bluuebunny/crossref_metadata_2025_split huggingface dataset:
School‐Based Rural Case Management: A Model to Prevent and Reduce Risk
Authors: Reel Sally J. , Morgan‐Judge Tina , Sue Peros Donna , Abraham Ivo L. 
Published: May 2005

PurposeTo describe the development of the School Based Rural Case Management: A Model to Prevent and Reduce Risk in a primary health care academic nursing center practice in West Virginia.Data SourcesSelected nursing and anthropological literature, regional health planning documents, and case examples.ConclusionsThe model guides identification of health risks and the provision of health service, health education, and support to students, families, and communities.Implications for PracticeAs primary health care services are developed within rural schools, a school‐based case management system assists matching appropriate services to the client, as well as supports program success.
Psychological Distress Among Abused Minority Women With Sexually Transmitted Diseases
Authors: Champion Jane Dimmitt , Shain Rochelle N. , Piper Jeanna , Perdue Sondra T. 
Published: May 2005

PurposeTo describe psychological distress among abused minority women with sexually transmitted diseases (STDs) and to identify needs for psychotherapeutic intervention for reduction in abuse, sexual risk behavior and STD.Data SourcesA controlled randomized trial of the effects of a behavioral intervention on STD recurrence. Eligibility was limited to English speaking Mexican‐American and African‐American women with a current non‐viral STD confirmed by laboratory testing (gonorrhea, chlamydia, syphilis or trichomonas). All eligible women who could be contacted were recruited from public‐health clinics in San Antonio. T‐tests, Chi square and correlation were used to analyze the data.ConclusionsWomen with STD and a history of abuse reported more symptoms of current psychological distress than nonabused women. This psychological distress was present in all dimensions of the SCL‐90‐R, including somatization, obsessive‐compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Increased current psychological distress and correlation was found not only for women with reports of sexual abuse but also forms of physical or psychological abuse. The majority of abuse was reportedly experienced during a relationship with a boyfriend or friend/acquaintance.Implications for PracticeAbused women with STD may benefit from the identification and assessment of abuse history and psychological distress so that appropriate psychological treatment can accompany medical treatment. The prevalence of woman abuse within a population of women with STD mandates the inclusion of violence in STD prevention programs.
Magnet Therapy: What's the Attraction?
Authors: Ratterman Rebecca , Secrest Janet , Norwood Barbara , Ch'ien Anne P. 
Published: May 2005

PurposeTo review the current state of the science of magnet therapy with respect to pain management and to view magnet therapy from a nursing perspective.Data SourcesExtensive review of the world‐wide scientific literature and of scientific peer‐reviewed journals regarding magnet therapy.ConclusionsMagnet therapy is gaining popularity; however, the scientific evidence to support the success of this therapy is lacking. More scientifically sound studies are needed in order to fully understand the effects that magnets can have on the body and the possible benefits or dangers that could result from their use.Implications for PracticeCredibility for advanced practice will be established across disciplines as nurses demonstrate their ability to critically evaluate practices. Alternative therapies are accepted and used by many patients today. While magnet therapy is popular, the scientific evidence to support its use is limited, at best. Advanced practice nurses have more effective treatment modalities in their repertoire and are advised to avoid practices for which efficacy is unsupported.
Use of an Insulin Pen by Homeless Patients with Diabetes Mellitus
Authors: Wilk Terry , Mora Pablo F. , Chaney Susan , Shaw Kathleen 
Published: May 2005

PurposeTo assess the impact of an insulin delivery system, the NovoPen®, on diabetes treatment for the homeless.Data SourcesHomeless patients (n=23) with diabetes and using insulin were identified from a registry of patients with diabetes maintained at the Homeless Outreach Medical Services clinical sites. Baseline evaluations included glycosylat‐ed hemoglobin (HbAlc) measurements and a questionnaire about the patient's current treatment practices. Patients were instructed in the use of the NovoPen(r); HbAlc measurements and questionnaires were repeated after 3 and 6 months of participation.ConclusionsReductions of HbAlc were observed at 3 and 6 months. The authors concluded that use of the pen improved patient compliance and thus glycemic control.Implications for PracticePatients had improved quality of life after using the pen to administer insulin. Nurse practitioners should recognize quality of life issues when treating patients with chronic diseases. Nurse practitioners who care for homeless diabetes patients can promote better care for this population by educating homeless shelter staff about diabetes and its management.
The Efficacy of Metered‐Dose Inhalers with a Spacer Device in the Pediatric Setting
Authors: Buxton Lance J. , Baldwin Joan H. , Berry Judith A. , Mandleco Barbara L. 
Published: May 2005

PurposeTo systematically review the published research and report on the efficacy of using a metereddose inhaler with a spacer (MDI‐S) device in a pediatric setting to treat acute exacerbations of asthma.Data sourcesA literature search was conducted on the CINAHL, Medline, and Cochrane databases; additional searches were made by hand from the reference lists in each study retrieved from databases and from review articles written on the same topic.ConclusionThis critical appraisal of the research demonstrates the MDI‐S is as effective as the nebulizer, faster in the delivery of medication, and cost‐effective.Implications for PracticeNo significant difference between the MDI‐S and nebulizer in delivering medication in an acute exacerbation of asthma was found in this analysis. The practitioner's choice of delivery methods should reflect the family's preference, the practice situation, and economic considerations.
Cognitive and Motor Symptoms in Dementia: Focus on Dementia with Lewy Bodies
Authors: Schumann Lorna , Lingler Jennifer Hagerty , Kaufer Daniel I. 
Published: May 2005

PurposeTo describe the clinical syndrome called dementia with Lewy bodies (DLB) and highlight its common and unique characteristics with respect to diagnosis and management.Data SourcesReview of the scientific literature including psychiatric literature, reports of clinical trials, and clinical practice guidelines.ConclusionsDLB is a clinical and histopathologic disease, which is second only to Alzheimer's disease (AD) as a cause of dementia in older adults. The clinical syndrome of DLB includes cognitive and motor deterioration reminiscent of symptoms associated with AD and Parkinson's disease (PD) respectively.Implications for PracticeThe late life intersection of cognitive and motor symptoms can present significant challenges in the primary care setting. Recognizing key features of common neurodegenerative disorders is essential to accurately diagnosing and appropriately treating the growing population of older adults who suffer from AD, PD, and DLB.
Workplace Empowerment, Collaborative Work Relationships, and Job Strain in Nurse Practitioners
Authors: Almost Joan , Spence Laschinger Heather K. 
Published: May 2005

PurposeTo test a theoretical model linking nurse practitioners’ (NPs) perceptions of workplace empowerment, collaboration with physicians and managers, and job strain.Data SourcesA predictive, nonexperimental design was used to test a model in a sample of 63 acute care NPs and 54 primary care NPs working in Ontario, Canada. The Conditions of Work Effectiveness Questionnaire, the Collaborative Behaviour Scale ‐ Parts A (physicians) and B (managers), and the Job Content Questionnaire were used to measure the major study variables.ConclusionsThe results of this study support the proposition that the extent to which NPs have access to information, support, resources, and opportunities in their work environment has an impact on the extent of collaboration with physicians and managers, and ultimately, the degree of job strain experienced in the work setting. Primary care NPs have significantly higher levels of workplace empowerment, collaboration with managers, and lower levels of job strain than acute care NPs.ImplicationsThese findings will benefit NPs and nursing leaders in their efforts to create empowering work environments that enable NPs to provide excellent quality patient care and achieve organizational outcomes.
CLINICAL PRACTICE GUIDELINES
Authors: Goolsby Mary Jo 
Published: May 2005

AbstractGastrointestinal (Gl) bleeding is a commonly encountered primary care clinical challenge. The AGA Medical Position Statement; Evaluation and Management of Occult and Obscure Gastrointestinal Bleeding, reviewed in this month's clinical practice guideline column, summarizes recommendations for the initial diagnostic approach and management for occult bleeding, as well as the subsequent diagnostic and management approach for obscure bleeding. The recommendations have applicability in primary care as nurse practitioners (NPs) assess the cause of occult bleeding and consult with specialists when obscure bleeding occurs.
Health Maintenance Throughout the Life Span for Individuals with Down Syndrome
Authors: Bosch Joni Jacobsen 
Published: May 2005

PurposeTo describe the routine health maintenance needs of individuals with Down syndrome who have specialized health needs associated with the multi‐system impact of the diagnosis.Data SourcesReview of scientific literature including peer‐reviewed articles, books, and online resources.ConclusionIn addition to the routine health maintenance needs of all persons, those with Down syndrome have specialized needs. Failure to address these specific health maintenance concerns may lead to misdiagnoses and failure to reach the highest level of function possible.Implications for PracticePatients with Down syndrome who have legit‐imate, treatable diagnoses may be misdiag‐nosed as having behavior problems or demen‐tia. Failure to identify abnormalities such as cardiac problems or sleep apnea may shorten life and interfere with ability to live life to the fullest.
Carpal Tunnel Syndrome; Current Theory, Treatment, and the Use of B6
Authors: Holm Gregory , Moody Linda E. 
Published: May 2005

PurposeTo present the current state of the science of pathophysiology, assessment and treatment of carpal tunnel syndrome, including the use of pyridoxine (B6).Data SourcesSelected research articles, texts, websites, per‐sonal communications with experts, and the authors’ own clinical experience.ConclusionsMuch is yet to be learned about carpal tunnel syndrome. While the basic treatment of NSAIDs and nighttime splints seems universally accepted, much controversy remains. The use of vitamin B6 as a treatment is one such controversy requiring further investigation.Implications for PracticeCurrent treatment for carpal tunnel syndrome should include NSAIDs, nighttime splinting, ergonomic workstation review, and vitamin B6 200mg per day.
Evaluation of a Rape Protocol; A Five Year Follow‐up with Nurse Managers
Authors: Lewis Carol M. , DiNitto Diana , Nelson Terri Spahr , Just Mary Margaret , Campbell‐Ruggaard Julie 
Published: May 2005

PurposeTo evaluate the use and effectiveness of a pro‐tocol developed for emergency nurses and other medical personnel to use with survivors of sexual assault. The Ohio Department of Health (ODH) Protocol for the Treatment of Adult Sexual Assault Survivors was developed by a multi‐disciplinary team in 1991–92 as a written guide to provide comprehensive, standardized, non‐judgmental, and equitabletreatment for survivors. In 1993, this 118‐page manual was sent to all Ohio hospitals. In 1994, a follow‐up video and training guide were also delivered. In 1997, Victims Rights Advocacy, a non‐profit agency in Ohio, and the Center for Social Work Research at The University of Texas at Austin collaboratively conducted an evaluation of the utilization and effectiveness of this protocol at Ohio hospitals.Data SourcesEmergency departments at Ohio hospitals were asked to complete a mailed survey regarding their policies and procedures for treating sexual assault patients. Telephone calls were made to the hospi‐tals that did not return a survey, and site visits were conducted at 20 hospitals in diverse areasof Ohio.ConclusionsOverall, respondents concurred that hospitals can benefit from using a standardized protocol, such as the ODH Protocol, for treating victims of sexual assault. Survey participants also indicated that training is needed on several topics, especially testifying in court, cultural awareness, and the needs of special populations, such as male, gay, lesbian, and bisexual survivors. In addition, findings indicate that survivors need more follow‐up services, and written information about these services should be provided to them.Implications for PracticeNurse practitioners can improve the treatment of sexual assault survivors in their communities through a variety of actions, such as gathering information about available protocols and training opportunities for personnel, and becoming familiar with resources that can help victims.
When Did You Last Talk With Your Legislators?
Authors: Towers Jan 
Published: May 2005

January 2003 marked the beginning of the 108th Congress. If you have not yet spoken with your federal legislators about nurse practitioners (NPs), now is the time to do so. As legislators begin introducing new bills for this session of Congress, it will be important for NPs to inform their legislators about problems and issues facing them and their patients that need to be addressed.If you have never talked with your legislators, you will want to make an appointment the next time he or she comes home. Most legislators have offices in a centrally located town in their district or, in the case of senators, in the capital and in the larger metropolitan areas of the stat represent. A call to “Telephone Information” should help you to locate their offices and local phone numbers. If you have difficulty finding them, the League of Women Voters or your local Republican and Democratic headquarters should have the information you need. If you have visited your legislator, let them know that you have spoken before and that you would like to talk again. If you had a previous successful interaction the legislator may remember you with pleasure and will want to meet with you again.If possible, when visiting your congressperson, take a group of NPs with you. Be sure to let the staff know that you are a constituent. Legislators are elected to represent the people in their electoral district in government. As a result, they are particularly interested in the concerns of the population responsible for putting them in office.
Onychomycosis: Current Treatment Options
Authors: Jones Ellen Davis 
Published: May 2005

PurposeTo describe current evidence regarding the treatment of clients with onychomycosis who have one or more chronic illnesses.Data SourcesCurrent review of research articles, standard pharmaceutical texts, and case studies.ConclusionsOnychomycosis is often considered only as a cosmetic diagnosis. Treatment is based on factors such as the client's willingness to pay for expensive therapy and the ability to physically comply with daily regimens; however, treatment of Onychomycosis in clients with chronic illnesses including diabetes and peripheral vascular disease should be strongly encouraged. For these clients, Onychomycosis is not just a cosmetic diagnosis because it has the potential to decrease mobility and blood flow to the affected digits if left untreated.Implications for PracticeThe primary care clinician's successful management of client's with chronic illnesses such as diabetes and peripheral vascular disease should include the treatment of onychomycosis. Recognizing the best treatment is a crucial decision.
Assessing Physical Activity in Adolescents: Common Activities of Children in 6th–8th Grades
Authors: Harrell Joanne S. , Pearce Patricia F. , Markland Ella Trivett , Wilson Kristina , Bradley Chyrise B. , McMurray Robert G. 
Published: May 2005

ObjectivesTo provide data for physical activity assessment in practice by describing the leisure time activ‐ities of adolescents and determining if the activities and the metabolic equivalents (MET levels) of those activities differ for boys and girls.Data SourcesThe study was conducted in five middle schools in three rural counties in North Carolina. Subjectswere 1,211 6th, 7th, and 8th graders aged 11–14 (mean 12.2) years. Half (52.5%) were girls. The sample was 64% white, 24% African‐American and 12% other races.ResultsThe top five activities of boys were football, basketball, bicycling, running, and baseball; the top five activities of girls were talking, running, walking, bicycling, and dancing. The average MET was 5.3 for boys and 4.3 for girls (p=0.000). By grade levels, 6th graders had an average MET of 4.9 and the MET of 8th graders was 4.5 (p<0.05). Older youth, girls, and children of parents with more education reported significantly more sedentary activities than the other youth.Implications for PracticePhysical activity is an integral component of overall health. Once activities and activity levels are known, current practices can be aug‐mented or changed to accommodate improved understanding of physical activity. Because an active lifestyle is important in preventing obesity and other chronic conditions and for general health, nurse practitioners (NPs) should ask adolescents about their common activities and encourage them to continue the more vigorous activities and reduce time spent in sedentary pursuits. Prescriptive physical activity can be included for primary, secondary, or even tertiary prevention, thus crossing all levels of NP practice.
Health Risk Behaviors in Smoking and Non‐Smoking Young Women
Authors: Kelley Frances J. , Thomas Sue Ann , Friedmann Erika 
Published: May 2005

PurposeTo compare the health, health risk behaviors and stress levels of college female smokers and non‐smokers.Data SourcesForty‐one college women, ages 18–21 years, participated in an interview and completed a health survey and the Derogatis Stress Profile.ConclusionsThe smokers perceived themselves to be more overweight (Chi square, p= <.001). Smokers used more marijuana (Chi square, p= <.003) and had higher scores on depression {t (39) = 2.29, p= .028}, hostility {t (39) = 2.562, p= .014} and perceived quality of health {t (39) = 2.72, p= .01}. In the interview, smokers identified social situations involving alcohol as the time they would most likely smoke. Smokers did not smoke when ill and all were interested in quitting. The non‐smoking women support smoking cessation for their peers.Implications for PracticeCollege alcohol and substance use prevention and treatment programs should address tobacco cessation. The majority of college women are not smokers and could be resources to encourage smoking cessation among their peers. Smoking cessation at this age has dramatic implications for futurehealth.
National Guideline Clearinghouse Guideline Synthses and Comparisons
Authors: Goolsby Mabry Jo 
Published: May 2005

AbstractAs the number of clinical practice guidelines relevant to clinical practice continues to grow, nurse practitioners may find it confusing to choose from two or more guidelines on the same or similar topics. The National Guideline Clearinghouse provides two resources to assist clinicians in comparing multiple guidelines on similar topics: guideline syntheses and guideline comparisons. This column describes the features of these two resources, using examples from guidelines on acute pharyngitis.
The Importance of Screening, Assessing, and Managing Urinary Incontinence in Primary Care
Authors: Gray Mikel 
Published: May 2005

PurposeTo present evidence that routine screening for urinary incontinence is justified because it is a clinically relevant and prevalent disorder that responds to treatment, resulting in improved outcomes for many patients managed by the nurse practitioner (NP).Data SourceSelected scientific literature.ConclusionsThe prevalence of urinary incontinence and success of treatment options justify routine screening, individualized assessment, and treatment.Implications for PracticeRoutine screening for urinary incontinence by NPs is uncommon. Based on the relative risk, the potential success of treatment and improved quality‐of‐life outcomes after treat‐ment, NPs should regularly screen and assess for incontinence.
Lichen Sclerosus of the Vulva in Women: Assessment, Diagnosis, and Management for the Nurse Practitioner
Authors: Edwards Quannetta Tucker , Saunders‐Goldson Sherri 
Published: May 2005

PurposeTo describe the etiology, clinical manifestations, assessment, and management of vulvar lichen sclerosus (LS) in women.Data SourcesSelected research and clinical articles in professional journals and online websites, peer review, educational technical bulletin from professional organization and the authors’ professional clinical experiences.ConclusionsVulvar LS can manifest with varied symptoms that may mimic other common vulvar disorders such as infections. Careful assessment of the vulva and biopsy of any suspicious skin changes are needed for diagnosis and management of vulvar LS. Treatment with high‐potency topical corticosteroids may alleviate uncomfortable symptoms and reduce physical changes. Follow‐up management is essential to check for progressing problems such as introital stenosis and to assess for skin changes that may indicate vulvar squamous cell carcinoma.Implications for PracticeAccurate diagnosis and successful management of vulvar LS requires thorough assessment of the genitalia, knowledge of the disorder and appropriate treatment and follow‐up management.
Practice Methods Among Nurse Practitioners Treating Depressed Women
Authors: Groh Carla J. , Hoes M. Linda 
Published: May 2005

ObjectiveTo determine practice methods and beliefs about degree of competence in the assessment, diagnosis, and treatment of depressive symp‐toms in women by nurse practitioners (NPs).Data SourcesA survey about the diagnosis and treatment of depressive symptoms in women was mailed to 3,000 NPs randomly selected from the mem‐bership of the American Academy of Nurse Practitioners. Family, adult, women's and gerontological NPs were included; 1,647 surveys were returned (55%).ConclusionsAssessment and treatment protocols used by NPs were consistent with the AHCPR guidelines and similar to the protocols used by psychiatrists and non‐psychiatric physicians, yet only 65% believed their education had adequately prepared them to assess/diagnose depression and only 52% believed they had been adequately prepared to treat depression.Implications for PracticeFindings suggest areas for improvement in the formal education and continuing education of NPs.
Screening, Diagnosis, and Monitoring of Hepatic Injury
Authors: Goolsby Mary Jo 
Published: May 2005

AbstractAlthough prophylactic vaccines and a better screened blood supply have contributed to a decreased incidence of viral hepatitis, liver injury remains a common problem. It is important that nurse practitioners know which patients are at risk for hepatic injury, when and how to screen for hepatic injury, and how to monitor patients diagnosed with hepatic damage. The National Academy of Clinical Biochemistry guidelines related to hepatic injury provide a framework for the screening, diagnosis, and monitoring of hepatic injury resulting from a variety of causes.