver narrative examples. This article’s purpose is not to be prescriptive (e.g., telling holistic health care practitioners what to say and how to say it). Instead, the purpose is to highlight the need for holistic health care practitioners to evaluate their caregivers’ individual needs for information and to attempt to provide this information in a sensitive yet factually accurate manner.
Uncovering Hope with Clients who have Psychotic Illness
Authors: McCann Terence V.
Published: March 2007

This article presents findings about how community mental health nurses enable young adult clients who have schizophrenia uncover hope for the future. Grounded theory methodology and simultaneous data collection and analysis took place using interviews and observations. The study was undertaken in the community in regional and rural New South Wales, Australia, and the participants were clients, significant others, and community mental health nurses. The study findings show that nurses used two main strategies to uncover hope: enhancing motivation and developing pathways to wellness. These activities have to be seen within the context of good nurse-client relationships, advancing client self-determination, education, and planning for the future. The process of uncovering hope can be compromised for various reasons. The findings highlight the importance of hope for clients with schizophrenia and the way in which nurses can enable the process.
Applied Concepts of Holistic Nursing
Authors: Gilbert Toni
Published: March 2007

As a holistic nurse, the author uses the concepts and processes of exploring clients’ dreams to provoke in them an understanding of life’s issues, including illness and injury. Dreams hold information about spiritual realities, self-development, mythological archetypal themes, and the health of mind and body. Dream research and contemporary techniques for remembering and analyzing dreams guide the author in the work necessary to help her clients achieve health and wholeness through a deeper understanding of themselves through dreams.
Nursing Presence
Authors: Doona Mary Ellen , Chase Susan K. , Haggerty Lois A.
Published: March 2007

Data sets from three individual studies on nursing judgment were reviewed from a wider perspective. This yielded meanings and phenomena not readily identified in the individual studies, and it was tentatively labeled presence. A hermeneutic study using 10 transcripts from each data set asked: What are the common features of the context of nursing judgment? and, What are the features of the nurses’ connection with the patient that contribute to nursing judgment? The analysis yielded six features of nursing presence: uniqueness, connecting with the patient’s experience, sensing, going beyond the scientific data, knowing (what will work and when to act), and being with the patient. These features of nursing presence are logical distinctions and serve as ways to grasp the idea of nursing presence.
Predictors of Transitions in Disease and Disability in Pre-and Early-Retirement Populations
Authors: Choi Namkee G. , Schlichting-Ray Linda
Published: March 2007

Objectives:This study analyzed rates of prevalence and incidence of, and transitions in, disease and disability statuses of those aged 51 to 61 years and the predictors of the transition outcomes—remaining free of disease or disability, getting better, or getting worse—over a 2-year period. Methods:Data from the 1992 and 1994 interview waves of the Health and Retirement Study were used for gender-separate binary and multinomial logistic regression analyses. Results:Despite high prevalence and incidence rates of chronic disease and functional limitations, the improvement rates in disabilities were also high. For both genders, age, years of education, health-related behaviors, and comorbidity factors were significant predictors of the transition outcomes. Discussion:The significance of health-related behaviors as predictors of transitions suggests that lifestyle factors may have a bigger influence on this age group than on older groups.
Age, Medical Advice about Cardiac Risk Reduction, and Patient Compliance
Authors: Young Rosalie F. , Kahana Eva
Published: March 2007

This study investigated the physician's role in proffering appropriate medical advice to aged patients and the patient's role in complying with that advice. Heart disease, which takes a major health toll among the aged but is amenable to risk reduction practices, exemplifies a condition that offers physicians the opportunity to play an important health promotion role. The advice given by physicians to 246 heart patients and their compliance with the advice is the subject of this article. Data were obtained from a longitudinal study of recovering myocardial infarction patients aged 60 and over (n = 204), and a comparison group of patients aged 45-59 (n = 42). The patient cohorts were similar in health and demographic factors. Findings from interviews conducted six weeks after hospital discharge indicated major age differences in cardiac risk reduction advice given by physicians, but no age effects of patient compliance with the medical advice. Neither preinfarction nor postinfarction cardiac health were factors in compliance. Findings suggest that older patients are systematically denied the opportunity for lessening risk of future heart problems by adopting behavioral changes, despite a lack of evidence that aged heart patients will not adhere to medical advice to engage in these changes. Suggestions are given for interventive efforts directed at both physicians and patients.
The Association of Roles and Attitudes with Disability among Midlife Women and Men
Authors: Mudrick Nancy R.
Published: March 2007

The association among roles, attitudes, and disability has been studied separately for men and women as factors that may link impairment and disability. The aim is to assess the probable influence on disability of social roles and attitudes regarding pain, tiredness, and self-esteem from work, and discern if there are gender differences in the factors associated with disability. Although prior studies have examined some of these variables, none has examined them as a set. Self-reports of disability are the dependent measure; severity of impairment, income, race, and education also are included as control variables. The data from 3,2.02 men and 2,317 women age 35-64 are analyzed using logit regression. Results reveal subtle gender differences in the role variables associated with disability. Also noteworthy are the associations of pain. fatigue, and work attitudes with disability. Overall, these findings buttress the paradigm in which disability is viewed as responsive to individual and societal circumstances.
Cognitive Processes, Self-Reports of Memory Functioning, and Mental Health Status in Older Adults
Authors: Scogin Forrest , Rohling Martin
Published: March 2007

A battery of cognitive tasks was administered to a group of community-dwelling older adults. They also completed questionnaires assessing their cognitive and memory functioning and mental health status. A person familiar with the participant completed the same set of questionnaires. Little or no association was observed among the laboratory-type cognitive tasks and the self-assessments of cognition and memory, but significant relationships were observed between self-reported mental health and both the cognitive tasks and the subjective memory assessments. However, significant others' assessments of the participants' cognitive and memory functioning were related to laboratory-assessed cognitive functioning. These results suggest that mental health status and both cognitive performance and self-reports of cognitive and memory functioning are linked. Results also suggest that significant others may be better judges of actual cognitive performance than are elders themselves.
Lay Consultation among the Elderly
Authors: Strain Laurel A.
Published: March 2007

Lay consultation is examined among a group of 78 elderly individuals whose arthritis has limited their activities and/or caused pain or worry. Virtually all respondents consult at least one family member or friend. The type of advice exchanged varies and may involve relating facts or receiving medical or nonmedical advice. Some individuals only "report" to their lay consultants; others only "consult". Still others engage in both reporting and consulting conversations. Spouses tend to be named as the consultant most frequently, followed by children. Some individuals consult family only, whereas others go beyond the family and include friends. Comparisons of the types of lay consultation network according to age, gender, marital status, and health status are made.
Characteristics of Nursing Homes that Affect Resident Outcomes
Authors: Spector William D. , Takada Hitomi Adrianna
Published: March 2007

Although there has been increased interest in using outcomes as measures of quality, few studies have shown a link between structure or process and outcomes. In this analysis, based on approximately 2,500 residents in 80 nursing homes in Rhode Island, multivariate models estimate which aspects of care are associated with resident outcomes after controlling for resident characteristics. Outcomes, measured over a 6-month period included death, functional decline, and functional improvement. Results suggest that higher staff levels and lower RN turnover were related to functional improvement. Facilities with high catheter use, low rates of skin care, and low participation in organized activities were associated with negative outcomes. Facilities with few private-pay residents were also associated with negative outcomes. Receipt of a serious federal citation was associated with improved outcomes. For-profit facilities appeared to be more efficient in use of resources.
Pathways to Hospital Death among the Oldest Old
Authors: Merrill Deborah M. , Mor Vincent
Published: March 2007

Using the 1986 National Mortality Followback Survey (N = 2, 090), this research examines the conditions under which the oldest old (85+ years of age) are discharged from a nursing home to enter and die in a hospital as well as the conditions under which community dwellers enter and die in a hospital. Given the need to plan for health services for this growing population and the recent policy changes in length of hospital stay, this analysis focuses on pathways leading to a hospital death. Results suggest that the factors that influence site of death are necessarily quite distinct for those who have entered the institutional long-term care system versus those who have not. Among institutionalized patients, the incidence of an acute condition appears to precipitate hospitalization, whereas among community dwellers, the presence of a social support network and the decedent's race are the only salient factors predicting hospital death. Implications are discussed.
Health and Inequalities among the Oldest Old
Authors: Thorslund Mats , Lundberg Olle
Published: March 2007

The elderly, and especially the oldest old, have generally been overlooked in research on social class inequalities in health. On the basis of nationally representative data from Sweden for the age group 77 to 98 (N= 537), we have been able to demonstrate clear differences in health between social classes. These inequalities were found both for men and women. It should be noticed, however, that the patterns of class differences varied depending on the health indicator used. The often employed global measure of self-rated health showed the smallest class gradient when controlling for age and sex, whereas larger differences were found with more concrete and descriptive measures such as peak flow rate.
Predictors of Decreased Self-Care among Spouse Caregivers of Older Adults with Dementing Illnesses
Authors: Gallant Mary P. , Connell Cathleen M
Published: March 2007

This study describes the health behaviors (alcohol consumption, exercise, sleep patterns, smoking, and weight maintenance) of a sample of older adult spouse caregivers (N = 233) and investigates the predictors of decreased self-care since caregiving began. Multiple regression results indicate that caregivers who experience greater developmental burden, report a greater number of depressive symptoms, perform a greater number of activities of daily living (ADL) tasks in caregiving and spend more hours in a day providing care, and who have lower self-efficacy for both self-care and spouse care are at greater risk for negative health behavior change. Results have implications for the identification of caregivers who may be particularly vulnerable to the negative health impact of caregiving.
Education-Specific Estimates of Life Expectancy and Age-Specific Disability in the U.S. Elderly Population 1982 to 1991
Authors: Manton Kenneth G. , Stallard Eric , Corder Larry
Published: March 2007

The authors used mortality data for 1982 to 1991 linked to survey records from the 1982, 1984, and 1989 National Long Term Care Surveys to calculate gender differences over age in mortality and functional status for high (8 or more years of schooling) and low (less than 8 years of schooling) education subgroups. Males and females with high education maintained better functioning at later ages than those with low education. The authors also found that mortality was higher, after conditioning on disability, in both the male and female low-education than the male and female high-education groups. The size of the education effect on both disability and mortality was large, for example, about 7.6 years difference in female life expectancy at age 65; a roughly 2-year difference for males.