bluuebunny/crossref_metadata_2025_split huggingface dataset:
Administrative Diagnosis—Implications for the Public's Health
Authors: Porter Eileen Jones 
Published: May 2007

AbstractThe nursing diagnosis of the health care needs of population groups has been deemed the responsibility of community nurse‐administrators. Yet it was not known whether these nurses actually formulate nursing diagnoses pertaining to population groups. The purpose of this study was to describe the diagnostic reasoning of these nurses so as to enable the development of a factor‐isolating theory of population group diagnosis using the grounded‐theory method. Data were obtained from 31 community nurse‐administrators regarding the health services they had created or discontinued within the last three years; it was assumed that these data could illuminate the diagnostic decisions that had preceded service change. The data revealed a first‐stage diagnostic process in which the group's state of health was determined. Prior to service change, a second‐stage diagnosis was made about the degree of match between the group's need and existing services; the nursing goal was to cultivate a need‐service match that would positively affect the group's health status. Labels for the first‐ and second‐stage diagnoses were developed based on the emergent theory and the relevant literature. The resultant factor‐isolating theory of community nurse‐administrator diagnosis was stated and the implications of the theory for the public's health were discussed.
Educational Needs of Community Health Nursing Supervisors
Authors: Duffy Sonia A. , Fairchild Nancy 
Published: May 2007

AbstractRecent legislative trends toward early hospital dismissal and cost containment have shifted the setting for health care from the hospital to the home. Consequently, community health nursing supervisors are becoming increasingly responsible both for coordinating care for sicker clients with fewer available resources, and for guiding staff nurses who provide high‐tech nursing skills in the home. This has resulted in new educational needs for these supervisors. To determine their educational needs and the barriers to implementing their roles, 160 community health nursing supervisors employed by community health nursing agencies in Michigan were surveyed. They reported educational needs related to labor relations, reimbursement procedures, fiscal management, marketing, and computer systems. Several types of educational experiences were found to influence their abilities to handle supervisory responsibilities, including enrollment in an educational program, highest level of education, and selected content areas taught in their formal educational programs. Nursing implications include using the research results to develop educational programs to meet the needs of community health nursing supervisors. Those who are adequately prepared educationally will be better able to provide effective supervision of staff nurses and ultimately, coordinate high‐level client home care.
Cardiovascular Risk Assessment in School‐Age Children: A School and Community Partnership in Health Promotion
Authors: Cowell Julia Muennich , Montgomery Andrew C. , Talashek Marie L. 
Published: May 2007

AbstractThere is little doubt that the primary prevention of cardiovascular disease is a pediatric problem that nursing must address. Cardiovascular health‐promotion activities for children have generally used an ecologic model, providing community‐based education programs in the schools. The purpose of this study was to identify changes in cardiovascular risk among sixth‐grade cohorts over eight years. Four variables known to be associated with such risk‐weight (obesity), pulse rate recovery index, blood pressure, and total cholesterol level‐were measured on 4900 students, and changes in their prevalence were analyzed.The data presented in this paper were compiled from a screening program conducted by a local health department in partnership with a school district's health‐education program. Although the school‐based health‐education program has been in existence for eight years, the prevalence of cardiovascular risk in sixth‐grade students has not declined, suggesting the need for nurses to target the children at risk, and address more directly the motivational and affective domains in addition to cognitively focused programs.
The Effectiveness of Public Health Nursing Services to Prenatal Clients: An Integrated Review
Authors: Baldwin Kathleen A. , Chen Shu‐Pi C. 
Published: May 2007

AbstractThe effectiveness of public health nursing interventions with prenatal clients was summarized from 17 studies, conducted between 1963 and 1988, that were identified through a comprehensive reference search. The review indicated that public health nursing interventions can increase birthweight, and the use of prenatal medical services, nutritional services, and childbirth classes. Because of methodological problems, however, it is difficult to conclude with certainty that such interventions make a significant difference in client outcomes. These problems included lack of construct validity, lack of specification of interventions, small convenience samples, lack of power to detect small treatment effects, nonexperimental research designs, lack of reliability information, and self‐selection and history biases. To overcome these problems, the authors suggest the use of conceptual frameworks, power calculations prior to initiation of research, experimental or quasi‐experimental designs, replication of research with different populations, and the calculation and reporting of reliability information.
A Framework for Planning Public Health Nursing Servicesm to Families
Authors: Vahldieck Rosemary K. , Reeves Sharon R. , Schmelzer Margaret 
Published: May 2007

AbstractWe designed a model to assist public health nurses and nursing supervisory staff in planning, delivering, and evaluating their services to families. Specifically, the intent was to assist nurses to estimate the numbers and types of services required. The model includes a gradient of family health characteristics, an original delineation of nine basic public health nursing services, a coping index and scoring guidelines, and a methodology for integrating assessment of health needs and coping abilities.
Patient Classification in Home Health Care: Are We Ready?
Authors: Cox Cheryl L. , Wood Joan E. , Montgomery Andrew C. , Smith Patricia C. 
Published: May 2007

AbstractThis longitudinal descriptive study retrospectively profiled the acutely ill patient in home health care and explored the utility of using patient record data in predicting agency resource use and patient outcome. The findings suggest that those variables traditionally relied on for reimbursement qualification and as components of patient‐classification schemes may not be wholly adequate to explain resource use and patient outcome in the home health setting. Professional nursing judgment of the patient's prognosis was found to be the most sensitive variable predicting outcome. Selected diagnoses and self‐care capacity of the patient were the major predictors of resource use. Suggestions are offered for further studies that may move public health nursing more quickly toward the development of consistent and accurate home health care case mix measures.
Public Health Nurses and Family Planning
Authors: Oakley Deborah , Swanson Janice , Swenson Ingrid , Marcy Shirley 
Published: May 2007

AbstractUnintended pregnancy is a health problem that is particularly important in the practice of public health nurses (PHNs). Data from 844 PHNs showed that they were likely to practice in settings that incorporate family planning services and were knowledgeable about specific family planning methods. They favored family planning services and an expanded supportive government role in both family planning and abortion. Since PHNs are an important resource for the community activism required to build the consensus needed to expand these services, a multiple‐regression analysis was performed to determine predictors of activism. Political participation was the major predictor for activism on both family planning and abortion.
A Study of Community Differences in Stress Among the Elderly: Implications for Community Health Nursing
Authors: Preston Deborah Bray , Crawford Charles O. 
Published: May 2007

AbstractIt has long been known that stressful states are linked to physical and mental health. An important dimension of emotional stress is community environment. That is, communities can produce stress in individuals but can also provide the coping resources that help modify these stressors. We examined differences in stress responses among a random sample of 900 elderly living in nine metropolitan and nine non‐metropolitan, randomly chosen communities in six northeastern states. Respondents were asked if, in the past year, they had experienced anything upsetting or stressful in their lives connected with family and friends, their health, and their finances. The findings support the existence of community differences in stress responses for these elderly respondents, and show evidence of a link between community structure and individual behaviors.
Rationale and Design for Health Promotion with Older Adults
Authors: Ruffing‐Rahal Mary Ann 
Published: May 2007

AbstractThe paper underscores the relevance of preventive and well health practices for older adults, given the current potential for extended life spans. One model for health promotion interventions consists of self‐care skills, emotional and spiritual integration, and social integration. It was based on research in which older adults identified dimensions of everyday well‐being.
Preterm Infant Follow‐up Project: A Multi‐Site Field Experiment of Hospital and Home Intervention Programs for Mothers and Preterm Infants
Authors: Kang Rebecca , Barnard Kathryn , Hammond Mary , Oshio Sachiko , Spencer Claudia , Thibodeaux Becky , Williams Judy 
Published: May 2007

Abstract This study was designed as a multi‐site field experiment to test the efficacy of hospital and home visit interventions to improve interaction between mothers and preterm infants. Hospital intervention consisted of State Modulation (SM) treatment, which focused on teaching mothers to read the behavioral cues and modulate the states of consciousness of preterm infants during feedings. Home visit intervention was a field‐tested program, Nursing Systems for Effective Parenting‐Preterm (NSTEPP), implemented during the first five months after the infant's hospital discharge. A hospital program on car seats (CS) and standard public health nursing home visits (PHN) served as comparison treatments. The sample consisted of 327 mothers and their preterm infants who were less than 36 weeks of gestational age at hospital discharge. Mothers were randomly assigned to intervention groups on the basis of their education. High education (HE) was ≤ 13 years of education, while low education (LE) was ≥ 12 years of education. HE mothers were only assigned to hospital programs, while LE mothers were assigned to combinations of hospital and home visit programs. Evaluations were conducted at 40 weeks conceptual age (expected date of birth), at 46 weeks conceptual age (1.5‐months‐corrected age), and 60 weeks conceptual age (5‐months‐corrected age).Comparisons were made within each educational group. For HE groups, SM infants gave significantly more clear cues during observations of feeding interactions at 1.5‐months‐corrected age and teaching interactions at 5‐months‐corrected age than infants in the CS group. During the teaching interaction, well‐educated SM mothers provided significantly more social‐emotional and cognitive stimulation than CS mothers. For LE groups, infants in the SM group combined with either PHN or NSTEP‐P exhibited significantly more responsive behavior during feeding observations than those infants in the CS/PHN group at 1.5‐months‐corrected age. LE mothers in the SM/NSTEP‐P group demonstrated more sensitivity and more stimulation during teaching interactions at 5‐months‐corrected age than mothers in the SM/PHN or CS/PHN groups. Findings suggest that State Modulation treatment is effective in influencing positive social interaction of infants regardless of the level of maternal education. State modulation treatment combined with NSTEP‐P is most effective in improving the social interaction between preterm infants and mothers with limited formal education. Such treatment‐specific
Incidence of Atrial Fibrillation Following Ventricular Defibrillation with Transvenous Lead Systems in Man
Authors: JONES GREG K. , JOHNSON GEORGE , TROUTMAN CHARLES , BUONO GRACE , GARTMAN DAVID M. , KUDENCHUK PETER J. , POOLE JEANNE E. , DOLACK G. LEE , BARDY GUST H. 
Published: May 2007

Atrial Fibrillation After Ventricular Defibrillation. Introduction: The induction of atrial fibrillation (AF) following implantable defibrillator therapy of ventricular fibrillation carries multiple risks. The frequency of shock‐induced AF may be more problematic in patients with transvenous defibrillators because current is often delivered through atrial tissue. Thus, the purpose of this study was to determine the incidence of AF following transvenous ventricular defibrillation. Methods and Results: Atrial electrograms were recorded before and after energy delivery in patients undergoing intraoperative testing of transvenous defibrillation lead systems. A total of 114 tracings were examined from 21 patients following ventricular defibrillation. Transvenous deflbrillation shock strength ranged between 200–800 volts (2–40 joules). Bipolar atrial electrograms were obtained from atrial electrodes with 1‐cm interelectrode spacing located on one of the defibrillation catheters. The timing of the ventricular defibrillation shock was expressed as a percentage of the preceding sinus PP interval. Three of the 114 transvenous shocks (2.6%) generated AF. Each episode of AF occurred in a different patient. The shocks responsible for AF occurred at 21%, 43%, and 84% of the preceding sinus PP interval. No relation was found between AF induction and the timing of pulse delivery, pulse strength, or pulse number. Conclusion: We conclude that transvenous ventricular defibrillation infrequently causes AF and that timing shock delivery to the atrial cycle is likely to be of marginal or no benefit in the prevention of shock‐induced AF. (J Cardiovasc Electrophysiol, Vol. 3, pp. 411–417, October 1992)
Transcatheter Endocardial Ablation: Acute Effects of Direct Current Countershock on Regional Myocardial Blood Flow
Authors: TCHOU PATRICK , REEVES WILLIAM , AKHTAR MASOOD , HARE JOHN , RIEDER MICHELLE , CHRISTENSEN CARL 
Published: May 2007

Effect of DC Shock Ablation on Myocardial Blood Flow. Introduction: High energy direct current ablative shocks delivered through endocardial electrode catheters have been used as a treatment for various cardiac arrhythmias including ventricular tachycardia. Frequently, these shocks result in depression of myocardial function, at least transiently. Methods and Results: This study assessed the effect of a 200‐joule direct current shock delivered endocardially to the apex of the heart in ten adult mongrel dogs. Arterial blood pressures were monitored continuously. Myocardial contraction was monitored via two‐dimensional echocardiography. Regional myocardial blood flows were measured using radionuclide labeled microspheres before delivery of the shock, 30 seconds after delivery of the shock, and at 5 and 10 minutes after the shock. The results of the study demonstrated that there was a marked drop in arterial blood pressure immediately after the shock that gradually recovered over a 20‐minute period. Regional myocardial blood flow at the site of catheter ablation was severely depressed immediately after the shock. The degree of myocardial blood flow depression was inversely related to the distance from the site of ablation. At 5–10 minutes after ablation there was a marked hyperemic response in areas that suffered from depressed flow immediately after the shock. Two‐ dimensional echocardiography demonstrated depressed contractile function immediately after the shock with gradual recovery over a 10‐ to 20‐minute period. The catheter shock also generated prominent echo densities within the myocardium surrounding the ablative site. In contrast to the intracavitary echo densities that cleared quickly, the intramyocardial densities cleared much more slowly. Conclusion: The results of the study confirm the clinical observation that human left ventricular function is depressed acutely following a high‐energy ablative shock delivered to the left ventricular endocardium. Our results also demonstrated for the flrst time the effect of such ablative shocks on regional myocardial blood flow. Such depressions of blood flow may help explain the sudden drop in contractile function of the heart. The persistent intramyocardial echoes seen after the shock probably represented generation of intramyocardial bubbles that could obstruct arterial flow as well as disrupt cellular function. (J Cardiovasc Electrophysiol, Vol. 3, pp. 40–47, February 1992)
Dantrolene Sodium‐Induced Purkinje Fiber Action Potential Duration Prolongation and Its Relation to the Geometry of the Preparation
Authors: WAXMAN MENASHE B. , ASTA JOHN A. 
Published: May 2007

Dantrolene‐Induced Purkinje Fiber Action Potential Prolongation. Introduction: The purpose of this study was to investigate the influence that the mode of drug administration and preparation geometry exerted on the ability of dantrolene to prolong sheep and canine Purkinje fiber (PF) action potential duration (APD). Methods and Results: Sheep PF with attached muscle were superfused with dantrolene 3–5 μg/mL for 90 minutes (group A), while identical preparations were incubated in dantrolene 33.3 μg/mL for 5 minutes, then washed for 60 minutes (group B). Additional preparations were incubated with dantrolene (as in group B) for 5 minutes, then washed for 60 minutes: sheep PF (group C); sheep PF attached to muscle at one end but tied off from the muscle (group D); PF as in group D with a freshly cut branch (group E); freshly cut canine PF (group F); and sheep PF attached to muscle at one end were placed in a partitioned bath and each side incubated with dantrolene separately and then washed for 60 minutes (group G). Superfusion (group A) or incubation (group B) with dantrolene prolonged PF APD by 93% and 83%, respectively (NS). Sealed PF of groups C and D: APD prolonged by 10% and 34%, respectively (compared to A, P < 0.01). Freshly cut PF in groups E and F: APD lengthened by 78% and 74%, respectively (compared to A, NS). Dantrolene administration to the PF side and to the muscle side in group G prolonged the PF APD on either side similarly. Conclusion: Thus, dantrolene is effective by prolonged superfusion or short incubation. Dantrolene penetrates sealed PF poorly, but readily penetrates freshly cut PF or ventricular muscle. In vitro geometry greatly influences dantrolene's effect on Purkinje fibers. (J Cardiovasc Electrophysiol, Vol. 3, pp. 119–127, April 1992)
On the Mechanism of Inhibition of KATP Channels by Glibenclamide in Rat Ventricular Myocytes
Authors: RIPOLL CRISTINA , JON LEDERER W. , NICHOLS COLIN G. 
Published: May 2007

Glibenclamide Block of KATP Channels. Introduction: The mechanism by which glibenclamide inhibits KATP channel activity has been examined in membrane patches from isolated rat ventricular cells. Methods and Results: Inside‐out patches were exposed to zero, or low, [ATP] to activate KATP channels. Glibenclamide did not affect single channel conductance, but reversibly reduced channel open probability from either side of the membrane. Internal (cytoplasmic) glibenclamide inhibited with half‐maximal inhibitory [glibenclamide] = 6 μM, Hill coefficient = 0.35. Complete channel inhibition was not observed, even at 300 μM [glibenclamide]. The response to step increases of internal [glibenclamide] could be resolved into two phases of channel inhibition (t1/2, fast, < 1 sec, t1/2, slow= 10.5 ± 0.9 sec, n = 8). Step decrease of [glibenclamide] caused a single resolvable phase of reactivation (t1/2= 20.4 ± 0.7 sec, n = 16). Channel inhibition by internal glibenclamide could be relieved by ADP, but only in the presence of Mg2+. Conclusion: Glibenclamide can inhibit KATP channels from either side of the membrane, with block from one side being competitive with block from the other. Internal MgADP antagonizes the blocking action of glibenclamide. Glibenclamide inhibition of cardiac KATP channels differs quantitatively and qualitatively from the inhibition of pancreatic KATP channels.
Reentrant Circuits and the Effects of Heptanol in a Rabbit Model of Infarction with a Uniform Anisotropic Epicardial Border Zone
Authors: Ph.D. GERALD NASSIF. , DILLON STEPHEN M. , RAYHILL STEVEN , WIT ANDREW L. 
Published: May 2007

Reentry in Rabbit Ventricles. Introduction: The purpose was to study reentry in a rabbit model of infarction. Methods and Results: A model of an infarct epicardial border zone was produced in Langendorff perfused rabbit hearts by freezing the inner two thirds of the left ventricular wall, allowing only a thin epicardial muscle layer to survive. Reentrant circuits causing stable ventricular tachycardia occurred in the surviving rim of epicardial muscle as shown by mapping impulse propagation with a 196–electrode array. The circuits were functional, and reentry did not occur around an anatomical obstacle. Slow conduction in the circuits was caused by the anisotropic properties of the epicardial muscle. Activation in the circuits was slow transverse to the long axis of the fiber bundles and rapid parallel to the long axis. Other features of the circuits, including orientation of the central functional line of block parallel to the fiber long axis, and an oval shape are also characteristic of anisotropic reentry. Since the slow conduction causing reentry is a result of poor transverse intercellular coupling, we determined whether the “uncoupler” heptanol would cause block in the circuits and terminate tachycardia. Heptanol in concentrations up to 1.2 mM slowed conduction in the transverse and longitudinal directions in the circuits and sometimes extended the central line of functional block. It did not, however, stop reentry because the reentrant impulse was still able to conduct around the ends of the block line. Conclusion: Drugs that decrease intercellular coupling may not be effective antiarrhythmic agents when uniform anisotropy causes functional reentry.