bluuebunny/crossref_metadata_2025 huggingface dataset:
INCORPORATING TASTING INTO A CONJOINT ANALYSIS OF TASTE, HEALTH CLAIM, PRICE AND BRAND FOR PURCHASING STRAWBERRY YOGURT1
Authors: VICKERS ZATA M.
Published: May 2007

The objective of this research was to examine some considerations arising from incorporating tasting into a conjoint analysis procedure studying the effects of taste, brand, price and health claim on the buying intent for strawberry yogurt. Specifically, the considerations were: (1) whether people could remember the sensory qualities of the products tasted well enough to re‐identify them in a follow‐up test, and (2) whether their memory of their liking for the products was stable. Two hundred people who purchased and ate strawberry yogurt participated in a three‐part test session. Part 1) They tasted and rated their liking for three yogurt samples and either did or did not take notes on the sensory attributes of the yogurts. Part 2) They rated 27 mock yogurt labels representing 3 brands x 3 taste qualities x 3 prices x 3 health claims on a buying intent scale. Part 3) They rated their liking of the three yogurt samples either from memory or by retasting and they attempted to re‐identify the three yogurt samples. Taking notes improved the proportion of completely correct re‐identifications (75% vs 50%). Liking reratings from memory were as stable as liking reratings by retasting. Taste and health claim had the largest influence on buying intent; brand had little influence on buying intent.
A COMPARISON OF TRAINED AND UNTRAINED JUDGES’ EVALUATION OF SENSORY ATTRIBUTE INTENSITIES AND LIKING OF CHEDDAR CHEESES
Authors: ROBERTS ANNA K. , VICKERS ZATA M.
Published: May 2007

The objective of this study was to compare the preferences and performance of three groups of judges, which represented different types and levels of training. Three groups of judges (descriptive analysis judges, ADSA dairy judges and untrained) rated their liking and the sensory attributes of five Cheddar cheeses. The trained panels rated two cheeses relatively lower in liking than did the untrained panel but otherwise generally agreed with the liking ratings of the untrained judges. The trained judges tended to find larger differences in liking among the cheeses than the untrained panel. Training did not improve the agreement among judges on the liking ratings assigned to the cheeses. The trained judges rated the cheeses less intense for most all of the attributes. The three panels disagreed on the relative size and direction of differences in intensity for most all of the attributes. The trained panels did not typically find larger differences among the cheeses in the intensity of the attributes than the untrained panel. Training improved agreement among panel members on the attribute ratings. The attributes of the dairy judges were less intercorrelated.
THE EFFECT OF MASTICATORY PATTERNS AS MEASURED BY TIME‐INTENSITY AND ELECTROMYOGRAPHY ON THE PERCEPTION OF BOVINE MUSCLE TENDERNESS
Authors: DUIZER L.M. , GULLETT E.A. , FINDLAY C.J.
Published: May 2007

The relationship between perception of tenderness and chewing activity was explored using the Time‐Intensity measurement of perception and electromyographic measurements of masseter muscle movement. Semitendinosus muscles from eight treatments of forage fed beef were evaluated by nine individuals. The Time‐Intensity parameters of Area Under the Curve and Decrease Area were the most useful for treatment separation based on tenderness. Information was obtained from the electromyogram regarding the number of chews, time to chew and mastication rate. However, more work with EMG measurements is required to accurately study the effect of masticatory patterns on tenderness perception.
OLFACTORY RESPONSIVENESS TO DIACETYL
Authors: LAWLESS HARRY T. , ANTINONE MICHAEL J. , LEDFORD RICHARD A. , JOHNSTON MARY
Published: May 2007

Odor thresholds in the headspace over aqueous solutions of diacetyl (butane‐2,3‐dione) were measured in quadruplicate by a forced‐choice procedure in 53 individuals. Mean individual thresholds varied over a factor of 256, with the group average at .005 μg/ml. Thresholds showed a modest negative correlation with suprathreshold intensity ratings. Intensity ratings were distributed bimodally, consistent with the existence of insensitive and sensitive groups and suggesting the possibility of a specific anosmia for this compound.
A STATISTICAL ANALYSIS OF DIFFERENCE TESTS WITH REPLICATIONS
Authors: PRISO HILAIRE EPESSE , DANZART MARC , HOSSENLOPP JOSEPH
Published: May 2007

This paper proposes a statistical method for difference tests with repetitions. Classical methods for difference tests are based upon the binomial distribution, and are not concerned with the number of repetitions per judge. But when more than one replication of a difference test is required, judgements from different judges are more independent than replicates from the same judge; these two cannot be combined in the classical methods. In this paper, we propose another approach that takes into account two points: the number of repetitions per judge, and the differences within subjects. Two examples are presented to illustrate this approach.
A RESEARCH NOTE: COMPARISON OF TIME‐INTENSITY AND THRESHOLD MEASURES FOR DETERMINING BITTER TASTE SENSITIVITY OF CAFFEINE USER AND NONUSER
Authors: TANIMURA SHUYA
Published: May 2007

Two taste sensitivity measures (detection threshold and time‐intensity [T/I]) were applied to evaluate bitter taste sensitivity of caffeine in both caffeine nonusers (n = 12) and users (n=12, caffeine consumption level; > 300mg/day). Taste thresholds of caffeine were significantly different between nonusers and users in two test sessions (p < 0.01 in first and p < 0.05 in second). In T/I measures, only the difference in peak height was observed between the two groups in one of two test sessions. The other two measures, half width and area of T/I curves showed no significant difference.
ORAL ASSESSMENT OF HARDNESS BETWEEN ELASTIC AND PLASTIC PRODUCTS
Authors: PEYRON MARIE‐AGNÈS , MIOCHE LAURENCE
Published: May 2007

This study examined how people compare the hardness of different materials. Simple models with either elastic or plastic behavior were prepared and controlled mechanically. Six elastomers were compared to 29 plastic dental waxes of different hardness. For each elastic sample, a psychophysical staircase method was used to determine its perceived hardness in comparison to the plastic samples. Single bites were performed and the forces were recorded by a small load‐cell placed between the sample and the teeth. Nine subjects. free of dental pathology, participated in this study. Subjects were able to match samples of both materials with a specific stress ratio which depended on the hardness of the elastic samples. Results indicated that people do not use the same sensory cues and, in this case, no clear role of the bite force was established.
PRODUCT TESTING 2: MODELING VERSUS MAPPING AND THEIR INTEGRATION
Authors: MOSKOWITZ HOWARD R.
Published: May 2007

Evaluations of multiple products in a category proceed with two different, unstated objectives, and two distinct analytic approaches. The first objective is to “map” the category ‐ viz., to put the products in a category onto some type of geometrical map with the property that products lying close to each other on the map share aspects in common. Researchers use mapping to identify which products compete with each other, as well as to discover whether or not there exist in the category unfilled “holes” that have promise. Researchers use modeling, in contrast, to identify the salient dimensions along which consumers differentiate products in the category. Modeling assumes that the researcher will create a relation between two or more attributes in the category. The analysis generates equations (or even only correlations) rather than maps. Mapping and modeling are complementary, yet often one approach is used to the exclusion of the other because of internal biases and points of view held by the researcher. This paper shows how the two are used, and how they can be integrated to create a more powerful analytic approach.
SELECTION OF ASSESSORS BASED ON THEIR SKILL IN IDENTIFYING BASIC TASTES IN LOW CONCENTRATION SOLUTIONS
Authors: HOUGH GUILLERMO , MARTINEZ EDGARDO , CONTARINI ADRIANA , BARBIERI TERESA , VEGA MARIA JOSE
Published: May 2007

A method for the first step in the selection of trained sensory assessors, based on their skill in identifying basic tastes in low concentration solutions, was defined and evaluated. The solutions used were: 0.4 and 0.8% sucrose; 0.03, 0.04 and 0.06% citric acid; 0.08 and 0.15% sodium chloride; 0.02 and 0.03% caffeine. Concentration ranges were found adequate. The criterion for selection was to have over 65% correct answers. Out of 226 candidates who received the test, 141 (62%) were selected. The probability of a candidate having more than a certain percentage of correct answers was calculated. The influence of the dilution water quality on the perception of basic tastes was significant; distilled water was the most adequate.
SENSORY CHARACTERISTICS OF POTASSIUM LACTATE AND SODIUM CHLORIDE IN A MODEL SYSTEM
Authors: BREWER M. SUSAN , GILLS LEBECCA A. , VEGA JUAN D.
Published: May 2007

The objective of this study was to assess the sensory characteristics of potassium lactate (PL) in combination with salt (NaCl) in a model system at common usage levels for meat systems. Using a gelatin‐based (3%) model system containing various concentrations of potassium lactate (0%, 1%, 2%, and 3%) and sodium chloride (0%, 0.5%, 1%, 1.5%, 2%, 2.5%, and 3%), a sensory panel (10) selected for salt sensitivity (0.08% threshold or less) scored the intensity of saltiness and bitterness of each treatment combination using a scale of 0 = none and 15 = intense. As salt concentration increased, saltiness increased and bitterness decreased; as PL increased, saltiness and bitterness increased. At 2% salt, the bitterness of PL was masked; however, salt concentrations below and above 2% were less effective in bitterness reduction.
A COMPARISON OF TWO MULTIVARIATE METHODS FOR THE ANALYSIS OF SENSORY PROFILE DATA
Authors: HUNTER E.A. , MUIR D.D.
Published: May 2007

Tables of means, over assessors, are often used to summarize the results of sensory profile experiments. These tables are sometimes further summarized by Principal Components Analysis (PCA) to give plots of the samples in the principal sensory dimensions. An alternative procedure is to use Generalized Procrutes Analysis (GPA) on the assessor data to allow for differences in usage of the vocabulary and in the proportion of the scale used. It is shown that these methods give different configurations in the principal sensory dimensions when applied to the data from a study of cheeses (Muir et al. 1995). Using a Jackknife method to calculate the variability of the samples in the principal sensory dimensions, the results from the GPA method are shown to have a higher dimensionality than from the PCA method. Jackknife estimates of variability are used to calculate confidence ellipses to attach to the sensory space maps.
SENSORY ANALYSIS IN MARKETING PRACTICE: COMPARISON AND INTEGRATION
Authors: VAN TRIJP HANS C.M. , SCHIFFERSTEIN HENDRIK N.J.
Published: May 2007

Sensory analysis has traditionally played a prominent role in quality control for food products. More and more principles from sensory analysis are also applied in the area of food product development, bringing sensory analysis more closely into the domain of marketing. Unfortunately, in practice integration between sensory and marketing practices is far from optimal. Differences in basic orientations between sensory and marketing are a major source contributing to this defective cooperation.

Sensory analysis has traditionally been product oriented with an emphasis on internal validity of the test results. Implicitly or explicitly this approach emphasizes the relationships between sensory evaluation and characteristics of the product. Marketing, on the other hand, stresses the external validity of test results: the extent to which test results can be generalized to market behavior. Emphasis on external validity requires an approach to sensory analysis that is fundamentally different from current sensory practice in terms of type of respondents, type of stimuli, scaling procedures adopted and test circumstances.

Closer integration between the product and consumer oriented approach to sensory analysis may contribute to the success of product development in the food industry. The literature suggests several factors that may contribute to a more fruitful cooperation between the two approaches to sensory analysis. The company's senior management plays a central role in the achievement of this integration by providing an infrastructure (in terms of personnel, organizational structure and financial resources) that paves the way for closer cooperation.
DESCRIPTIVE ANALYSIS FOR WINE QUALITY EXPERTS DETERMINING APPELLATIONS BY CHARDONNAY WINE AROMA
Authors: McCLOSKEY L.P. , SYLVAN M. , ARRHENIUS S.P.
Published: May 2007

Since producer based sensory analysis of wine appellations remains in widespread use worldwide by wineries, modern sensory methods were developed for industry judge panels. U.S. appellations were studied using modern sensory analysis processes which accommodated the industry professionals’ biases for perceived quality and provincial sensory language. A panel was assembled comprised of wine industry quality experts (n = 26). First, judge quality biases were determined using a multi‐wine preference‐testing method (n = 48) in which judges freely record their aroma terms. Subsequently QDA° type strategies were used to create the sensory language from analysis of 1100 wine X judge interactions in which free use of terms was used to describe the wines. Next, an experiment analyzed the wines using a new descriptive analysis scorecard which contained the ten most frequently used terms; and scores were computed from the number of times terms were selected by the judges (frequency of use). Groups of sixteen wines, for which the judges had no large negative bias, from the Carneras American Viticutural Areas (AVA), were compared to those from California wine growing regions (Central Coast, Napa and Sonoma). Replicate trials showed Carneras AVA and Central Coast wines clustered in the principal components (PCA) analysis of the sensory data. The detection of regional typicalness by professionals: (1) was linked to their perceived quality bias, (2) was easily detected in high quality wines linked to grape attributes more than to winemaking attributes, and (3) was not possible when judges had determined that perceived wine quality was low. ANOVA and polar spider plot analysis of the clusters indicated that the important aroma attributes of Carneros wines included Citrus and Green Apples/Pears. Lastly, the sensory analysis data was compared to chemical analysis of terpenes for several wines (n = 22). Chardonnay terpene (linalool) concentrations were highly correlated (p < 0.01) with the attribute scores for Citrus which was important in the PCA analysis of the sensory data. These sensory processes offer a descriptive analysis process that accommodates the wine industry professional. The method also offers several advantages over flavor profiling methods including the reduction of the potentially confounding problems of “quality” and “standard terms” among industry professionals as well as speed and correlation with chemical analyses.
THE GENERATION OF SENSORY EXPECTATION BY EXTERNAL CUES AND ITS EFFECT ON SENSORY PERCEPTION AND HEDONIC RATINGS: A REVIEW
Authors: DELIZA R. , MacFIE H.J.H.
Published: May 2007

Expectations are generated by a variety of factors. We indicate a flow chart for the role of expectations at the point of choice and in influencing sensory perception at the time of consumption. We review the sparse literature on how advertising, packaging and information generate sensory expectations. The application of various theories to explain the observed effects of sensory expectations are reviewed. There is overwhelming evidence for assimilation‐contrast effect, although no studies have been specifically designed to detect it. Finally we review the reasons why individuals might differ in the way that expectations influence sensory perception. These reasons include ideas from persuasion literature and private body consciousness. A number of behavioral hypothesis that follow from these theories are developed.
TASTE GROUP THRESHOLDS AND SENSORY EVALUATION OF SPANISH WINE VINEGARS
Authors: GONZÁLEZ‐VIÑAS M.A. , SALVADOR M.D. , CABEZUDO M.D.
Published: May 2007

Wine vinegar is a product obtained from wine acidification which contains at least 5% by wt. of acetic acid, in general without any additives or colorings.

Aspects studied in this work include: the determination of the taste group thresholds (geometric mean of the individual best‐estimate thresholds “BET”) of two different acids (citric and acetic acids) in aqueous solution and spanish vinegars produced from table and sherry wines. The results obtained suggest that wine vinegar can be considered something more than just an acidulant agent.

In order to evaluate differences among wine vinegars, discriminant tests for twenty‐five spanish vinegars (sherry, table and flavored vinegars) were applied. Six of the twelve attributes freely chosen by assessors allowed grouping of the spanish wine vinegars according to their sensory aspects.
SENSORY CHARACTERISTICS OF SODIUM LACTATE AND SODIUM TRIPOLYPHOSPHATE IN A MODEL SYSTEM
Authors: KIM NANCY M. , BREWER M. SUSAN
Published: May 2007

The purpose of this study was to assess the sensory characteristics of sodium lactate (SL) in combination with sodium tripolyphosphate (STP) in a model system at common usage levels for meat products. Using a gelatin‐based (2%) system containing various concentrations of sodium lactate (0%, 1%, 2%, or 3%) and sodium tripolyphosphate (0%, 0.1%, 0.2%, 0.3%, or 0.4%) a thirteen‐member trained sensory panel scored samples for saltiness, bitterness, and soapiness. As sodium lactate and sodium tripolyphosphate levels increased, saltiness increased. Bitterness decreased with addition of 1% SL and increased with 2 and 3% SL. Soapiness also increased with increasing levels of SL. Bitterness and soapiness were not affected by increasing STP concentrations.
A MULTIFACETED CATEGORY RESEARCH STUDY: HOW TO UNDERSTAND A PRODUCT CATEGORY AND ITS CONSUMER RESPONSES
Authors: MUÑOZ ALEJANDRA M. , CHAMBERS EDGAR , HUMMER SOPHIE
Published: May 2007

In the multifaceted category research study described herein, several category appraisal studies are conducted (e.g., consumer, descriptive, instrumental). The main applications of this approach are (1) the thorough understanding of the product category in terms of the products’ characteristics and its consumer responses, and (2) the establishment of a data base used to interpret the category's consumer responses through laboratory data (e.g., descriptive, instrumental data).

A multifaceted category research study was completed for commercial hot dogs to demonstrate the methodology and the applications of this approach. The descriptive category review showed two main segments of products with unique flavor and texture characteristics: a meat and a poultry/grain segment. Through consumer‐descriptive data relationships, the product category's critical attributes (i.e., attributes that affect consumer liking), and the attributes that signal consumer responses of interest were identified. The hot dogs’ critical attributes needed to ensure high liking are: cured meat, smoke, moistness, moisture release, cohesiveness, cohesiveness of mass, oiliness, fat aromatic, sweetness and saltiness. Descriptive attributes that signal consumer HOT DOG FLAVOR and CHEWINESS were also identified.
The Nurse Practitioners’ Role in Smoking Cessation
Authors: Christman Claudia , Blngham Mona
Published: May 2007

Most people who smoke want to quit. Smoking is a combination of nicotine addiction, psychologic dependency, and habit. Nurse practitioners are in a unique position to influence clients to stop smoking. The authors discuss individual and group therapy programs and the role of the nurse practitioner. Nurse practitioners are encouraged to start smoking cessation programs in their communities.
Clinical Communication Strategies of Nurse Practitioners with Patients
Authors: Martin Leonide L. , Barfcan Howard
Published: May 2007

Nurses' awareness of their communication strategies is critically important both in identifying effective patterns in their interaction and in teaching themselves to improve their patient education techniques. Ineffective communication between client and nurse practitioner can result in failure to improve health status or deterioration of health status when recommendations are not followed. Studies of nonverbal aspects of clinical communication tend to count or average types of communication behaviors over the entire interaction rather than use sequential analysis of these behaviors. This paper presents initital results of a pilot study that used a sequential analysis of strategic roles played by nonverbal communication in nurse practitioner‐patient interactions involving patient education. Because there is little previous work in applying sequential analysis, the grounded theory approach was used to identify nonverbal communication behaviors. Routine visits that focused on osteoporosis prevention were conducted by three nurse practitioners. Two visits per nurse were videotaped and analyzed for sequential events of nonverbal communication by the researchers alone and then in combination with the nurse conducting the visit. Descriptions of each visit were developed based upon both the verbal and nonverbal characteristics of the nurse‐patient interactions as observed in the videotaped visits. From these, vignettes were created that summarized each nurse‐patient visit according to the nature of the clinical communication that took place. Interviews of both nurses and patients were conducted before and after the visits to explore osteoporosis knowledge, goals, and strategies for the visit Essentially all consciously stated strategies of both nurses and patients were cognitive (i.e., presenting or seeking information). After viewing their videotaped visits and an open‐ended interview with the researchers, the nurses were able to identify many of their nonverbal strategies. Use of videotaped visits can increase nurse practitioners’ awareness of nonverbal communication strategies that may assist them in more effective clinical communication and patient teaching.
Part I Report of the American Academy of Nurse Practitioners National Nurse Practitioner Survey
Authors: Towers Jan
Published: May 2007

This report is the first of a series of reports on the total results of the National Nurse Practitioners Survey of the American Academy of Nurse Practitioners. Data regarding educational status, length of time in practice, employment settings, physician contact and interaction, and charges according to specialty are presented.
Components Necessary in a Successful Nurse Practitioner‐Physician Collaborative Practice
Authors: Hughes Anna Marie , Mackenzie Christine Scanlon
Published: May 2007

In recent years, collaborative practice has gained much attention from nurse practitioners in primary health care settings. This is because many nurse practitioners feel that nurse practitioners and physicians can complement each other's roles. Together, they can provide more comprehensive, quality primary health care than either profession can provide by itself. Nurse practitioners and physicians working together to care for a common group of patients may have varying degrees of collaboration in their practice. This article discusses some elements and components necessary to maximize the quality and extent of collaboration.
Career Trends of Master's Prepared Family Nurse Practitioners
Authors: PhD JoEllen Wilbur , Zoeller Linda H. , EdO Marie Talashek , Sullivan Judith A.
Published: May 2007

The purpose of this study was to examine the career trends of family nurse practitioner (FNP) graduates of one master's program. A questionnaire was mailed to all FNPs (A/= 113) who graduated 1‐11 years earlier; there was a response rate of 83%. The survey revealed that for both first and present jobs the majority were providing direct patient care as a primary care provider or practicing in an indirect role. The study findings indicate that for these graduates there is a long term commitment (demonstrated through continued employment) as well as opportunity to practice in the nurse practitioner role in a direct or indirect capacity.
A Classic Manuscript Reprinted in Celebration of 25 Years of Progress
Authors: Spitzer Walter O. , Sackett David L , Sibley John C. , Roberts Robin S. , Kergin Dorothy J. , Hackett Brenda C. , Olynich Anthony , Lefroy G. , Sweeny G. , Nielsen H. S. , MacKrell E. V. , Brame A. , Fedor E. , Wright K.
Published: May 2007

From July 1971, to July 1972, in a large suburban Ontario practice of two family physicians, a randomized controlled trial was conducted to assess the effects of substituting nurse practitioners for physicians in primary‐care practice. Before and after the trial, the health status of patients who received conventional care from family physicians was compared with the status of those who received care mainly from nurse practitioners. Both groups of patients had a similar mortality experience, and no differences were found in physical functional capacity, social function or emotional function. The quality of care rendered to the two groups seemed similar, as assessed by a quantitative “indicator‐condition” approach. Satisfaction was high among both patients and professional personnel. Although cost effective from society's point of view, the new method of primary care was not financially profitable to doctors because of current restrictions on reimbursement for the nurse‐practitioner services. (N Engl J Med 290:251‐256,1974)
Survey of Geriatric Nurse Practitioners in the West: Scope of Practice and Effectiveness
Authors: Deitrich Carole E. , Chambers Donald , Resnik Barbara
Published: May 2007

This survey research conducted during a 3‐year period was designed to describe the scope of practice and effectiveness of the geriatric nurse practitioner (GNP) in providing health care to older adults in a variety of settings. The University of California, San Francisco, in collaboration with three other GNP programs surveyed graduates (n= 123). Also surveyed were administrators, directors of nursing, and the primary medical consultant where the GNPs were employed. A high degree of agreement among the professional groups was found. Some comparisons are made with the results of previous studies.
Practice Characteristics and Marketing Activities of Nurse Practitioners
Authors: PhD Jan Towers
Published: May 2007

This report includes information about the practice characteristics of nurse practitioners according to location of practice and specialty. Information regarding hospital privileges, contracts, job descriptions, evening call, practice support and marketing are included.
An Explanatory Model of Nurse Practitioner Job Satisfaction
Authors: Koelbel Pamela Wilkie , Fuller Sara G. , Misener Terry R.
Published: May 2007

Job satisfaction influences employee retention, worker productivity, and performance quality. To retain qualified nurse practitioners (NPs), health administrators must identify sources of job satisfaction and dissatisfaction. Herzberg's dual‐factor theory of job satisfaction addresses extrinsic and intrinsic work‐related factors. Expansion of the model to include global job satisfaction and individual differences provided a broad framework for the assessment of nurse‐practitioner job satisfaction. The expanded model was used to analyze the job satisfaction of 132 NPs registered with the South Carolina State Board of Nursing in 1988 (final response rate= 90%). Participants completed the Index of Job Satisfaction (US), the Minnesota Satisfaction Questionnaire‐Short Form (MSQ‐SF), and the Personal and Work Background Questionnaire (PWBQ). Although the NPs were moderately satisfied with their overall jobs, extrinsic factors were found to be major sources of dissatisfaction. The optimal combination of variables predicted by regression analysis to influence global job satisfaction were age, number of children, urban locations, achievement, company policies and practices, creativity, independence, and compensation. Implications for health administrators to improve the work environments of NPs are discussed.
Outpatient Initiation of Insulin: A Nurse Practitioner Protocol
Authors: Howe Rufus S. , Chrlstman Claudia
Published: May 2007

Noninsulin dependent diabetes (type II diabetes) is a chronic disease characterized by hyperglycemia. Clients can generally be controlled by diet and exercise or a combination of diet, exercise, and oral hypoglycemic agents. When this therapy is not effective in controlling the hyperglycemia, the health care provider must choose to initiate insulin therapy. Outpatient initiation of insulin is an alternative to hospitilization in the type II diabetic client. Clinical guidelines for the initiation of insulin on an outpatient basis and management of the diabetic client are presented.
Postpolio Syndrome
Authors: Winters Reng
Published: May 2007

The recurrence of symptoms many years after the rehabilitation of individuals who survived the acute illness, poliomyelitis, is a major concern. The purpose of this article is to provide information to the nurse practitioner (NP), who, as a primary health care provider, may be the first health professional to encounter persons with such complaints. Although no cure has been identified, diagnosis and treatment is available and is important to the psychosocial well‐being of those who suffer from postpolio syndrome. This article reviews research on the syndrome including etiology, pathophysiology, symptoms and management, psychological issues, and the role of the aging process. Some areas where further research is indicated are also identified.
An Educational Model for Implementing Community‐Based Primary Health Care
Authors: Fenton Mary V. , Rounds Linda R. , Anderson Elizabeth T.
Published: May 2007

With increasing health care costs, public health agencies and other institutions have a critical need for master's‐prepared nurses who can provide health care for common health problems of individuals and families but also assess, plan, intervene, and evaluate the needs of communities. This article describes the development of a nursing master's degree program to meet that need which combines the traditional roles of the nurse practitioner and the community health nurse. The program is based on the global concept of primary health care as defined by the World Health Organization, which includes more emphasis on economic, political, environmental, and social factors.
The Denver II
Authors: Sperhac Arlene M. , Salzer Judith L.
Published: May 2007

To maximize the potential of a child with a developmental delay, early detection and intervention is essential (Frankenburg and Thornton, 1989). The nurse practitioner who includes a developmental screening with the child's general assessment may detect a developmental delay during a routine office visit. The purpose of this article is to provide an overview of the Denver II, a new developmental screening test.
Battering in a Population of Adolescent Females
Authors: Richards Julie A.
Published: May 2007

The purpose of this study was to assess the prevalence of battering in a population of adolescent females, to gain information regarding the impact of battering on their health, and to test a portion of the Campbell and Humphreys (1984) framework, which states that our patriarchal society and the resulting machismo attitudes toward women are the cause of battering. If the framework is correct, partners who batter would possess characteristics indicative of machismo. The sample for this descriptive study consisted of a convenience sample of 59 females from a shelter for displaced teens. The subjects provided information on themselves and 92 male partners via interviews. Of 59 subjects, 69% had been battered before the age of 18 and 41.5% had been battered during pregnancy. Health care problems were frequent in all the subjects, especially depression and suicidal ideation. The nonbattered and battered subjects as well as their partners were compared with respect to several demographic variables. There was a statistically significant higher rate of reported qualities of machismo among batterers when compared with nonbatterers. Recommendations include suggestions for further research.
Assessment and Initial Management of Infertility
Authors: Saulsbery Susan Bean , Pohlhaus Mari F.
Published: May 2007

The rate of infertility is increasing in this country. Primary and secondary infertility affect almost 25% of all couples of childbearing age. Because of the large number of couples affected by infertility, primary care nurse practitioners (NPs) should expect to encounter this problem within their practice. Initial assessment, diagnosis, and management, as well as education, consultation, and support, are well within NPs' scope of practice. This article details the initial history, physical examination, and tests that might precede referral to an infertility specialist. The psychosocial aspect of infertility is also addressed.
Pressure Ulcers, Part Two: Management Strategies
Authors: Sanders Susan L.
Published: May 2007

The goal of this article is to facilitate the successful resolution of pressure ulcers. The nurse practitioner (NP) is an ideal health care professional to manage pressue ulcer care. This article reviews the basic principles related to wound care. The healing trajectory is discussed to assist an NP to determine appropriate therapy. Current, research‐based management strategies are provided.
Hypothyroidism: A Comprehensive Review
Authors: Johnson Jennal L. , Felicetta James V.
Published: May 2007

Hypothyroidism is a common clinical entity encountered frequently in most adult primary care settings. The reported prevalence in the general population is approximately 3% in men, but as high as 10% in women (Sawin, Geller, Hershman, Castelli, & Bacharach, 1989). The disease process affects every major organ system, contributing to a broad range of symptoms. Clinicians need to be familiar with the signs, the symptoms, and the appropriate laboratory studies, so that timely and accurate diagnoses can be made. This article reviews normal thyroid physiology and thyroid pathophysiology, as well as the diagnosis and treatment of several important clinical entities resulting in hypothyroidism. Research findings are included insofar as they relate to current clinical practice.
The Structure, Content, and Quality of Family Nurse Practice
Authors: Pickwell Sheila M.
Published: May 2007

Relatively little data has been collected documenting the scope of family nurse practitioner (FNP) clinical practice, and virtually no research definitively describes the quality of that practice. Physicians have led the way in quantitative collection of practice content information. The resulting analyses have determined not only the most common diagnoses in primary care but also the content of teaching and research in family practice. Nurse clinicians, educators, and researchers have assumed this content to be pertinent to FNP practice as well. This article describes the major studies of family physician practice and the few studies of nurse practitioner/ FNP practice, and advocates intensified review of FNP clinical content as an empirical basis for practice, education, and research.
Complications of Menopause and the Risks and Benefits of Estrogen Replacement Therapy
Authors: Marten Susan K.
Published: May 2007

Every woman who lives long enough will become menopausal. While menopause is not a disease, the increased mortality and morbidity in menopausal women due to osteoporotic fractures, cardiovascular disease, and coronary heart disease are felt by many to be related to the decrease in endogenous estrogen. Therefore, one possible solution is estrogen replacement therapy. This article reviews recent literature on the complications of menopause and the risks and benefits of estrogen replacement therapy. The article also will discuss how a nurse practitioner can utilize the theory of care seeking behavior to implement this knowledge into practice.
Health Care Delivery to Farmworkers in the Southwest: An Innovative Nursing Clinic
Authors: LaPlante Lea M.
Published: May 2007

The migrant and seasonal farmworkers of the United States constitute a medically underserved population with many health care needs. Barriers to health care among farmworker families include financial constraints, cultural factors, restrictive labor practices, and absence of accessible clinics in rural areas. The Migrant Health Outreach Program is a federally funded mobile nursing clinic created to deliver health care to farmworkers where they live and work. The Migrant Health Outreach Team, composed of family nurse practitioners, registered nurses, and health care workers, offers primary care including health care maintenance and treatment of acute and chronic illness. The mobile nursing clinic serves the target population of farmworkers as a successful alternative to a traditional medical clinic.
The Role of the Nurse Practitioner in the Diagnosis and Management of Bulimia Nervosa, Part 2: Physiologic Management
Authors: Muscari Mary E.
Published: May 2007

Physiologic management of bulimia nervosa is targeted primarily toward restoration and maintenance of nutrition and prevention and treatment of complications. The intensity, frequency, and duration of care depend on the severity of the disorder. Some form of physiologic management is recommended while the client is in psychotherapy. The client should be monitored for the possibility of hospitalization. Consistent management will allow for better health care.
Toward Healthy People 2000: The Role of the Nurse Practitioner and Health Promotion
Authors: Burns Candace M.
Published: May 2007

The central purpose of Healthy People 2000 is to increase the proportion of Americans who live long and healthy lives. The best health promotion strategies are those related to individual lifestyle, and include personal choices made in a social context that have a significant influence over one's health. The primary lifestyle activities include: physical activity; nutrition; alcohol, tobacco, and other drug use; family planning; and violent and abusive behavior. Nurse practitioners play a significant role in promoting healthy lifestyle behaviors in their patients. This article presents an innovative teaching strategy used to teach health promotion concepts and intervention strategies to nurse practitioner students. The course design follows a clinical protocol format, which facilitates translation to clinical practice.
Chronic Fatigue Syndrome: A Review and Practical Guide
Authors: Fox Deborah S.
Published: May 2007

Diagnosis and management of chronic fatigue syndrome (CFS) is a difficult challenge for nurse practitioners. The syndrome is widespread, poorly‐defined, and problematic. Despite extensive etiologic research, no cause has been identified. Each case should be carefully evaluated for possible organic, psychiatric, and other factors reported as potential causes. Clinical manifestations, possible causes, and options for management are reviewed.
Factors that Prevent Women of Low Socioeconomic Status from Seeking Prenatal Care
Authors: Johnson Jennal L. , Primas Phyllis J. , Coe Mary Kathryn
Published: May 2007

While there is an international trend toward lowering infant mortality, the United States ranks 19th among industrialized nations. In Arizona, as across the nation, a large and increasing number of low birth weight (LBW) infants are being delivered. This number is viewed with alarm as LBW is associated with infant mortality; however, LBW may be preventable in many cases if mothers receive adequate prenatal care. Despite recognition that absent or inadequate prenatal care is an important risk factor, a large number of women deliver without such care. In Arizona, the percentage of women delivering at a large metropolitan public hospital without prenatal care doubled in a 2‐year period, reaching 14% (764 women). The majority of these women were of low socioeconomic status. The purpose of this study was to explore the reasons given by women delivering at this hospital for not seeking prenatal care. It was determined that a qualitative methodology was most appropriate; thus, an interview guide was developed with both demographic and open‐ended probing questions. Fifteen respondents‐5 Caucasian, 8 Latino (5 Spanish‐speaking only), 1 Afro‐American, and 1 Native American—participated in the interviews. The data were transcribed from taped interviews and studied using content analysis. Eleven barriers were identified and sorted into two categories: internal and external. Internal barriers identified by the women were attitudes associated with low motivation, knowledge deficits, fear, and fatigue. External barriers elicited were finances, transportation, system difficulties, lack of support, lack of child care, missed work, and insufficient time. These barriers are the same as those identified in other studies conducted over the past 10 years related to barriers to prenatal care. This study differs from prior ones in that it addresses programmatic and social issues related to these barriers.
Sleep Problems in the Elderly
Authors: Johnston Joan E.
Published: May 2007

Sleep problems in older adults are so common that nearly half of all hypnotic prescriptions written are for persons over 65 years old. Although normal aging affects sleep, the practitioner should evaluate the many factors that cause insomnia: medical illness, psychiatric illness, dementia, alcohol and/or polypharmacy, restless legs syndrome, periodic leg movements, and sleep apnea syndrome. Nonpharmacologic treatment of sleep disorders is preferred. The nurse practitioner can assess and manage elderly patients with sleep disorders, but they need to refer those who can benefit from evaluation to a sleep disorder center.
Practical Knowledge and Competencies of the Healing Role of the Nurse Practitioner
Authors: Lewis Phylicia Hancock , Karen A. Brykczynski DNSc, RNC, FNP
Published: May 2007

This qualitative study describes the practical knowledge and competencies of the healing role of the nurse practitioner. The conceptual framework is based on Benner's (1984) domains of nursing practice and aspects of practical knowledge and Brykczynski's (1985) study of the clinical practice of nurse practitioners. The healing role is described within the context of the healing domain of the National Organization of Nurse Practitioner Faculties' curriculum guidelines (Zimmer et al., 1990) and Benner's aspects of practical knowledge. The study used the interpretive research approach of Heideggerian hermeneutic phenomenology. The findings contribute two maxims that constitute aspects of practical knowledge: “little things mean a lot” and “healing begins with listening,” and two additional healing competencies: sensitive humor and risk taking.
Group B Streptococcal Disease: A Life‐Threatening Infection in the Newborn
Authors: Gallagher Robin J. , Fuller Cheryl A.
Published: May 2007

Group B streptococcal (GBS) disease, a life‐threatening infection in newborns in the United States, causes considerable neonatal morbidity and mortality. GBS is also a major source of maternal infection. Screening during pregnancy leads to early identification. Intrapartal treatment of affected mothers can prevent harmful neonatal effects. Implementation of screening and treatment protocols is recommended for the protection of all obstetric and neonatal patients.
How One School‐Based Clinic is Meeting the Challenge of Adolescent Health Care
Authors: Falsetti Donna , Kovel Arthur
Published: May 2007

Today's adolescent confronts a host of medical, social, and economic problems that have a significant impact on their lives as well as on society. The teenage population of the North Side area of the city of Pittsburgh is no exception. To address the needs of these teens a school‐based clinic was established in one of the city's middle schools. It became known as the Allegheny Middle School/Allegheny General Hospital Wellness Center (AMS/AGH Wellness Center). Located on the school grounds, this clinic remained in operation during school hours. Student interest was obvious as they began using the services provided by the clinic immediately after its establishment. After only 1 school year of operation, nearly 60% of the student body was enrolled. The number of patient visits totaled 1086. Evidence from the literature attesting to the advanced skills, cost effectiveness, and holistic approach to patient care of nurse practitioners led to the selection of a family nurse practitioner as the primary health care provider for the middle school students. Other clinic staff include a part‐time physician, ambulatory technician, secretary, and part‐time psychiatric social worker. The establishment and operation of the Wellness Center is discussed in this article.
Sickle Cell Disease: Comprehensive Screening and Management in Newborns and Infants
Authors:   SCD Guideline Panel
Published: May 2007

This Quick Reference Guide for Clinicians contains highlights from the Clinical Practice Guideline for Sickle Cell Disease: Screening, Diagnoses, Management, and Counseling in Newborns and Infants. An algorithm shows the sequence of events related to sickle cell screening, diagnosis, medical management, and counseling in newborns and infants. Clinicians should refer to the complete guideline for more detailed analysis and discussion of the available research, critical evaluation of the assumptions and knowledge of the field, health care decision making, and references.
Primary Immunodeficiency Disease in Children: Recognizing Problems in Primary Care Practice
Authors: Cochran Jill , Dempster Judith S.
Published: May 2007

Dealing with recurrently ill children is a difficult task. Understanding when the health care provider should suspect primary immunodeficiency and what screening tests can be beneficial prior to referring a child to another health care facility is important for the primary care provider. This article presents a brief description of the immune system, diseases of primary immune deficiencies, and the clinical evaluation of a child with a primary immunodeficiency.
Outcomes Research: Contemporary Issues and Historical Significance for Nurse Practitioners
Authors: Burns Margaret , Moores Patricia , Breslin Eileen
Published: May 2007

Outcomes research is not new to the discipline of nursing. However, the driving forces of today's health care environment are resulting in increased emphasis on the study of outcomes. This article presents an overview of the scope of outcomes research, including a historical perspective and contemporary issues. Outcomes research provides an opportunity to demonstrate the effectiveness of nurse practitioner practice.
Rural Nurse Practitioners: Perceptions of Ethical Dilemmas
Authors: Turner Lorri N. , JD Kathy Marquis , Burman Mary E.
Published: May 2007

The purposes of this study were to identify ethical dilemmas encountered by rural nurse practitioners in primary practice and to identify constraints or enhancers that influenced ethical decision making. Nine nurse practitioners from Wyoming and Colorado responded to in‐depth interviews. Six categories of ethical dilemmas and a list of constraints and enhancers were identified. One central concept, conflict between personal values and professional responsibility, emerged. Beneficence, nonmaleficence, justice, and patient autonomy, as core ethical principles, were related to this central conflict.