bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to Preventive Health Care for Young Children
Authors: Kataoka‐Yahiro Merle R. , Munet‐Vilaro Frances 
Published: May 2005

PurposeTo review the literature on barriers to availability, access, and utilization of preventive health care for young children three to five years of age and their families and to discuss the role of nurse practitioners (NPs) in future research, education, and practice in this area.Data SourcesA comprehensive literature search was conducted of online material and CINAHL and Medline (CD‐ROM 1990 to present). In addition, experts in this area were asked to recommend extra reading materials. Additional references in textbooks and articles were examined.ConclusionsThe literature review supports that there are major barriers to be addressed in the areas of availability, access, and utilization of preventive health care services for young children and their families. Major concerns include mandatory system for preventative health care, lack of health insurance coverage, cultural issues, and parental effects.Implications for PracticeHealth professionals in the community will need to work together to reevaluate current preventive health care practices for young children. Alternative methods for approaching and providing preventive health care services may become increasingly important if these services for young children are to be provided at current or increased levels.
New Vaccine Technology ‐ What Do You Need to Know?
Authors: Minichiello Virginia 
Published: May 2005

PurposeTo review the vaccine technology presently under development, in trials, or in some cases already available with a focus on applications for the primary care provider.Data SourcesSelected scientific literature and Internet sources.ConclusionsVaccine technology has made significant advances in the last 100 years. Newer approaches in vaccine designs include recombinant subunit vaccines, reassortment virus vaccines, live viral vectors, conjugate vaccines, and DNA vaccines. Traditional vaccines are generally expensive to produce and both live vaccines and protein‐based vaccines require special storage conditions. These factors limit the worldwide usefulness of the familiar vaccines of today.Implications for PracticeKeeping abreast of changes in this rapidly changing technology is necessary for health care providers to fulfill their roles effectively. New protocols that use nasal, vaginal, and intraperitoneal routes as well as subcutaneous injections and skin patches, edible vaccines and time release methods may be preferred depending on factors such as the age, health status, and emotional status of the patient. These advances hold promise for further progress in the development of vaccines that are protective against multiple organisms in more acceptable delivery systems.
Advanced Practice Nurses: A Study of Client Satisfaction
Authors: Bryant Rebecca , Clark Graham Margaret 
Published: May 2005

PurposeTo describe the satisfaction of clients with care provided by advanced practice nurses (APNs) in the Wright State University (WSU) Pilot Project. The Pilot Project was created through state legislation that recognized APNs associated with three universities in Ohio for the purpose of granting the APNs title protection, prescriptive authority, and recognition leading to reimbursement.Data SourcesThe Interactional Model of Client Health Behavior (Cox, 1982), which proposes that client characteristics and interactions with health professionals determine health outcomes, served as the framework for this descriptive study. The study measured client (n=506) satisfaction with care delivered by 36 APNs at 26 different practice sites using an adapted Client Satisfaction Tool (CST). The internal consistency of the adapted CST was 0.935.ConclusionsClient (n=506) satisfaction scores ranged from 28 to 50, with a mean score of 47.15 (SD=4.00). Findings suggest that clients are very satisfied with APNs in the WSU Pilot Project.Implications for Nursing PracticeClient satisfaction is one indicator used to determine quality of care. Consumer satisfaction benefits the individual client and provides important information for the health care payer. Measuring and reporting client satisfaction with care provided by APNs may increase the visibility and marketability of APNs.
Diagnosing and Treating Alzheimer's Disease: A Practitioner's Overview
Authors: Schumann Lorna , Langbart Cynthia 
Published: May 2005

PurposeTo provide an overview of current diagnostic protocols of Alzheimer's disease (AD), screening techniques, tests, and a review of standard and new treatments.Data SourcesSelected articles from the scientific literature, online sources, and standard texts were examined.ConclusionsStandard tools, such as the Geriatric Depression Scale, the Mini Mental State Evaluation, and the 7‐Minute Screen, are useful in the primary care setting for screening elderly patients. Other tools, such as the Clinical Dementia Rating (CDR) and the Global Deterioration Scale, are useful for staging and monitoring progression of disease and response to treatment. Clinical diagnostic testing is still in developmental stages, but the hope is to have a reliable and objective diagnostic tool in order to diagnose AD in the earliest stages.Implications for PracticeThe diagnosis and treatment of AD is becoming a more frequent challenge in the primary care office. Clinicians must keep abreast of the rapid changes in new technologies in order to make informed diagnostic and therapeutic decisions.
The Primary Care Nurse Practitioner: Advocate for Self Care
Authors: Thrasher Christine 
Published: May 2005

PurposeTo critically analyze the role of the primary care nurse practitioner (NP) as advocate in promoting health through self care.Data SourcesSelected philosophical and theoretical texts and articles, scientific literature, professional standards, and ethical arguments.ConclusionsPhilosophical reasoning and nursing theory must be used to validate and direct human practice. If self‐care and well‐being are desirable as an end and are defined as a movement toward self‐determination, then the philosophical goal of the NP must be the protection and promotion of self care and autonomy through client advocacy. Implications for Practice The role of the NP must be defined by its philosophy of care rather than by its function. The influence of philosophical reasoning, nursing, and critical social theory impact the ability of the NP to promote self‐care through advocacy. Understanding the lived experience is an essential component of advocacy.
The Master's Portfolio: Validating a Career in Advanced Practice Nursing
Authors: Hayes Eileen , Chandler Genevieve , Merriam Dorothy , Christine King M. 
Published: May 2005

PurposeTo describe the process of portfolio development and faculty review that offers graduate credit within a framework of structural empowerment and mentoring for documented educational and clinical accomplishments for family nurse practitioners (FNPs).Data SourcesSelected literature and examples from one student's portfolio to illustrate the process.ConclusionsThe degree granting process assists certified FNPs to fulfill career aspirations through achieving graduate level education at the University of Massachusetts, Amherst, School of Nursing.Implications for PracticeThe portfolio process affords practicing FNPs not only the opportunity to acquire an advanced degree but a framework for examining and validating a career. For the student in this exemplar, it was a “significant, introspective, satisfying learning experience,” a rare opportunity in a busy professional life.
The Role of Exercise in the African‐American Woman with Type 2 Diabetes Mellitus: Application of the Health Belief Model
Authors: Koch Julie 
Published: May 2005

PurposeTo determine whether aging African‐American women with a diagnosis of type 2 diabetes mellitus who maintain a regular exercise regimen possess different health beliefs and benefit from greater glycemic control than those who do not exercise regularly.Data SourcesA 32‐item health belief model diabetes scale was administered to a convenience sample of 31 African‐American women with type 2 diabetes.ConclusionsA group t‐test identified statistically significant differences between “exercisers” and “nonexercisers” in perceived benefits and barriers to exercise and glycemic control.Implications for PracticeFindings may be utilized in the development of diabetic educational programs and compliance‐ enhancing treatment interventions that focus on the barriers and benefits of diabetes self‐management.
Challenges of Outcomes Research for Nurse Practitioners
Authors: Breslin Eileen , Burns Margaret , Moores Patricia 
Published: May 2005

PurposeTo describe the numerous methodological challenges nurse practitioners (NPs) face in designing and conducting outcomes research and provide practical tips to implement an outcomes study within an institution.Data SourcesReview of world wide scientific literature on outcomes research.ConclusionsNurse practitioners must be aware of the challenges of conducting outcomes research. Challenges associated with variable definition, designing outcomes studies, use of data sets, and instrument development and selection must be understood prior to undertaking an outcome studyImplications for PracticeValuable studies have laid a foundation for evidence of quality care provision by NPs. Now is the time to measure patient outcomes of the NP care longitudinally over significant periods of time.
Efficacy of Raloxifene for Treatment of Menopause: A Systematic Review
Authors: Boyack Mark , Lookinland Sandra , Chasson Susan 
Published: May 2005

PurposeTo critically appraise recent randomized controlled trials (RCT) of raloxifene and its effects on the long‐term consequences of menopause.Data SourcesAll RCTs of greater than six months duration in post‐menopausal women found in MEDLINE through July 2000.ConclusionsRaloxifene lowered lipids, but estrogen had a more beneficial effect on HDL and fibrinolytic markers. Raloxifene had a more beneficial effect on triglycerides, inflammatory and thrombogenic markers. Compared to placebo, raloxifene reduced vertebral fractures but had a similar although lesser effect on bone mineral density and markers of bone turnover than estrogen. Estrogen receptor positive breast cancer was reduced by 90% with no increase in the incidence of endometrial cancer with raloxifene. The most serious side effect of raloxifene was an increased incidence of deep vein thromboses and pulmonary emboli.ImplicationsRaloxifene has been shown to be beneficial using cardiovascular and osteoporosis endpoints in studies of short duration. More RCTs of longer duration with comparisons to other traditional treatments are needed before raloxifene becomes the treatment of choice.
Addressing Use of Herbal Medicine in the Primary Care Setting
Authors: Egan Colleen D. 
Published: May 2005

PurposeTo critically evaluate existing approaches to the integration of allopathic and complementary and alternative medicine (CAM) and develop a middle ground approach to addressing use of herbal medicine and other forms of CAM in the primary care setting.Data SourcesExtensive review of scientific literature and Internet sources supported by legal, philosophical, and ethical arguments.ConclusionsA review of medical literature indicates that a growing number of people perceive both allopathic and CAM to be valued aspects of health care. Whether we agree with this perception or not, ethical, legal, clinical, and social considerations dictate that we assist patients in their efforts to derive benefit from use of CAM while helping them to minimize risks. Yet the current approach to addressing CAM in primary care is “don't ask, don't tell,” with approaches to filling this clinical void ranging from “just say no” to CAM use, to allopathic practitioners who also are CAM practitioners.Implications for PracticeIt is possible to occupy the middle ground, neither rejecting nor embracing CAM, but recognizing its significant impact on health care. In order to do this safely, clinicians need to be informed about herbs and other CAM practices, document thoroughly the informed consent and decision‐making process, and monitor patients carefully for adverse effects.
Promoting Health Among Perimenopausal Women through Diet and Exercise
Authors: Lange‐Collett Jennifer , Schumann Lorna 
Published: May 2005

PurposeTo review the literature related to health promotion during the perimenopausal years and suggest methods for integrating those changes into the lifestyles of women in primary care.Data SourcesSelected scientific literature and guidelines for exercise programs.ConclusionsThe transition into perimenopause presents an opportunity for addressing health promotion issues, such as diet and exercise. As a woman senses perimenopausal changes, health awareness emerges. Such personal insight motivates the woman to implement lifestyle changes.Implications for PracticeConsidering the average women will spend approximately one third of her life past menopause, a concerted effort is needed to ensure her well‐being. Diet and exercise represent two modifiable areas of concern for perimenopausal women. Dietary selections of phytoestrogens, calcium, fiber and fat along with exercises plans are relatively simple interventions to begin the process of change.
A Profile of Nurse Practitioners in Emergency Care Settings
Authors: Cole Frank L. , Ramirez Elda 
Published: May 2005

PurposeTo determine characteristics of nurse practitioners (NPs) who provide emergency care.Data SourcesDescriptive cross‐sectional study of a convenience sample of 113 NPs in emergency care obtained from the online Resource Directory of Nurse Practitioners in Emergency Care.ConclusionsThe majority of NPs in emergency care worked in facilities that were located in urban/suburban areas, were responsible for providing care in both the main emergency department and fast track area, held a Master of Science degree in nursing, obtained their education as a family nurse practitioner, and were certified as an NP by a national certifying agency. They were experienced registered nurses before becoming an NP but were relatively new to the NP role.ImplicationsThe results of this study provide information about characteristics of NPs who provide emergency care.
Utilization and Scope of Practice of Nurse Practitioners and Physician Assistants in Montana
Authors: Larsson Laura S. , Zulkowski Karen 
Published: May 2005

PurposeTo explore the licensing, certification, governance and education requirements of nurse practitioners (NPs) and physician assistants (PAs) in the state of Montana. Services provided and privileges retained in employment were also analyzed.Data SourcesThis was a descriptive study using a survey of rural hospital administrators (N=34).ConclusionsSurvey results show that 92.5% of PAs in Montana meet their supervision requirement by a telephone contact provision outlined by the state board of medicine. In contrast, 54.2% of NPs, who are autonomous by legal definition, have a telephone supervision requirement imposed on them by their employers.Implications for PracticeThese findings have implications for the current and prospective professionals and the businesses for which they work. Nurse practitioners and their professional organizations need to consider the implications these findings have on the professional image and marketability of all NPs.
Early Recognition of Marfan's Syndrome
Authors: Schumann Lorna , Amado Juan A. , Thomas Debera J. 
Published: May 2005

PurposeTo describe the classical features of Marfan's syndrome to help nurse practitioners (NPs) diagnose it in the early stages of progression and perhaps prevent many of its deleterious effects.Data SourcesSelected research‐based articles in the scientific literature and classic medical texts.ConclusionsThe cause of Marfan's syndrome is unknown, but studies have linked it with a disorder of chromosome 15. It is a degenerative connective tissue disorder that affects the musculoskeletal, ocular, integumentary, respiratory, and neurologic systems. The most lethal effect is on the cardiovascular system causing dissecting aortic aneurysms.Implications for PracticeEarly diagnosis is essential for a positive course of management. Marfan's syndrome can have fatal consequences and is often underdiagnosed and misdiagnosed.
Gaining Insight into Age‐Related Macular Degeneration
Authors: Frock Terri L. 
Published: May 2005

Purpose/objectiveTo enhance nurse practitioner (NP) recognition of clients with age‐related macular degeneration (AMD) based on history and physical examination findings, to encourage prompt initial referral of these clients to an ophthalmologist for a treatment evaluation, and to acquaint NPs with low vision rehabilitation services.Data sourcesGovernment documents, professional association practice guidelines, original research articles, journal articles, and Internet resources.ConclusionsAge‐related macular degeneration is a common, chronic vision‐threatening condition necessitating prompt recognition and professional evaluation. If not recognized early, AMD can lead to low vision and a diminished quality of life for the elderly client.Implications for practiceEven though NPs have a limited role in the treatment of AMD, they are in an instrumental position as a primary care providers to screen for this disease chiefly by: (a) adherence to eye examinations intervals, (b) recognition of risk factors, (c) use of the Amsler grid, (d) awareness of psychosocial dimensions, (e) making appropriate referrals, and (f) advocating low vision rehabilitation services.
Outcomes of a Community‐Based Three‐Year Breast and Cervical Cancer Screening Program for Medically Underserved, Low Income Women
Authors: Schulz Marcia A. , Ludwick Ruth , Cukr Penelope L. , Kelly Dennis 
Published: May 2005

PurposeTo evaluate a community level three‐year breast and cervical cancer screening program for medically underserved, low income women.Data SourcesDescriptive data on 128 women gathered from five semiannual screening programs held between 1995 and 1997 were analyzed.ConclusionsPoor and medically under served women often face barriers that may discourage or prevent screening activity and measures for early detection of breast and cervical cancer. Besides success in recruiting women to the program, community collaborative partnerships were established that continue to sustain this program.Implications for PracticeThe results from this project provide an example of how advance practice nurses (APNs) can demonstrate meaningful and competitive health care services for underserved women and how APNs can actively evaluate programs they offer that affect the health practices of communities in need.
Assisted Living Facilities as a Site for NP Practice
Authors: Wink Diane M. , Holcomb Lygia Owen 
Published: May 2005

PurposeTo describe what an assisted living facility (ALF) is, who resides in ALFs, and the benefits of nurse practitioner (NP) practice in an ALF for the client, facility, NP, and practice.Data SourcesSelected scientific literature, legal and regulatory guidelines, consumer information and guidelines, Internet sites, and the authors'experiences.ConclusionsAssisted living facilities are nonmedical residential settings grounded in a philosophy of providing residents with choice, autonomy, privacy, independence, dignity, and respect in a housing environment as homelike as possible. Nationally, ALFs vary considerably by size, services provided, and regulations imposed by states.Implications for PracticeAssisted living facilities are now a popular choice for individuals who desire assistance with selected activities of daily living (ADL) while maintaining maximum independence. They are becoming an excellent site for the provision of in‐home primary care in order to facilitate aging in place.
Nuts and Bolts of NP Practice in Assisted Living Facilities
Authors: Holcomb Lygia Owen , Wink Diane M. 
Published: May 2005

PurposeTo describe the practical issues associated with setting up a nurse practitioner (NP) practice in an assisted living facility (ALF), including record keeping, maintaining communication, and scheduling and coordination issues.Data SourcesSelected scientific literature, legal and regulatory guidelines, and the authors’ experiences.ConclusionsInitiating a NP practice in an ALF can be a rewarding experience, but it will not be without its own unique challenges. Procedures that maintain excellent communication between the NP, the home practice site, the resident and family, the ALF facility, and other services required by the needs of the resident take time and effort to establish but are worth the extra effort.Implications for PracticeNurse practitioners who establish a practice in an ALF need to be familiar with state regulations, facility procedures and culture, and the needs of elders who are aging in place and integrate all that into their office practice sites in order to be successful.
Chronic Cough: Evaluation and Management
Authors: Schumann Lorna , Madler Billie Jo 
Published: May 2005

PurposeTo inform the nurse practitioner of the common causes of chronic cough, to educate how each cause can be identified, and to suggest treatment options for the most common causes.Data SourceSelected research and review articles from professional journals.ConclusionChronic cough is a common presenting complaint in the primary care setting. Although at first the symptom may seem simple, the etiology, diagnosis, and treatment of chronic cough can be challenging. Furthermore, without proper identification of the cause, effective treatment most likely will not be obtained.Implications for PracticeBy familiarizing oneself with this topic, nurse practitioners will feel confident in treating chronic cough.
Doctorial Dissertations On Nurse Practitioners: 1970–2000
Authors: Hooker Roderick S. , Mayo Helen G. 
Published: May 2005

PurposeTo understand more about the nurse practitioner (NP) profession, a study was undertaken of the dissertation literature.Data SourcesA search of Dissertation Abstracts Online yielded 134 dissertations that included NPs in the title or abstract and were awarded between 1970 and 2000.ConclusionsMost of the degrees are either PhD (61%) or EdD (27%). State‐based universities produced the most degrees (70%) and six universities accounted for one‐fourth of the degrees. The topics of NP‐focused dissertations are wide ranging and include history, medical economics and managed care, NP education and professional role, and clinical and behavioral research.Implications for PracticeThis dataset provides an important source of information for research on the NP profession.
Screening, Diagnosis, and Clinical Care for Depression
Authors: Goolsby Mary Jo 
Published: May 2005

Depression is an extremely common condition, which usually responds well to prescribed treatment. Many patients have undiagnosed depression or related illnesses. There are a variety of screening tools that can be applied in practice settings. It is recommended that adult patients be screened for depression in practice sites able to coordinate the actual diagnosis and treatment of depression. This column reviews two sets of recommendations specific to the screening, diagnosis, and treatment of depression.Readers are invited to submit suggestions for future CPG columns and manuscripts reviewing CPGs. NPs interested in contributing to the column are invited to contact the column editor, Dr. Goolsby, to discuss their ideas. JAANP's readership is broad, covering all NP specialties. CPGs applicable to any areas of care can be submitted (from acute care to long term care, from neonatal care to geriatric care).