bluuebunny/crossref_metadata_2025 huggingface dataset:
Cuidado humanizado de enfermería al final de la vida: el proceso humanizado de muerte
Authors: Lopera B. Martha Adiela
Published: September 2018

Esta investigación cualitativa con enfoque etnográfico busca describir el cuidado que brindan las enfermeras a los pacientes en proceso de morir según el significado que ellas le dan a la forma de morir. Para esto, se realizaron entrevistas a 23 enfermeras y 100 horas de observación en un hospital de Medellín, Colombia, entre noviembre de 2013 y noviembre de 2014. De acuerdo con los hallazgos, la muerte es un proceso que comprende desde el diagnóstico de enfermedad sin posibilidad de curación, hasta después del fallecimiento; las enfermeras buscan que este proceso tenga los atributos de una muerte humanizada, los cuales son: muerte digna: cuando la persona conserva sus derechos; muerte tranquila: cuando conserva sus preferencias; muerte buena o en paz: cuando es aceptada; y muerte linda: cuando la muerte sucede en casa. Se concluye que la muerte humanizada de los pacientes requiere la participación y liderazgo de la enfermera con acciones de cuidado.
Produtividade de Brassica oleracea em sistema de transição orgânica no Sul do Brasil
Authors: Moura Cláudia Solange de , Bisognin Ramiro Pereira , Silva Danni Maisa da , Guerra Divanilde , Bianchetto Renan , Souza Eduardo Lorensi de
Published: September 2018

A produção sustentável de alimentos é um paradigma atual da agricultura moderna. Diante da redução dos estoques mundiais de fertilizantes tradicionalmente empregados na agricultura, fontes alternativas de adubação podem ser utilizadas como opção de substituição parcial de nutrientes em sistemas de transição. O presente trabalho teve como objetivo avaliar a influência de fontes de nutrientes no cultivo da couve manteiga crioula em transição orgânica. Nesse estudo foram utilizadas quatro fontes de fertilização do solo, formando quatro tratamentos: fertilizante mineral NPK, adubo orgânico cama de frango, calcário e pó de rocha. O experimento foi conduzido em uma propriedade no município de Três Passos, Rio Grande do Sul. O delineamento experimental foi em blocos ao acaso com quatro repetições. Foram avaliadas: altura de plantas, número de folhas de plantas, peso de folhas, peso de plantas e produtividade. O fertilizante orgânico cama de frango obteve valor próximo ao adubo mineral NPK quanto à altura, peso, número de folhas e produtividade. Verificou-se que os tratamentos com calcário, pó de rocha, cama de frango e NPK obtiveram valores médios, respectivamente, de 7, 11, 15 e 23 Mg ha-1 de produtividade. O tratamento com pó de rocha apresentou resultado similar relação à cama de frango em todos os parâmetros avaliados. Com a utilização do pó de rocha como fonte de adubação é possível obter produtividades estatisticamente semelhantes àquelas obtidas quando a cama de frango é utilizada na couve, evidenciando o uso do pó de rocha como fonte alternativa para a fertilização.
Calotropis procera (Ait.) Apocynaceae cultivada em substratos orgânicos
Authors: Moreira Francisco José Carvalho , Menezes Ademir Silva , Nascimento Francisco Mikael Oliveira , Silva Maria Elisâgela Souza , Pinheiro Neto Luis Gonzaga
Published: September 2018

Várias são as fontes de insumos orgânicos que podem ser utilizadas no meio agrícola para a produção de mudas. Objetivou-se com este trabalho avaliar a porcentagem de emergência de plântulas de ciúme (Calotropis procera) e seu crescimento inicial em diferentes substratos, no sentido de averiguar qual dos substratos apresenta melhor comportamento para esta espécie. O experimento foi conduzido no Instituto Federal do Ceará Campus Sobral, sendo doze substratos areia; Solo; Esterco caprino; Bagana; fibra de coco; Areia + esterco; Areia + fibra de coco; Areia + bagana; Solo + esterco caprino; Solo + fibra de coco; Solo + bagana; Solo + esterco caprino + bagana) com quatro repetições. Foi mensurada a porcentagem de emergência, altura das plantas, diâmetro caulinar e número de folha, comprimento de raiz, massa seca da parte aérea e massa seca de raiz das plantas de ciúme. Os substratos quando combinados com fibra de coco, bagana e esterco caprino proporcionam melhores condições de vigor e melhor desenvolvimento da parte aérea das plantas de ciúme. Os substratos considerados não ideais para emergência de plântulas de C. procera são esterco caprino e solo + esterco caprino.
Extratos de nim no controle da Spodoptera frugiperda em milho
Authors: Uchôa Luiz Romário , Almeida Filho Ivan Isidorio de , Souza Joaci Pereira , Santos Cristian De França , Santos Daniel Lima
Published: September 2018

O milho é uma cultura de grande importância econômica, no entanto, é bastante prejudicada pelo ataque da lagarta do cartucho, onde é utilizado o controle químico, que é tóxico à biodiversidade, necessitando-se desenvolver alternativas de controle natural. Assim, objetivou-se avaliar os efeitos de diferentes extratos derivados de nim no controle da lagarta-do-cartucho (Spodoptera frugiperda) em cultivo de milho irrigado. O experimento foi conduzido em condições de campo, no Instituto Federal de Educação, Ciência e Tecnologia do Ceará, Campus Iguatu. Para a realização do experimento, foi utilizado o delineamento em blocos ao acaso, com 6 tratamentos e 4 repetições totalizando 24 parcelas. Os tratamentos à base de nim utilizados foram: sem inseticida; frutos; folhas; folhas + sementes; óleo comercial e o inseticida químico. Avaliou-se o nível populacional das lagartas (S. frugiperda) assim como o comprimento das mesmas aos 18, 36, 54, 72 e 90 dias após o plantio. Paralelamente, realizou-se uma avaliação visual dos danos provocados ao cartucho e folhas expandidas das plantas de milho, com base em uma escala visual (escala Dives). O tratamento com os frutos do nim apresentou os melhores resultados em todas as variáveis analisadas, podendo ser utilizado em substituição de produtos químicos no controle da lagarta-do-cartucho. Para o número e comprimento das lagartas, os tratamentos com frutos e inseticida químico se destacaram dos demais. Em relação aos danos, os tratamentos com frutos, folhas, frutos mais folhas e inseticida químico não tiveram diferença estatística entre si. O tratamento com óleo comercial de nim não apresentou resultados satisfatórios.
Adubos orgânicos no desenvolvimento de variedades da palma forrageira
Authors: Lima Wagner Dos Santos , Perez-Marin Aldrin Martin , Lambais George Rodrigues
Published: September 2018

A palma forrageira é uma cultura de extrema importância para o semiárido brasileiro, sendo utilizada como fonte alternativa para alimentação dos rebanhos em períodos críticos de estiagem. No entanto, para que essa espécie consiga atingir todo seu potencial de crescimento são necessários solos que apresentem bons níveis de fertilidade. Objetivou-se avaliar o desenvolvimento de três variedades de palma forrageira, resistentes à cochonilha do carmim, com diferentes fontes de adubação orgânica. O delineamento experimental utilizado foi de blocos casualizados, com quatro repetições, no esquema fatorial (3x4): três variedades de palma forrageira (Orelha de Elefante Mexicana, Baiana e Miúda/Doce) e quatro tratamentos de adubação (Esterco, Ácido fúlvico, Ácido húmico e Testemunha). Aos 90 e 240 dias após o plantio, foram realizadas avaliações de desenvolvimento das plantas, tais como o índice de sobrevivência; altura da planta; número de brotações por planta; bem como as variáveis para os cladódios (área, índice de área, peso médio, comprimento, largura e espessura) e por fim, a produtividade média de fitomassa. A adubação com esterco apresentou resultados significativos para a área de cladódio e o índice de área de cladódio, principalmente na variedade Orelha de Elefante Mexicana em relação à testemunha e o Ácido fúlvico. O aumento da área de cladódio nessa variedade de palma forrageira em função da aplicação de Esterco representou 63, 34 e 40% sobre o Ácido fúlvico, Ácido húmico e a Testemunha, respectivamente. A variedade Orelha de Elefante Mexicana respondeu positivamente à adubação com Esterco, obtendo a maior produtividade média de fitomassa entre as demais estudadas, com 81 t ha-1 ao final do experimento. Dentre as fontes de adubos orgânicos utilizadas, somente o Esterco teve um efeito significativo para a variedade de palma forrageira Orelha de Elefante Mexicana.
Association of HindIII-polymorphism in kappa-casein gene with milk, fat and protein yield in holstein cattle*
Authors: Miluchová Martina , Gábor Michal , Candrák Juraj , Trakovická Anna , Candráková Kristína
Published: September 2018

The aim of the paper was to evaluate the effect of genetic polymorphism of kappa-casein on the milk production in Holstein cattle. A total 210 cows of Holstein cattle were use in this study. On the basis of PCR-RFLP analyses we established genotype structure of cattle population and calculated allelic frequencies. In Holstein cattle population was detected all three genotypes – AA (69.52%), AB (27.62%) and BB (2.86%). The frequency of allele A was 83.33% and allele B was 16.67%. Effectiveness of allele incidence and genetic diversity was evaluated with following parameters: theoretical heterozygosity (Heexp), experimental heterozygosity (Heobs), polymorphism information content (PIC), expected homozygosity (E), effective number of alleles (ENA), level of possible variability realization (V%). The Holstein cattle kept in Slovak Republic exhibit high value of homozygosity and low values of polymorphism information content, effective number of alleles and level of possible variability realization. The effect of polymorphism of CSN3 gene on average breeding values for milk production traits as the yield of milk, fat and protein in kilograms as well as contents of fat and protein in percentages was detected using by the packed SAS 9.3 of SAS Enterprise Guide 5.1. We detected statistical significant difference between genotypes only at an average breeding value for the percentage of protein in milk during assessment the variability of observed traits in depending on polymorphism of CSN3 gene. For other breeding values the impact of individual genotypes CSN3 gene on their variability was not observed.
Influence of oleic acid in different solvent media on BRL 3A cell growth and viability
Authors: Liu Runqi , Xu Chuang , Yang Wei , Xia Cheng , Chen Yuanyuan , Gao Sansi , Huang Baoyin , He Ping , Dong Zhihao
Published: September 2018

Abstract: Oleic acid (OA) is widely used in pathology studies of hepatocellular lipid deposition. Identifying the effects of different solvents on OA-induced liver lipid deposition would be beneficial for studies on hepatocytes. We treated BRL 3A cells with OA dissolved in different solvents. After 12 h incubation, cell viability was assessed using MTT assays, reactive oxygen species (ROS), triglyceride (TG) and  total cholesterol (TC) counts, and expression level of glucose regulated protein (GRP78), sterol regulatory element binding protein (SREBP-1C) and fatty acid synthase (FAS) were analyzed. As results, H2O, PBS and DMSO are disadvantageous to the dissolution of OA that did not cause the corresponding response of hepatocytes. Alcohol+OA group caused severe ER stress, oxidative stress and hepatic fat deposition degree were significantly increased, but the alcohol group also leads to liver injury. BSA can promote cell growth and 1.2% BSA+OA group showed a lower grade TG and endoplasmic reticulum stress compared with KOH+OA and Alcohol+OA groups. KOH was not effective for BRL 3A cells. When treated with OA dissolved in KOH, BRL 3A cells showed a typically hepatocyte damage. KOH was considered the suitable choice of OA solvents for BRL 3A cells in hepatic lipidosis research.
An investigation into Designing Smart city in Accordance with Designing for Children toward Child-Friendly Smart Cities
Authors: Rastegar Amir , Irani Mazdak , Shojaedingivi Behzad
Published: September 2018

The process of urban planning should be multi-dimensional and comprehensive meaning that it takes into consideration all groups of people especially less able ones. Children are one of these groups who should be taken into consideration more in urban planning and urban design. Planning to make cities smart is one of the new approaches in urban design. However, children are often largely ignored in these plans. The researchers of the present study tried to examine the position of children in smart city-related planning. To this end, the concepts of child-friendly cities are dealt with and studied so that its common indexes with the smart city would be extracted hoping that the position of children in smart cities would be considered more. The research method employed in the study is library-based and analytic-descriptive.
Health Promotion and Disease Prevention in the Worksite
Authors: LUSK SALLY L.
Published: September 2018

U.S. and Canadian research studies (n = 73) on health promotion/disease prevention programs in the worksite reported from 1990 through 1994 were reviewed for this chapter. In those studies, diverse intervention foci were provided and outcomes specific to the foci, as well as numerous additional outcomes, cost and cost benefit being the most common, were measured. To aid future researchers, two appendices list reports by foci of intervention and by outcomes measured. Deficiencies and inadequacies in reports and studies are described. Nearly all (68 out of 73) of the published studies obtained positive results in terms of benefiting health or reducing costs. The Johnson & Johnson LIVE FOR LIFE Program® is presented as an exemplar of a comprehensive, multifaceted, worksite health promotion/disease prevention program whose effects were consistently assessed. Although health promotion and prevention of disease has always been an important component of nursing practice, few reports included nurse scientists as authors or coauthors. Potential explanations for the limited involvement by nurse scientists and recommendations regarding future research directions are presented. The worksite remains the best place to promote improved health for adults and this area of research represents an opportunity for greater involvement by nurse scientists.
The Development of Sexual Risk Taking in Adolescence
Authors: JADACK ROSEMARY A. , KELLER MARY L.
Published: September 2018

This chapter reviews literature from 1985 to the present that is focused on the development of sexual behaviors in adolescents, decision making about sexual behavior, and sexual risk-taking behaviors. Results show that sexual behavior is part of most people’s lives from childhood through adulthood, and that the majority of adolescents begin to engage in sexual behaviors in their teenage years. Synthesis of this large body of research reveals a lack of theoretical frameworks to guide research in sexual risk taking, resulting in an incomplete understanding of the predictors of sexual risk-taking behavior in adolescents. New and broader approaches in the study of sexual risk taking are needed that include consideration of the social and developmental context from which adolescents make decisions about sexual behavior.
Health Promotion in Old Age
Authors: HEIDRICH SUSAN M.
Published: September 2018

The empirical literature on health promotion in old age was reviewed. A developmental perspective was used to examine 42 studies: studies relating health behaviors to health outcomes, descriptive studies of health promotion in old age, studies of the outcomes of health promotion programs in old age, and studies of factors related to older adults’ participation in health promotion activities. In general, elderly adults perceived health promotion activities as beneficial, engaged in health behaviors more frequently than younger adults, and participated in community-based and other health promotion programs. There is little definitive evidence that health promotion activities result in better health outcomes for older adults, however. Identifying appropriate outcomes related to health promotion in old age is a critical need.
Childhood Nutrition
Authors: KENNEDY CHRISTINE M.
Published: September 2018

This review focuses on the research in normative nutrition for children aged 2 to 12, published from 1985 to 1996. The chapter uses a primary prevention framework and the Healthy People 2000 (Public Health Service, 1990) objectives to identify and review those areas relevant for childhood health promotion and nursing practice. Current research demonstrates that food intake in early childhood is causally linked to health-related problems later in life, therefore obesity and cardiovascular research are highlighted in this review. Environmental and societal factors affect the nutritional health of children, thus the contribution of the media, poverty, cultural, and family practices are also reviewed. The chapter concludes with a summary of strengths and weaknesses of the body of research and suggestions for a nursing agenda in the area of childhood nutrition.
Prevention of Mental Health Problems in Adolescence
Authors: KOOLS SUSAN
Published: September 2018

Mental health problems in adolescence are noteworthy in that they are outside of the normative adolescent developmental experience. Twenty percent of adolescents in the United States experience significant and persistent mental disorders, which indicates the need for prevention and early intervention. The purpose of this chapter is to review research on the prevention of mental health problems in adolescence. Various sociocontextual factors that place an adolescent at risk for mental health problems are examined. In particular, studies that identify risk factors for problems common to adolescence, including depression, suicide, and disorders of conduct and eating are reviewed. Evaluative research on prevention and early intervention programs in this substantive area are also critically reviewed. A summative report and critique on the state of research in this area is given along with suggestions for future research. A call for the active involvement of nursing in this research agenda is made.
Wandering in Dementia
Authors: ALGASE DONNA L.
Published: September 2018

In this paper, published research studies addressing the phenomenon of wandering in dementia are reviewed. Empirical findings of 108 studies are categorized and summarized to reveal dimensions of wandering behavior, significance of wandering as a clinical phenomenon, correlates of wandering, and tested intervention strategies. Implications for improving methodological rigor of future studies are offered and gaps in the current knowledge base are identified.
Uncertainty in Chronic Illness
Authors: MISHEL MERLE H.
Published: September 2018

In this chapter, the research on uncertainty in chronic illness is reviewed and critiqued. Two theoretical perspectives of uncertainty that can be applied across the range of chronic illness are presented. Research on the causes and consequences of uncertainty in chronic illness are considered and critiqued. The review addresses research on adults and on parents of chronically ill children. Conclusions include the areas requiring further investigation.
Music Therapy
Authors: SNYDER MARIAH , CHLAN LINDA
Published: September 2018

Nurses have used music as an intervention for many years. A sizeable number of investigations to determine the efficacy of music in managing pain, in decreasing anxiety and aggressive behaviors, and in improving performance and well-being have been conducted by nurses and other health professionals. Nursing and non-nursing research reports published between the years 1980–1997 were reviewed. Great variation existed in the type of musical selection used, the dose of the intervention (number of sessions and length exposure), the populations studied, and the methodologies used. Overall, music was found to be effective in producing positive outcomes.
Family Interventions to Prevent Substance Abuse: Children and Adolescents
Authors: LOVELAND-CHERRY CAROL J.
Published: September 2018

Substance abuse often begins in adolescence and is a major factor determining health outcomes for adolescents and adults; thus, it is an important focus for prevention strategies. The use of drugs, especially alcohol, can lead to chronic addiction to substances as well as contribute to a number of common chronic conditions. These conditions include cancer, cardiovascular disease, disability from accidents or violence, and unplanned pregnancy and are major causes of morbidity and mortality among adolescents and adults. As the major social unit responsible for socialization of children and stabilization of adult personalities, the family has been the target of prevention efforts. In this chapter the empirical literature on family interventions to prevent substance use in adolescents is critically reviewed, generalizations and implications for practice identified, and directions for future research projected.
School-Based Interventions for Primary Prevention of Cardiovascular Disease: Evidence of Effects for Minority Populations
Authors: MEININGER JANET C.
Published: September 2018

The purposes of this review were to analyze and evaluate the results of school-based studies that have used population-wide approaches for primary prevention of cardiovascular diseases and to assess the extent to which strategies tested to date have been effective for minority populations in the United States. The literature included in the review was restricted to studies published between 1986 and August 1999; they sampled elementary, middle, or high school students and incorporated a control or comparison group. There were no consistent effects of school-based interventions on blood pressure, lipid profiles, or measures of body mass and obesity. There was evidence that changes in knowledge and health behaviors occurred. Findings are interpreted within the context of population-wide approaches to prevention, and recommendations for future research directions are discussed.
Children with Epilepsy: Quality of Life and Psychosocial Needs
Authors: AUSTIN JOAN K. , DUNN DAVID W.
Published: September 2018

In this chapter, research related to quality of life in children with epilepsy and their psychosocial needs is reviewed. Nursing and nonnursing research reports and descriptions of instruments developed between January 1994 and February 1999 are included. Most research reports described quality-of-life problems, especially psychological functioning in school-age children. Less attention was devoted to psychosocial needs. Major gaps included intervention studies and research on infants and young children. Conclusions include recommendations for future research.
Adherence in Chronic Disease
Authors: DUNEAR-JACOB JACQUELINE , ERLEN JUDITH A. , SCHLENK ELIZABETH A. , RYAN CHRISTOPHER M. , SEREIKA SUSAN M. , DOSWELL WILLA M.
Published: September 2018

Nonadherence to treatmeot regimen is a prevalent problem of patients with chronic disorders. Approximately half of the patients with a chronic disease have problems following their prescribed regimen to the extent that they are unable to obtain optimum clinical benefit. This chapter reviews the state of knowledge regarding adherence to chronic disease regimens across the life span and demonstrates that the extent and nature of the adherence problems are similar across diseases, across regimens, and across age groups. Adherence to the commonly prescribed regimens is addressed, including pharmacological therapies, therapeutic diets, and therapeutic exercise. Randomized, controlled studies focusing on various educational, behavioral, cognitive, and affective interventions to improve adherence are included. Based on this review, further work is needed to better understand and improve adherence. New strategies for analysis and measurement will support these needed advances in the field of adherence.
Intimate Partner Violence Against Women
Authors: HUMPHREYS JANICE , PARKER BARBARA , CAMPBELL JACQUELYN C.
Published: September 2018

Intimate partner violence against women has received considerable attention from nurse-researchers over the past 10 years. Although the amount and sophistication of both quantitative and qualitative research have changed over time, nursing research on intimate partner violence against women has not lost its perspective; nurse-researchers have continued to address women survivors’ full range of human responses to violence. Research into violence during pregnancy and battered women’s psychological responses to abuse have received considerable attention. Research into violence during pregnancy and battered women’s psychological responses to abuse have received considerable attention. Research into violence during pregnancy accounts for fully 20% of all the reviewed nursing research. The largely qualitative research into women’s psychological. responses to violence is particularly rich and remarkably similar across multiple studies. International studies on intimate partner violence are beginning to appear in the literature and research that addresses the unique experience of ethnically diverse women is occurring with greater frequency. The purpose of this chapter is to review nursing research on intimate partner violence against women in the past decade. Future directions for nursing research, practice, and education are included.
Female Troubles: An Analysis of Menstrual Cycle Research in the NINR Portfolio As a Model for Science Development in Women’s Health
Authors: REAME NANCY K.
Published: September 2018

The National Institute for Nursing Research (NINR) has been active in developing a research portfolio of investigator-initiated studies in addressing the cause and consequences of menstrual cycle and menopause-related health problems, This chapter provides an overview of the nature and level of research activity funded by NINR since its inception in 1986, major findings generated by the most successful award recipients, the impact on the broader field of women’s reproductive health and directions for future research. Presented here is an analysis of research designs and methodologies framed within the context of 4 stages of scientific development in the field: exploratory, descriptive studies in well women; illness as a biobehavioral phenomenon; knowledge generation in understudied populations; and the development and testing of clinical therapeutics for symptom management and health promotion strategies. Nursing science contributions to the NINR portfolio of women’s health research has been focused primarily on the definition and management of the symptoms of premenstrual syndrome and menopause. The increasing numbers of intervention studies suggests a coming-of-age in nursing science with respect to the development of evidence-based outcome data for the management of menstrual cycle and menopause-related symptoms. Clearly, the range and diversity of NINR grant-funded activity suggest that menstrual cycle research is a strong area of interest in nursing science.
Hearing Impairment
Authors: WALLHAGEN MARGARET I.
Published: September 2018

The purpose of this chapter is to review the literature on hearing impairment, specifically the impact of hearing impairment on the functioning of elders, interventions that minimize the impact of hearing loss on functioning, and identification of issues raised by the review for nursing research. Computerized (MEDLINE, PsychINFO, and CINAHL) and manual searches were used to obtain research reports from a range of disciplines. Research articles including elders (≥ 60) and published between 1989 and 2001 were included. Twenty-five articles were selected for critical review, four written by nurses. The diversity of methodologies, the criteria used to define hearing impairment, the range of sample characteristics, and the assessment measures make comparisons across studies difficult. Most studies, however, support the negative impact of hearing impairment, especially on psychosocial functioning. Measures that are condition specific are generally more effective in capturing the impact of hearing loss than generic measures. Findings related to physical disability are less consistent. The results of intervention studies suggest that hearing devices can improve psychosocial and communication outcomes, but behavioral interventions have not shown long lasting benefit. For nurses to assist elders and their families manage the impact of hearing impairment, further research is needed in several areas that have been poorly explored. These include the dyadic experience of hearing impairment, the way in which culture influences the experience of hearing loss, the needs of hearing impaired individuals across settings, the long-term impact of ototoxic medications, and strategies to assist elders in coping with hearing impairment and utilizing available technologies.
Pressure Ulcer Prevention and Management
Authors: LYDER COURTNEY H.
Published: September 2018

This chapter reviews 218 published and unpublished research reports of pressure ulcer prevention and management by nurse researchers and researchers from other disciplines. The electronic databases MEDLINE (1966-July 2001), CINAHL (1982-June 2001), AMED (1985-July 2001), and El Compedex*Plus (1980-June 2001) were selected for the searches because of their focus on health and applied research. Moreover, evaluations of previous review articles and seminal studies that were published before 1966 are also included. Research conducted worldwide and published in English between 1930 and 2001 was included for review. Studies using descriptive, correlational, longitudinal, and randomized control trials were included. This review found that numerous gaps remain in our understanding of effective pressure ulcer prevention and management. Moreover, the majority of pressure ulcer care is derived from expert opinion rather than empirical evidence. Thus, additional research is needed to investigate pressure ulcer risk factors of ethnic minorities. Further studies are needed that examine the impact of specific preventive interventions (e.g., turning intervals based on risk stratification) and the cost-effectiveness of comprehensive prevention programs to prevent pressure ulcers. Finally, an evaluation is needed of various aspects of pressure ulcer management (e.g., use of support surfaces, use of adjunctive therapies) and healing of pressure ulcers.
Pain in Older Adults
Authors: MILLER Lois L. , TALERICO KAREN A.
Published: September 2018

This chapter reviews 80 published research reports of pain and pain problems in older adults by nurse researchers and researchers from other disciplines. Reports were identified through searches of MEDLINE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) using the search terms pain, older adult, aged and pain, and dementia. Reports were included if published between 1985 to 2001, if conducted on samples age 60 or older, if conducted by nurses or relevant to nursing research, and if published in English. Descriptive, qualitative, correlational, longitudinal, and intervention studies were included. Key findings include the following: pain is widely prevalent in older adult populations; few studies have included minority groups; underidentification and undertreatment of pain in older adults is a consistent interpretation of research findings; pain intensity rating scales are as valid and reliable in older populations as in younger populations; current observational methods of assessing pain in cognitively impaired older adults must be used with caution; nursing intervention studies demonstrate the beneficial effects of education and interventions aimed at improved pain assessment. The main recommendations are: careful attention should be given to the conceptualization and definition of pain; examination of pain should include physiological, motivational, cognitive, and affective factors; studies evaluating undertreatment of pain should include measures of pain selfreport; standardized pain measures should be used; studies of persons over the age of 85 and studies of ethnic minorities are needed; more attention should be given to nursing intervention studies and should include both pharmacological and nonpharmacological, psychosocial interventions.
Children Living With Chronic Illness: An Examination of Their Stressors, Coping Responses, and Health Outcomes
Authors: STEWART JANET L.
Published: September 2018

This chapter reviews nursing research from the last decade on children and adolescents coping with chronic illnesses. Studies were identified by searches of MEDLINE and CINAHL and were included if at least one primary author was a nurse, the primary informants were children, and the focus of the study was on children’s responses to illness and/or developmental stressors. Synthesis of the reviewed studies yielded typologies of illness-related and developmental stressors faced by chronically ill children, the coping strategies they commonly employed, and indices of their adjustment to illness. Although there was considerable agreement across illnesses, age ranges, and methodologies, the lack of explicitly employed developmental models or other theoretical perspectives means that very little is known about the processes by which individual characteristics, stressors, coping strategies, and outcomes are related. Recommendations for future research include the development and testing of conceptual models that will promote our understanding of how children’s medical, psychosocial, and developmental outcomes can be improved, and a more systematic approach to understanding how children’s maturing cognitive abilities affect their appraisal of stress and utilization of coping strategies in response to the demands of chronic illness.
Cancer in U.S. Ethnic and Racial Minority Populations
Authors: UNDERWOOD SANDRA M. , POWE BARBARA , CANALES MARY , MEADE CATHY D. , EUN-OK IM
Published: September 2018

Discoveries, breakthroughs, and advances made in the area of cancer prevention and cancer control over the last 2 decades have led to declines in the rates of cancer incidence and mortality and increases in life expectancy and survival for many cancer patients. However, although the trends relative to cancer incidence, mortality, and 5-year survival for the nation as a whole have significantly improved, data reveal that there are significant disparities in the degree to which the burden of cancer that remains is borne by racial and ethnic minority population groups. As a practice-oriented discipline grounded in research, nursing could have a dominant role in efforts aimed toward eliminating the cancer disparities experienced by racial and ethnic population groups. Several reports of nursing studies have been published in the peer-reviewed literature that address factors associated with the cancer disparities experienced between and among U.S. racial and ethnic minority groups. However, given that few efforts have been undertaken to comprehensively review and critique this body of research, little is known about the scope, quality, and potential impact of this body of nursing science. This report presents the results of one of the first comprehensive reviews of nursing research undertaken to explore and address factors associated with the evolution of the cancer-related health disparities in ethnic and racial minority population groups within the United States. The findings reveal that, while the body of nursing research has contributed much to the identification and understanding of factors associated with the excess cancer morbidity and mortality of minority populations, in order for the profession to more fully contribute to the elimination of cancer-related disparities, there is a need for nurses to further expand and strengthen this base of knowledge.
Utilization of Complementary and Alternative Medicine Among Racial and Ethnic Minority Populations: Implications for Reducing Health Disparities
Authors: STRUTHERS ROXANNE , ANNE NICHOLS LEE
Published: September 2018

This chapter provides a review of research literature and describes the use of complementary and alternative medicine (CAM) among racial and ethnic minority populations. The relevance of CAM to health disparities is also discussed. Complementary and alternative medicines are terms used to describe methods of health care beyond the usual Western biomedical model. These treatments are prevalent and increasing in the United States. Many CAM therapies are ancient therapies among certain racial and ethnic minorities. Thus, it seems that complementary and alternative medicine is being used and/or could be used to decrease health disparities among these populations. A review of 26 research articles shows that we are at the beginning stages of examining this phenomenon and that CAM use by any population is only now being described. Of the reviewed studies, 19 studies documented use of CAM among racial and ethnic minorities; 7 revealed that CAM is not used more among ethnic groups than among White (non-Hispanic) populations. Although it is known that racial and ethnic people utilize CAM, the vast array of research questions and aims, CAM definitions, CAM practitioners, and diverse research methodologies result in mixed research findings and conclusions. In some instances, utilization of CAM modalities is stated to be a result of culture among particular groups. Even so, there is currently no evidence that scientifically supports the notion that CAM can be used to reduce health disparities within racial and ethnic minority populations.
Structural and Racial Barriers to Health Care
Authors: BOLTON LINDA B. , GIGER JOYCE NEWMAN , GEORGES C. ALICIA
Published: September 2018

Limited access to health care and a system fraught with discriminatory practices inhibit some racial and ethnic minorities from gaining access to health care and assurance of equal treatment once they enter the health care system. The purpose of this chapter is to critically and systematically analyze the research literature to determine what impact individual and institutional racism has had on the prevailing health disparities across racial and ethnic minority groups. The chapter includes the following: (1) a review of the term racism and a brief overview of the history of racism in health care; (2) a review of the research literature analyzing the impact of racism on health disparities; and (3) recommendations to end the systematic institutional racism in scientific research, which is necessary to end health disparities.
Race and Racism in Nursing Research: Past, Present, and Future
Authors: PORTER CORNELIA P. , BARBEE EVELYN
Published: September 2018

Nursing research on race and racism began in the 1970s. However, because these concepts were seen as cultural attitudes, race and racism were obscured. The evidence on the presence of negative attitudes, biases, and stereotypes about different racial and ethnic groups is inconsistent. During the past two decades, research on race and racism has grown, but there is still an urgent need for more high-quality research on this subject. The major recommendations from this review are to conduct observational research on racism in clinical and practice settings, not as an intellectual end in itself; to assist in eliminating of the historically based disparities among members of racial and ethnic groups; and to conduct research about racism as it affects mobility in educational and practice settings.
Fall and Injury Prevention
Authors: Currie Leanne M.
Published: September 2018

Falls and related injuries are increasingly being recognized as a nursing-sensitive quality indicator, and they continue to be an unsolved patient safety problem in inpatient and outpatient care areas as well as in the community at large. The purpose of this review is to summarize the current research related to fall and injury prevention. The chapter is organized presenting research in (1) the community and (2) acute and long-term care settings. For each setting, the research that addresses risk factors, risk assessment instruments, and fall and injury prevention efforts are reviewed. There is a large body of research that investigates fall and injury prevention across the care continuum. In the community setting, targeted risk evaluation in the emergency department and management of vitamin D deficiency appear to be promising preventive methods. However, further research needs to explore staffing ratios, automated methods of assessing and communicating fall risk, improved methods and timing of risk evaluation and methods by which existing and new evidence might be translated into practice.
Psychoneuroimmunology and Related Mechanisms in Understanding Health Disparities in Vulnerable Populations
Authors: Briones Teresita L.
Published: September 2018

The nervous system as well as the endocrine system maintain extensive communication with the immune system through the influence of hormones and neurotransmitters and also by way of the hardwiring of sympathetic and parasympathetic nerves to the lymphoid organs. There is now convincing evidence that the communication between these three body systems is bidirectional. This chapter will provide a succinct review of how neuroendocrine and immune functions are affected in factors that impact vulnerability, such as aging, acute infection, and central nervous system injury. Given that the relevant literature on these topics is vast, the presentation in this chapter will serve to highlight primary references that reflect state of the science in these systems of focus.
Rural Health Nursing Research Review: Global Perspectives
Authors: Greiner Doris S. , Glick Doris F. , Kulbok Pamela A. , McKim Mitchell Emma
Published: September 2018

The CINAHL and MEDLINE databases were used to conduct a review of international rural nursing research published between 2003 and 2007. In total, 41 articles were reviewed and organized based on the United Nations Human development Index, which categorizes countries based on development status. Critical review of international rural nursing research yielded three major organizational themes: clinical issues, aspects of nursing practice, and nursing and health policy research. Despite the variety in international locale of the research, these themes and other common findings emerged. The need for increased access to specialized nursing knowledge, resources, and support is an ongoing issue facing nurses in rural and remote settings.
Matters of the Heart: Cardiovascular Disease and Rural Nursing
Authors: Stewart Fahs Pamela , Kalman Melanie
Published: September 2018

Cardiovascular disease (CVD) is the leading cause of death in the United States and around the world. Most of the work done on CVD among rural populations uses mortality versus prevalence rates because prevalence data for rural populations is difficult, if not impossible, to find in national data sets as currently published. Cardiovascular disease is a significant threat to rural dwellers and those in rural nursing need evidence on which to base their practice. This chapter provides an examination of the CVD literature as it relates to rural populations with an emphasis on studies that include or are limited to rural women as subjects. Topics reviewed included: awareness and symptoms of heart disease among women, heart failure (HF) in rural women, hypertension (HTN) in rural areas, stroke in rural populations, quality care in acute myocardial infarction (MI) in rural facilities, mortality and CVD, and CVD risk factors in rural populations. The authors reviewed 134 research articles published between 2000 and 2007. Overall, the CVD research literature in rural populations has small sample sizes, except for epidemiologic studies, and tends to be descriptive in nature. There is a dearth of literature on prevalence among rural populations from a national perspective and little is written on interventions to reduce CVD risks and physiological markers that include large samples from rural populations. Future nursing research on CVD in rural populations needs to move beyond the descriptive to intervention studies, which need to be robust in power to guard against Type II errors.
An Attempt to Improve Self-Esteem by Modifying Specific Irrational Beliefs
Authors: Nielsen David M. , Horan John J. , Keen Bethanne , St. Peter Carolyn C. , Ceperich Sherry Dyche , Ostlund Deborah
Published: September 2018

In a double-blind study, subjects with low to moderate self-esteem received either of two cognitive restructuring interventions. The experimental treatment addressed specific irrational beliefs previously found to be correlated with low self-esteem; the control treatment focused on irrational beliefs not empirically related to self-esteem. Each intervention produced appropriate changes on targeted irrationality measures. The pattern of changes on targeted and nontargeted irrationality scales, however, suggests that improvements in specific rationality readily generalize, a phenomenon which may have obscured posttest differences between the two interventions on a battery of self-esteem measures. Nevertheless, the self-esteem improvements of subjects within each treatment were consistently related to changes on the previously linked beliefs, and conversely, only sporadically related to changes on the nonlinked beliefs.
Self-Other Working Models and Eating Disorders
Authors: Friedberg Naomi L. , Lyddon William J.
Published: September 2018

In this study, Bartholomew’s (1990) four-category model of attachment (secure, preoccupied, dismissing, and fearful) was used to test Guidano’s (1987) notion that the personal cognitive organization (P.C. Org.) of individuals with eating disorders is characterized by an enmeshed, preoccupied working model of attachment. Consistent with this characterization, Bartholomew’s preoccupied and secure attachment dimensions were found to significantly discriminate a clinical eating disorder sample (n = 17) from normal subjects (n = 27).
Postmodern Cognitive Psychotherapy: Moving Beyond Modernist Dualisms
Authors: Lyddon William J.
Published: September 2018

Despite their range of reactions, the rejoinders to Lyddon and Weill’s article (in this issue) converge on two fundamental issues facing cognitive psychotherapists in the postmodern era: (1) the relation between human knowing and reality and (2) contrasting constructions of the self. In this article I critically evaluate the various rejoinders with respect to these issues. I also suggest that recent developments in the cognitive sciences parallel the postmodern shift away from modernist dualisms and dichotomies toward a more complex and integrative view of psychological phenomena.
Articulated Cognitive Distortions and Cognitive Deficiencies in Maritally Violent Men
Authors: Eckhardt Christopher I. , Kassinove Howard
Published: September 2018

Twenty maritally violent (MV) and 20 maritally satisfied, nonviolent men (SNV) participated in an Articulated Thoughts in Simulated Situations (ATSS) assessment. Participants listened to audiotaped interpersonal interactions and articulated their thoughts at 30-second intervals. As predicted by Holtzworth-Munroe’s (1992) information processing model of marital violence, MV participants emitted more global irrational beliefs and automatic thoughts, especially in response to interactions designed to induce anger. MV men also emitted a greater number of specific cognitive distortions (Demandingness, Low Frustration Tolerance, Global Self/Other Ratings, Arbitrary Inference, Overgeneralization, Magnification, and Dichotomous Thinking statements). In contrast, SNV men emitted more Anger Control statements during anger arousal, indicating that MV men may have a deficiency in generating effective conflict resolution strategies. Implications of these data in terms of information processing theories of marital anger and aggression are discussed.