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Full-Text Articles in Medicine and Health Sciences
Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree
Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree
Jill Scott-Cawiezell
OBJECTIVE: To develop an instrument to measure organizational attributes relevant for family practices using the perspectives of clinicians, nurses, and staff. DATA SOURCES/STUDY SETTING: Clinicians, nurses, and office staff (n=640) from 51 community family medicine practices. DESIGN: A survey, designed to measure a practices' internal resources for change, for use in family medicine practices was created by a multidisciplinary panel of experts in primary care research and health care organizational performance. This survey was administered in a cross-sectional study to a sample of diverse practices participating in an intervention trial. A factor analysis identified groups of questions relating to latent …
Infusing Research Into Practice To Promote Quality Care, M. G. Titler, Charmaine Kleiber, Victoria Steelman, C. Goode, Barbara Rakel, J. Barry-Walker, S. Small, Kathleen Buckwalter
Infusing Research Into Practice To Promote Quality Care, M. G. Titler, Charmaine Kleiber, Victoria Steelman, C. Goode, Barbara Rakel, J. Barry-Walker, S. Small, Kathleen Buckwalter
Barbara A. Rakel
This article describes the Iowa Model of Research in Practice, a heuristic model used at the University of Iowa Hospitals and Clinics for infusing research into practice to improve the quality of care. The components of the model are presented with examples. The impact of the model on patient, staff, and fiscal outcomes is delineated.
University Of Iowa Hospital And Clinics: Outcomes Management, Mary Berg, M. Dreher, K. Davenport, J. Greiner, R. Howell, A. Mutnick, G. Jensen, Barbara Rakel, F. Johlin, V. Kraus, R. Reiter, K. Leo, J. Ryan, J. Mccloskey
University Of Iowa Hospital And Clinics: Outcomes Management, Mary Berg, M. Dreher, K. Davenport, J. Greiner, R. Howell, A. Mutnick, G. Jensen, Barbara Rakel, F. Johlin, V. Kraus, R. Reiter, K. Leo, J. Ryan, J. Mccloskey
Barbara A. Rakel
Delivery of quality patient care and management of patient outcomes is critical to the success of academic medical centers in the ever-changing health care market. The University of Iowa Hospitals and Clinics (UIHC) promotes quality care through the provision of organizational structures and processes that are described in this article. In addition, quality of care and outcomes management are described by members in various roles within the UIHC health care system. It is the authors' belief that understanding quality from these various perspectives helps UIHC work across departments to achieve excellence in patient care.
Innovative Approaches For Teaching Children With Chronic Conditions, J. Engvall, Ann Mccarthy
Innovative Approaches For Teaching Children With Chronic Conditions, J. Engvall, Ann Mccarthy
Ann Marie McCarthy
No abstract provided.
A Conceptual Model Of Factors Influencing Children's Responses To A Painful Procedure When Parents Are Distraction Coaches, Ann Mccarthy, Charmaine Kleiber
A Conceptual Model Of Factors Influencing Children's Responses To A Painful Procedure When Parents Are Distraction Coaches, Ann Mccarthy, Charmaine Kleiber
Ann Marie McCarthy
The purpose of this article is to present a model of factors that may influence a child's response to a painful procedure when parents are distraction coaches during the procedure. Nonpharmacological interventions, in particular, distraction, and parents as coaches for their children during procedures are discussed. A conceptual model is presented that illustrates the multiple factors and their possible relationships. A selected review of studies is provided that supports the inclusion of these factors in the model. The model and literature review focus on three major areas: characteristics of the child, characteristics of the parent, and procedural variables. The model …
Striving For Distraction. Interview By James M Stubenrauch, Ann Mccarthy, Charmaine Kleiber
Striving For Distraction. Interview By James M Stubenrauch, Ann Mccarthy, Charmaine Kleiber
Ann Marie McCarthy
As part of its Raise the Voice campaign, in November 2006 the American Academy of Nursing (AAN) named Ann marie McCarthy and Charmaine Kleiber as "Edge Runners"--nurses who identify new models of care that integrate the physical and mental health of patients and who make a "clear connection between research and practical solutions." Pat Fort-Rogner, chief executive officer of the AAN, says "We hope patient-advocacy groups and federal agencies like the Agency for Healthcare Research and Quality will take note."
Health Status And Resources Of Rural Homeless Women And Children, Martha Craft-Rosenberg, S. Powell, Kennith Culp
Health Status And Resources Of Rural Homeless Women And Children, Martha Craft-Rosenberg, S. Powell, Kennith Culp
Kennith R. Culp
The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence ofsubstance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that …
Acute Confusion Indicators: Risk Factors And Prevalence Using Mds Data, J. Mentes, Kennith Culp, Meridean Maas, M. Rantz
Acute Confusion Indicators: Risk Factors And Prevalence Using Mds Data, J. Mentes, Kennith Culp, Meridean Maas, M. Rantz
Kennith R. Culp
OBJECTIVE: The purpose of this study was to use Minimum Data Set (MDS) data from LTC (long-term care) in one Midwestern state to test whether risk variables derived from a conceptual model developed from findings in acute care predicted acute confusion in long-term care residents. DESIGN: Cross-sectional. SETTING: MDS nursing home records. POPULATION: The sample was composed predominantly of women (n = 1,775). INTERVENTIONS: The 1995 MIS annual reviews of nursing home residents from a Midwestern state provided the data for analysis; however missing data, on the average about 10% for the acute confusion/delirium indicators, reduced the sample to 2,318. …
Impaired Fgf Signaling Contributes To Cleft Lip And Palate, B. Riley, M. Mansilla, J. Ma, Sandra Daack-Hirsch, B. Maher, L. Raffensperger, E. Russo, A. Vieira, C. Dode, M. Mohammadi, M. Marazita, J. Murray
Impaired Fgf Signaling Contributes To Cleft Lip And Palate, B. Riley, M. Mansilla, J. Ma, Sandra Daack-Hirsch, B. Maher, L. Raffensperger, E. Russo, A. Vieira, C. Dode, M. Mohammadi, M. Marazita, J. Murray
Sandra Daack-Hirsch
Nonsyndromic cleft lip and palate (NS CLP) is a complex birth defect resulting from a combination of genetic and environmental factors. Several members of the FGF and FGFR families are expressed during craniofacial development and can rarely harbor mutations that result in human clefting syndromes. We hypothesized that disruptions in this pathway might also contribute to NS CLP. We sequenced the coding regions and performed association testing on 12 genes (FGFR1, FGFR2, FGFR3, FGF2, FGF3, FGF4, FGF7, FGF8, FGF9, FGF10, FGF18, and NUDT6) and used protein structure analyses to predict the function of amino acid variants. Seven likely disease-causing mutations …
Microdeletions At Chromosome Bands 1q32-Q41 As A Cause Of Van Der Woude Syndrome, B. Schutte, A. Basart, Y. Watanabe, J. Laffin, K. Coppage, B. Bjork, Sandra Daack-Hirsch, S. Patil, M. Dixon, J. Murray
Microdeletions At Chromosome Bands 1q32-Q41 As A Cause Of Van Der Woude Syndrome, B. Schutte, A. Basart, Y. Watanabe, J. Laffin, K. Coppage, B. Bjork, Sandra Daack-Hirsch, S. Patil, M. Dixon, J. Murray
Sandra Daack-Hirsch
Van der Woude syndrome (VWS) is an autosomal dominant disorder comprising cleft lip and/or cleft palate and lip pits. We reported previously a family whose underlying mutation is a 500-800 kb deletion localized to chromosome bands 1q32-q41 [Sander et al., 1994: Hum Mol Genet 3:576-578]. Along with cleft lip/palate and lip pits, affected relatives exhibit developmental delays, suggesting that the function of a gene nearby may also be disrupted. To further localize the VWS gene we searched for other deletions that cause VWS. An allele loss assay was performed using a novel highly polymorphic marker, D1S3753. From a panel of …
Discordant Mz Twins With Cleft Lip And Palate: A Model For Identifying Genes In Complex Traits, M. Mansilla, J. Kimani, L. Mitchell, K. Christensen, D. Boomsma, Sandra Daack-Hirsch, B. Nepomucena, D. Wyszynski, T. Felix, N. Martin, J. Murray
Discordant Mz Twins With Cleft Lip And Palate: A Model For Identifying Genes In Complex Traits, M. Mansilla, J. Kimani, L. Mitchell, K. Christensen, D. Boomsma, Sandra Daack-Hirsch, B. Nepomucena, D. Wyszynski, T. Felix, N. Martin, J. Murray
Sandra Daack-Hirsch
Monozygotic (MZ) twins may be discordant for complex traits due to differential environmental exposure in utero, epigenetic variability in imprinting, X chromosome inactivation, or stochastic effects. Occasionally MZ twins may be discordant for chromosomal and single gene disorders due to somatic mosaicism. For complex traits, which are due to the interactive effects of multiple genes and environmental factors, the affected twin of a discordant MZ pair offers the possibility for identifying somatic mutations in candidate genes. DNA sequencing of candidate genes in discordant MZ twins can identify those rare etiologic mutational events responsible for the different phenotypes since the confounding …
X-Chromosome Inactivation Patterns In Monozygotic Twins And Sib Pairs Discordant For Nonsyndromic Cleft Lip And/Or Palate, J. Kimani, M. Shi, Sandra Daack-Hirsch, K. Christensen, D. Moretti-Ferreira, M. Marazita, L. Field, J. Canady, J. Murray
X-Chromosome Inactivation Patterns In Monozygotic Twins And Sib Pairs Discordant For Nonsyndromic Cleft Lip And/Or Palate, J. Kimani, M. Shi, Sandra Daack-Hirsch, K. Christensen, D. Moretti-Ferreira, M. Marazita, L. Field, J. Canady, J. Murray
Sandra Daack-Hirsch
Nonsyndromic clefts of the lip and/or palate are common birth defects with a strong genetic component. Based on unequal gender ratios for clefting phenotypes, evidence for linkage to the X chromosome and the occurrence of several X-linked clefting syndromes, we investigated the role of skewed X chromosome inactivation (XCI) in orofacial clefts. Our samples consisted of female monozygotic (MZ) twins (n = 8) and sister pairs (n = 152) discordant for nonsyndromic clefting. We measured the XCI pattern in peripheral blood lymphocyte DNA using a methylation based androgen receptor gene assay. Skewing of XCI was defined as the deviation in …
Facts And Fallacies: The Practice Doctorate, A. Sperhac, Patricia Clinton
Facts And Fallacies: The Practice Doctorate, A. Sperhac, Patricia Clinton
Patricia K. Clinton
In the past year there has been continued discussion within professional organizations regarding the emergence of the practice doctorate. This in turn has caused concerns among some nurse practitioners. The purpose of this article is to provide an overview of the practice doctorate, current progress and development of the concept, and the potential impact on practicing pediatric and other nurse practitioners.
Innovative University Partnership Meets Neonatal Nurse Practitioner Program Need Amid Faculty Shortage, Rebecca Siewert, L. B. Rasmussen, M. A. Lofgren, Patricia Clinton
Innovative University Partnership Meets Neonatal Nurse Practitioner Program Need Amid Faculty Shortage, Rebecca Siewert, L. B. Rasmussen, M. A. Lofgren, Patricia Clinton
Patricia K. Clinton
This nation is facing a significant nursing faculty shortage not only at the undergraduate but also at the graduate level. As nursing faculty, we must be innovative in considering ways of consolidating resources in this time of demand for advanced practice nurses. With the apparent need for qualified neonatal nurse practitioners in Iowa, the University of Iowa understood the importance of starting a neonatal nurse practitioners program. The University of Iowa College of Nursing and the University of Missouri-Kansas City formed a partnership to educate neonatal nurse practitioners. Although this partnership concentrates on a specific subspecialty population, it can serve …
National Agenda For Advanced Practice Nursing: The Practice Doctorate, Patricia Clinton, A. Sperhac
National Agenda For Advanced Practice Nursing: The Practice Doctorate, Patricia Clinton, A. Sperhac
Patricia K. Clinton
The purpose of this article was to provide the background and rationale for the practice doctorate in nursing. The American Association of Colleges of Nursing's Position Statement on the Practice Doctorate in Nursing, approved in October 2004, will be discussed. Outlined are some of the changes that will be needed in education, regulation, and advanced practice. Common questions and concerns that advanced practice nurses have, including titling, salary, and transitioning to the doctor of nursing practice degree, will be addressed.
University Of Iowa Hospital And Clinics: Outcomes Management, Mary Berg, M. Dreher, K. Davenport, J. Greiner, R. Howell, A. Mutnick, G. Jensen, Barbara Rakel, F. Johlin, V. Kraus, R. Reiter, K. Leo, J. Ryan, J. Mccloskey
University Of Iowa Hospital And Clinics: Outcomes Management, Mary Berg, M. Dreher, K. Davenport, J. Greiner, R. Howell, A. Mutnick, G. Jensen, Barbara Rakel, F. Johlin, V. Kraus, R. Reiter, K. Leo, J. Ryan, J. Mccloskey
Mary Berg
Delivery of quality patient care and management of patient outcomes is critical to the success of academic medical centers in the ever-changing health care market. The University of Iowa Hospitals and Clinics (UIHC) promotes quality care through the provision of organizational structures and processes that are described in this article. In addition, quality of care and outcomes management are described by members in various roles within the UIHC health care system. It is the authors' belief that understanding quality from these various perspectives helps UIHC work across departments to achieve excellence in patient care.