bluuebunny/crossref_metadata_2025 huggingface dataset:
Leadership for Quality Improvement in Health Care: Empirical Evidence on Hospital Boards, Managers, and Physicians
Authors: Weiner Bryan J. , Alexander Jeffrey A. , Shortell Stephen M.
Published: March 2007

This article explores factors promoting leadership from the top for hospital quality improvement (CQI/FQM). From literature on governance, quality improvement, and organization theory, working hypotheses were developed about the effects of physician and management involvement in governance on CQIITQM adoption, board leadership for quality, and top management leadership for quality. Hypotheses were tested using a sample of 2,030 hospitals obtained by merging two national mailed surveys. Probit and logistic regression showed physician involvement in governance played a significant role in CQI/FQM adoption and board activity in quality improvement. Formal management involvement in governance demonstrated little effect on CQI/FQM adoption, board leadership for quality, or top management leadership for quality. Informal management involvement in governance, as reflected in opportunities to influence board composition, had negative effects on board and top management leadership for quality. Top management leadership for quality increased board leadership for quality. Implications are discussed.
From Child Victim to Adult Victim: A Model for Predicting Sexual Revictimization
Authors: Arata Catalina M.
Published: March 2007

Women with histories of child sexual abuse (N = 221) participated in a study designed to test a model for predicting adult/adolescent sexual revictimization and post-assault functioning. Participants completed anonymous questionnaires regarding their sexual victimization history, post-sexual assault symptoms and attributions, and consensual sexual behavior. Repeated victimization was defined as having experienced child sexual abuse and a separate incident of adolescent/adult victimization. Repeated victimization was associated with having experienced child sexual abuse involving physical contact, including intercourse and/or penetration. Women with repeated victimization engaged in more self-blame, reported higher levels of post-traumatic symptoms, and reported more high-risk sexual behavior. A path model was developed that indicated that the relationship between revictimization and child sexual abuse was mediated by self-blame, post-traumatic symptoms, and consensual sexual activity. The results suggest the need for further research on revictimization as well as suggesting areas for intervention to prevent sexual revictimization.
The Youngest Victims of Child Maltreatment: What Happens to Infants in a Court Sample?
Authors: Bishop Sandra J. , Murphy J. Michael , Hicks Roger , Quinn Sister Dorothy , Lewis Paul D. , Grace Martha P. , Jellinek Michael S.
Published: March 2007

Current data show that infants represent an increasing proportion of cases of child maltreatment. To learn more about how infants fare in the current system and to provide baseline data against which to compare outcomes following recent legislative reforms, this study examined a subsample of infants in a sample of 200 care and protection cases brought before the Boston Juvenile Court in 1994. Child, parent, and case characteristics of infants 0 to 3 months of age (n = 46) were compared with characteristics of older children in the sample. All cases were followed prospectively for 4 years, and data were abstracted from court records. Results revealed that the infants were primarily children of substance abusers who had extensive prior histories of child protective service system involvement. Although the majority of the infants were eventually permanently removed from parental custody and adopted, many experienced time delays and multiple placements before achieving permanent homes.
Children's Perspectives in the Assessment of Family Violence: Psychometric Characteristics and Comparison to Parent Reports
Authors: Kolko David J. , Kazdin Alan E. , Day Brian T.
Published: March 2007

This study examines the factor structure, consistency, stability, and validity of children's reports of violence and verbal aggression in the home. Children recruited from clinic and community settings (N = 323) and their parents or guardians were administered the Conflict Tactics Scales to represent different perspectives on the patterns and severity of family violence. Based on children's reports, violence and verbal aggression among family members were quite common and moderately stable over a 2-year period. Children reported considerably higher rates of mother-to-child violence than did mothers, but the opposite pattern occurred for child-to-mother violence. Children's reports of verbal aggression and violence between different dyads predicted forms of children's dysfunction, especially antisocial behavior, at 2-year follow-up. Child reports provided important information not available from parent reports alone. The findings suggest the need for a comprehensive assessment of violence and hostility among family members.
Abusive Head Trauma? A Biomechanics-Based Approach
Authors: Hymel Kent P. , Bandak Faris A. , Partington Michael D. , Winston Ken R.
Published: March 2007

Medical professionals frequently evaluate infants and children with head trauma. If the child's cranial injuries are not explained by the history, child abuse must be considered. A significant body of research regarding cranial injury mechanisms is available. This article presents a synthesis of a subset of the biomechanics literature relevant to head injury. The potential application of this knowledge base is explored through five questions: (a) What physical laws govern the response of the head-brain complex to the application of a mechanical force? (b) What are the causal mechanisms of head injury? (c) What properties of living tissues affect responses to the application of a mechanical force? (d) How can specific cranial injuries be linked to their biomechanical origins? and (e) Can the biomechanical history explain the cranial injuries? The authors propose a biomechanics-based paradigm for analysis of pediatric head trauma and seek a qualitative rather than a quantitative understanding.
Using Geographical Information Systems to Enhance Community-Based Child Welfare Services
Authors: Robertson John G. , Wier Kimberly R.
Published: March 2007

Knowledge about community services and neighborhood characteristics is vital in effective child welfare practice. Geographical information systems (GIS), a computerized mapping technology, can give child welfare practitioners, managers, and planners the ability to query and analyze case and program data. This article discusses the use of GIS in child welfare practice using a series of applications related to (a) case management—matching a client with community resources; (b) program planning—matching services for children to community needs; and (c) evaluation—assessing the effect of a community intervention. Implementing GIS technology into child welfare practice is outlined. Differences in GIS software are discussed along with hardware and training needs. Gathering and applying demographic and community information to develop applications is explored.
Coming to Terms with a Consensual Definition of Child Maltreatment
Authors: Portwood Sharon G.
Published: March 2007

This study addresses the critical need to clarify current definitions of child maltreatment by identifying the extent to which consensus exists and highlighting those areas in which key decision makers disagree as to what affects an abuse determination. Participants (N = 323) were mental health, legal, and medical professionals; teachers; parents; and adult non-parents. Respondents agreed that actual physical or psychological harm to the child, whether the act is sexual in nature, seriousness and frequency of the act, and an intent to harm the child are key factors. The groups began to diverge on their evaluations of the degree to which intent should be factored into such a decision. Suggestions for future research aimed at developing more consistent legal and practice standards are presented.
Reframing Child Safety in Michigan: Building Collaboration among Domestic Violence, Family Preservation, and Child Protection Services
Authors: Findlater Janet E. , Kelly Susan
Published: March 2007

In recognition of the substantial overlap between domestic violence and child maltreatment, Michigan's domestic violence, family preservation, and child protection programs are working together to enhance the safety of children and their battered mothers. This article discusses the development of Michigan's collaborative efforts, including the identification of obstacles that had prevented cooperation in the past. This article then describes three components of Michigan's collaboration. First, the development and implementation of statewide cross-training: on domestic violence for family preservation and child protection staff, and on family preservation and child abuse and neglect for domestic violence staff. Second, providing intensive family preservation services to battered women and their children by direct referral from domestic violence service programs. Third, the development of CPS policy to support these collaborative training and program initiatives. Finally, this article concludes with some observations about statewide implementation of collaborative work.
Qualitative Inquiry and the Deprivatization of Experience
Authors: Gubrium Jaber F. , Holstein James A.
Published: March 2007

Contemporary social life is increasingly deprivatized, that is, conducted under the auspices of formal and informal groups, organizations, bureaucracies, and institutions. In these circumstances, personal (often private) experiential objects such as family, self, and the life course are subjected to extensive public discussion, debate, and definition. This article raises the question, Do contemporary social theory and society reflect one another with regard to the public-private distinction? By way of response, the authors argue that theory has not adequately come to grips with the relatton between deprivati zation and the interpretation of experience. The article suggests an analytic approach that more adequately locates and accounts for the relation of public to private life theoretically and empirically, and it presents related methodological guidelines for qualitative inquiry.
(Re)Presentation and Voice
Authors: Tierney William G.
Published: March 2007

This article considers the accessibility of language in scholarly work and discusses what makes a work boring and what the implications are for those who have a broad range of inquiry. In particular, the author discusses the development of the text in qualitative research and the struggles authors face as qualitative researchers. The author first considers the role of the author in the text and he then takes up the issue of readership. He subsequently discusses the relationship between the researched and the researcher and offers avenues for further consideration.
Authenticity in Constructivist Inquiry: Methodological Considerations Without Prescription
Authors: Manning Kathleen
Published: March 2007

Principles concerning authenticity in constructivist inquiry are described in the context of the emergent paradigm. Suggestions are offered from which the researcher can choose to work toward, though never prescriptively guarantee, high-quality research findings.
Known in Part: The Transformational Power of Narrative Inquiry
Authors: Hones Donald F.
Published: March 2007

This article explores the unique possibilities offered by narrative research for fostering continued communication between the researcher/self and diverse others. The first part of the article provides an overview of narrative research as a mode of inquiry and addresses representational and interpretive dilemmas arising in life history research with Shou Cher, a refugee from Laos. The second part of the article presents a series of narrative dialogues between Shou Cher and the researcher. These dialogues take the form of juxtaposed stories and interpretations, transcribed conversations, and reflections on the place of the poetic voice in qualitative research. The final part of this article contains some suggestions for others who may wish to explore the use of life history and narrative in their own journeys between the academy and the community, between the Self and the Other.
Influences of Fraternity Membership, Athletics, and Male Living Arrangements on Sexual Aggression
Authors: BOERINGER SCOT B.
Published: March 2007

Fraternal membership, intercollegiate athletic participation, and sex composition of living arrangements were investigated as possible correlates of sexual coercion. Four hundred seventy-seven male undergraduates enrolled in a large southeastern university were surveyed in classroom settings regarding their experiences with sexual aggression and coercion, as well as their self-reported rape proclivity. Fraternity members displayed significantly more use of intoxicants in obtaining sex, and also more use of nonphysical verbal coercion, but no greater use of physical force, than independents (nonfraternity members). Athletes displayed greater rape proclivity, but no greater coercive/aggressive sexual behavior. Sex composition of living arrangements had no significant effect on rape proclivity or sexual victimization. The results are discussed in light of other recent evidence indicting fraternities for their sexual conduct.
Violence and Women With Disabilities
Authors: CHENOWETH LESLEY
Published: March 2007

Women with disabilities typically occupy positions of extreme marginalization and exclusion that make them more vulnerable to violence and abuse than other women. There is a profound silence around the lived experiences of many women with disabilities that has meant that the violence in their lives is largely invisible and unknown. Further, many of our social practices involving women with disabilities appear to be based on contradictory assumptions that give rise to a series of paradoxes. Practices such as overprotection, segregation, the training of women with disabilities to comply with requests from staff, and a prevailing view that women with disabilities are simultaneously asexual and promiscuous all increase the incidence of abuse and violence rather than prevent it. This article examines experiences of a number of Australian women with disabilities, their mothers and other women who work with them, and official reports of several Australian inquiries into violence.
Situational Determinants of Police Responses to Civil and Criminal Injunctions for Battered Women
Authors: RIGAKOS GEORGE S.
Published: March 2007

Informed by a feminist perspective, this article examines the enforcement practices of police officers when responding to breaches of civil restraining orders and Canadian Criminal Code peace bonds. Police officers for Delta, British Columbia, were administered a questionnaire (N = 45) focusing on their actions when presented with a restraining order by a survivor at a domestic call. Self-report data show that an arrest ensues in only 21% of the cases where there is a breach of a civil restraining order (N = 19), and 35% of the cases where a breached peace bond is presented (N= 29). Despite this, more officers report recommending women obtain a civil restraining order (62%) than a peace bond (53%). The police disclose that when they do arrest for breaches of protective court orders, there are signs of forced entry, a potentially violent offender, or signs of a struggle. A woman's plea that the police arrest is ranked sixth out of 12 situational variables inciting the police to enforce the order.
Victim-Perpetrator Reconciliation
Authors: BARCUS ROBERT A. , BERNSTEIN BARBARA G.
Published: March 2007

Reconciliation between incest perpetrator and victim is rarely noted in the literature. The authors report their work with an uncle and niece who were able to reconcile many years after the incest had occurred. The niece entered treatment and initiated the confrontation and eventual reconciliation with her uncle. Only because he acknowledged the incest and his responsibility for it was reconciliation possible. Case histories, therapeutic issues, legal and ethical ramifications, and case management factors are presented. The authors offer this case history with the hope that their collaboration may generate some new ideas for others working toward reconciliation between victim and perpetrator.
Recent or Imminent Separation and Intimate Violence Against Women
Authors: SEV'ER AYSAN
Published: March 2007

The focus of this article is the link between recent or imminent separation and violence against female partners. First, various bodies of literature are reviewed to establish the fact that separation heightens the risk of violence. Second, the conceptual contributions of social learning and power and control theories are presented as they pertain to intimate violence against women. Third, an expanded version of the power-and-control model is used to underscore the violence proneness of separations, especially when the separations are initiated by women. To illustrate the expanded model, numerous Canadian examples are provided, drawn from interviews with divorced women, survivors of intimate violence, and news media reports. Finally, different strategies to break the cycle of violence, ranging from changing gendered attitudes and behavior to those that focus on incremental ways to reclaim one's freedom, are summarized.
Dating Status Variations and Woman Abuse
Authors: ALVI SHAHID , SELBEE KEVIN
Published: March 2007

Few have attempted tests of explanations of variations in woman abuse across dating status categories. We provide a test of Ellis and DeKeseredy's dependence, availability, and deterrence (DAD) model. The model contends that highly dependent men in situations of high availability and with low deterrence are more abusive than those who are less dependent, encountering low availability and high deterrence. Using data from male respondents to the 1993 Canadian National Survey on woman abuse in university/college dating, this article provides provisional support for the model.
A Post-Structuralist Review of the Theoretical Literature Surrounding Wife Abuse
Authors: O'NEILL DAMIAN
Published: March 2007

Since men's violence toward their partners or wives came to public attention as a major social problem in the 1970s, there has been great variation in the way the social science community has responded, both in terms of defining the issues and in formulating appropriate policy and intervention strategies. This has become one of the most controversial topics in the social sciences, as various schools of thought have sought to implement their perspective. This post-structuralist overview of the theoretical literature seeks to present an account of the different discourses at work within the field of domestic assault and men's violence in the home, to elaborate on the implications of each discourse, and to illuminate the dynamics of conflict and tension that exist within this most controversial area. The cultural constructions and resources being employed within the field are identified and located within the broader cultural heritage of society.
The Prevalence and Characteristics of Male Perpetrators of Acquaintance Rape
Authors: RUBENZAHL SAMUEL A. , CORCORAN KEVIN J.
Published: March 2007

Previous research has found that whereas 15% to 25% of college women report being the victims of acquaintance rape, only 4% to 15% of men report committing acquaintance rape. This study follows Kazdin's suggestion to use all of the potentially important components to attempt to find a result when previous researchers have failed to achieve significant findings. A new methodology is used to attempt to find a percentage of males who admit to committing acquaintance rape that is commensurate with the percentage of women reporting that they were victims. The results indicate that although an alcoholexpectancy manipulation was not related to admission of involvement in acquaintance rape, the new methodological conditions (i.e., consumption of a nonalcoholic beer, a sexually explicit story, a private room, and a male experimenter) successfully resulted in a higher percentage of men reporting that they perpetrated sexual aggression and acquaintance rape. Specifically, 24% of the men admitted committing acquaintance rape based on a broad definition, and 10% admitted committing acquaintance rape based on a stringent definition of acquaintance rape. Suggestions are provided for further research.
Antigrowth Politics or Piecemeal Resistance?
Authors: Burbank Matthew J. , Heying Charles H. , Andranovich Greg
Published: March 2007

Regime theory predicts that opponents of a regime’s pursuit of economic development will have limited prospects for success. Some scholars, however, contend that evidence of widespread growth control movements poses a challenge to regime theory. The authors assess the viability of growth opponents when confronting an active growth regime under conditions that should enhance the prospects for the development of an antigrowth movement by examining opposition to Olympic-related growth in Los Angeles (1984), Atlanta (1996), and Salt Lake City (2002). Despite favorable circumstances for developing an opposition coalition, little evidence of viable antigrowth movements is found. Rather, opposition is better characterized as piecemeal resistance.
Financing Home Ownership
Authors: Bradford Calvin
Published: March 2007

This paper traces federal housing policies related to single-family home ownership from their creation in the 1930s to the present. In particular, the article focuses on policies of the Federal Housing Administration and the Federal Home Loan Bank Board and other federal regulators of financial institutions. The theme of the article is that the original policies of FHA and the financial institution regulators either directly prohibited (FHA) lending to minorities or other residents in minority or racially mixed neighbor hoods or discouraged lending in such neighborhoods. This helped lead to a situation where these neighborhoods were starved for credit. In response to civil rights and neigh borhood movements, FHA radically reversed its policies, underwriting almost any loan in older, minority, and integrated neighborhoods, while the regulatory agencies generally made no effort to reverse existing lending practices. The result was that these neighbor hoods became inundated with FHA lending, which was often subject to fraud and abuses leading to high concentrations of foreclosures and abandonments. Thus, the federal attempts to cure the problems of inner-city housing finance actually made the situation much worse.
The Developing Nurse-Client Relationship: Nurses' Perspectives
Authors: Forchuk Cheryl , Westwell Jan , Martin Mary-Lou , Bamber-Azzapardi Wendy , Kosterewa-Tolman Donna , Hux Margaret
Published: March 2007

This descriptive qualitative study of the nurse-client relationship used an interpersonal focus and Leininger's (1985) method of qualitative analysis. The setting was a tertiary care psychiatric hospital in southern Ontario, Canada. Nurses within 10 newly formed dyads participated in interviews. The research questions focused on the nature and progression of the relationship and the identification of helping and hampering influences. Helping influences identified included consistency, pacing, listening, positive initial impressions, and attention to comfort and control. Relationships were hampered by inconsistency, unavailability, client factors related to trust, nurses' feelings about the client, confronta tion of delusions, and unrealistic expectations. Phases consistent with those described by Peplau (1952, 1991) were identified within dyads that progressed well. However, a different set of phases was identi fied in nontherapeutic relationships. (J Am Psychiatr Nurses Assoc [2000]. 6, 3-10.)
Some Unresolved Issues in the Era of Biopsychosocial Nursing
Authors: Peplau Hildegard E.
Published: March 2007

Four unresolved issues of importance to nurses in this era of biopsychosocial nurs ing are considered in this article. These issues are as follows: first, nature versus nurture; second, matters related to community and family nursing; third, primary and advanced practice nursing; and fourth, external versus internal regulation of nurses. Each issue is considered in a historical context, as well as with a contempo rary perspective. It is suggested that the resolution of these four issues are central to the dialog and debate that will shape the future of psychiatric nursing. (J AM PSYCHIATR NuRsEs Assoc [1995]. 1, 92-96.)
Social Access to the Internet
Authors: Bucy Erik P.
Published: March 2007

The relative costs and expertise associated with using the Internet, labeled technological and social access, have led to a concern about the rise of a “digital divide” between information haves and have-nots. To address whether and to what extent the Internet has become a medium of the masses and to identify the factors associated with social access to the Internet, I examine Internet use data from two statewide surveys, the Carolina Poll and the Indiana Poll, conducted during spring 1998. Multivariate analysis reveals that income, education, age, and family structure are important social determinants of on-line access and that Internet use is lowest among single mothers, members of lower socioeconomic groups, and older respondents. Although the online population is beginning to diversify, the Internet cannot yet claim a committed, nonelite mass audience. It is argued that the disparities in Internet use portend a looming information gap between those with access and those without.
Positioning Political Parties
Authors: Collins Neil , Butler Patrick
Published: March 2007

Political parties enjoy a symbiotic relationship with the media. Like commercial organizations, parties must know where they stand in their “market.” Marketing is not an activity that political parties may indulge in at their discretion; it is a constant and necessary political function that they attend to implicitly or explicitly, successfully or otherwise. The concern of this article is to move the analysis of political marketing to the strategic level. Rather than analyzing parties in terms of ideology, historical origin, or policy platforms, we consider them in terms of relative market standing or competitive position.
Getting the Message Out:
Authors: Coglianese Cary , Howard Margaret
Published: March 2007

Few social scientists have paid attention to how the press covers regulatory policy making in the United States. Those who have argue that the press does not cover regulatory policy with vigor. To assess this view, we compared what the Environmental Protection Agency did in one year with the coverage the agency received in two national newspapers in that same year. We find that the newspapers did not neglect the EPA. Although the newspapers certainly did not cover everything the agency did, they covered those regulatory actions that had the most direct impact on the public. The press gets out the message about regulatory actions that affect everyday life, shift policy in novel directions, and result in policy failure. Our findings suggest that scholars should pay more attention to the impact press coverage might have on the regulatory process.
Media Diplomacy
Authors: Gilboa Eytan
Published: March 2007

This article contends that the use of media diplomacy as a theoretical concept has been highly confusing and misleading. It substantially revises and restricts the concept to one particular and distinctive relationship between the media and diplomacy. The article expands and adds two more conceptual models, public diplomacy and media-broker diplomacy, to investigate the other relationships. Each model exists only when certain characteristics or conditions are present, and each has different professional and ethical ramifications for the three main factors involved in diplomacy: the government, the media, and public opinion. The article demonstrates the analytical usefulness of the models through applications to various examples and case studies of significant contemporary diplomatic processes.
From Saturated Elasticity to Finite Evolution, Plasticity and Growth
Authors: Epstein Marcelo
Published: March 2007

A complete theory of saturated nonlinear elasticity is formulated in terms of a relaxed energy function, whose existence and uniqueness are proved. Within this reversible context, it is shown that a normality rule for the post-saturated strains emerges naturally. Special consideration is given to saturation conditions expressed in terms of the logarithmic stress. Introducing the concept of material evolution, the passage to irreversible theories, such as plasticity and growth, is effected by means of a criterion of instantaneous healing imposed on any given underlying saturation scheme.
Image Singularities of Green's Functions for an Isotropic Elastic Half-Plane Subjected to Forces and Dislocations
Authors: Ma Chien-Ching , Lin Ru-Li
Published: March 2007

Although the Green's function for an isotropic elastic half-space subjected to a line force or a line dislocation is well-known, the physical meaning of the solution is not clear. Green's functions for twodimensional plane-strain and plane-stress problems of an isotropic elastic half-space with a free or rigidly fixed surface subjected to line forces and line dislocations are reexamined in this study. The results are more explicit when compared with existing solutions in the literature. The Green's function for a half-space consists of four or five Green's functions for an infinite space, the number depending on the boundary condition at the half-space surface and the applied loading. One of the Green's functions in the infinite space has its singularity located in the half-space where the load is applied, and the other image singularities are located outside the half-space with the same distance from the surface as that of the applied load. The nature and magnitude of image singularities have been derived from the principle of superposition and classified according to different loads. The image singularities are found to possess some interesting properties. It is found that the fundamental solutions required to construct all the image singularities of applied forces and dislocations for the half-space are only forces and dislocations and their differentiations in the infinite space. Furthermore, the limiting case of the applied force or dislocation approaching the surface is also discussed in this study.
Positive Definiteness of Anisotropic Elastic Constants
Authors: Ting T. C. T.
Published: March 2007

When the elastic constants of an anisotropic material are written as a 6 x 6 symmetric matrix C, the elastic energy of the material is positive if the matrix C is positive definite. There are two criteria that one can use to see if C is positive definite. We present each criterion and discuss its merits and drawbacks. For a two-dimensional deformation, it suffices to consider a 5 x 5 symmetric matrix C'. In the Stroh formalism for two-dimensional deformations, the matrix C0 is replaced by three 3 x 3 matrices N1, N2, N3. Deleting the elements that are either zero or unity, the N3 is reduced to a 2 x 2 matrix &3, and the N1 is reduced to a 3 x 2 matrix N1. We show that C' is positive definite if and only if N2 and - N3 are positive as well. The matrix N1 can be arbitrary. In particular, a new relation 1C0 I = I -N3 j IN2 I - is obtained. Generalized to three-dimensional deformations, it is shown that positive definiteness of the 6 x 6 matrix C is equivalent to positive definiteness of two 3 x 3 matrices. In the special case of monoclinic materials with the symmetry plane at xl = O,x2 = 0, or x3 = 0, positive definiteness of C is equivalent to positive definiteness of three 2 x 2 matrices.
The Maximum Modulus Eccentricities Surface for Masonry Vaults and Limit Analysis
Authors: Luccmmsi M. , Padovani C. , Pasquinelli G. , Zani N.
Published: March 2007

This paper presents a constitutive equation for masonry vaults which associates to each pair of generalized strains (A, K), where A are the strains, K are the curvature changes of the mean surface, the pair of generalized internal forces, (N, M) with N and M being the normal forces and bending moments per unit length, respectively The maximum modulus eccentricities surface is defined, and its main properties are proved. Subsequently, the limit analysis for masonry vaults is set forth and applied to the evaluation of the collapse load for a toroidal tunnel subjected to its own weight and an uniform load applied on the top circle.
An Analysis of the Linearized Equations for Axisymmetric Deformations of Hyperelastic Cylinders
Authors: Negron-Marrero Pablo V.
Published: March 2007

The equations describing the axisymmetric deformations of a cylindrical body composed of a hyperelastic isotropic material define a system in two variables (radius and height due to axisymmetry) of quasilinear partial differential equations subject to nonlinear mixed boundary conditions. The author considers the boundary value problem of specifying the displacement of the lateral surface of the cylinder subject to zero normal stresses on the top and bottom. It is shown that this problem admits a trivial solution consisting of a uniform expansion or compression in the radial and height directions. The author studies the linearization of the full nonlinear equations about the trivial solution and constructs solutions for the resulting system of linear partial differential equations. As a consequence of these explicit representations, one gets the characteristic equation defining the eigenvalues of the linearized problem, which represent bifurcation points of the nonlinear system. The corresponding eigenfunctions can be classified into those that are symmetric about the z = 0 axis (midplane of the cylinder) representing either necked or barreled states of the cylinder and those that break this symmetry. For a class of Hadamard-Green type materials and all cylinder heights, the existence of eigenvalues for the symmetry-preserving and symmetry-breaking characteristic equations is shown.
Structured Deformations as Energy Minimizers in Models of Fracture and Hysteresis
Authors: Choksi R. , Piero G. Del , Fonseca I. , Owen D.
Published: March 2007

This paper reviews recent theories of nonclassical, structured deformations and integral representations for their Helmholtz free energy. Energy minimizers for a body undergoing shearing at two different length scales and for a bar experiencing both smooth extension and macroscopic fractures are determined, and applications to the shearing of single crystals and to the cohesive fracture of solids are discussed. Yield, hysteresis, and the associated dissipation in two-level shears are shown to arise from instabilities at the micro level, and the dichotomy between brittle and ductile fracture is related precisely to a critical length of a bar.
Stem Cell Transplants for Multiple Sclerosis Provide New Options for Patients and New Challenges for Home Care
Authors: Zink Margo R. , Vance Mary Lynn , Vance Thomas
Published: March 2007

Multiple sclerosis (MS), a chronic disease of the central nervous system, had few treatment options until recently. Stem cell transplantation, originally used for cancer patients, may provide an opportunity for MS patients to stop the progressive course of their disease. This article describes the experience of an early participant in a stem cell transplant study at the Fred Hutchinson Cancer Research Center in Seattle. The procedure includes extensive outpatient evaluation, an inpatient stay, and a lengthy recovery period. A strong caregiver network and professional home care assistance provide the needed support system during this process.
Advanced Practice Nurses in Home Care: Is there a Role?
Authors: Milone-Nuzzo Paula , Pike Adele
Published: March 2007

The current challenges affecting home care make the environment ripe for the development of new models of advanced practice nursing in home care. This article explores the barriers and benefits of advanced practice nursing in home care and describes the changes needed to fully integrate the advanced practice nurse into the home care delivery system.
Establishing a Nursing Presence within a Community-Based Domestic Violence Program
Authors: Lancaster Sandra M.
Published: March 2007

Community-based domestic violence centers provide an array of services, tailored to meet the multiple needs of victims and their families: counseling, safe shelter, legal aid, and social services. One community-based center observed another unmet need among its clients: the essential need for a client and his or her family to achieve and maintain optimal levels of health and well-being. Collaborating with other community providers, a committee was created and charged with developing a health program that would address the need for case management, health education, and advocacy. This article chronicles the work of this organization in developing provider partnerships and support for integration of a nursing presence in this nontraditional practice setting. A case scenario is provided to demonstrate the complexity of a domestic violence victim’s needs and to illustrate how an advance practice registered nurse or extensively experienced and skilled baccalaureate-prepared registered nurse is well suited for this role.
The Role of the Managed Care Medical Director in Case Management
Authors: Waldman Clifford R.
Published: March 2007

Case management is a major element of most managed care organization’s (MCO) medical management programs. Although the responsibility for the actual case management activities rests with a wide range of health care professionals with specialized training, the MCO medical director must take an active role in the development, implementation, and evaluation of the case management program. The medical director’s clinical knowledge and experience makes him or her a valuable consultant for the case manager, and his or her communication and leadership skills allow him or her to take an active role in enhancing the effectiveness of the program both within the managed care organization and in the medical community.
Nonpharmacologic Measures to Reduce Cancer Pain in the Home
Authors: Rhiner Michelle , Dean Grace E. , Ducharme Sandra
Published: March 2007

A recent survey estimated that over 60 million people used unconventional therapies each year in the United States for a variety of ailments that included cancer pain, arthritis, acquired immunodeficiency syndrome (AIDS), gastrointestinal (GI) problems, incontinence, eating disorders, and headaches. The methods chosen included massage, acupressure, acupuncture, heat, cold, imagery, and biofeedback. Estimated out-of-pocket expenditure for those surveyed exceeded $10.3 billion per year. Health care providers have the opportunity to enhance cancer pain management, especially in the home setting, through the use of physical and cognitive methods. Optimal pain relief depends on a thorough nursing assessment, pharmacologic management, and appropriate nondrug interventions.
Perceived Quality of Sleep and Levels of Daytime Sleepiness among Elderly Women Caregivers of Alzheimer's Disease Patients
Authors: Riccio Patricia A.
Published: March 2007

Perceived quality of nocturnal sleep and levels of daytime sleepiness were measured using the S3Q and Nicholson Stone scales (sleep quality) and the Stanford Sleepiness scale (sleepiness). A sample of 15 elderly (mean age 72 [±8.9] years) women who were primary caregivers and who resided in the same household as the patient participated in the study for 3 consecutive days a week over a 9-week period. Results showed caregivers had "fair" sleep quality and a "moderate" level of daytime sleepiness.
What Clients with Panic Disorder Want Their Caregivers To Know
Authors: Busch Priscilla E.
Published: March 2007

This study investigated the experiences and concerns of individuals diagnosed with panic disorder. It addressed the family's response to the panic individual's sudden burst of emotional and somatic symptoms. The help-seeking behaviors and caregiver's reaction to the panic individual's distress are reported. The study looked at the intensity of symptoms experienced and treatments employed, and stressors and coping strategies used. A focused ethnologic method was selected. Eleven individuals were interviewed at a location of their choice for 1 to 3 hours and were audiotaped and later transcribed. An interview guide was used but the questions were open ended. The participants were either self-referred or referred by others aware of the author's interest. Participants recalled the intensity and frequency of attacks. In many instances family members were not viewed as supportive. Participants suggested that caregivers become more sensitive to their plight and not demean their symptoms. Education was emphasized. Many felt that physicians and nurses were not capable or willing to assist them. For some, medication controlled the attacks. Others refused medication or did not take it as prescribed. Cognitive/behavioral approaches were used minimally. The stigma of mental illness was evident in the participants' disclosure of shame and embarrassment.
Nursing Assessment of Families with Young Children: Developmental Screening Tools for Home Use
Authors: Curry Linda Cox , Bradley Patricia , Benefield Lazelle E.
Published: March 2007

Five assessment tools appropriate for families with young children are discussed. The tools chosen are valid and reliable and adaptable to use within the home setting. The tools identified are: The Brazelton Neonatal Assessment Scale, The Denver II, The HOME Scale, The Family APGAR, and The McMaster Family Assessment Device. With the shift in health care delivery into the community, nurses need to be prepared to complete assessments efficiently and effectively. The tools presented are widely used. None is diagnostic but each serves as a basis for further evaluation when combined with other available data. Each is best used when combined with a comprehensive, primary health care approach that is fundamental to health promotion and early intervention.
Increasing Performance and Motivating Staff for Middle Management
Authors: Greene Ida
Published: March 2007

As a leader, supervisor, or health care professional, you affect the behavior of persons working with you and under your leadership. Their performance is a direct result of your beliefs, attitude, and behavior. Likewise, your work ethics match your performance. And if you are performing at a high level, your employees will attempt to approximate what you do. People try to emulate and please the person to whom they are accountable. When you are excited, motivated, full of energy to improve and excel, your workers will be also. You can increase the performance of others by setting a high standard of performance for them to emulate. Therefore you must first motivate yourself. And you must maintain your joy and enthusiasm by working daily on your self-esteem. Constantly seek ways to increase your personal power by being a better person, a kind, sensitive, caring, humane person. The better you are as a role model, the greater will be your influence over others. Learn how to Light the Fire Within You™ to increase and maximize your performance and others'.
Grief, Long-Term Care, and Hospice: A Partnership to Enhance the Quality of Life of Dying Patients
Authors: LoCicero Jack P.
Published: March 2007

Facilitating the task of dying continues to be an ongoing problem for long-term care facilities. This problem is compounded by high staff turnover, inadequate grief training of staff, and a lack of emotional support for staff. As baby boomers continue to age, long-term care will be faced with the task of providing care to greater numbers of people. Developing a partnership with hospice is one way to assist long-term care in providing their front line staff with the appropriate training and skill development to face this task. This training will bring an enhanced quality of life to patients in their final days.
The Importance of Appropriate Admission and Recertification of Patients to Hospice
Authors: Hughes Angela R.
Published: March 2007

Hospice programs are under increased scrutiny by external regulatory enforcers today. Questions surrounding appropriate admission and recertification of patients to the Hospice Medicare Benefit have raised major concerns regarding patient care delivery, payment of services, and charges of fraud and abuse. To remain viable, hospices must have a thorough knowledge of current legislation, state and federal hospice eligibility and coverage criteria, and internal utilization patterns. Operation Restore Trust and Kennedy-Kassebaum legislation are two products of health care reform that hospices must understand to realize the repercussion of inappropriate admission and recertification of patients to a hospice benefit. The hospice teams' knowledge of eligibility and coverage requirements, National Hospice Organization (NHO) Guidelines for Determining Prognosis in Selected Non- Cancer Diseases, and the correlation between documentation and denial are critical for a successful hospice program today.
Creating an Ethical Foundation for Home Telemedicine
Authors: Roman Linda L. , Stockwell Scott C. , Louvier Vicki B. , Clements Faye
Published: March 2007

The entry of telemedicine into the home makes it imperative that home health care professionals prepare to meet the challenge of new ethical issues. Telehome health care accelerates the need for nurse training on a code of ethics, because this new method of health care delivery transforms the patient from the usual object to be acted on into the primary actor in his or her own self-care.
Traditional Practices of Neonatal Care in India
Authors: Schwoebel Ann
Published: March 2007

In the upheavals of its long history, India's traditions and mores have been continuously evolving. India has absorbed, adopted, and adapted outside cultures and influences, which have merged into Indian society. This article describes the traditional practices of childbearing and neonatal care in India today. The impact of 850 million people on the health care system along with the educational process for the Indian nurse is discussed. The author reports on her neonatal care experiences over the past 9 years in India.
Culturally Competent Care for Taiwanese Temporary Residents
Authors: (Daphne) Liang Hwey-Fang , De Chesnay Mary
Published: March 2007

This article describes a problem relevant to home health care, that of treating foreign nationals. The problems of providing culturally competent care for Taiwanese nationals stimulated the authors to review the literature and to conduct unstructured interviews with Taiwanese temporary residents of the United States in an effort to generate specific suggestions for improving the negotiation of the American health care system for these people. The first author, herself a member of the population of interest, conducted interviews in Chinese with members of her acquaintance. Findings were that, while language was often problematic, of more concern was the lack of understanding about Taiwanese culture that led health care providers to make inappropriate suggestions to their patients. Suggestions are offered for how home health care providers can decrease the confusion experienced by the Taiwanese patient.