bluuebunny/crossref_metadata_2025 huggingface dataset:
A COMPARISON OF DESCRIPTIVE ANALYSIS OF VANILLA BY TWO INDEPENDENTLY TRAINED PANELS1
Authors: HEYMANN HILDEGARDE
Published: May 2007

Descriptive analysis panelists create, through training, a consensus language to describe perceived differences among samples. If DA gives reliable, objective descriptions of samples, it would be expected that data obtained from independently trained panels be consistent. Two DA panels were trained independently using the same samples. Vanillin and four vanilla samples each at 3‐fold, 10‐fold and 20‐fold concentration were evaluated. Panel J used 14 terms to describe the vanillas and panel K used 16 terms. Eleven and thirteen terms, respectively, significantly discriminated among the samples. Principal component analyses (PCAs) for the two panels were visually similar. Both separated vanillin, Bourbon, Bourbon Processed Bali, Indonesian and Indonesian Non‐smoky vanillas across the first PC. Procrustes analysis of the two spaces had a 0.80 fit value. Both the PCAs and the Procrustes analysis indicated considerable overlap of similar descriptive terms. Thus it appears that DA does give reliable consistent results across independently trained panels.
MEASURING SOURCES OF ERROR IN SENSORY TEXTURE PROFILING OF ICE CREAM
Authors: KING BONNE M. , ARENTS PAUL
Published: May 2007

This paper presents a general protocol for the sensory texture profiling of ice cream using eleven descriptors. Four ice cream bases, all containing 10% butter fat, were used in the profiling experiments. The composition of the bases was varied to create differences in softness, cold sensation and toughness. In addition, three sources of error were investigated: temperature, manner of serving and order of presentation. The importance of each type of error was determined by ANOVA techniques. Texture variables (descriptors) are influenced not only by the composition of an ice cream base, but also by the temperature of the ice cream during evaluation. When good standard procedures are used to scoop samples and to present them to panelists, sensory evaluations need not suffer from the other two sources of error examined.
USING CUMULATIVE RANKS TO DETECT INDIVIDUAL DIFFERENCES IN SENSORY PROFILING
Authors: NAES TORMOD , HIRST DAVID , BAARDSETH PERNILLE
Published: May 2007

This paper is about detection of individual differences among assessors in sensory profiling. A discussion of different types of such differences are given and a graphical tool that can be used for detection of some of them is presented. It is also discussed how this tool, the so called Eggshell plot, can be used in practice and how it is related to the different types of individual differences. The theory is illustrated by two examples from sensory profiling, one from analysis of sausages and one from analysis of cheese.
PLEASANTNESS OF COOKIES, JUICE AND THEIR COMBINATIONS RATED IN BRIEF TASTE TESTS AND FOLLOWING AD LIBITUM CONSUMPTION
Authors: TUORILA H. , HYVÖNEN L. , VAINIO L.
Published: May 2007

Four combinations of cookie and juice were presented to 42 subjects for ratings of pleasantness of the items and their combinations (Experiment 1). Pleasantness of juice contributed to the pleasantness of a combination more than that of cookie (multiple regression analysis). In Experiment 2, subjects (N=41) rated each combination after ad libitum consumption in four separate sessions. Pleasantness of a cookie contributed more to the pleasantness of a combination than that of juice, and the average R2 obtained in multiple regression analysis was higher than in Experiment 1, suggesting that ratings after ad libitum consumption are more reliable. Pleasantness ratings explained ad libitum consumption of an item up to 23%, but perceived hunger and thirst, and consumption of the other item were at least equally good predictors. It is concluded that the pleasantness is only one among the multiple factors affecting amounts consumed in laboratory conditions.
THE USE OF STANDARDIZED FLAVOR LANGUAGES AND QUANTITATIVE FLAVOR PROFILING TECHNIQUE FOR FLAVORED DAIRY PRODUCTS
Authors: STAMPANONI CHANTAL R.
Published: May 2007

Sensory terminology is very important in descriptive analysis and perceptions are greatly influenced by the language. Definitions can be very useful for specifying and describing a sensation. However, many sensory attributes are not easily defined and physical reference standards can contribute a great deal to smoothing language problems. They can be used to develop the proper descriptive language, to reduce the amount of time required to train the sensory subjects, and to calibrate the panel in the use of the intensity scale, all the while providing documentation of the sensory terminology.

The Quantitative Flavor Profiling (QFP) technique was applied to evaluate flavored cheese analog, yoghurt and sweetened milk samples. Specific standardized flavor languages were developed for each product type and included reference standards for each sensory descriptor. The results of QFP were analyzed by principal component analysis.
A COMPARISON OF FREE CHOICE PROFILING AND MULTIDIMENSIONAL SCALING OF VANILLA SAMPLES1,2
Authors: HEYMANN HILDEGARDE
Published: May 2007

In Free Choice Profiling (FCP) each individual panelist creates his own series of descriptors to describe the differences among a set of samples. This is in contrast to multidimensional scaling (MDS) where the panelists assess the similarities among the samples. The objective of this study was to compare the results obtained from two FCP panels (one composed of “sensory‐savvy” persons and the other of “sensory‐naive” individuals) with MDS results. Vanillin and four vanilla samples each originally at 3‐fold, 10‐fold and 20‐fold concentration were evaluated. On average the sensory‐savvy (SS) panelists did not use significantly more descriptors than the sensory‐naive (SN) group. However, the terms used by the SS group were more likely to discriminate among the samples than the SN terms. Procrustes analysis indicated that the SN data did not have a true consensus space while the SS data did. The MDS data space was visually similar to the FCP space.
MATCHING THE SHAPE OF TIME‐INTENSITY CURVES1
Authors: DIJKSTERHUIS GARMT , VAN DEN BROEK ELS
Published: May 2007

Time‐Intensity Curves are often summarized by average curves. From these curves TI‐parameters are inferred. In this paper a different method is proposed in which the shape of the curves is the central concept. Isotropic scaling factors are computed for each curve. These factors can be tabled and inspected. Often a large number of scaling factors will be computed, which makes it hard to study them in a table. In such cases they can be represented in a plot, for which in this paper PCA is suggested. In this plot a structure in the scaling factors for the different TI‐curves may become visible. It is also possible to make a plot in which the homogeneity of the panel of subjects can be studied.
TWO MODELS FOR ESTIMATING THE DISCRIMINABILITY OF FOODS AND BEVERAGES
Authors: HAUTUS MICHAEL J. , IRWIN R. JOHN
Published: May 2007

In order to evaluate the suitability of signal detection theory methods for assessing the discriminability of foods and beverages, the discriminability of two dairy milk products that differed in fat content was measured with two detection‐theoretic methods: the single‐interval rating method, and the same‐different method. The nominal fat contents of the milk products were 0.1 and 1.6%. Measures of discriminability for three observers were derived by fitting receiver operating characteristics (ROCs) based on equal‐variance normal models to the ratings of each observer with a procedure that combined jackknifing and maximum‐likelihood estimation. The fitted ROCs provided a good fit to the data indicating that the equal‐variance models were appropriate for these tasks. The best‐fitting estimates of d′ obtained for each task were not significantly different, demonstrating that d′ is a measure of sensitivity that is largely independent of the task from which it is determined. However, estimates of proportion correct obtained for each task were shown to be significantly different.
FACTORS AFFECTING PUNGENCY OF MALT DISTILLATES AND ETHANOL‐WATER MIXTURES
Authors: WITHERS STEPHANIE J. , PIGGOTT JOHN R. , LEROY GWENN , CONNER JOHN M. , PATERSON ALISTAIR
Published: May 2007

paungency is a physical sensation usually perceived as a component of flavor. Foods and beverages which are described as pungent often impart unpalatable sensations to those uninitiated in the experience. Variations in pungency were examined in whiskies, ethanol‐water mixtures, and whisky model systems. Effects on sensory pungency of changes in composition showed that pungency in whisky is not only dependent on the concentration of ethanol in the headspace, but also on a complex of other effects.
TABLE FOR TESTING THE SIGNIFICANCE OF THE R‐INDEX
Authors: BI JIAN , O'MAHONY MICHAEL
Published: May 2007

A table is provided for testing the significance of R‐index values. The use of the table is illustrated and the theory and assumptions behind the method are explained.
SCREENING INDIVIDUAL ABILITY TO PERFORM DESCRIPTIVE ANALYSIS OF FOOD PRODUCTS: BASIC STATEMENTS AND APPLICATION TO A CAMEMBERT CHEESE DESCRIPTIVE PANEL
Authors: ISSANCHOU SYLVIE , LESSCHAEVE ISABELLE , KÖSTER E.P.
Published: May 2007

A battery of sensory tests is proposed to select potential descriptive panelists. This set of tests is flavor specific. Several abilities are examined: odor and taste recognition, odor memory, discrimination and descriptive capacities. A detailed example of such a battery to select a Camembert cheese descriptive panel is given. The objectives of each test are discussed. Stimuli are chosen to be consistent with the sensory properties which can be perceived in cheese. Score distributions demonstrate the discrimination among candidates for each test. Globally, results show the difficulty to find 20 panelists amongst about a hundred with good scores on each test. The panel leader has to choose the final criteria taking into account whether or not some abilities could be improved by training and whether weak capacities (small deficiencies) in some panel members could be compensated for by other subjects.
SALIVATION OF SENSORY PANELISTS: EFFECTS OF SELECTED PSYCHOPHYSIOLOGICAL FACTORS1
Authors: BRAMESCO NICOLE P. , SETSER CAROLE S.
Published: May 2007

Salivation may affect texture and taste perception. Thus, any influences that affect salivation also might affect a panelist's sensory responses. Twelve sensory panelists were compared for psychophysiological factors that might influence their salivary responses. Medication, body mass index (Quetelet), dieting‐induced deprivation, nutrient deficiency, and caffeine, tannin, and fiber consumptions along with smoking were considered. Specific nutrient deficiencies or fiber consumption did not affect salivation of the panelists studied. All other factors, especially smoking and diet‐induced deprivation, appeared to warrant further study with a larger population.
A COMPARISON OF METHODOLOGY APPLIED TO THE SELECTION OF A PANEL FOR SENSORY EVALUATION OF INSTANT COFFEE
Authors: ZAMORA M.C. , CALVIÑO A.M.
Published: May 2007

Twenty judges performed a variety of chemosensory tasks in order to select the best scores to form a panel for coffee evaluation. An average of correct responses (P%), one‐way analysis of variance (ANOVA) and principal components analysis (PCA) were compared. The tests involved: ability to recognize the four basic tastes, identification and matching of odors, taste intensity evaluation and perception of small differences in taste. P% accounted for 71.17 ± 4.34% and 10 of the judges had scores greater than the final average. ANOVA and PCA resulted in 2 different panels consisting of 9 and 12 judges, respectively. The panel was composed by the nine panelists selected by the three methods. The other three panelists that were doubtful could improve to the point of acceptance with additional training. These methods should be used simultaneously to have more security in the acceptance or rejection of panelists.
Delivery Outcomes of Low Risk Births: Comparison of Certified Nurse Midwives and Obstetricians
Authors: Wilson Barbara L.
Published: May 2007

This study determined differences in delivery outcomes of primiparous women (n = 107) by certified nurse midwives versus similar deliveries by experienced obstetricians through a retrospective chart review of low risk births. The use of both forceps and midline episiotomies were found to be significantly higher in the obstetrician group. Obstetricians also were more likely to use anesthesia than the midwife group. No significant differences were found in the number or degree of perineal lacerations or in the mean Apgar scores.
Communication as it Affects the Therapeutic Alliance
Authors: Mejo Susan L.
Published: May 2007

The therapeutic relationship, the working bond between the nurse practitioner and patient, is considered to be a significant factor that affects treatment outcome. Components of the therapeutic relationship viewed from the nurse practitioner's perspective and also from the patient's viewpoint are reviewed. Modes of communication the client uses directly influences the therapeutic relationship or alliance. Two communication modes are used to exemplify two case examples in which the patient's mode of perceiving his or her world is an important consideration in the working alliance.
Effective Case Presentations—An Important Clinical Skill for Nurse Practitioners
Authors: Coralli Connie H.
Published: May 2007

Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation—introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case—are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text.
Assessing the Need for Family Nurse Practitioners—The Florida Experience
Authors: Graham Mary Virginia , Pierce Patricia M.
Published: May 2007

This article presents results of a descriptive study designed to assess the need for Family Nurse Practitioners (FNPs) in Florida. The need for FNPs was examined within the context of the current crisis in access to health care in the United States and in Florida, where unique features of the state's population and economy combined to create inequities in the health care system. Data were also collected related to the number of primary care agencies already employing nurse practitioners, the educational preparation of these nurses, and the likelihood of agency nurses enrolling in an FNP program if such a program were available. A ten‐item questionnaire was mailed to nursing service administrators at 330 health care agencies involved in the delivery of primary care. Ninety‐seven questionnaires were returned. Results from the study indicated that the agencies will require increased numbers of primary care providers in the next 5 years. Further, a minority of nurse practitioners are prepared at the Master's level in the surveyed agencies, suggesting a need for increased educational opportunities for nurses if they are to enter advanced practice. The study represents one approach to establishing needs for FNPs that might be used in other states both to develop educational programs and to influence legislators regarding health and nurse practitioner issues affecting access to care.
Lyme Disease: Easy to Treat, Easy to Miss
Authors: Sivertson Debra Benoit
Published: May 2007

Lyme disease is a relatively newly identified entity that has received much attention in the public press. Because of the confusion of information and the seriousness of the disease, nurse practitioners need to know the facts and resources, including prevention, diagnosis, and treatment. The author discusses recent information in these areas and presents easy reference tables for guidelines.
Papanicolaou Smear: An Update on Classification and Management
Authors: Fullerton Judith T. , Barger Mary K.
Published: May 2007

Current research has caused us to reconsider the factors associated with cervical dysplasia. New recommendations for the collection of cervical specimens, interpretation of the Papanicolaou smear, and patient management have also evolved. Research findings and a discussion of the classifications to be used when reporting the results of the smear are updated in this paper. Interpretation and nurse‐practitioner management of the normal and mildly abnormal Pap result is included.
Fibromyalgia Syndrome
Authors: Johnson Jennal L. , Collo Mary Bourne , Finch William R. , Felicetta James V.
Published: May 2007

Fibromyalgia is a chronic rheumatologic disorder. The primary symptoms include musculoskeletal pain and aching, disturbed sleep, fatigue, morning stiffness, and local tenderness. It is frequently misdiagnosed, despite being a fairly common, chronic disorder in most primary care clinics. Failure to make this diagnosis often leads to unnecessary medical and surgical treatment.

The treatment of fibromyalgia syndrome is multifaceted. Goals include reassurance, education about pain management and modification, and symptom reduction. Exercise may be beneficial. Amitriptyline is effective in reducing certain symptoms of fibromyalgia, such as pain and lack of restful sleep. Narcotics, steroids, and nonsteroidal anti‐inflammatory drugs (NSAIDs) should be avoided.
The Use of Antidepressant Medication: A Guide for the Primary Care Nurse Practitioner
Authors: MA Susan Mejo
Published: May 2007

Antidepressant medications are being used to treat a broad spectrum of depressive syndromes. Newer uses of antidepressants are briefly presented. The mechanism of action and side‐effect profile of antidepressants are outlined to help the nurse practitioner choose which antidepressant to use. Pharmacologic treatment is discussed. A case presentation illustrates important aspects of discontinuing antidepressant medication.
Judgment Strategies for Coping With Ambiguous Clinical Situations Encountered in Primary Family Care
Authors: DNSc Karen Brykczynski
Published: May 2007

This naturalistic study identifies and describes strategies for clinical problem solving in situations of uncertainty, from observations of patient/family visits in a family health center. Judgment strategies were described for four types of uncertainty: information, diagnosis, treatment, and patient response that roughly correspond to the phases of assessment, planning, implementation, and evaluation of the clinical problem‐solving process. The study contributes to increased understanding of the practical (experiential) knowledge involved in clinical judgment.
Evaluation of Consequences of Repeal of the Abortion Law on Teenage Pregnancy
Authors: Horner Sharon D. , Hilde EIDonna
Published: May 2007

Teenage pregnancy is a complex issue in the current sociopolitical milieu. The enactment of abortion laws adds to the complexity of the problem, involving moral and ethical issues, as well as social, economic, and health status consequences that should be considered in the development of legislation surrounding this issue. The tree of impact diagram is a mechanism for forecasting possible consequences of abortion laws. Historical, social, developmental, economic, and legal forces are considered in creating the tree of impact in relation to the health and well‐being of teenage mothers and their children.
Venous Ulcers: A Nursing Challenge
Authors: Lamont Linda J.
Published: May 2007

The prevalence of individuals with venous ulcers is estimated to be over 500,000 in the United States. Management should be based on an understanding of the pathophysiology of venous insufficiency and venous ulcers. This article presents a review of the anatomy venous system of the lower leg and the pathophysiology of venous insufficiency. In addition, a current theory of the etiology of venous ulcers, their complications, and management options are discussed. Emphasis is placed on patient education, compression therapy, and dressing choices.
Maternal Concerns During the Early Postpartum
Authors: Hiser Patricia L.
Published: May 2007

The trend toward shortened, postpartum hospitalization has greatly reduced the time available to teach child care and parenting techniques to new mothers. This study surveyed 120, low‐risk mothers during the early postpartum period to identify their concerns and learning needs. During home interviews, a card‐sort tool and questionnaire were used to gather information. Frequencies for family, mother, and infant items are listed. Participants were worried about family finances, meeting the needs of everyone at home, and being a good mother. They were also interested in learning more about their infant.
Self‐Management of Recovery: Implications for Nursing Practice
Authors: Pesut Daniel J. , Massey Jean
Published: May 2007

This article describes and discusses differences in responses to a 60‐item survey instrument, the Carolina Self‐Regulation Inventory (CSRI) from a selected sample of university faculty and staff. The CSRI was designed to measure the types of self‐regulation strategies (SRS) individuals use to facilitate their recovery from illness episodes. When the CSRI was developed, 1,306 university employees participated in the survey. Four hundred eighty (36%) employees classified themselves as faculty; 346 (26%), staff; 418 (32%), midlevel administrators; and 62 (6%), blue‐collar workers. This report focuses on the differences between the faculty and staff groups in the survey. Analysis revealed that the staff used a variety of strategies and had higher statistically significant means on the following CSRI subscales: visualization (t= 2.53, P > .01), self‐talk (t= 6.801, P > .001), and external attention deployment strategies (t= 4.08, P > .001). No significant differences were found between faculty and staff in the use of exercise and physical activity or interactive self‐regulation strategies. Higher‐educated faculty women tended to use fewer SRS when compared with female staff (F= 4.70; df= 8,819; P= .0009). Faculty women were similar to faculty men in their use of SRS. Female staff used significantly more SRS when compared with faculty of both genders and male staff (t= 2.81, P= .05). Nursing implications of self‐regulation nursing assessments are discussed in terms of nursing interventions and need for more research.
A Comparative Analysis of Nurse Practitioners With and Without Prescriptive Authority
Authors: Feeney Diane
Published: May 2007

This article reports findings from a national random sample of nurse practitioners (NPs) who were actively practicing in adult primary care settings during 1986. An analysis of their demographic and practice characteristics revealed a statistically significant association between certain characteristics and the NPs' prescribing status. Nurse practitioners with prescriptive authority had more years of experience and were more likely to practice in rural or suburban areas and work in nongroup settings than NPs without prescriptive authority. These findings suggest that giving NPs' prescriptive authority may be an enabling factor that supports NP practice in medically underserved locations.
Primary Health Care of Elderly Women
Authors: Swenson Melinda M.
Published: May 2007

Traditional health care of the expanding elderly population has focused on illness diagnosis and management. However, because more individuals, women especially, are living longer and living better, the emphasis should be shifted and modified to include primary health care for elderly people. Primary health care includes active health promotion and health maintenance, prevention of illness or disability, and attention to the quality as much as to the quantity of life. Unfortunately, the health concerns of elderly women, especially the oldest‐old groups who live more or less independently, have been addressed inadequately in medical and nursing literature. Routine approaches to health care for women aged 70 and older must consider women's apparent hardiness, potential social isolation, and unique worries about safety and independence. Nurse practitioners in adult health, family practice, and gerontology must expand their repertoire of health promotion and health maintenance strategies to meet the needs of this special population. This article outlines the role of the nurse practitioner in the care of the well elderly woman.
Understanding, Identification, and Assessment A Psychosociocultural Perspective, Part 1
Authors: Hoff Lee Ann
Published: May 2007

The clinical implications of research with battered women and their families are discussed using the holistic framework of nursing and anthropology. Moving beyond superficial answers to “Why do battered women stay?,” barriers to leaving that stem from the sociocultural roots of violence are examined. Understanding these obstacles and the characteristics of violent men is fundamental to sensitive interaction with abused women who frequently enter and leave health care systems with no direct attention given to their primary problem of abuse. Assessment techniques are suggested, and triage and comprehensive assessment protocols are presented to aid nurse practitioners and nurses in their response to this urgent public health problem.
Writing for Publication: It's a Matter of Personal Style
Authors: Messner Roberta L. , Gardner Sylvia S.
Published: May 2007

One of the best ways a nurse practitioner can make a lasting contribution is through the published word. A nurse writer publishes to inform, instruct, challenge, and inspire. This sharing of ideas is critical for professional growth and visibility. The writing process may appear at first glance to be difficult, yet the tips and techniques described in this article demonstrate that writing is a craft which can be learned. Although the process that results in a final, published manuscript may, at times, appear lengthy, the approach to preparing a manuscript is simple, requiring a modicum of skill and a strong desire to share knowledge.
Factors Discriminating Between Genuine Stress and Mixed Incontinence
Authors: Burns Patricia A. , Nochajski Thomas H. , Pranikoff Kevin
Published: May 2007

Nurse practitioners (NP) are often confronted with female clients who describe various types of urine loss symptoms. To establish an accurate diagnosis and therapeutic intervention, it is important for the NP to identify the etiology of the urine loss complaint. The purpose of the study is to compare symptoms and physical findings that differentiate between the urodynamic diagnoses of genuine stress incontinence (GSI) and mixed incontinence (MI) in 135 clinical trial subjects: 123 diagnosed as GSI and 12 as MI. These subjects participated in a randomized controlled clinical trial to investigate the efficacy of biofeedback and pelvic floor exercises for incontinence treatment. Data were analyzed for significant differences between these two groups on urologic and gynecologic symptoms, pelvic muscle relaxation, vaginal mucosa, vaginal electromyograph readings, urodynamic parameters, and quantified measure of urine loss. One‐way analysis of variance (ANOVA) showed significant difference in nocturnal and diurnal voidings and urine loss immediately after sensing the urge to void in the MI and GSI subjects. Chi‐square analyses found a significantly decreased incidence of poor vaginal tone and atrophic vaginal mucosa in the MI group as compared to the GSI group. The MI group also lost significantly more urine than did the GSI group on the hand wash maneuver of the perineal pad test. Although the sample size of MI subjects was small, these results show that a noninvasive history and physical examination can differentiate between urologic diagnoses. This approach provides a cost‐effective expedient protocol to aid the NP in establishing a differential diagnosis between genuine stress and mixed incontinence.
Noncompliance in the Elderly: A Pathway to Suicide
Authors: Meisekothen Linda M.
Published: May 2007

Current suicide statistics only represent a portion of suicides committed by the elderly. Indirect self‐destructive behaviors (ISDBs) cause many more deaths than direct methods yet they often are ignored, misinterpreted, or unidentified. Medical noncompliance is identified as a form of ISDB, leading to diminished quality of life and an expedited death. While noncompliance occurs for a variety of reasons, it is a form of self‐destruction for a portion of the elderly population. The nurse practitioner is in a unique role to identify ISDBs, as well as risk factors for developing these behaviors, and to construct methods for intervening and supporting those who wish to continue life.
The Patient With an Automatic Implantable Cardioverter Defibrillator
Authors: Boley Theresa M. , Sagehorn Kelli K. , Curtis Jack J.
Published: May 2007

Sudden cardiac death is the leading cause of death in the United States. A relatively new technology used to treat ventricular dysrhythmias that lead to sudden cardiac death is the automatic implantable cardioverter defibrillator. This device uses patches on the heart to deliver an energy current to convert lethal dysrhythmias. The nurse practitioner can expect to encounter these devices when seeing patients for a variety of diagnoses. This article will serve as a resource for clinical management and patient education.
Blood Pressure and Mood Responses in Hypertensive Patients on Antihypertensive Medications
Authors: Potempa Kathleen , Babich Karen , Fruh Sharon , Fogg Louis
Published: May 2007

Nurse practitioners who are responsible for the clinical management of patients with hypertension must choose antihypertensive medications that minimize side effects. Nurse practitioners must be aware of the drugs' potential influences on physiologic and psychological variables and include adequate assessment of these responses in patients during treatment. Pindolol, propranolol, and hydrochlorothiazide were equally effective in reducing systolic and diastolic blood pressure in essential hypertensives, although pindolol and hydrochlorothiazide did not affect resting heart rate (an advantage in some patients). Hydrochlorothiazide was associated with a trend for several negative mood changes in black subjects; depression scores of black subjects were significantly increased with hydrochlorothiazide. The results of this study indicate the need to consider race and other factors in research about antihypertensive mood responses.
Promotion of Adaptation in Battered Women: A Self‐Efficacy Approach
Authors: Varvaro Filomena F. , Palmer Mary
Published: May 2007

The purpose of this article is to describe the use of the Self‐Efficacy Scale for Battered Women (SESFBW) in the development of a treatment plan for the abused woman. The authors describe how the SESFBW was developed to assess the self‐efficacy needs of women (N= 43) who came to the emergency department with injuries and self‐reported current abuse. Four needs related to self‐efficacy were identified: a decreased ability to (a) talk to the nurse or doctor about the abusive situation, (b) call a shelter for abused women, (c) shrug off self doubts, and (d) express thoughts and feelings without fear. How data from a self‐efficacy assessment were used in developing a teaching plan and intervention is included. Pre‐ and posttest scores on the SESFBW of six battered women showed a significant increase in self‐efficacy scores at the completion of a group educational program. They conclude that the SESFBW is an easy and effective tool to assess self‐efficacy and can form the basis for developing an individualized teaching plan to increase self‐efficacy.
The Phenomenon of Dysautonomia and Mitral Valve Prolapse
Authors: Styres Kathryn S.
Published: May 2007

In recent years research has shown that subsets of patients with mitral valve prolapse also have associated autonomic or neuroendocrine dysfunction that can result in a number of related symptoms, including fatigue, palpitations, chest pain, exercise intolerance, dyspnea, dizziness, headache, sleep disorders, gastrointestinal disturbances, cold extremities, and panic attacks. These patients have been classified as having mitral valve prolapse syndrome. This article discusses the pathogenesis and management of mitral valve prolapse syndrome and serves to make clinicians aware of newer developments in the study of autonomic function and dysfunction.
Application of Control Chart Statistics to Blood Pressure Measurement Variability in the Primary Care Setting
Authors: Nelson Frances E. , Hart Marilyn K. , Hart Robert F.
Published: May 2007

This study was undertaken as an interdisciplinary effort in response to a frequently frustrating clinical problem of interpreting variable blood pressure measurements under uncertain conditions of quality control. The method is an application of the Shewhart Control Chart analysis to blood pressure measurement in adults in an academic nursing center. The natural variability found in a series of blood pressure readings is measured and described after a pilot study to eliminate examiner, equipment, and time interval variability. Results revealed that there was a significant drop from the first systolic reading to subsequent readings. A three standard deviation limit will be met if the range between the second and third systolic reading does not exceed 13 and the range between the second and third diastolic readings does not exceed 11. Thus for recognition and management of measurement variability, three blood pressure measurements 1 minute apart should be taken as a routine, and the average of the second and third reading recorded. The positive impact on clients, providers, and interdisciplinary research colleagues in changing measurement technique to achieve greater quality in clinical practice is discussed. Limitations and recommendations are presented.
Benign Prostatic Hyperplasia: Diagnosis and Treatment
Authors:   BPH Guideline Panel
Published: May 2007

This Quick Reference Guide for Clinicians contains highlights from the Clinical Practice Guideline for Benign Prostatic Hyperplasia: Diagnosis and Treatment. The Benign Prostatic Hyperplasia Guideline Panel, a private‐sector panel of health care providers, developed the guideline after comprehensively analyzing the research literature. As a result, this guideline comprises the most current scientific knowledge of the development, diagnosis, and treatment of benign prostatic hyperplasia (BPH). The guideline makes specific recommendations to identify both the most effective methods for diagnosing BPH and the most appropriate treatments for BPH based on patient preference and clinical need. BPH affects quality of life and is very rarely a life threatening disease. Motivation to seek active treatment will, for most patients, depend on how much their symptoms bother them. Many patients choose a regimen of “watchful waiting.” The guideline details the relative benefits and harms associated with all diagnostic and treatment approaches. Treatment options discussed include watchful waiting, alpha blocker and finasteride medications, balloon dilation, and the surgical options of transurethral incision, transurethral resection, and open prostatectomy. This Quick Reference Guide for Clinicians contains excerpts from the Clinical Practice Guideline, but users should not rely on these excerpts alone. Clinicians should refer to the complete Clinical Practice Guideline for more detailed analysis and discussion of the available research, critical evaluation of the assumptions and knowledge of the field, considerations for patients with special needs, and references. The full Guideline Report has the most complete discussion of relevant research, including complete tables and graphs. Decisions to adopt particular recommendations from any publication must be made by practitioners in light of available resources and circumstances presented by individual patients.
Congestive Heart Failure: Early Recognition of Congestive Heart Failure in the Primary Care Setting
Authors: Yontz Lynn L.
Published: May 2007

Approximately 400,000 patients in the United States are newly diagnosed with congestive heart failure each year. The vast majority of these patients will not survive 5 years. Symptoms that indicate a decline in patient status often go unrecognized by providers. Early identification of insidious changes and prompt intervention can improve cardiac function and decrease the incidence of acute episodes and repeated hospitalizations. Nurse practitioners in the primary care setting are often called upon to manage these patients. By understanding the physiological changes as they occur and the underlying etiology, management is enhanced.
Family Nurse Practitioner Clinical Competencies in Alcohol and Substance Use
Authors: Talashek Marie L. , Gerace Laina M. , Miller Arlene G. , Lindsey Marie
Published: May 2007

The prevalence of substance use among patients presenting to primary health care settings mandates clinical competency in the area for nurse practitioners (NPs). An educational intervention with an evaluation component is described. The effect of incorporating substance use content into a Family Nurse Practitioner (FNP) curriculum was tested with a convenience sample of 16 FNP students and 8 practicing NPs. Students' knowledge increased significantly; however, differences in students' and practicing NPs' knowledge did not reach significance. Students' clinical competency increased significantly, as demonstrated by standardized patient clinical evaluations, and was significantly better than the practicing NPs in the skill domains of evaluation and record keeping. Educational intervention can improve NP identification of substance‐abusing patients in primary health care settings.
Variables Related to Obesity and Body Fat: Avenues to Change
Authors: Keller Colleen S. , Thomas Katherine T.
Published: May 2007

Obesity and overweight constitute major health concerns in this country today. This article provides a description of the terms overweight and obese, variables contributing to diet and exercise adherence, and practice implications for nurse practitioners.
What's Happening
Authors: Fairbanks Jo , Viens Diane
Published: May 2007

Health professionals who live and practice in rural areas have limited opportunities to further their education. In order to pursue advanced nursing degrees, nurses have to leave their communities. A collaborative distance education project involving the University of New Mexico College of Nursing, the Area Health Education Center, and Western New Mexico University has provided a partial solution to this problem. Six registered nurses living and practicing in a rural site are now receiving their Family Nurse Practitioner degrees via two‐way audio/video teleconferencing equipment. Distance education can improve the numbers of primary care providers in rural areas; however, projects will require extensive planning and resources.
The Moral Reasoning of Nurse Practitioners
Authors: Viens Diane C.
Published: May 2007

This qualitative research study was conducted to describe the moral reasoning utilized by participating nurse practitioners to resolve moral dilemmas in their clinical practice. Five major essential features of moral reasoning emerged from the data: the contextual framework for moral reasoning, values, influencing factors, recognizing the dilemma, and outcomes. The interrelationship of the essential features of moral reasoning provided insight into how NPs deal with moral dilemmas as well as the role that caring and the nurse‐patient relationship played as a part of the moral decision making process.
Functional Health Status of Older Women
Authors: Gale Betty J. , Templeton Lynn A.
Published: May 2007

By the year 2000 in the United States, there will be 32 million adults age 65 or over, representing 12% of the population, with the majority being women. Older women are experiencing greater longevity but worse overall health than men. The assessment of functional health status in older women is often neglected yet is the major contributor to independent living. Functional health status includes the dimensions of physical health, independent health, and psychosocial health. Studies of two different groups of non‐institutionalized older women who reside in the same Southwestern state are discussed in relation to national study samples and implications for nurse practitioners.
Transient Ischemic Attacks (TIA): Current Issues in Diagnosis and Management
Authors: Gross Stacey B.
Published: May 2007

Transient ischemic attacks (TIAs) affect more than 500,000 Americans each year. Stroke risk approximates 4% to 8% within 1 month and increases to 12% to 13% at one year. This has led to stroke being one of the leading causes of death and disability. TIAs are focal neurologic events that are temporary in nature and warn of potential stroke. Most TIAs resolve within 24 hours. Hypertension, smoking, heart disease, and diabetes are the major risk factors for stroke. A comprehensive history of symptoms can help identify carotid vs. vertebrobasilar disease. Timely evaluation of TIAs should be performed according to recent guidelines set forth by the American Heart Association. Aspirin continues to be the gold standard for stroke prevention, conferring a 48% risk reduction in stroke or death. The use of ticlopidine has been recommended as a second‐line agent in patients with aspirin intolerance. Surgical intervention (carotid endarterectomy) is indicated in symptomatic patients with high grade stenosis of 70% or greater. For patients with less significant stenosis, inconclusive data exists regarding the benefit of medical vs. surgical treatment. Patient education should address identification of symptoms, the need for prompt medical attention, and risk factor modification. A collaborative plan between clinician and client will facilitate early intervention ultimately leading to preservation of function and prevention of the catastrophic sequelae of stroke.
Using an Encounter Form to Develop a Clinical Database for Documenting Nurse Practitioner Primary Care
Authors: Courtney Reni , Rice Carol A.
Published: May 2007

A clinical database will enable nurse practitioners to document and improve characteristics of their practices. This information is vital if nurse practitioners expect to achieve success in the changing U.S. health care system. This article describes the process of creating an encounter form and a related clinical database. Changes made in a family practice clinic that were derived from using a clinical database are presented. Additional uses for a clinical database, such as quality assurance, clinical evaluation, and clinical research, are discussed.
A Comparison of the Ovulation Method With the CUE Ovulation Predictor in Determining the Fertile Period
Authors: Fehring Richard J.
Published: May 2007

The purpose of this study was to compare the CUE Ovulation Predictor with the ovulation method in determining the fertile period. Eleven regularly ovulating women measured their salivary and vaginal electrical resistance (ER) with the CUE, observed their cervical‐vaginal mucus, and measured their urine for a luteinizing hormone (LH) surge on a daily basis. Data from 21 menstrual cycles showed no statistical difference (T= 0.33, p= 0.63) between the CUE fertile period, which ranged from 5 to 10 days (mean = 6.7 days, SD = 1.6), and the fertile period of the ovulation method, which ranged from 4 to 9 days (mean = 6.5 days, SD = 2.0). The CUE has potential as an adjunctive device in the learning and use of natural family planning methods.
Promotion of Cardiovascular Health in Children by Nurse Practitioners and Physicians in Family Practice
Authors: Jessup Ann N. , Harrell Joanne S.
Published: May 2007

The purpose of this study was to describe cardiovascular (CV) health promotion practices of nurse practitioners (NPs) and physicians (MDs). Clinical practice was described for three age groups of children both with and without parental premature heart disease. Differences in clinical practice by type of provider and by age and risk level of the child were examined. A 42‐question survey was mailed to all family NPs in North Carolina and to MDs randomly selected from the roster of the North Carolina Academy of Family Physicians; 94 responded. A high level of blood pressure measurement for all children and counseling regarding smoking for 13 to 19 year olds was found among all participants. Fewer health promotion activities were reported for other risk factors for the oldest group and for the younger children in general. Health promotion practices increased with the age of the child. Nurse practitioners had significantly higher total CV health promotion scores than did MDs, regardless of the age or risk level of the child. An increase in counseling about prudent diet and increased physical activity is needed for all children, regardless of risk level. In addition, there should be an increase in CV health promotion activities with younger children.
The Relationship of Social Support to Women's Obtaining Mammography Screening
Authors: Fite Susan , Frank Deborah I. , Curtin John
Published: May 2007

This study examined the relationship between social support and obtaining mammography screening. Fifty women, half of whom had undergone mammography, were matched for age and ethnicity and interviewed related to perception of their social support networks. Results revealed a significant difference in the levels of social support and mammography screening. Women who had undergone mammography perceived a higher level of social support than those who had not. Parse's Theory of Human Becoming was used as a framework to discuss nursing implications of the findings.
Childhood Primary Care Services in Wyoming
Authors: Burman Mary E.
Published: May 2007

Provision of childhood primary care services and differences between types of providers (family practice physicians, pediatricians, nurse practitioners, and physicians’ assistants) were explored in this study. A mail survey was conducted in Wyoming using a questionnaire based on the recommendations from the U. S. Preventive Service Task Force. Sixty‐one percent of the providers returned questionnaires. While some areas of assessment, screening, and treatment/counseling services were provided at high levels, many were not. Gaps exist particularly in the areas of behavioral and lifestyle assessment and treatment/counseling. Only small differences existed between types of providers. However, nurse practitioners and pediatricians were more likely to report that they followed recommendations, while physicians’ assistants were least likely to report that they followed recommendations.