bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acquired Long QT Syndrome: Risk Assessment, Prudent Prescribing and Monitoring, and Patient Education
Authors: Kunkler Kathleen 
Published: May 2005

PurposeTo inform nurse practitioners (NPs) about risk factors that precipitate the potentially fatal cardiac arrhythmia torsade de pointe (TdP) in patients with long QT syndrome (LQTS), and to recommend preventative strategies and prudent prescribing advice to use in clinical practice.Data SourcesA review of the current literature is used to explain factors that cause prolonged repolarization during phase 2 and phase 3 of the cardiac action potential and relate these to the development of LQTS and TdP. The major risk factors reviewed are drugs, drug‐drug interactions, electrolyte disturbances, and populations at risk for LQTS.ConclusionsThe LQTS is an increasingly recognized cardiovascular problem. Nurse practitioners should be cognizant of the risk factors and be able to apply them in clinical practice.Implications For PracticeRecognition of patients at risk for acquired LQTS is imperative in primary care practice. Currently, there are no practice guidelines that address acquired LQTS. In lieu of practice guidelines, the prudent NP uses physiology to guide treatment decisions, especially those decisions related to the use of drugs.
Domestic Violence: What Do Nurse Practitioners Think?
Authors: Bryant Sharon A. , Spencer Gale A. 
Published: May 2005

PurposeTo examine factors that influence nurse practitioners’ (NPs) ability to incorporate universal domestic violence screening practices (e.g., asking, identifying, referring and reporting) into their practices.Data SourcesA stratified random survey of certified NPs New York state was conducted in 1999. There were 118 family, women's health, OB/GYN, and adult NPs in the survey. Chi‐square and ANOVA were used to analyze the data.ConclusionsThere were significant differences in the domestic violence screening practices among women's health, OB/GYN, adult, and family NPs. Women's health and OB/GYN NPs were more likely to ask screening questions and identify victims of domestic violence than their other NP counterparts.Implications for PracticeThere is a need to identify strategies that encourage all NPs to incorporate universal domestic violence screening behaviors into their practices.
Considerations in the Management of the Patient with Comorbid Depression and Anxiety
Authors: Sekula L. Kathleen , DeSantis Joe , Gianetti Vincent 
Published: May 2005

PurposeTo provide clinicians with guidelines for the assessment, evaluation, diagnosis, and manage‐ment of comorbid depression and anxiety in the primary care setting.Data SourcesResearch‐based articles in the medical and psy‐chiatric literature, literature reviews by experts in the field, and DSM‐IV‐TR.ConclusionsComorbid anxiety and depression occurs at a high rate in primary care, and is costly to both the individual and to society. These patients most often present in primary care settings, have more severe symptoms, and require more health care resources. The presentation of depression and anxiety together pose complicated diagnostic and treatment challenges, leading to inadequate diagnosis and treatment resulting in unnecessary patient distress and increased utilization of health care services.Implications for PracticeThis article is a review of comorbid depression and anxiety with a focus upon societal and patientsignificance and impact, under recog‐nition and under treatment, diagnostic chal‐lenges, medical comorbidity, treatment consid‐erations, and educational strategies. Effective assessment, evaluation, diagnosis and treat‐ment can lead to better treatment outcomes and improved quality of life inprimary care patients.
Procedures Taught in Family Nurse Practitioner Programs in the United States
Authors: Cole Frank L. , Ramirez Elda 
Published: May 2005

PurposeTo determine the most frequently taught procedures and how important it is to teach these procedures in Family Nurse Practitioner (FNP) programs in the United States according to FNP program directors.Data SourcesEach of the 178 directors of FNP programs in the United States was mailed a survey to complete anonymously. The survey, designed for this study, listed 78 procedures. Directors were asked to indicate whether or not the procedure is taught in their FNP program and how important they think itis that FNP programs in the United States should teach that procedure. A total of 114 (64%) responded.ConclusionsA total of 10 of the 78 procedures were taught in 50% or more of the FNP programs. These procedures were; obtaining Papanicolau smears, testing visual acuity, audiometry, tym‐panometry, splinting of extremities, interpret‐ing 12‐Lead electrocardiograms, interpreting blood gases, local infiltration of anesthetics, single layer wound closure, and fluorescein staining of the eyes. The directors believed that six of these were very important to teach in FNP programs.Implications for PracticeThe findings of this study can be used to plan course content related to procedures in new FNPprograms or to revise course content in existing programs. The study results are helpful to individuals who develop continuing education courses to target skills that NPs may find valuable or may need for their current employment setting but were not taught in their educational programs.
Guidelines for the Diagnosis and Management of Asthma: Update on Selected Topics 2002
Authors: Goolsby Mary Jo , Judd Deborah M. 
Published: May 2005

AbstractAsthma is an extremely common disorder, affecting more than 17 million people in the United States. Asthma is the most frequently treated chronic disease in primary care settings and affects patients of all ages. The recently published update to the NHLBI asthma diagnosis and management guidelines, a valuable resource for NPs in all specialties, is summarized in this column.
Primary Care Management of Sexually Transmitted Urethritis in Adolescent Males
Authors: Lindberg Claire E. 
Published: May 2005

PurposeTo describe current knowledge about diagnosis, screening, and treatment of sexually transmitted urethritis among adolescent and young adult males.Data SourcesCurrent research, systematic reviews, consensus guidelines and the author's clinical experience.ConclusionsUrethritis, the most common sexually transmitted syndrome in young males, is most frequently caused by Chlamydia trachomatis and/or Neisseria gonorrhea. Symptoms include dysuria and penile discharge, although up to 50% of males are asymptomatic. Risky sexual behaviors and lack of access to healthcare increase incidence of this infection. Transmission to female partners can lead to pelvic inflammatory disease, infertility, and neonatal infection.Implications for PracticeYoung males with urethritis must be treated as soon as diagnosis is established. Consensus guidelines exist for diagnosis and treatment of gonococcal and non‐gonococcal urethritis. Careful patient education is necessary to ensure successful treatment. Prevention of repeat infections requires partner treatment and detailed education about safer sexual practices. Improved access to preventive services for young males should be a healthcare priority.
Recognizing and Managing Celiac Disease in Primary Care
Authors: Michael Melanie 
Published: May 2005

PurposeTo heighten the awareness of primary care clinicians regarding the prevalence, clinical manifestations, diagnosis, and treatment of celiac disease (CD) in the primary care setting.Data SourcesSelected research, clinical guidelines, research and clinically based articles from current scien‐tific literature, and current medical textbooks.ConclusionsCeliac disease is commonly under diagnosed or misdiagnosed. Until recently, it was considered rare in the United States. New data indicate that 1:150 Americans are affected and demonstrate the protective effects of early diagnosis and treatment.Implications for PracticeDelays in the diagnosis and treatment of CD increase the risk of early mortality, associated autoimmune disease, neurologic complica‐tions, gastrointestinal malignancy, and fetal growth retardation, where pregnancy precedes diagnosis. Primary care clinicians must culti‐vate a high index of suspicion for CD in the primary care setting and bear it in mind as a differential diagnosis in many clinical situations.
A Systematic Review of the Effectiveness of Garlic as an Anti‐Hyperlipidemic Agent
Authors: Alder Ryan , Lookinland Sandra , Berry Judith A. , Williams Mary 
Published: May 2005

PurposeTo 1) conduct a thorough search of the literature for randomized controlled trials (RCTs) addressing the efficacy of garlic as an antihy‐perlipidemic agent, 2) critically appraise those studies, and 3) make a recommendation for practicing health care professionals.Data SourcesTwo independent reviewers extracted data from the articles identified from several data bases, using the previously tested Boyack and Lookinland Methodological Quality Index (MQI) as the standard.ResultsSix of ten studies found garlic to be effective. The average drop in total cholesterol was 24.8 mg/dL (9.9%), LDL 15.3 mg/dL (11.4%), and triglycerides 38 mg/dL (9.9%). The over‐all average MQI score was 39.6% (18%‐70%). Major shortcomings of many of the RCTs included short duration, lack of power analysis and intention to treat analysis, as well as lack of control of diet as a confoundingvariable.Conclusion/ImplicationsThe low methodological quality of the studies make it difficult to recommend garlic as an antihyperlipidemic agent. Until larger RCTs of longer duration, which correct the existing methodological flaws, are designed and carried out, it is best not to recommend garlic be used to treat mild to moderate hyperlipidemia.
An Analysis of Expert Nurse Practitioners’ Diagnostic Reasoning
Authors: Ritter Barbara J. 
Published: May 2005

PurposeTo examine whether the Information Processing Model or the Hermeneutical Model or a combination ofthe two models best describes expert nurse practitioners (NPs) diagnostic reasoning.Data SourcesContent analysis of “think‐aloud” verbaliza‐tions elicited while diagnosing a patient were used todescribe diagnostic reasoning behaviors. Post‐session interviews were also used to identify diagnostic reasoning behaviors in NPs’ practice.ConclusionResults indicate that NPs use the information processing Model 55% of the time and the Hermeneutical Model 45% of the time. Reasoning behaviors do not strictly exemplify individual components of either model.Implications for PracticeEducators may need to devise additional methods to develop novice NPs’ clinical reasoning. This may require changes in the NP curriculum. Students need to identify significant clinical data, determine the meaning of data, and reason about patient problems in ways aligned to those of expert practitioners.
All in the Family: Resources and Referrals for Alcoholism
Authors: Barnett Mary Ann 
Published: May 2005

PurposeTo emphasize the family as the unit of treatment when one member has alcoholism, discuss the impact of alcoholism on families, and identify resources and referrals available for primary care nurse practitioners (NPs) to assist the patient and family in improving recovery outcomes and family function.Data SourcesExtensive review of current research, literature, and Internet‐based resources, supplemented and illustrated with a case study.ConclusionsAlcohol dependency flourishes within the social context of the family system and is one of the leading causes of family dysfunction. Understanding the impact that alcoholism has on the family system and being familiar with resources and referrals are critical facets of the overall management of treatment for the patient and family.Implications for PracticePatients often seek health care in a primary care clinic for treatment of medical problems related to alcohol use or abuse, and the primary care NP is frequently the initial point of contact. It is imperative that the family be recognized as the unit of treatment and be included in the treatment plan. As the first line of defense, primary care NPs play a critical role in making appropriate referrals for management of family alcoholism. Helping families make changes leads to improved functioning and recovery outcomes for patients with alcoholism as well as to improved family function.
The Discovery of Unique Nurse Practitioner Theory in the Literature: Seeking Evidence Using an Integrative Review Approach
Authors: Nicoteri Jo Ann , Andrews Caryn 
Published: May 2005

PurposeTo determine if theory unique to nurse practitioners (NPs) exists and to describe the attributes of such theory.Data SourcesAn integrative review of the literature was used. CINAHL and MEDLINE were searched using key terms such as nurse practitioners, theory, or research. Forty‐five articles contributed to the final analysis.ConclusionsThe NP role evolved from nursing yet is heavily influenced by medicine. This integration may affect both the use of theory in NP literature and the types of theories that are used to guide NP literature generation and research. Evidence was found of emerging theory unique to NPs with theoretical origins grounded in nursing, medicine, and social science.Implications for PracticeNPs are beginning to develop theories of “nurse practitionering.” This development is imperative for NP education, practice, and research to further the knowledge of the discipline and to help articulate the unique body of knowledge possessed by NPs.
Knowledge of AIDS, Perceived Risk of AIDS, and At–Risk Sexual Behaviors Among Older Adults
Authors: Maes Cheryl A. , Louis Margaret 
Published: May 2005

PurposeTo identify older adults' knowledge of acquired immune deficiency syndrome (AIDS), perceptions of their risk of AIDS, and at‐risk behaviors by using a questionnaire derived from the health belief model.Data SourcesA descriptive correlation design was used to survey persons 50 years of age and older who participate in university‐based senior programs. The sample of 166 persons (55% return rate) had a mean age of 71 years and included 33% males. The sample is representative of the participants in these programs.ConclusionsFive hypotheses based on the health belief model were tested. Statistical analyses showed significant predictors of the likelihood of using recommended safe sexual practices were gender, knowledge of AIDS, perceived susceptibility to AIDS, and perceived threat of AIDS. The results indicated the respondents were knowledgeable about human immunodeficiency virus (HIV) transmission through casual contact and medical aspects of AIDS. Although the respondents recognized the seri‐ousness of AIDS, they generally did not believe that they were susceptible to this disease, even though about 10% indicated sexual activity outside of a long‐term relationship.Implications for PracticeThe study findings support the need for nurse practitioners to assess sexual behaviors in and provide information about safe sex practices to older clients because of the documented rising incidence of AIDS in persons over 50 years of age.
An Approach to Postmenopausal Osteoporosis Treatment: A Case Study Review
Authors: Kessenich Cathy 
Published: May 2005

PurposeTo review and discuss the clinical evaluation and therapeutic options for a postmenopausal woman with osteoporosis.Data SourcesReview of scientific literature, practice guidelines, and a case study.ConclusionsTo prevent and treat postmenopausal osteoporosis, women should be encouraged to per‐form weight‐bearing exercise, to not smoke, and to optimize calcium and vitamin D intake through diet and supplements. Drug regimens are effective and well tolerated in post‐menopausal women with osteoporosis.Implications for PracticeDrugs currently approved by the U.S. Food and Drug Administration for the treatment of postmenopausal osteoporosis include the bisphosphonates risedronate and alendronate; the selective estrogen receptor modulator, raloxifene; and intranasal calcitonin‐salmon spray. Bisphosphonates have demonstrated the most impressive fracture risk reduction in prospective clinical trials of women with post‐menopausal osteoporosis. Risedronate has consistently demonstrated significant reductions in vertebral fracture risk at 1 year and in vertebral and nonvertebral fracture risk at 3 years. Alendronate has demonstrated significant reductions in vertebral and nonvertebral fracture risk after 3 years.
Nurse‐Managed Primary Care: Outcomes of a Faculty Practice Network
Authors: Edwards Joellen B. , Oppewal Sonda , Logan Carol Lee 
Published: May 2005

PurposeTo describe selected outcomes of nurse‐managed primary care in a large faculty practice network (FPN) and to use guidelines proposed by the National Organization of Nurse Practitioner Faculties (NONPF) to evaluate those outcomes.Data SourcesMission and goals, nursing control, fiscal stability, health care outcomes, and faculty role integration were examined.ConclusionsOutcomes show that the FPN directly supports the mission and goals of the East Tennessee State University College of Nursing and is managed by nurse faculty members. The FPN uses earned revenue, grants, and contracts to maintain fiscal stability. Patients are highly satisfied with services, and external and internal audits find the quality of care to be excellent. Students are educated in the centers. Faculty members publish and present research and other scholarly work derived from the FPN.Implications for PracticeThis model demonstrates that faculty practice can work, can meet the evaluation components of guidelines of a major national organization, and can contribute to the improvement of health for vulnerable populations.
Benefits of Swim Training for Children and Adolescents with Asthma
Authors: Rosimini Cherri 
Published: May 2005

PURPOSETo r eview scientific evidence related to the benefits of swimming and present an evidence‐based approach to prescribing swim training for children and adolescents with asthma.DATA SOURCESExtensive literature review of all research that has been done on swim training in asthmatic children and adolescents, using the databases CINAHL, Medline, and ProQuest.CONCLUSIONSWhen swimming is compared to other sports in the scientific literature, it has been found to have a lower asthmogenicity. It has also been shown to decrease the severity of asthma symptoms. Swimming may be an effective nonpharma‐cological intervention for the child or adolescent with asthma.IMPLICATIONS FOR PRACTICEResearch findings are summarized regarding the benefits of swim training on children and adolescents with asthma, and a stepped three‐level approach to swim prescription is outlined along with safety recommendations.
Hispanic Women's Experience With “el Cambio de Vida”
Authors: Longworth Judith C. D. 
Published: May 2005

PurposeTo examine the factors that influence Hispanic women's decisions to initiate or not initiate hormone replacement therapy (HRT) during menopause to manage symptoms or to prevent longer‐term conditions.Data SourcesA descriptive study of 51 Hispanic women who completed the Spanish version of the Menopausal Decision‐Making Questionnaire (S‐MDMQ) to describe their experience with and perceptions about menopause.ConclusionsMost of the low‐income Hispanic women in this study would elect not to take HRT; however, they do use exercise, diet, vitamins, and other self‐care activities to manage symptoms of menopause. Hispanic women were eager to discuss how to manage their health care during perimenopause and menopause with one another and their health care providers.Implications for PracticeNurse practitioners need to understand factors that might influence Hispanic women's decisions regarding management of menopausal symptoms, including the use of HRT, and to be able to assist women in making an individ‐ualized personal treatment choice that is culturally acceptable.
Management of Molecular‐Targeted Therapy for Chronic Myelogenous Leukemia
Authors: Ault Patricia , Kaled Suzan , Rios Mary Beth 
Published: May 2005

PurposeTo provide primary care providers with guidelines on the evaluation and manage‐ment of treatment for patients with chronic myelogenous leukemia (CML) with emphasis on the molecular‐targeted therapy imatinib mesylate.Data SourcesResearch‐based articles in the medical literature, review articles, and clinical practice guidelines.ConclusionsCML is a clonal stem cell disorder causing 5,000 new cases annually. Research on mol‐eculartargeted therapy confirms that specific protein kinases have broad conse‐quences for the development of future drugs to treat CML. The most recent discovery is a new compound, imatinib mesylate, which has become commercially available. Currently, the standard of care for CML is this agent. This therapy has changed management strategies for treatment of patients with the diagnosis of CML.Implications for PracticeLong‐term observations and evaluations are needed for final determination of treatment effectiveness; thus, primary care providers will follow patients with CML in the community. Unforeseen toxicity may surface, requiring accurate assessment and evalua‐tion. Primary care providers will be actively involved with providing symptom management for these patients.
Predictors of Nurse Practitioners’ Autonomy: Effects of Organizational, Ethical, and Market Characteristics
Authors: Ulrich Connie , Soeken Karen , Miller Nancy 
Published: May 2005

PurposeTo identify the predictors of autonomy of nurse practitioners (NPs) affiliated directly and/or indirectly with managed‐care systems (e.g., HMOs).Data SourcesA mailed survey sent to a stratified random sample of 254 NPs certified and licensed to practice in the state of Maryland. The measures consisted of selected organizational char‐acteristics; market factors of HMO penetration and percentage of client population enrolled in managed care; and factors of ethical concern, such as ethical ideology, ethics education, and autonomy. The County Surveyor Database was used to assess market penetration in the state.ConclusionsAlthough NPs were ethically concerned about their autonomy in a managed‐care environment (70.2%), actual autonomy scores were high. The higher the percentage of HMO penetration, percentage of client population enrolled in managed care, and perceived ethi‐cal concern, the lower the perceived autonomy of NPs.Implications for PracticeFindings may be used for future research to address the complexity of variables that influence the autonomous practice of NPs.
Promoting Lifestyle Change in the Prevention and Management of Type 2 Diabetes
Authors: Whittemore Robin , Bak Patricia S. , Melkus Gail D'Eramo , Grey Margaret 
Published: May 2005

PurposeTo present the theoretical background for lifestyle change interventions in the prevention and management of type 2 diabetes and to provide pragmatic strategies for advanced practice nurses (APNs) to incorporate such interventions into their practices.Data SourcesSelected scientific literature and the Internet.ConclusionsThere is an epidemic of obesity and type 2 diabetes among adults in the United States. Preventing or managing these health conditions requires significant lifestyle changes by individuals.Implications for PracticeAPNs are in a key role to deliver lifestyle change interventions, particularly in the primary care setting. Strategies to assist APNs with lifestyle change counseling include (a) assessment, (b) mutual decision making, (c) referral to education programs, (d) individualized treatment goals, (e) strategies to assist with problem solving, (f) continuing support and encouragement, (g) relapse prevention, and (h) ongoing follow‐up.