bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual Health Practices of Homeless Youth
Authors: Rew Lynn , Fouladi Rachel T. , Yockey Ronald D. 
Published: April 2004

Purpose: To describe the sexual health practices of homeless adolescents, examine relationships among variables in a conceptual model of sexual health practices, and determine direct and indirect effects of population characteristics, cognitive‐perceptual factors, and behavioral factors on sexual health practices among homeless adolescents.Design and Methods: Descriptive exploratory design. A survey was administered to a convenience sample of 414 homeless young men (244) and young women (170) aged 16–20 years, the majority of whom were Anglo American.Findings: Thirty‐five percent reported homosexual or bisexual orientation, and sexual orientation was reported as a reason for leaving home. Over half reported a history of sexual abuse and nearly one in four had been treated for gonorrhea. Safe‐sex behaviors were related to age, time away from home, assertive communication, social support, future time perspective, connectedness, perceived health status, intentions to use condoms, and condom self‐efficacy. A parsimonious model with good fit indicated that the only direct paths to safe‐sex behaviors were future time perspective, intentions to use condoms, and self‐efficacy to use condoms, and the direct paths to sexual self‐care behaviors were from assertive communication, social support, and self‐efficacy to use condoms.Conclusions: As in other studies of homeless youth, respondents reported a high incidence of sexual abuse and homosexual and bisexual orientation. Their safe‐sex behaviors were surprisingly similar to those of university students, were modestly related to cognitive‐perceptual variables in the sexual health model, and might be amenable to brief culturally relevant interventions.
Rational Suicide in the Terminally Ill
Authors: Fontana Joyce S. 
Published: April 2004

Purpose: To examine the current debate over the right to die specific to the rational suicide of terminally ill patients.Methods: Literature was reviewed for information concerning historical end‐of‐life practices and the past acceptance of suicide. Another review showed philosophical opinions and perspectives that spanned from ancient Greece and the Roman Empire to modern philosophical discourse. A case study of a terminally ill woman who chose suicide is presented to apply the history and philosophy to nursing care today.Conclusions: As more nursing care is delivered in patients' homes, nurses will face this situation with increasing frequency. A call is made for organizations to provide guidelines for nursing practice.
Finding the Findings in Qualitative Studies
Authors: Sandelowski Margarete , Barroso Julie 
Published: April 2004

Purpose: To describe the challenges of finding the findings in qualitative studies.Method: Review of literature on representation in qualitative research and analysis of 99 reports of qualitative studies of women with HIV infection.Findings: Factors complicating finding the findings in qualitative studies include varied reporting styles, misrepresentation of data and analytic procedures as findings, misuse of quotes and theory, and lack of clarity concerning pattern and theme. Theses and dissertations present special challenges because they often contain several of these problems.Conclusions: Given the varied beliefs about findings among qualitative researchers, the challenge is to find ways to present findings that will make them discernible to the diverse audiences for whom they are intended, including researchers and practitioners.
Economic Evidence for Evidence‐Based Practice
Authors: Stone Patricia W. , Curran Christine R. , Bakken Suzanne 
Published: April 2004

Purpose: To explicate (a) the types of economic analyses available to nurses, (b) the measurement of costs in different types of economic evaluations, (c) recommendations for standardization, and (d) the assessment of economic evaluations for evidence‐based practice.Methods: Five types of economic analyses are reviewed. Recommendations for standardization of cost‐effectiveness analyses are included as well as a worksheet for use in critiquing economic evaluations for validity and applicability to clinical settings.Findings: Limited knowledge and a lack of consistent approaches to economic analyses are evident in the nursing and health care literature. However, nurses have not contributed to the conduct of rigorous economic evaluations or research to the extent found in other health care disciplines.Conclusions: Basing nursing practice on the best available evidence is now the expected standard of care. Applying economic evidence to practice requires understanding the methods used to conduct economic evaluations and to analyze the rigor of such evaluations.
Building a Model of Self‐Care for Health Promotion In Aging
Authors: Leenerts Mary Hobbs , Teel Cynthia S. , Pendleton Mary K. 
Published: April 2004

Purpose: To synthesize knowledge about self‐care in older community‐dwelling people, identify essential dimensions of self‐care related to health promotion and well‐being in aging, and organize the findings into a literature‐based, integrated model with applicability in practice, research, and education.Organizing Construct: Self‐care and health promotion. Related concepts included self‐concept, self‐care ability, and self‐care activity.Methods: These terms were used to search Medline, CINAHL, and PsycINFO data bases. Theoretical and research articles from the last decade that related to self‐care and health promotion in community‐dwelling elders and that provided recommendations for education and practice were selected for inclusion in the analysis.Findings: Self‐care for health promotion in independent elders is multidimensional. Synthesis of literature findings resulted in development of the model of Self‐care for Health Promotion in Aging, with five dimensions: internal and external environment, self‐care ability, education, self‐care activity, and outcomes. Examples of education plans that are developed in partnership with clients to promote better health and maximize quality of life are presented.Conclusions: Findings from current theoretical and empirical literature were synthesized to develop a model of self‐care for health promotion in aging. Suggestions are made regarding application of the model in clinical practice and further theory building and hypothesis testing.
Lessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care
Authors: Brooten Dorothy , Naylor Mary D. , York Ruth , Brown Linda P. , Munro Barbara Hazard , Hollingsworth Andrea O. , Cohen Susan M. , Finkler Steven , Deatrick Janet , Youngblut JoAnne M. 
Published: April 2004

Purpose: To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research.Organizing Construct: The Quality Cost Model of APN Transitional Care.Methods: Review of published results of seven randomized clinical trials with very low birth‐weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care.Findings: APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group.Conclusions: To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in‐depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost.
Revisioning Nursing Scholarship
Authors: Riley Joan M. , Beal Judy , Levi Pamela , McCausland Maureen P. 
Published: April 2004

Purpose:To propose a universal model of nursing scholarship that (a) indicates the importance of professional practice disciplines, (b) incorporates the synthesis of intellectual pursuit with social change, and (c) is holistic in its design.Organizing Construct:Scholarship, traditionally viewed as part of or generated in the university enterprise, must be an expectation in all settings in which a community of scholars from both discipline and practice can and do coexist.Methods:Review and synthesis of the literature on scholarship, nursing scholarship, nursing as a practice discipline.Findings:The history, culture, and intellectual property of nursing comprise an appropriate basis for adopting a universal holistic model of scholarship built upon a set of universal assumptions about nursing scholarship. As a discipline and a profession, nursing should include four connected domains in a universal holistic model of scholarship: knowing, teaching, practice, and service.Conclusions:Confirmation of this universal holistic model of scholarship can contribute significantly to a larger nursing identity. Use of universal holistic model of nursing scholarship indicates responsibility of the nursing profession collectively and all nurses individually. Additional work is needed to understand how a universal holistic model of nursing scholarship evolves across cultures, domains, and work settings.
Vitamin A Supplementation and Health Outcomes for Children in Nepal
Authors: Grubesic Ruth B. , Selwyn B.J. 
Published: April 2004

Purpose: To compare vitamin A supplementation status of children age 6–60 months to the prevalence of vitamin A deficiency disease, malnutrition, diarrhea, and acute respiratory infection.Methods: The nutritional status of children was estimated using mid‐upper‐arm circumference measurements. A trained ophthalmology assistant assessed for clinical signs of vitamin A deficiency disease. A trained female community health worker interviewed mothers about child health status using a standardized questionnaire.Results: Compared to children who did not receive supplements, children who received vitamin A supplements regularly had less malnutrition, diarrhea, and acute respiratory infection, regardless of the number of children per household, age, sex, or father's occupation.Conclusions: Supplementation with vitamin A is necessary twice a year. Children who received a vitamin A capsule only one time were not as protected as were those children who received vitamin A as a regular twice yearly scheduled dose.
Concepts in Caregiver Research
Authors: Hunt Chantal K. 
Published: April 2004

Purpose: To clarify and delineate conceptualizations of the effects of caregiving for nursing research and practice with family caregivers.Organizing Construct: The biopsychosocial (psychosocial and physiological) sequelae, both negative and positive, associated with providing care for a relative or friend with a chronic illness.Methods: Literature reviewed was obtained via searches of CINAHL, MEDLINE, and PsycInfo computerized databases through mid‐2002. Key words for the searches were caregiver, caregiving, family caregiving, caregiver burden, and caregiver appraisal. Reports of both earlier reviews of literature and original research were included.Findings: Negative concepts included caregiver burden, hassles, strain, and stress. Positive concepts included caregiver esteem, uplifts of caregiving, caregiver satisfaction, finding or making meaning through caregiving, and gain in the caregiving experience. A neutral concept for describing the caregiving process is caregiver appraisal. Although earlier studies were focused on negative aspects of caregiving, more recent research has also included positive aspects.Conclusions: More attention should be given to (a) gender and cultural differences in caregiving, (b) development of flexible interventions, and (c) the biophysical sequelae of caregiving.
Desire for Children Among Black Women With and Without HIV Infection
Authors: Wesley Yvonne 
Published: April 2004

Purpose: To determine the relationship among self‐esteem, self‐efficacy, and desire for children, and to contrast these concepts between Black women with and without HIV infection.Design: Correlational analysis.Methods: A nonrandom sample of 98 Black women, 52 HIV positive and 46 HIV negative, recruited from an American inner‐city health center, completed four questionnaires: the Rosenberg Self‐Esteem Scale, the General Self‐Efficacy Subscale, a modified Index of Parenthood Motivation, and a background information sheet. Data were analyzed using descriptive statistics, zero‐order correlations, and multiple regression techniques.Findings: Increased self‐esteem and self‐efficacy were positively correlated with desire for children in both HIV infected and uninfected Black women. No significant difference in the intensity of desire for children was found between uninfected Black women and HIV‐infected Black women. The combination of age, number of previous abortions, and strength of religious belief was a better predictor of desire for children than was self‐esteem and self‐efficacy.Conclusions: Variables other than HIV status were significantly correlated with desire for children among these low‐income Black women with and without HIV infection.
Psychological Factors in Nepali Former Commercial Sex Workers with HIV
Authors: Eller Lucille Sanzero , Mahat Ganga 
Published: April 2004

Purpose: To examine perceived stress, coping style, and symptoms of anxiety and depression in HIV‐positive Nepali women who were formerly commercial sex workers (CSWs).Design: Descriptive, correlational study with a convenience sample of 98 Nepali women with HIV recruited from a nongovernmental organization (NGO) in Nepal.Methods: Investigator‐administered questionnaires included a sociodemographic questionnaire, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WOC), the Center for Epidemiologic Studies Depression Scale (CES‐D), and the Symptoms Checklist‐90 (SCL‐90)Anxiety Subscale. Analytical methods included descriptive statistics and hierarchical regression analysis.Findings: The level of perceived stress was similar to that observed in a healthy female population of similar age. The primary coping style was problem‐focused, with the strategy of seeking social support used most. Depression measured with the entire CES‐D was 3% but is was 18% on the somatic subscale. Twenty‐two percent of the variance in depression was predicted by the combination of perceived stress and the coping strategy of escape avoidance. Twenty‐four percent of the variance in anxiety was predicted by the combination of perceived stress and three coping strategies: problem solving, accepting responsibility, and distancing.Conclusions: This sample had a low prevalence of psychological symptoms. Somatic symptoms, which may be more relevant than affective symptoms in non‐Western populations, were the best indicator of depression. Future studies are needed to examine culturally relevant appraisals, coping style, and psychological symptoms. Knowledge of psychological factors can be used to develop interventions for this population that has no access to treatment for HIV disease.
Profession and Society
Authors: Uzun Özge 
Published: April 2004

Purpose: To determine the frequency and sources of verbal abuse against nurses working in clinical settings in different hospitals in the last 12 months, to identify nurses' perceptions about verbal abuse, and to determine types of emotions experienced by nurses who had encountered verbal abuse.Design and sample: This descriptive study was conducted in May 2001 in Turkey. Data were collected from 467 nurses working in various clinical settings in three hospitals.Methods: The instrument was a 23‐item questionnaire on verbal abuse. Data were evaluated using frequency and descriptive statistics.Findings: The findings revealed that the majority of nurses had experienced verbal abuse in the last 12 months (86.7%, n= 405). Most nurses (92%) reported that verbal abuse negatively affected their morale. The most common sources of verbal abuse were patients' relatives and patients themselves.Conclusions: Workplace verbal abuse events cannot always be anticipated. Contingency plans to handle potential situations should be developed.
Beyond MEDLINE for Literature Searches
Authors: Conn Vicki S. , Isaramalai Sang‐arun , Rath Sabyasachi , Jantarakupt Peeranuch , Wadhawan Rohini , Dash Yashodhara 
Published: April 2004

Purpose: To describe strategies for a comprehensive literature search.Organizing Construct: MEDLINE searches result in limited numbers of studies that are often biased toward statistically significant findings. Diversified search strategies are needed.Methods: Empirical evidence about the recall and precision of diverse search strategies is presented. Challenges and strengths of each search strategy are identified.Findings: Search strategies vary in recall and precision. Often sensitivity and specificity are inversely related. Valuable search strategies include examination of multiple diverse computerized databases, ancestry searches, citation index searches, examination of research registries, journal hand searching, contact with the “invisible college,” examination of abstracts, Internet searches, and contact with sources of synthesized information.Conclusions: Extending searches beyond MEDLINE enables researchers to conduct more systematic comprehensive searches.
Media Portrayal of Nurses' Perspectives and Concerns in the SARS Crisis in Toronto
Authors: Hall Linda McGillis , Angus Jan , Peter Elizabeth , O'Brien‐Pallas Linda , Wynn Francine , Donner Gail 
Published: April 2004

Purpose: To describe nursing work life issues as portrayed in the media during the SARS crisis in Toronto.Methods: Content analysis of local and national news media documents in Canada. Media articles were sorted and classified by topic, and themes were identified.Findings: Themes were: (a) changing schemas of nursing practice: the new normal; (b) barriers to relational nursing work; (c) work life concerns: retention and recruitment; (d) nursing virtue: nurses as heroes and professionals; (e) paradoxical responses to nurses from the community; and (f) leadership in nursing during the SARS crisis.Conclusions: This analysis enhanced understanding of how nurses are portrayed in the media, but it indicated the significance of quality of work life and issues about work‐home life. Some descriptions of the care and caring of nurses have made nursing seem like an important and influential profession to potential applicants who might previously have dismissed nursing as a career.
Understanding and Responding to Patients' Requests for Assistance in Dying
Authors: Schwarz Judith Kennedy 
Published: April 2004

Purpose: To explore how nurses experience and respond to patients' requests for assistance in dying (AID).Design and Methods: A phenomenological study of 10 self‐selected nurses.Findings: Four major themes: Being Open to Hear and Hearing; Interpreting and Responding to the Meaning; Responding to Persistent Requests for AID, and Reflections. When faced with persistent requests for AID, participants provided a continuum of interventions: refusal, providing palliative care that might secondarily hasten dying, respecting and not interfering with patients' or families' plans to hasten dying, and providing varying types and degrees of direct AID. Their responses were context‐driven rather than rule‐mandated, and they drew a distinction between secondarily hastening and directly causing death.Conclusions: Few nurses in this study unequivocally agreed or refused to directly help a patient die. Most struggled alone and in silence to find a morally and legally acceptable way to help patients who persisted in requesting AID. Regardless of how they responded, many described feelings of conflict, guilt, and moral distress.
The Trypanocide Diminazene Aceturate Is Accumulated Predominantly through the TbAT1 Purine Transporter: Additional Insights on Diamidine Resistance in African Trypanosomes
Authors: de Koning Harry P. , Anderson Laura F. , Stewart Mhairi , Burchmore Richard J. S. , Wallace Lynsey J. M. , Barrett Michael P. 
Published: April 2004

ABSTRACT

Resistance to diminazene aceturate (Berenil) is a severe problem in the control of African trypanosomiasis in domestic animals. It has been speculated that resistance may be the result of reduced diminazene uptake by the parasite. We describe here the mechanisms by which [
3
H]diminazene is transported by
Trypanosoma brucei brucei
bloodstream forms. Diminazene was rapidly accumulated through a single transporter, with a

K
m

of 0.45 ± 0.11 μM, which was dose dependently inhibited by pentamidine and adenosine. The

K
i

values for these inhibitors were consistent with this transporter being the P2/TbAT1 adenosine transporter. Yeast expressing
TbAT1
acquired the ability to take up [
3
H]diminazene and [
3
H]pentamidine.
TbAT1
-null mutants had lost almost all capacity for [
3
H]diminazene transport. However, this cell line still displayed a small but detectable rate of [
3
H]diminazene accumulation, in a nonsaturable manner. We conclude that TbAT1 mediates [
3
H]diminazene transport almost exclusively and that this explains the observed diminazene resistance phenotypes of
TbAT1
-null mutants and field isolates.
Broth Microdilution Susceptibility Testing forLeptospiraspp
Authors: Murray Clinton K. , Hospenthal Duane R. 
Published: April 2004

ABSTRACTLeptospirosis in humans has traditionally been treated with penicillin or doxycycline. The choice of therapy offered at the time of initial patient presentation is often empirical, as definitive diagnosis can take weeks. Determining the activity of numerous antimicrobial agents against a wide range ofLeptospiraserovars may broaden empirical therapeutic options. Various antimicrobials have been shown to be active against a limited number of serovars in in vitro studies, chiefly by the use of broth macrodilution techniques. We developed a broth microdilution technique using the commercially available growth indicator alamarBlue. MICs produced by this technique were compared to MICs and minimal bactericidal concentrations produced by the traditional broth macrodilution technique. The internal validity of our methods was assessed with 11 runs over numerous days with a single isolate ofLeptospira interrogansserovar Icterohaemorrhagiae. By either method, the MICs for these internal-validity runs fell within 2 dilutions of each other for more than 90% of antimicrobials. A broader application of these two techniques included 12 serovars (including seven species) ofLeptospiraand six antimicrobials (penicillin G, doxycycline, chloramphenicol, erythromycin, cefotaxime, and ciprofloxacin). Observed reproducibility fell within 2 dilutions for 99% of the duplicate result sets for the MIC microdilution method, compared to 89% for the MIC macrodilution method. The macrodilution method tended to have a higher MIC at which 90% of the isolates were inhibited (MIC90) than did the microdilution method, but the MIC90s of both methods were within 2 dilutions of each other for all six drugs. The macrodilution and microdilution techniques produced similar results, with microdilution allowing a faster, more streamlined method of producing MIC results.