bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity as a Confounding Health Factor Among Women With Mobility Impairment
Authors: Sharts‐Hopko Nancy C. , Sullivan Maureen P. 
Published: May 2005

PurposeTo examine the relationships between self‐reported height and weight and factors associated with disabilities that impair mobility among adult women.Data SourcesSurvey data were gathered from a convenience sample of 83 women with disabilities at community events targeting the disabled population. Height, weight, and factors associated with their disabilities were reported on a demographic questionnaire. Body mass index (BMI) was estimated using a conversion table and the self‐reported height and weight of each participant.ConclusionsThe average self‐reported weight was 168.3 lb. Only 38% of the women fell into the normal range on estimated BMI, but 62% of the women fell into the categories of overweight or obese. The incidence of overweight and obesity exceeded that reported for the general population of women in a national sample X2= 6.48, p= 03, 2 df). Self‐reported weight was positively correlated with the number of comorbidities reported by the women (r= .419, p < .0001).ImplicationsThe issue of obesity is an important problem facing women with disabilities. Women who have mobility limitations need to be weighed periodically, and strategies should be devised for weight management, including both dietary plans and appropriate exercise regimens given their limitations.
Abnormal Cervical Cytology: New Names, Familiar Smears
Authors: Carulli Denise Trower 
Published: May 2005

PurposeTo discuss the newest 2001 changes in The Bethesda System of cervical cytology classification and management guidelines for abnormal Pap smears.Data SourcesExtensive review of scientific literature and consensus guidelines.ConclusionsDecision making about abnormal cervical cytology can be frustrating and controversial. It is imperative that nurse practitioners understand and practice the appropriate management protocol for cytological abnormalities.Implications For PracticeAlarmingly, many providers are unsure of management guidelines for abnormal cervical cytology. The information in this article offers providers a clear protocol for cervical cytology classification to facilitate the confident management of abnormal Pap smears.
Case Study of Hip Fracture in an Older Person
Authors: Hayes Karen S. , Steinke Elaine E. , Heilman Annette 
Published: May 2005

PurposeTo discuss proximal femoral (hip) fractures as the leading cause of hospitalization for injuries among older persons, using a case example that illustrates not only the orthopedic injury but also how an older person's chronic problems complicate the acute event.Data SourcesExtensive review of scientific literature on the conditions discussed, supplemented by the case study.ConclusionsHip fractures in older adults can present multiple challenges to care when complicated by preexisting or coexisting conditions. This case of an older man with a hip frac‐ture emphasizes the resuscitation priorities for the patient found after a “long lie” and the impact of chronic alcoholism and mal‐nutrition, which lead to serious complica‐tions.Implications for PracticeCareful physical and psychosocial assessment is important for determining the pre‐senting problem and comorbid conditions. Priorities for postoperative management of hip fracture and its complications guide the nurse practitioner through the successful return of the patient to the community.
Factor V Leiden and Venous Thromboembolism: Risk Associated With Hormone Replacement Therapy
Authors: Park Brandon Dee , Lookinland Sandra , Beckstrand Renea L. , Chasson Susan 
Published: May 2005

PurposeTo determine the risk‐benefit ratio of hormone replacement therapy (HRT) and the cost‐effectiveness of screening in perimenopausal and postmenopausal women who are carriers of factor V Leiden, as well as to provide evidence‐based clinical recommendations for the primary care provider.Data SourcesDatabases searched included EMBASE, BIOSIS, MEDLINE, CINAHL, PubMed, SciSearch, and the Cochrane Database. Two reviewers extracted, reviewed, and concurred upon relevant evidence identified in the data‐bases.ResultsResults confirmed that all women have a higher risk for the development of venous thrombosis while on HRT. The presence of a genetic mutation, such as factor V Leiden, in combination with HRT dramatically increased an individual's chance for developing venous thrombi.Conclusion/ImplicationsBased on the findings of the studies reviewed, it is recommended that women wishing to initiate HRT be thoroughly screened for known risk factors of thrombosis. If risk factors are identified, genetic testing for factor V Leiden may be warranted.
Spiritual‐Care Process and Content: Lessons Learned From the ECHO Project
Authors: Graham Julia B. , Brush Barbara L. , Andrew Reverend Maureen 
Published: May 2005

PurposeTo describe the process and content of spiritual caregiving delivered by a minister to 18 homeless male addicts in recovery and to determine whether and how advanced practice nurses can integrate similar counseling into practice.Data SourcesNotes from the minister's clinical sessions with individuals in the study sample were analyzed to identify the procedures used in spiritual counseling and the overall content of the interactions. Results were then reviewed in light of the literature on the nurse's role in spiritual caregiving to determine realistic implications for practice.Implications for PracticeAdvanced practice nurses are currently mandated to integrate spiritual care into clinical practice as part of their holistic‐practice model. Although theoretically sound, in practice, the time‐dependent and specialized nature of spiritual caregiving may be more appropriately and effectively delivered by ministers as part of the primary care team when time, personal, and other constraints exist.
Sleep‐Disordered Breathing in Patients With Heart Failure: Pathophysiology, Assessment, and Management
Authors: Spieker Evelyn D. , Motzer Sandra Adams 
Published: May 2005

PurposeTo provide clinicians in primary care settings information on the effects of sleep‐disordered breathing in patients with heart failure (HF). Assessment and screening tools, as well as management considerations, are presented.Data SourcesReview of the scientific literature of the past 10 years, along with classic studies and Internet sources.ConclusionsHF is an increasingly prevalent problem with a high degree of associated sleep‐disordered breathing. There are two broad categories of sleep‐disordered breathing: obstructive sleep apnea and central sleep apnea/Cheyne‐Stokes breathing. Both of these occur on a continuum of mild hypopnea to severe apnea with hypoxia. Sleep apneas are particularly harmful to patients with HF and, if left untreated, may adversely affect their prognosis. Yet sleep apnea is not routinely screened for in this population.Implications for PracticeGiven the serious consequences of untreated sleep‐disordered breathing, there is sound justification to screen for sleep apnea in all patients with HF. Subsequent treatment of those patients with sleep apnea can significantly improve their quality of life and can decrease their mortality.
Nurse Practitioner Self‐Confidence and Attitudes Regarding Managed Care
Authors: Hayes Eileen F. 
Published: May 2005

PurposeTo examine the relationship between nurse practitioner (NP) perceived self‐confidence in performing managed care tasks and NP attitudes toward managed care.Data SourcesA random sample of NPs‐members of the Massachusetts Coalition of Nurse Practitioners‐completed a demographic survey, responded to questions measuring self‐confidence in performing managed care tasks and attitudes toward managed care, and wrote about their managed care experi‐ences.ConclusionsNPs were only moderately confident in performing managed care tasks and had mostly negative attitudes toward managed care. They reported intense frustration related to prescriptive coverage and referrals to specialty services, potential trust issues between providers and patients, and ethical and legal dilemmas in tailoring plans of care to fit the patient's insurance. The NPs' written comments indicate a need for more in‐depth exploration of NP attitudes toward managed care.Implications for Practice and EducationContinuing education in selected managed care competencies, better education of NP students, and promotion of organizational cultures that support interdisciplinary teamwork as well as population‐ and evidence‐based practice may help NPs to embrace the promise of managed care and to offer solutions to its problems.
Improving Access—An Innovative Model
Authors: Geyer Nelouise 
Published: May 2005

PurposeTo present a model of health care delivery in South Africa that made health care services accessible and affordable to members of the community who do not have medical insurance.Data SourcesStatutes and laws governing the practice of health care professionals in South Africa, published professional guidelines, local research data, and the author's experience of the model of health care delivery.ConclusionsThe innovative and visionary approach of a few health care professionals has established a model of health care delivery specifically suited to their community's needs. This model of service delivery has provided an affordable and accessible health service to members of the local community, who have indicated their satisfaction with the service.Implications for PracticeEconomic and legal barriers to accessible and affordable health care services can be overcome to ensure that health care is available to the whole population. The nurse practitioner has an important role to play in making health care affordable and accessible to the community.
Migraine Headaches
Authors: Goolsby Mary Jo 
Published: May 2005

ABSTRACTMigraine headaches are the source of significant disability for many individuals and their management can present a considerable clinical challenge. The American Academy of Family Physicians (AAFP) and American College of Physicians ‐ American Society of Internal Medicine (ACP‐ASIM) “Pharmacologic Management of Acute Attacks of Migraine and Prevention of Migraine Headaches,” provides a succinct, evidence‐based resource for primary care nurse practitioners. In addition to reviewing this clinical practice guideline, this column describes related supporting documents.
A Review of Ludwig's Angina for Nurse Practitioners
Authors: Winters Sandra 
Published: May 2005

PurposeTo discuss the causative factors, clinical course, and current treatment modalities for Ludwig's angina, a submandibular cellulitis, and to raise nurse practitioners' (NPs') awareness of this condition.Data SourcesRecent clinical articles, research, case studies, and medical texts.ConclusionsLudwig's angina may be fatal. Early diagnosis, aggressive antibiotic therapy, and management involving a multidisciplinary team approach are imperative for the patient to progress without complications.Implications for PracticeEducation and awareness are crucial for successful diagnosis of and management of treatment for Ludwig's angina. Although NPs have a limited role in the treatment of Ludwig's angina, their ability to recognize the signs and symptoms will prompt emergency care and treatment and facilitate better outcomes for their clients.
A Comparison of Student Outcomes Following Problem‐Based Learning Instruction Versus Traditional Lecture Learning in a Graduate Pharmacology Course
Authors: Miller Sally K. 
Published: May 2005

PurposeTo determine if there would be a difference in students' performance and level of satisfaction when taught pharmacology in a problem‐based learning format as compared to traditional lecture format.Data SourcesControl (n = 12) and experimental (n = 10) group means for middle‐of‐term examina‐tions, final examinations, end‐of‐course numerical averages, and numerical scores of satisfaction were analyzed with at test for statistically significant differences.ConclusionsThere was no significant difference between groups for any of the items measured, suggesting that problem‐based learning and traditional lecture format may be equally effective course delivery methods. Replication with a larger sample is recom‐mended.ImplicationsThe small sample size precludes generalizing results to the entire population, but outcomes of this pilot study suggest that problem‐based learning may be at least as effective as traditional lecture and should be explored in larger studies.
A Comparison Study of the Utilization of National Cholesterol Education Program Guidelines by Cardiology and Internal Medicine Practices: Implications for the Advanced Practice Nurse
Authors: Patel Lopa , Abriam‐Yago Katherine , Harkins Elizabeth Ann 
Published: May 2005

PurposeTo determine whether patients with hypercho‐lesterolemia were being treated according to the updated 2001 National Cholesterol Education Program (NCEP) clinical guide‐lines and whether a difference existed between internists and cardiologists in the implementation of these guidelines.Data SourcesThis retrospective study used data obtained from a review of 200 patient charts that were compared with the NCEP guidelines.ConclusionsResults indicated that 67% of internal medicine patients and 71% of cardiology patients who qualified for pharmaceutical treatment received prescriptions for cholesterol‐lowering medications. The difference between internal medicine and cardiology physicians was not statistically significant.Implications for PracticeLike physicians, nurse practitioners should become familiar with and utilize the updated guidelines as standards of practice to promote and improve patient outcomes over the life span.
Diagnosis And Treatment Of Hypertension In Children And Adolescents
Authors: Peters Rosalind M. , Flack John M. 
Published: May 2005

PurposeTo provide nurse practitioners (NPs) with updated information regarding the etiology, diagnosis,and treatment of childhood hypertension.Data SourcesExtensive review of the scientific literature regarding hypertension, including the latest NIH recommendations.ConclusionsHypertension affects more than 350,000 American children. While the majority of hypertension in early childhood occurs from secondary causes, the incidence of essential hypertension in later childhood and adolescence is rising, raising concerns as elevated pressures in childhood “track” into adulthood. Early detection and treatment of elevated childhood pressures represent important steps in reducing long‐term cardiovascular risk.Implications for PracticeNPs must be able to accurately differentiate between primary and secondary hypertension in childhood. Secondary hypertension requires prompt diagnosis and treatment, and controlling primary childhood hypertension has life‐long implications. Given the familial predispo‐sition to hypertension, it is important for adult NPs to be aware of the risks faced by children of hypertensive patients.
Interstitial Cystitis
Authors: Newsome Grace 
Published: May 2005

PurposeTo describe the pathophysiology, assessment, diagnosis, and management of interstitial cystitis.Data SourcesSelected professional publications and presentations.ConclusionsInterstitial cystitis (1C) is a chronic and disabling condition. Symptoms include urinary frequency and urgency, pain, dyspareunia, and nocturia. It occurs primarily in women. Onset is predominately in adulthood although 1C does occur in childhood. Bladder wall defects, auto‐immune disorder, viral and/or bacterial infection, toxin exposure, pelvic floor dysfunction and inflammatory response are possible causes. Diagnosis is by history, physical examination, laboratory tests, and cystoscopic examination. The management of interstitial cystitis includes dietary changes, antihistamines, tri‐cyclic antidepressants, oral and intravesicle glu‐cosaminoglycans, hydrodistention, pain management and emotional support.Implications for PracticeNurse practitioners need to be knowledgeable about the occurrence and debilitating effect of IC. Inclusion of IC into the differential diagnoses related to urgency, frequency, and abdominal pain will help assure the timely and effective diagnosis and management of this unusual disease.
Myasthenia Gravis: Diagnosis and Treatment
Authors: Armstrong Shannon Mortensen , Schumann Lorna 
Published: May 2005

PurposeTo provide information about myasthenia gravis (MG), including pathophysiology, differential diagnosis, treatments, diagnostic work up, patient teaching, and diagnostic algorithms for ptosis and weakness related to MG.DataClinical and research journal articles, medical textbooks, and a patient with MG.ConclusionsMyasthenia Gravis is a very complex disease with many different signs and symptoms, which may be quite noticeable or vague. The presenting symptoms of ptosis and/or diplopia should cause the clinician to consider a work‐up for MG.Implications for PracticeBecause of the low incidence MG (1 in 10,000) has in the U.S., a delay in diagnosis of one to two years is not uncommon. It is vital to diagnose this disease and begin treatment as soon as possible to decrease the signs and symptoms.
Cognitive Function Assessment in Individuals at Risk for Alzheimer's Disease
Authors: Cotter Valerie T. , Clark Christopher M. , Karlawish Jason H.T. 
Published: May 2005

PurposeTo describe brief assessments of functional performance and cognition to detect Alzheimer's disease (AD) and depression in older adults for the primary care provider.Data SourcesReview of the literature.ConclusionsIt is important for the clinician to interview both the patient and a knowledgeable informant to assess changes in the patients’ functioning in daily life tasks and to administer brief screening tests to detect cognitive impairment and depression in older adults. Several suggested instruments for use in the primary care setting are included.Implications for PracticeStandardized assessments of functional performance and brief cognitive tests identify individuals with clinically meaningful cognitive impairment and provide baseline measurement against which to compare future assessments.
Using the Nursing Interventions Classification to Describe the Work of the Nurse Practitioner
Authors: Haugsdal Cindy S. , Scherb Cindy A. 
Published: May 2005

PurposeTo extend the specialty use research based on the Iowa Intervention Project using the Nursing Interventions Classification (NIC) and identify and the 20 most prevalent inter‐ventions described by practicing nurse practitioners (NPs).Data SourcesA descriptive survey using a mailed question‐naire was sent to 1,190 NPs with prescriptive authority in Minnesota. Results are based on 414 (37%) useable responses.ConclusionsOf the 486 NIC interventions on the questionnaire, NPs reported using an average of 120 at least once per month. The 20 most frequently selected were reported by 71%‐90% of respondents as being used at least once per month. Four core interventions (documentation, telephone consultation, teaching: prescribed medication, and emotional support) were common to NPs in all specialties.Implications for PracticeCommon medical coding does not reflect the nursing aspects of NP practice. As NPs attempt to define what is different about NP practice, the use of a standardized nursing language such as the NIC may facilitate this process. One clarification that needs to be made with regard to the NIC in future research with NPs is the distinction between prescribing and performing the interventions.
Motivating Health: Strategies for the Nurse Practitioner
Authors: Duran Lynne S. 
Published: May 2005

PurposeTo provide the nurse practitioner (NP) with a practical prescription for acquiring expertise in health behavior change using integrated principles from the transtheoretical model of change and motivational interviewing.Data SourcesExtensive literature review of current theory and research on health behavior change.ConclusionExpertise in motivating health behavior change is essential to effective health promotion and to the NP role.Implications for PracticeLifestyle choices are principal contributors to the leading causes of death and most chronic diseases in the United States. Traditional health behavior interventions are often ineffective in motivating and sustaining lifestyle change.
Diabetes Medical Nutrition Therapy: Practical Tips to Improve Outcomes
Authors: Daly Anne , Warshaw Hope , Pastors Joyce Green , Franz Marion J. , Arnold Marilynn 
Published: May 2005

PurposeTo describe the evolving and expanding role of nurse practitioners (NPs) in providing diabetes medical nutrition therapy (MNT) as the United States faces epidemics of diabetes and obesity.Data SourcesScientific literature and reports from the public health, diabetes, and nutrition fields.ConclusionsAlthough clinically effective for both prevention and treatment of diabetes, MNT is often underutilized. The majority of people with diabetes are cared for by primary care providers; the role of NPs as primary care providers is evolving and expanding. NPs are recognized as leaders who creatively adapt to the rapidly changing health care delivery system.Implications for PracticeNPs can serve as role models by presenting accurate, basic nutrition messages, referring patients to registered dietitians for MNT, reinforcing nutrition and the importance of lifestyle change as primary treatments for their disease, and following up on their patients' progress with nutrition interventions.
Health Problems of Women with Severe Mental Illness
Authors: Perese Eris F. , Perese Kerry 
Published: May 2005

PurposeTo provide a review of the health problems of women with severe mental illness (SMI) that are related to their psychiatric disorders and disabilities, prolonged use of psychotropic medications, and high‐risk lifestyle practices.Data SourcesReview of current literature uncovered through MEDLINE, Cumulated Index to Nursing and Allied Health, and Psychological Abstracts as well as the authors' clinical experiences.ConclusionsWomen with SMI are at increased risk for obesity as well as cardiovascular, endocrine, and infectious disorders. They also experience psychotropic medication‐related disorders such as amenorrhea, galactorrhea, sexual dysfunction, breast cancer, and osteoporosis. High‐risk lifestyle practices, excessive weight gain, low physical activity, substance abuse and unprotected sexual activity increase risk for health problems. The mental illness, residual disabilities, sequelae of childhood abuse, poverty, limited social support and health knowledge deficits affect their ability to maintain optimum health.Implications for PracticeKnowledge about women with SMI and their health problems will enable nurse practitioners to better meet the needs of this vulnerable population.
Case Study of a Young Man With Tremor
Authors: Hawkins‐Walsh Elizabeth 
Published: May 2005

PurposeTo provide the clinician with an opportunity to review the most common causes of tremor in young adults.Data SourcesExtensive review of international scientific literature on tremors and other movement disorders, supplemented by a recent case study.ConclusionsEssential tremor (ET) is the most common tremor disorder in the world. In contrast to common expectations, the 2nd decade of life represents a period of peak incidence. The early presentation may be so mild that the tremor goes unnoticed by patients and clinicians for many years. The most important movement disorder to rule out in the workup of patients with tremors is Parkinson's disease.Implications for PracticeThe diagnosis of ET is generally made on clinical grounds. A comprehensive history and careful physical examination that rules out cerebellar or extrapyramidal disease is required. The clinician must distinguish between resting tremors and action tremors. If the appropriate diagnosis is unclear, a tremor recording (elec‐tromyogram) may assist in this distinction. Referral to a neurologist may be warranted.