bluuebunny/crossref_metadata_2025_split huggingface dataset:
Financing Long‐term Health Care of the Elderly: Dismantling the Medical Model
Authors: Reinhard Susan 
Published: May 2007

AbstractEfforts are being made to shift federal financing of long‐term care of the elderly from a medical to a health model. The forces of fiscal constraints and an aging population are precipitating a crisis in the current government‐financed medical model of long‐term care that fosters sending the elderly to institutions. Problems associated with this approach are stimulants to the development of an alternative health model that incorporates nursing, medical, and social components of long term care. Selected government‐sponsored research in this area has implications for policy. Although project results have been inconclusive in terms of cost effectiveness, they have inspired legislative proposals to effect changes. Several federal bills have potential effects on service delivery and nursing practice in the home and community. Consideration of the issues, proposals, and political climate forms the foundation for strategies to monitor policy options, protect nursing's practice arena, and initiate desired alternatives. Nurses are urged to acquire the information, political skill, and networking capability to become powerful advocates of reimbursement changes that will support consumer needs and the profession's advancement.
Public Health Nursing: A Study of Role Implementation
Authors: Gulino Claire , LaMonica Grace 
Published: May 2007

AbstractThe activities and services of the public health nurses during home visits in a Southwestern county health department were examined through a record audit. The data were taken from 186 client records representing 774 home visits. Seventy‐nine percent of the sample nursing interventions were for health counseling and education. The records reviewed reflected nursing activities on the primary, secondary, and tertiary levels of prevention.
Health Services in Day‐Care Centers: A Public Health Nursing Design
Authors: Schmelzer Margaret , Reeves Sharon R. , Zahner Susan J. 
Published: May 2007

AbstractRecognizing national and local needs, a public health nursing service model for children enrolled in licensed full day‐care centers in the city of Madison was developed by the Madison Department of Public Health and funded from the state maternal and child health/prevention block grants for fiscal year 1982–1983. The department was awarded continuation funding at the same level through December 31, 1984. The public health nurse is an essential provider in this model, working directly and indirectly with children, parents, teachers, and key community professionals. The nurse identifies problems early and promotes significant and timely health education, thereby facilitating the improvement of emotional, physical, and social potentials for children and their families. The goals for the educational and service programs were aimed at fostering positive health behaviors, providing early health screening and problem management, and improving knowledge about safety measures in the day‐care population. Programs and services were developed based on the assessed health and health education needs of approximately 1500 children through a needs‐assessment tool administered to parents and day‐care staff. The goals of the grant were furthere enhanced through the innovative use of videotaping as an educational tool.
Helping Students Assess Parenting Education Needs
Authors: Davis Janet Haggerty , Eyer Jane , Drott Patricia M. 
Published: May 2007

AbstractA card‐sort exercise based on the tenets of adult education and Q methodology was developed to offer baccalaureate nursing students an alternative to current approaches to assessing parents' needs for education on home visits. The card sort was designed to facilitate parents' self‐diagnosis of learning needs in relation to infant care and postpartum self care behaviors; emphasize the importance of parents' role in the assessment process; and promote structured mutuality in home visiting. The technique was field tested on student home visits to new parents and was evaluated as an effective aid for engaging parents in the assessment process.
Nominal Group Process as an Instructional Method with Novice Community Health Nursing Students
Authors: Butterfield Patricia G. 
Published: May 2007

AbstractThe selection and use of nominal group process as an instructional method in a clinical conference is outlined. A step‐by‐step guide is provided for the instructor interested in using this teaching method. Data obtained from the use of this method with students in a community health nursing rotation yielded the students' perceptions of barriers encountered during clinical experience involving home visits with low income families. The most critical barriers identified by these students included “client's cycle of decreased energy perpetuates poor coping strategies,”“client is present oriented with no plans for future,” and “client lacks resources to access and receive adequate health services.”
Reliability of a Problem‐Classification Index for Well Mothers and Children in Community Health Nursing
Authors: Helberg June L. 
Published: May 2007

AbstractCommunity health nurses in county health departments continue to provide disease‐prevention and health‐promotion services to mothers or families with children who are considered well. We lack available instruments with demonstrated reliability that can classify the nursing problems of these clients by type and seventy. The purpose of this pilot study was to determine the reliability of a classification index for well mothers and children in community health nursing practice. The study indicated that Cronbach's alpha was 0.98 for the composite index and that the internal consistency for each of the six component subscales in the index ranged from 0.91 to 0.98.
Public Health Nursing Costs in Home Care
Authors: Kovner Christine 
Published: May 2007

AbstractThis article discusses the measurement of costs, particularly the cost of public health nursing in the home health setting, and describes typical cost‐accounting procedures. Alternatives are analyzed and four models for measuring costs are presented: per diem, acuity, hourly, and diagnoses. Since each model measures cost in a different way, selection of one over another will affect research results.
Home Visiting and Prenatal Care: A Survey of Practical Wisdom
Authors: Peoples‐Sheps Mary D. , Efird Cathy , Miller C. Arden 
Published: May 2007

AbstractPublic health nurses and other professional and paraprofessional workers have engaged in prenatal home visiting for many decades. Yet, the extent to which this and other prenatal interventions influence maternal behavior is largely unknown. This study was undertaken to collect and categorize perceptions of experts in the organization and delivery of prenatal care about the value of selected strategies for encouraging participation in care, for education, and for changing behavior, with special emphasis on home visiting. The survey sample consisted of 151 experts who were identified by directors of maternal and child health programs in 48 of the 50 states. One hundred eighteen of the experts, almost half of whom were nurses, responded to the survey. The findings suggest important discrepancies between respondents' perceptions about the effectiveness of some prenatal strategies and the actual extent of their use in practice. In addition, the results raise questions about the appropriate mix of type of home visitor and purpose of visit. These questions should form the basis for subsequent investigations.
An Epidemiological Approach to Community Assessment
Authors: Finnegan Lorna , Ervin Naomi E. 
Published: May 2007

AbstractAn epidemiological approach to community assessment is useful for students and practicing nurses. Shamansky and Pesznecker's definition of community is applied to the community assessment process in order to provide an organized framework for data collection, data analysis, and community diagnosis. We applied the framework to an actual community in a case study format.
Public Health Nursing and The Future of Public Health
Authors: Ward Debbie 
Published: May 2007

AbstractThe recent Institute of Medicine report. The Future of Public Health, reviews the history, current status, and potential of the public health system in the United States, and makes detailed recommendations for its revitalization. Although public reports such as this risk speedy obscurity, many are used by planners and legislators and a few exert significant influence. Public health nursing is inadequately represented in this potentially influential document, and this has unfortunate implications for public health nursing.
The Life Span Perspective: A Developmental Approach to Community Health Nursing
Authors: McCool William F. , Susman Elizabeth J. 
Published: May 2007

AbstractFollowing the nursing theorists' tradition of using an interdisciplinary approach to community health model building, the concepts of the life span perspective on human development were applied to the practice of community health nursing. As with the perception of individual development from this perspective, communities are viewed as evolving over time, with changes occurring across levels of influence‐ human, societal, historical, and cultural. These levels are interdependent, and factors from any one or more can affect the growth and functioning of the community. Implied in this interdependence is the ability not only to intervene in a community's development, but to go beyond this and recognize that a community has a degree of control over its own development. To be accurate and thorough in working with communities, the community health nurse who takes a life span perspective must be cognizant of the fact that communities do exist in a continual, multilevel, interactive manner that develops through time. Demonstrating the practical use of this perspective, a model for the assessment phase of the nursing process as applied to community study was developed. A pilot study was performed using this model, and initial results suggest that taking a life span perspective toward community health is both valid and practical, and warrants further scholarly investigation.
Holistic Concepts and the Professionalization of Public Health Nursing
Authors: Allen Carol Easley 
Published: May 2007

AbstractThe sociology of knowledge provided the conceptual and methodologic basis for this study of the relationship between the philosophic concept of holism and the professionalization of public health nursing. Set in the context of the history of ideas, the discussion examines the various meanings of holism and the circumstances surrounding their adoption, modification, and use in public health nursing. The nursing literature from the late 1800s to the 1980s was analyzed to explicate the pragmatic consequences of holism for public health nursing, and to examine holism's moral value and its part in establishing and extending public health nursing's professional domain.
Specialty Roles in Community Health Nursing: A National Survey of Educational Needs
Authors: Riportella‐Muller Roberta , Selby Maija L. , Salmon Maria E. , Quade Dana , Legault Claudine 
Published: May 2007

AbstractThis study identified population groups, health conditions, and employment settings considered appropriate for graduate‐level community health nursing (CHN) practice and employment, and described the relative importance of each of these areas as assessed by CHN leaders. According to 588 leaders in CHN service and education, (1) the population groups most in need of graduate‐prepared CHNs are the elderly, persons of low socioeconomic status, the homeless, adolescents, and the unemployed; and (2) the health conditions most in need of CHN services are AIDS, pregnancy and prenatal problems, low birth weight and infant mortality, stress‐related illness, and Alzheimer's and other chronic diseases of the elderly. Among the many employment settings rated as having a great need for CHNs are state and local health departments and home health agencies. The findings provide the direction and justification for developing specialty options within CHN that correspond to these identified and changing needs. This article provides suggestions and possible alternatives for initiating educational change to prepare graduate‐level CHNs for these various specialties and for the settings in which the specialties will be applied.
Assessing for Abuse: Self‐Report Versus Nurse Interview
Authors: McFarlane Judith , Christoffel Karen , Bateman Louise , Miller Virginia , Bullock Linda 
Published: May 2007

AbstractEstimates are that 1.8 million women are physically abused each year by their husbands. To prevent abuse and promote physical safety, routine assessment is essential. Planned Parenthood of Houston and Southeast Texas added four self‐reported abuse assessment questions to their standard intake form completed by all initial and annual‐visit clients. After one month of self‐report by 477 women, the prevalence of physical abuse was 7.3%. To compare self‐report to nurse interview assessment, the same four questions were asked of 300 women coming to the same clinic for initial or annual visits. The reported prevalence of abuse after a nurse interview was 29.3%.
Profiling of alterations in platelet proteins during storage of platelet concentrates
Authors: Thiele Thomas , Steil Leif , Gebhard Simon , Scharf Christian , Hammer Elke , Brigulla Matthias , Lubenow Norbert , Clemetson Kenneth J. , Völker Uwe , Greinacher Andreas 
Published: May 2007

BACKGROUND: The quality of platelet concentrates (PCs) is primarily determined in vitro by selective methods (e.g., pH, aggregometry), which provide only limited information on certain platelet (PLT) characteristics. In contrast, proteomic technologies provide a comprehensive overview of the PLT proteome. High interassay variability, however, limits meaningful assessment of samples taken from the same product over time or before and after processing.STUDY DESIGN AND METHODS: Differential in‐gel electrophoresis (DIGE) and mass spectrometry were applied to analyze changes in the PLT proteome during storage of PCs.RESULTS: DIGE provides a comprehensive and reproducible overview of the cytoplasmic PLT proteome (median standard deviation of protein spot intensities, 5%‐9%). Although 97 percent of cytosolic PLT proteins remained unchanged over a 9‐day storage period, septin 2 showed characteristic alterations that preceded by several days more widespread alterations affecting numerous other proteins. Also β‐actin and gelsolin are potential marker proteins for changes in the PLT proteome. Interestingly septin 2 and gelsolin are affected during apoptosis, indicating that apoptosis in PCs may have an impact on PLT storage.CONCLUSION: DIGE is a tool for comprehensively assessing the impact of storage on the global proteome profile of therapeutic PCs. Most of the changes detected are in high‐abundance PLT proteins.
Effects of β‐Adrenergic Receptor Activation on Intracellular Calcium and Membrane Potential in Adult Cardiac Myocytes
Authors: YAMADA KATHRYN A. , CORR PETER B. 
Published: May 2007

β‐Adrenergic Receptor Activation and Intracellular Ca2+. Introduction:β‐Adrenergic receptor agonists have been shown to increase the voltage‐dependent Ca2+ current in cardiac myocytes. Additionally, adrenergic receptor activation has been shown to increase intracellular Ca2+, to increase systolic Ca2+ transients and to enhance Ca2+ uptake into the sarcoplasmic reticulum, thereby accelerating relaxation. The present study was designed first to characterize the influences of β‐adrenergic receptor activation on intracellular Ca2+ activity as well as membrane potential in ventricular myocytes characterized as normal based on rigorous morphologic and electrophysiologic criteria. The second objective was to assess whether the increase in intracellular Ca2+ activity elicited by β‐adrenergic receptor activation could elicit afterdepolarizations and triggered activity. Methods and Results: Intracellular Ca2+ and whole‐cell voltage recordings were measured in cells in which indo‐1 free acid was delivered intracellularly through the recording pipette. Isoproterenol produced complex Ca2+ transients underlying both early and delayed afterdepolarizations during pacing as well as aftertransients underlying triggered action potentials and delayed afterdepolarizations in the absence of pacing. The coupling interval of Ca2+i aftertransients was frequency dependent and followed that of the delayed afterdepolarizations. Ca2+i after transient amplitudes, however, exhibited a biphasic response with frequency revealing that factors other than pacing frequency alone contribute to control of the amplitude of the aftertransients. Inhibition of sarcoplasmic reticular release of Ca2+ by ryanodine abolished Ca2+i aftertransients and afterdepolarizations otherwise elicited by isoproterenol. Conclusion: These data demonstrate that normal cells stimulated by β‐adrenergic agonists exhibit marked changes in intracellular Ca2+ homeostasis that may serve as the substrate for abnormal ion fluxes that ultimately contribute to electrophysiologic derangements underlying arrhythmogenesis in the intact heart. (J Cardiovasc Electrophysiol, Vol. 3, pp. 209–224, June 1992)
Calcium Current in Single Human Cardiac Myocytes
Authors: COHEN NERI M. , LEDERER W.J. 
Published: May 2007

Calcium Current in Human Heart. Introduction: Significant species‐, issue‐, and age‐dependent differences have been described for the L‐type calcium current (ICa). Therefore, extrapolation data obtained from the many animal models to human cardiac physiology is difficult. In this study, we have characterized the voltage‐dependent properties of ICa from pediatric and adult, atrial and ventricular human heart tissue. Methods and Results: ICa, was measured in single human heart muscle cells using the “whole cell,” voltage clamp method. Single myocytes were isolated from myocardial specimens obtained intraoperatively from both pediatric and adult patients (ages 3 months to 75 years) undergoing cardiac surgery. Cells obtained for these experiments appeared to be healthy; the resting potential was between ‐80 and ‐85 mV. The action potential shape and duration and current‐voltage relationship for 1Ca were similar to that reported by others for human heart cells. The steady‐state activation variable, dx was found to be similar in both pediatric atrial and ventricular cells but shifted approximately 5 mV negative in the adult atrial and ventricular cells. I, of all cells displayed biex‐ponential inactivation and steady‐state inactivation was incomplete at positive potentials (steady‐state inactivation curves turned up at positive potentials) consistent with inactivation arising from voltage‐dependent and calcium‐dependent processes as reported in heart cells from many species. The potential of maximal inactivation was more negative for adult cells (around ‐10 mV) than pediatric cells (around 0 mV). Estimates of the calcium “window” current, using a modified Hodgkin‐Huxlcy model, could explain measured differences in action potential shape and duration. Conclusion: Human cardiac I, can be investigated using whole cell, voltage clamp methods and a modified Hodgkin‐Huxley model. Quantitative characterization of many of the properties of ICa in human heart tissue suggests that important species differences do exist and that further investigations are required to characterize the dependence of inactivation on [Ca2+]i in human heart cells. Since the array of characteristics of ICa in different species varies, the study of human myocardial cells per se continues to be important when examining human cardiac physiology.
Identifying the End of Ventricular Activation:
Authors: BERBARI EDWARD J. , LANDER PAUL , GESELOWITZ DAVID B. , SCHERLAG BENJAMIN J. , LAZZARA RALPH 
Published: May 2007

Late Potentials: Epicardial and Body Surface. Introduction: Identification of the end of the QRS is perhaps the single most important feature obtained from the high resolution signal‐averaged electrocardiogram (SAECG). This point relies on computer algorithms to select a point ahove the noise levels. Prior studies to suhstantiate this approach using eleetrograms for comparison have demonstrated many examples of the hody surface recordings failing to detect the full extent of the late potentials. Methods and Results: An animal model that generates late potentials was used in conjunction with epicardial cardiac mapping system to systematically examine the rea.sons for these failures. In I I of 13 dogs we found a concordance hetween the signal‐averaged recordings and Ihe epicardial recordings within 5 msec. The two discordant studies were attrihuted to a failure of epicardial mapping to record all late potential sources. Also, a means of accurately comparing measurements from the two recording technologies was required in this study as well as a new definition for identifying the end of activation currents in epicardial eleetrograms. Conclusion: To achieve these results required approaches different from those used in the clinical setting to record the SAECG. These include: (1) the analysis of individual XYZ leads as opposed to the vector magnitude derived from these leads; (2) visual identification of very low level signals, as automatic algorithms often fail to detect low level signals: and (3) the use of finite impulse response digital filters instead of the bidirectional Butterworth filter.
Effects of Partial and Complete Ablation of the Slow Pathway on Fast Pathway Properties in Patients with Atrioventricular Nodal Reentrant Tachycardia
Authors: STRICKBERGER S. ADAM , DAOUD EMILE , NIEBAUER MARK , WILLIAMSON BRIAN D. , MAN K. CHING , HUMMEL JOHN D. , MORADY FRED 
Published: May 2007

Fast Pathway Properties. Introduction: The purpose of this study was to prospectively compare the effects of complete and partial ablation of slow pathway function on the fast pathway effective refractory period (ERP). Methods and Results: The subjects were 20 patients (mean age 43 ± 13 years) with atrioventricular nodal reentrant tachycardia (AVNRT), no structural heart disease, and easily inducible AVNRT. Autonomic blockade was achieved with propranolol (0.2 mg/kg) and atropine (0.04 mg/kg). After elimination of AVNRT and during autonomic blockade, the presence of residual slow pathway function was determined by the presence of a single AV nodal echo and/or dual AV nodal physiology. After autonomic blockade and before ablation, the mean fast pathway ERP was 319 ± 44 msec and the mean slow pathway ERP was 251 ± 31 msec. After slow pathway ablation and during autonomic blockade, 7 patients had residual slow pathway function and 13 did not. Complete loss of slow pathway function was associated with a shortening of the fast pathway ERP from 334 ± 35 msec to 300 ± 62 msec (P < 0.01), while the fast pathway ERP did not change significantly in patients with residual slow pathway function (291 ± 29 msec vs 303 ± 38 msec, respectively; P = 0.08). A shortening of 30 msec or more in the fast pathway ERP was observed in 11 of 13 patients who did not have residual slow pathway function, compared to 0 of 7 patients with residual slow pathway function (P < 0.001). Conclusion: Shortening of the fast pathway ERP after successful ablation of AVNRT is dependent upon complete loss of slow pathway function. This observation is consistent with electrotonic inhibition of the fast pathway by the slow pathway.