bluuebunny/crossref_metadata_2025_split huggingface dataset:
Femoral Bone Adaptation to Unstable Long‐Term Cemented Total Hip Arthroplasty in Dogs
Authors: Bergh Mary Sarah , Muir Peter , Markel Mark D. , Manley Paul A. 
Published: April 2004

Objective—To evaluate femoral adaptation after unstable long‐term cemented total hip arthroplasty (cTHA) in dogs.Study Design—Clinical study.Animals—Four dogs.Methods—Paired femurs were examined from client‐owned dogs that were donated to a retrieval program after death from causes unrelated to their cTHA. Mean (±SEM) dog age was 10.0±1.5 years and implant duration was 6.0±1.4 years. Implanted femurs had radiographic changes associated with implant loosening and gross mechanical instability at femur retrieval. Femurs were evaluated at 3 levels relative to implant length. Cortical area and medullary area were measured at each level, and cortical porosity was assessed at each level in 4 quadrants and in 3 regions. Implanted femurs were compared with the contralateral non‐implanted femurs.Results—Cortical area and cortical porosity were increased at all levels in femurs with unstable implants. Implanted femurs had increased porosity in all quadrants and regions at the proximal 2 levels, and increased porosity in only the cranial quadrant and mid‐cortical area at the distal level, when compared with contralateral non‐implanted femurs. Corresponding medullary areas were not different.Conclusions—Significant histomorphometric changes occur in femurs after unstable cTHA. The patterns of periosteal bone formation and endosteal bone resorption support mechanisms of stress shielding and wear debris‐mediated osteolysis as factors that may contribute to femoral adaptation and implant loosening.Clinical Relevance—Despite popularity and excellent return to function with cTHA, aseptic loosening remains a serious long‐term complication. Substantial net bone loss and unfavorable environment with unstable cTHA may make revision surgery less successful.
Transpelvic Urethrostomy in 11 Cats Using an Ischial Ostectomy
Authors: Bernarde A. , Viguier E. 
Published: April 2004

Objective—To investigate the feasibility and long‐term outcome of a modified subpubic urethrostomy technique termed transpelvic urethrostomy (TPU) in cats.Study Design—Prospective clinical study.Animals—Eleven male cats with obstructive lower urinary tract disease that could not be relieved, and requiring a surgical urinary diversion, were selected for TPU.Methods—With the cat in dorsal recumbency, the penis was exposed and the ventral pelvis was denuded by median adductor muscle elevation. An ∼12 mm×15 mm area of ischium was removed. The pelvic urethra, 8–20 mm cranial to the bulbourethral glands, was incised longitudinally and sutured to the skin to create a urethrostomy.Results—All cats were neutered males (2–9 years); none were uremic or hyperkalemic at admission. Urine was cultured if there was leukocyturia, nitrituria, and/or bacteriua. Bacteria were isolated from 2 specimens. A patent urethrostomy was created in all cats without operative complications. Except for 1 cat without associated clinical signs, stricture was not evident between 9 and 42 months after urethrostomy. One cat had postoperative urinary incontinence (UI) that resolved within 4 weeks. Two cats each had 1 episode of idiopathic lower urinary tract disease after 6‐month follow‐up; both responded to medical therapy.Conclusions—TPU was used as a successful urinary diversion procedure relieving signs of urinary tract obstruction and preventing further obstruction, with few complications. The incidence of UI after TPU remains minimal.Clinical Relevance—TPU should be considered as a salvage urinary diversion procedure in cats (as an alternative to prepubic and subpubic techniques). TPU may also be considered as a possible primary urinary diversion solution (an alternative to perineal urethrostomy) for obstructive lower urinary tract disease in cats.
Information Needs of Elderly Postsurgical Cancer Patients During the Transition from Hospital to Home
Authors: Hughes Linda C. , Hodgson Nancy A. , Muller Pat , Robinson Linda A. , McCorkle Ruth 
Published: April 2004

Purpose:To describe information needs of elderly postsurgical cancer patients. Few reports have described learning needs of postsurgical cancer patients during the initial weeks after hospitalization. Responding to information needs during the transition to home is important for helping patients and families to appropriately manage illness.Design:Descriptive, using records kept for patients assigned to the experimental group in a larger study completed in 1996. The sample was 148 American patients surgically treated for a new diagnosis of prostate, breast, gastrointestinal, lung, or head and neck cancer. Information needs were identified from topics addressed by advanced practice nurses during 4‐week episodes of home care.Methods:Content analysis of 3,280 statements of teaching interventions.Findings:Teaching themes were instructing on postoperative self‐care, advising on symptom management, clarifying the illness experience, discussing psychological responses, and preparing patients and families to coordinate follow‐up care. Topics included describing the expected course of illness, informing about community resources, identifying events that require physician notification, and advising on pain management. Topic emphasis varied by site of cancer.Conclusions:Information needs of elderly postsurgical cancer patients during transition from hospital to home are extensive. Teaching interventions ranged from giving concrete instructions about care of a surgical wound to interpreting complex information about options for cancer treatment. Elderly postsurgical cancer patients need informational support during the transition from hospital to home.
Sleep in Acute Care Settings: An Integrative Review
Authors: Redeker Nancy S. 
Published: April 2004

Purpose:To report an integrative review about sleep patterns, factors that influence sleep, and sleep interventions in acutely ill hospitalized adults; discuss methodological challenges associated with studying sleep in this population; and propose future research.Organizing framework:Research literature on sleep patterns of acutely ill hospitalized adults, obtained using computerized searches of Medline and CINAHL, was reviewed. Studies of patients on intensive care and medical‐surgical units conducted in a range of health disciplines over a span of almost 30 years were included. Studies were organized into the following categories: descriptive studies of sleep using objective and subjective measures; correlational studies of personal, health status, and environmental variables and sleep; and intervention studies.Findings:Sleep disturbance is a common but highly variable experience during acute care hospitalization. Multiple personal, health status, and environmental factors are related to sleep disturbance. Behavioral interventions show promise as a means to modify factors related to sleep. Few studies have shown the outcomes of sleep disturbance in acute care settings.Conclusions:More systematic research is needed to determine correlates of sleep disturbance in acutely ill hospitalized adults. Such studies can help investigators to identify patients who are most at risk for sleep disturbance and to provide the theoretical and conceptual bases for sleep‐promoting interventions. Methodological challenges include characteristics of acute care patients and hospital environments, as well as the complexity of measuring sleep.
Reducing Negative Thinking and Depressive Symptoms in College Women
Authors: Peden Ann R. , Hall Lynne A. , Rayens Mary Kay , Beebe Lora L. 
Published: April 2004

Purpose: Although cognitive‐behavioral interventions have been successful in treating depression, no studies were found that focused solely on reducing negative thinking via group intervention as a means of preventing depression in at‐risk groups. The purpose of this randomized controlled trial was to test the effectiveness of a cognitive‐behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self‐esteem in young women at risk for depression.Design: A randomized controlled trial with 92 college women ages 18 to 24 who were at risk for depression was conducted.Methods: Participants were randomly assigned to either the control or experimental group. The experimental group participated in a 6‐week cognitive‐behavioral group intervention. Data on self‐esteem, depressive symptoms, and negative thinking were collected via selfreport questionnaires from control and experimental groups at baseline, 1 month after the intervention, and at 6‐month follow‐up. Data were analyzed using mixed‐model methodology and the Cochran‐Mantel‐Haenszel chi‐square test.Findings: Compared to those in the control group, women who received the intervention had a greater decrease in depressive symptoms and negative thinking and a greater increase in self‐esteem, and these beneficial effects were maintained over 6‐months.Conclusions: The findings document the effectiveness of this cognitive‐behavioral group intervention and indicate empirical support for the beneficial effects of reducing negative thinking by the use of affirmations and thought‐stopping techniques on women's mental health.
A Test of Braden's Self‐Help Model in Adults with Chronic Pain
Authors: LeFort Sandra M. 
Published: April 2004

Purpose:To test hypothesized relationships in Braden's Self‐Help Model in a sample of people with idiopathic chronic pain. Testing theoretical explanations and predictions with various clinical populations under different sociocultural, economic, climatic, and health system environments provides evidence about the applicability of the underlying theory among diverse populations.Design:This study was part of a larger randomized, controlled trial of a community‐based nursing psycho‐educational intervention: the Chronic Pain Self‐Management Program (CPSMP). Pretest and posttest data were collected in 1995–1996 in Newfoundland, Canada.Methods:Participants completed a battery of valid and reliable self‐report instruments to measure pain, disability, uncertainty, resourcefulness, self‐efficacy, adult role behaviors, and life satisfaction. Two tests of the self‐help model were performed, the first with pretest data (N=110) and the second with 3‐month posttest data (N=102) after half the sample had participated in the CPSMP intervention. Causal modeling path analysis was done with the Statistical Package for the Social Sciences (SPSS) program and tests of goodness‐of‐fit were conducted using EQS for Windows.Results:Results supported the overall hypothesized pattern of relationships in the self‐help model. Amounts of variance explained in the two major outcomes of the model (self‐help: 42% to 53% and life quality: 45% to 47%) were consistent with results from other studies. Indices of goodness of fit showed an adequate fit of the model to the data, particularly the posttest data.Conclusions:Braden's Self‐Help Model appears to be robust in a variety of clinical populations, among different settings and environmental conditions, and provides a useful framework to guide nursing psycho‐educational interventions in chronic illness.
Health Status of Young Offenders and Their Families
Authors: Shelton Deborah 
Published: April 2004

Purpose: To describe the health status of youth committed and detained by the Maryland Department of Juvenile Justice. The problem of complex health needs of young offenders is gaining importance as the number of youth under the care of state juvenile justice systems steadily increases.Methods: The health status of a random sample (N = 350) of male and female committed or detained young offenders was assessed utilizing a record review and a self‐report health survey.Results: Ninety‐seven percent of the sample reported levels of physical discomfort and 92% reported emotional discomfort. Nearly half (45%) of the youth had some medical condition, 53% had been abused, 20% injured, 16% sustained a gunshot or stab wound. Of youth reporting physical injury, 12% did not receive treatment. Family members, including siblings experienced similar health problems.Conclusions: Patterns of physical and behavioral health problems were noted within these families, as were patterns of criminal behavior. Trans‐generational patterns of at‐risk behaviors were evident. Most youth (86%) perceived themselves to be healthy. However, when specific health indicators were examined, discrepancies between health status and health perceptions were noted.
Evidence‐Based Practice and Reviews of Therapeutic Touch
Authors: O'Mathúna Dónal P. 
Published: April 2004

Purpose:To present principles for accurately representing research for evidence‐based practice and health care policies, and to evaluate how original research results indicated adherence to those principles in literature reviews of therapeutic touch.Organizing constructs:Critical thinking and scientific integrity.Sources:Reviews of therapeutic touch literature published in nursing journals between 1994 and 1998 and the research studies cited in those reviews.Methods:Statements made in reviews about the efficacy of therapeutic touch were compared with the results and conclusions of the research cited. General conclusions reported in reviews were evaluated against a broad range of therapeutic touch (TT) research studies, including many not cited in reviews. How accurately reviewers represented the research studies was evaluated by comparing reviewers' conclusions with those of the researchers.Findings were organized into principles to guide evidence‐based reviews.Findings:Literature reviews about therapeutic touch often cited only research with favorable findings. When citing studies with contradictory findings, only the favorable findings were usually mentioned. In many reviews, research cited as indicating the efficacy of therapeutic touch indicated it was ineffective. Every review examined had at least one significant mistake concerning how research studies were represented.Conclusions:Accurate presentation of original research results is needed to make evidence‐based decisions and to ensure that limited healthcare resources are used effectively and safely. Evidence‐based principles should be followed in reviewing therapies and practices, including alternative therapies.
Access to Health Care: Effects of Public Funding On The Uninsured
Authors: Smith‐Campbell Betty 
Published: April 2004

Purpose: To determine whether a state funding policy influenced access to health care for the uninsured in one county of the American Midwest.Design: The Aday, Andersen, and Fleming (1980) Access Framework guided this descriptive study. The Framework indicates that health policy may directly affect the characteristics of the health care system, which in turn may affect utilization patterns and satisfaction of consumers.Methods: A descriptive cross‐sectional survey in 1996 was used to explore client satisfaction with care at Health Care Access (HCA), the only organization in the county that received funding under a new state policy. HCA's purpose was to provide primary health care to the medically underserved. Satisfaction was measured using an adapted version of the Patient Satisfaction with Health Care Provider Scale (Marsh, 1996). To measure utilization patterns according to insurance status, data were collected to determine visits to the Emergency Department (ED) at the only hospital (LMH) in the county before and after implementation of the state policy. ED data were collected for 1988, 1990, 1993, and 1995; initial funding to HCA began in April 1992.Findings: Within 3 years after state funding was initiated, uninsured visits to the ED decreased by almost 40%, while insured visits continued to increase. The survey results showed that HCA clients had a high level of satisfaction.Conclusions: This descriptive study showed that the change in state policy increased access to health care for the medically underserved.
Health Systems and Maternal and Child Survival in Central Asian Republics
Authors: Veenema Tenaer Goodwin 
Published: April 2004

Purpose: To describe the status of health care systems in five Central Asian Republics (CAR): Kyrgzstan, Kazakhstan, Uzbekistan, Turkmenistan, and Tajikistan, with particular attention to women's and children's health.Organizing construct: Changing mortality profiles are investigated using the “protractedpolarized” model of epidemiologic transition.Sources: Empirical evidence was drawn from the World Health Organization (WHO) database for the region, along with additional evidence presented at a maternal‐child health conference held in Bishkek, Kyrgyzstan, on November 11–14, 1998. The conference was sponsored by the Albert Schweitzer Institute and the Soros Foundation. This evidence is evaluated for completeness, validity, and reliability. Trends are identified using the 1998 and 1999 World Health Reports and 1999/2000 World Bank Development Report.Findings: Incomplete data prohibited comprehensive analysis. Available data indicated high but variable rates of maternal and child mortality and overall declines in health status and the health care infrastructure in the 1990s.Conclusions: Data collection and analysis from this part of the world are often incomplete and unreliable. Future research should focus on improving maternal and child health indicators by enhancing resource sharing and opportunities for international collaboration.
Attachment Theory and Violence Toward Women by Male Intimate Partners
Authors: McClellan Ann C. , Killeen Maureen Reed 
Published: April 2004

Purpose: Explore whether understanding of violence toward women by their male intimate partners is enhanced by attachment theory.Organizing Framework: This review was focused on the evidence that men prone to intimate partner violence were insecurely attached as infants, and as a consequence, their internal working models of attachment relationships include the use of aggression to gain power and control. These internal working models are brought to their adult relationships with intimate partners. The intergenerational transmission of violence occurs when children who witness episodes of violence in their homes, or experience violence directly as victims, become aggressive in adult relationships. Parallels between concepts of infant attachment and adult romantic attachment, such as maintaining proximity to attachment figures, were examined.Methods: The literature on attachment theory and intimate partner violence was reviewed. References were identified from electronic databases and from a manual search of the literature.Conclusions: Evidence about intimate partner violence is consistent with attachment theory. This framework is a base for extension of knowledge of intimate partner violence. Changes in practice, research, and policy to support an attachment perspective are discussed.
Feeling Safe: The Psychosocial Needs of ICU Patients
Authors: Hupcey Judith E. 
Published: April 2004

Purpose: To describe the psychosocial needs of critically ill patients, including descriptions of patients' experiences when these needs are not met, and behaviors of families, friends, and ICU staff that help or impede meeting these needs.Design: A qualitative research design was used. Participants were 45 adult critically ill patients in the medical or surgical ICU for a minimum of 3 days in a large, rural American tertiary care center.Methods: Data collection and analysis were conducted using methods of grounded theory, including theoretical sampling and the constant comparative process. Unstructured taperecorded interviews were conducted with patients once they were stable in the ICU or immediately following their transfer to a general unit. Data were collected and analyzed simultaneously. This process continued until saturation was reached and a model of the psychosocial needs of ICU patients was developed.Findings: The overwhelming need of ICU patients was to feel safe. The perception of feeling safe was influenced by family and friends, ICU staff, religious beliefs, and feelings of knowing, regaining control, hoping, and trusting.Conclusions: ICU patients in this study said that feeling safe was their overarching need. Patients described feelings of distress when they did not feel safe and stated how family, staff, and religion could both positively and negatively affect this feeling. Nurses can intervene in numerous areas to foster the feeling of safety in critically ill patients.
Accuracy of Children's Self‐Reported Adherence to Treatment
Authors: Burkhart Patricia V. , Dunbar‐Jacob Jacqueline M. , Rohay Jeffrey M. 
Published: April 2004

Purpose: To examine the relationship between self‐reported and electronically monitored adherence to a recommended asthma treatment and to assess the accuracy of the diary data reported by school‐age children.Design: A randomized, controlled clinical trial of the effectiveness of an asthma self‐management program. The relationship between self‐reported and electronically recorded daily peak expiratory flow rate (PEFR) adherence was assessed in a sample of 42 children, ages 7 through 11 years with moderate to severe asthma in one community in West Virginia, USA. Cognitive social learning theory served as the framework for the intervention.Methods: At‐home adherence to PEFR monitoring during the 5‐week study was evaluated using the self‐report Asthma Diary and an electronic PEFR meter. Recommended twice daily (morning and evening) PEFR monitoring was measured.Results: Self‐reported and electronically recorded PEFR adherence were modestly correlated. Self‐reported adherence was significantly higher than electronically monitored adherence during Week 5. Accuracy of the self‐reported PEFR declined over time, and over half of the children fabricated at least one PEFR value during the final week of the study.Conclusions: Clinicians often evaluate the efficacy of prescribed treatment for children with chronic conditions based on the children's self‐reported diary data. The findings indicate that these children's self‐reported adherence behaviors contained errors. Parent education regarding supervision of children's adherence, including validating the accuracy of diary data, is critical for successful self‐management in children with chronic conditions.
History and Trends in Clinical Information Systems in the United States
Authors: Staggers Nancy , Thompson Cheryl Bagley , Snyder‐Halpern Rita 
Published: April 2004

Purpose: To provide a synopsis of issues about clinical information systems for nurses not schooled in nursing informatics.Organizing construct: The past, present, and future of clinical computing, including major factors resulting in the early hospital information systems (HIS) and decision support systems (DSS) in the United States, current advances and issues in managing clinical information, and future trends and issues.Methods: Literature review and analysis.Findings and Conclusions: The first HIS and DSS were used in the late 1960s and were focused on applications for acute care. The change from fee‐for‐service to managed care required a change in the design of clinical information systems toward more patient‐centered systems that span the care continuum, such as the computer‐based patient record (CPR). Current difficulties with CPR systems include lack of systems integration, data standardization, and implementation. Increased advances in information and technology integration and increased use of the Internet for health information will shape the future of clinical information systems.