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Articles 1 - 30 of 95
Full-Text Articles in Medicine and Health Sciences
Persistence Of Episomal Hiv-1 Infection Intermediates In Patients On Highly Active Anti-Retroviral Therapy, Mark Sharkey, Ian Teo, Thomas Greenough, Natalia Sharova, Katherine Luzuriaga, John Sullivan, R. Bucy, Leondios Kostrikis, Ashley Haase, Claire Veryard, Raul Davaro, Sarah Cheeseman, Jennifer Daly, Carol Bova, Richard Ellison, Brian Mady, Kwan Lai, Graeme Moyle, Mark Nelson, Brian Gazzard, Sunil Shaunak, Mario Stevenson
Persistence Of Episomal Hiv-1 Infection Intermediates In Patients On Highly Active Anti-Retroviral Therapy, Mark Sharkey, Ian Teo, Thomas Greenough, Natalia Sharova, Katherine Luzuriaga, John Sullivan, R. Bucy, Leondios Kostrikis, Ashley Haase, Claire Veryard, Raul Davaro, Sarah Cheeseman, Jennifer Daly, Carol Bova, Richard Ellison, Brian Mady, Kwan Lai, Graeme Moyle, Mark Nelson, Brian Gazzard, Sunil Shaunak, Mario Stevenson
Associate Professor Mark Nelson
Treatment of HIV-1-infected individuals with a combination of anti-retroviral agents results in sustained suppression of HIV-1 replication, as evidenced by a reduction in plasma viral RNA to levels below the limit of detection of available assays. However, even in patients whose plasma viral RNA levels have been suppressed to below detectable levels for up to 30 months, replication-competent virus can routinely be recovered from patient peripheral blood mononuclear cells and from semen. A reservoir of latently infected cells established early in infection may be involved in the maintenance of viral persistence despite highly active anti-retroviral therapy. However, whether virus replication …
The Rbans Effort Index: Base Rates In Geriatric Samples, K. Duff, C. Spering, S. O'Bryant, L. Beglinger, D. Moser, J. Bayless, Kennith Culp, J. Mold, R. Adams, J. Scott
The Rbans Effort Index: Base Rates In Geriatric Samples, K. Duff, C. Spering, S. O'Bryant, L. Beglinger, D. Moser, J. Bayless, Kennith Culp, J. Mold, R. Adams, J. Scott
Kennith R. Culp
The Effort Index (EI) of the RBANS was developed to assist clinicians in discriminating patients who demonstrate good effort from those with poor effort. However, there are concerns that older adults might be unfairly penalized by this index, which uses uncorrected raw scores. Using five independent samples of geriatric patients with a broad range of cognitive functioning (e.g., cognitively intact, nursing home residents, probable Alzheimer's disease), base rates of failure on the EI were calculated. In cognitively intact and mildly impaired samples, few older individuals were classified as demonstrating poor effort (e.g., 3% in cognitively intact). However, in the more …
Twelve-Month Mortality Among Delirium Subtypes, S. Decrane, Kennith Culp, B. Wakefield
Twelve-Month Mortality Among Delirium Subtypes, S. Decrane, Kennith Culp, B. Wakefield
Kennith R. Culp
This study used data from the Delirium Among the Elderly in Rural Long-Term Care Facilities Study and data from the National Death Index (NDI) to examine mortality among 320 individuals. Individuals were grouped into noncases, subsyndromal cases, hypoactive delirium, hyperactive delirium, and mixed delirium on the basis of scoring using the Confusion Assessment Method (CAM), NEECHAM Scale, Mini-Mental State Examination (MMSE), Clinical Assessment of Confusion-A (CAC-A), and Vigilance A instruments. Risk ratios of mortality using "days of survival" did not reach statistical significance (alpha = .05) for any subgroup. Underlying cause of death (UCD) using International Classification of Disease, 10th …
Sleeplessness, Deborah Schoenfelder, Keela Herr
Sleeplessness, Deborah Schoenfelder, Keela Herr
Deborah P. Schoenfelder
This article identifies and reviews research related to sleeplessness reported by nurses in the literature. The current state of clinical nursing research as it relates to sleep is evaluated, including the content, methodology, and implications for further research. Although the review indicates current interest in sleep by clinical nurse researchers, the number of nursing studies in the literature is limited, especially within specific areas, such as age groups and setting. Also, directions for future nursing research on sleep are recommended.
Caregiving: Concept Analysis And Outcomes, Elizabeth Swanson, Deborah Schoenfelder, Janet Specht, M. Johnson, Meridean Maas, D. Saylor
Caregiving: Concept Analysis And Outcomes, Elizabeth Swanson, Deborah Schoenfelder, Janet Specht, M. Johnson, Meridean Maas, D. Saylor
Deborah P. Schoenfelder
More than ever before, caregiving has become a salient public policy issue. A number of recent and anticipated demographic, economic and social changes have occurred that make it imperative for researchers to critically examine the impact of caregiving on family caregivers' health, behavior, emotions, and social status. Researchers at the University of Iowa College of Nursing are working to classify standardized nursing-sensitive patient outcomes for use in language development, practice, research, and education to evaluate the effectiveness of nursing interventions and clinical nursing services. This article focuses on family caregiving and the analysis of caregiver role performance in both direct …
Acute Confusion/Delirium, S. Sendelbach, P. Guthrie, Deborah Schoenfelder
Acute Confusion/Delirium, S. Sendelbach, P. Guthrie, Deborah Schoenfelder
Deborah P. Schoenfelder
No abstract provided.
An Exercise Program To Improve Fall-Related Outcomes In Elderly Nursing Home Residents, Deborah Schoenfelder, L. Rubenstein
An Exercise Program To Improve Fall-Related Outcomes In Elderly Nursing Home Residents, Deborah Schoenfelder, L. Rubenstein
Deborah P. Schoenfelder
This study tested a 3-month ankle-strengthening and walking program designed to improve or maintain the fall-related outcomes of balance, ankle strength, walking speed, risk of falling, fear of falling, and confidence to perform daily activities without falling (falls efficacy) in elderly nursing home residents. Nursing home residents (N = 81) between the ages of 64 and 100 years participated in the study. Two of the fall-related outcomes, balance and fear of falling, were maintained or improved for the exercise group in comparison to the control group.
Evidence-Based Guideline. Individualized Music For Elders With Dementia, L. Gerdner, Deborah Schoenfelder
Evidence-Based Guideline. Individualized Music For Elders With Dementia, L. Gerdner, Deborah Schoenfelder
Deborah P. Schoenfelder
No abstract provided.
Outcome Indicators For Direct And Indirect Caregiving, Deborah Schoenfelder, Elizabeth Swanson, Janet Specht, Meridean Maas, M. Johnson
Outcome Indicators For Direct And Indirect Caregiving, Deborah Schoenfelder, Elizabeth Swanson, Janet Specht, Meridean Maas, M. Johnson
Deborah P. Schoenfelder
Informal caregiving and outcomes for caregiving are an important part of health care and of particular importance in nursing. The purpose of this research is to report the results of a survey mailed to nursing experts for validation of the outcome labels Caregiver Role Performance: Direct Care and Caregiver Role Performance: Indirect Care and their accompanying indicators. Experts were asked to rate how important the identified indicators were for assessing those two outcomes. In addition, the respondents were asked to what extent nursing interventions influence the achievement of each identified indicator for Caregiver Role Performance: Direct Care and Caregiver Role …
From Risk For Trauma To Unintentional Injury Risk: Falls--A Concept Analysis. Nursing Diagnosis Extension And Classification Research Team, Deborah Schoenfelder, C. Crowell
From Risk For Trauma To Unintentional Injury Risk: Falls--A Concept Analysis. Nursing Diagnosis Extension And Classification Research Team, Deborah Schoenfelder, C. Crowell
Deborah P. Schoenfelder
TOPIC: Concept analysis of the nursing diagnosis risk for trauma. PURPOSE: To examine the nursing diagnosis risk for trauma and to specify the risk factors for falling. SOURCES: Research and informational articles on falling, and NANDA Nursing Diagnoses: Definitions and Classification, 1999-2000. CONCLUSIONS: Replace the current nursing diagnosis risk for trauma with the more specific nursing diagnosis unintentional injury risk: falls. The other risks included in risk for trauma (e.g., burns) also will need to be developed.
Simply The Best: Teaching Gerontological Nursing Students To Teach Evidence-Based Practice. Creating Tip Sheets Can Help Achieve The Goal Of Implementing Ebp In Clinical Facilities, Deborah Schoenfelder
Simply The Best: Teaching Gerontological Nursing Students To Teach Evidence-Based Practice. Creating Tip Sheets Can Help Achieve The Goal Of Implementing Ebp In Clinical Facilities, Deborah Schoenfelder
Deborah P. Schoenfelder
This article describes a teaching strategy used in an undergraduate gerontological nursing clinical course to familiarize students with evidence-based practice. Students are required to read and summarize an assigned evidence-based practice guideline published by The University of Iowa Gerontological Nursing Interventions Research Center. They then develop a "tip sheet," based on the assigned guideline, to disseminate to health care staff at their practicum sites, which is either a long-term care facility or a hospital-based skilled nursing facility. Nursing students' reactions to the assignment and nursing staff's responses to the tip sheets are discussed.
Evidence-Based Guideline. Wandering, M. Futrell, K. Melillo, R. Remington, Deborah Schoenfelder
Evidence-Based Guideline. Wandering, M. Futrell, K. Melillo, R. Remington, Deborah Schoenfelder
Deborah P. Schoenfelder
No abstract provided.
Creative Practicum Leadership Experiences In Rural Settings, Deborah Schoenfelder, J. Valde
Creative Practicum Leadership Experiences In Rural Settings, Deborah Schoenfelder, J. Valde
Deborah P. Schoenfelder
Rural healthcare systems provide rich learning environments for nursing students, where strong nursing leaders manage care for people with diverse health problems across the lifespan. The authors describe the development, implementation, and evaluation of rural clinical leadership practicum, a prelicensure course that specifically focuses on the application of leadership concepts in small rural healthcare systems.
The Independent Nurse Role In Community Care Gerontological Nursing, Deborah Schoenfelder, Janet Specht, Meridean Maas
The Independent Nurse Role In Community Care Gerontological Nursing, Deborah Schoenfelder, Janet Specht, Meridean Maas
Deborah P. Schoenfelder
No abstract provided.
A Fall Prevention Educational Program For Community Dwelling Seniors, Deborah Schoenfelder, K. Van Why
A Fall Prevention Educational Program For Community Dwelling Seniors, Deborah Schoenfelder, K. Van Why
Deborah P. Schoenfelder
The purpose of this research was to assess participants' responses to a fall prevention educational program. Fourteen persons volunteered to participate in the study conducted at a large senior center. Descriptive statistics were used to characterize the sample and to assess subjects' awareness about falls, attitudes about fall risk, fall prevention behaviors, and incidence of falls before the fall prevention program and again at one month and three months after the program. Forty-six percent of the sample had fallen in the previous year. In general, subjects' perceptions that their risk of falling was lower than others of the same age …
Homesafe: Supportive Assistance For Elderly Individuals Through A Nurse-Managed Plan, Deborah Schoenfelder, Meridean Maas, Janet Specht
Homesafe: Supportive Assistance For Elderly Individuals Through A Nurse-Managed Plan, Deborah Schoenfelder, Meridean Maas, Janet Specht
Deborah P. Schoenfelder
A lack of quality, cost-effective alternatives to nursing home care for community-dwelling older adults exists. The evidence suggests that case management provides quality care in a cost-efficient manner to help older adults remain at home safely and as independently as possible. This article describes HomeSafe, a nurse-managed membership plan that assists older individuals to enhance their health and quality of life, and to age in place in their homes and communities. HomeSafe serves as an innovative model of care and a teaching site for undergraduate and graduate nursing students and nursing faculty at The University of Iowa.
Work Restrictions: Documenting A Patient's Return To Work, Kerri Rupe
Work Restrictions: Documenting A Patient's Return To Work, Kerri Rupe
Kerri A. Rupe
Patients frequently ask NPs to write work restrictions, even if it is not in their best interest. This article helps providers construct valid work restrictions and addresses specific tasks and issues to keep the patient and coworkers safe when returning to work.
Assigning Surgical Cases With Regional Anesthetic Blocks To Anesthetists And Operating Rooms Based On Operating Room Efficiency, Cormac O'Sullivan, F. Dexter
Assigning Surgical Cases With Regional Anesthetic Blocks To Anesthetists And Operating Rooms Based On Operating Room Efficiency, Cormac O'Sullivan, F. Dexter
Cormac T. O'Sullivan
The popularity of regional anesthesia blocks for both intraoperative anesthesia and postoperative pain management supports the inclusion of the administration of regional anesthesia into discussions about operating room (OR) efficiency. This article reviews the literature on OR efficiency with a focus on day-of-surgery decision making. Vignettes show regional anesthesia block placement is a variable that can affect the efficiency of use of OR time. Clinical examples highlight OR management issues and staff assignment decisions on the day of surgery. Regional anesthetic block placement can affect surgical schedules, and thus OR efficiency. When patient safety is unaffected, rearranging OR schedules on …
Economics And The Education Of Nurse Anesthetists: Part 1, Cormac O'Sullivan, E. Thompson
Economics And The Education Of Nurse Anesthetists: Part 1, Cormac O'Sullivan, E. Thompson
Cormac T. O'Sullivan
No abstract provided.
Economics And The Education Of Nurse Anesthetists: Part 2, Cormac O'Sullivan, E. Thompson
Economics And The Education Of Nurse Anesthetists: Part 2, Cormac O'Sullivan, E. Thompson
Cormac T. O'Sullivan
Economic assumptions and other factors affecting the economics of nurse anesthesia education are presented in Part 2 of this 2-part column. In Part 1, published in the October 2004 issue of the AANA Journal, general economic principles and healthcare economic principles in particular were described, explained, and related to the current US healthcare system.
Evidence-Based Management Assessment Of Return On Investment From Anesthesia Information Management Systems, Cormac O'Sullivan, F. Dexter, D. Lubarsky, M. Vigoda
Evidence-Based Management Assessment Of Return On Investment From Anesthesia Information Management Systems, Cormac O'Sullivan, F. Dexter, D. Lubarsky, M. Vigoda
Cormac T. O'Sullivan
A systematic and comprehensive review of the scientific literature revealed 4 evidence-based methods that contribute to a positive return on investment from anesthesia information management systems (AIMS): reducing anesthetic-related drug costs, improving staff scheduling and reducing staffing costs, increasing anesthesia billing and capture of anesthesia-related charges, and increased hospital reimbursement through improved hospital coding. There were common features to these interventions. Whereas an AIMS may be the ideal choice to achieve these cost reductions and revenue increases, alternative existing systems may be satisfactory for the studied applications (i.e., the incremental advantage to the AIMS may be less than predicted from …
An Examination Of The Sustainable Adoption Of Whole-Person Care (Wpc), Maria Joseph, D. Laughon, Richard Bogue
An Examination Of The Sustainable Adoption Of Whole-Person Care (Wpc), Maria Joseph, D. Laughon, Richard Bogue
Maria (Lindell) Joseph
AIM: This study illustrates how King's theory of goal attainment was used to focus an examination of whole-person care (WPC) and to extend the range of knowledge needed for WPC and nursing practice. BACKGROUND: Leadership implemented a faith-based innovation using continuing education for patient care that incorporates body-mind-spirit and eight principles called CREATION. Three questions arose: (1) Is there an evidence-based framework to determine whether the philosophy supports the discipline of nursing? (2) How extensive is the adoption and application of WPC? (3) Does the model make a difference in the context of nurse-patient interactions and outcomes in support of …
Vitamin D And Chronic Lung Disease: A Review Of Molecular Mechanisms And Clinical Studies, J. Finklea, Ruth Grossmann, V. Tangpricha
Vitamin D And Chronic Lung Disease: A Review Of Molecular Mechanisms And Clinical Studies, J. Finklea, Ruth Grossmann, V. Tangpricha
Ruth E. Grossmann
Vitamin D is classically recognized for its role in calcium homeostasis and skeletal metabolism. Over the last few decades, vitamin D deficiency has increased in prevalence in adults and children. Potential extraskeletal effects of vitamin D have been under investigation for several diseases. Several cross-sectional studies have associated lower vitamin D status with decreased lung function. This finding has prompted investigators to examine the association of vitamin D deficiency with several chronic lung diseases. One major focus has been the link between maternal vitamin D status and childhood asthma. Vitamin D deficiency has also been associated with increased risk of …
Evaluation Of Vehicle Substances On Vitamin D Bioavailability: A Systematic Review, Ruth Grossmann, V. Tangpricha
Evaluation Of Vehicle Substances On Vitamin D Bioavailability: A Systematic Review, Ruth Grossmann, V. Tangpricha
Ruth E. Grossmann
Vitamin D insufficiency is a common medical condition. Vitamin supplements can be ingested to improve vitamin D status. It is not known if the vehicle substance that is combined with the vitamin D tablet influences the bioavailability of vitamin D. The purpose of this review is to examine the impact of different vehicles on vitamin D bioavailability. A comprehensive literature search identified studies that directly compared the absorption of vitamin D from two or more vehicles. The change in mean serum 25(OH)D per average daily dose of vitamin D supplemented was calculated and compared among the studies. We identified four …
Expanded Adult Day Program As A Transition Option From Hospital To Home, K. Jones, S. Tullai-Mcguinness, M. Dolansky, Amany Farag, M. Krivanek, L. Matthews
Expanded Adult Day Program As A Transition Option From Hospital To Home, K. Jones, S. Tullai-Mcguinness, M. Dolansky, Amany Farag, M. Krivanek, L. Matthews
Amany A. Farag
This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants …
Nurses' Perception Of Their Manager's Leadership Style And Unit Climate: Are There Generational Differences?, Amany Farag, S. Tullai-Mcguinness, M. Anthony
Nurses' Perception Of Their Manager's Leadership Style And Unit Climate: Are There Generational Differences?, Amany Farag, S. Tullai-Mcguinness, M. Anthony
Amany A. Farag
AIM: To describe and compare how nurses representing four age cohorts perceive their manager's leadership style and unit climate. BACKGROUND: The current workforce consists of nurses representing four generational cohorts. Nursing literature suggests that nurses from each age cohort think, behave and approach work differently. Limited empirical evidence, however, exists about how nurses from each age cohort perceive two aspects of their work environment: their managers' leadership style and unit climate. METHOD: This cross-sectional, descriptive survey was conducted using a convenience sample of 475 registered nurses working in different inpatient units in three community non-magnet hospitals. RESULTS AND CONCLUSION: Only …
Perceived Stress In Prodromal Huntington Disease, Nancy Downing, M. Smith, L. Beglinger, J. Mills, K. Duff, K. Rowe, E. Epping, J. Paulsen, Group Predict-Hd Investigators Of Huntington Study
Perceived Stress In Prodromal Huntington Disease, Nancy Downing, M. Smith, L. Beglinger, J. Mills, K. Duff, K. Rowe, E. Epping, J. Paulsen, Group Predict-Hd Investigators Of Huntington Study
Nancy R Downing
This study examines perceived stress and its relationship to depressive symptoms, life changes and functional capacity in a large sample of individuals who are positive for the Huntington disease (HD) gene expansion but not yet diagnosed. Participants were classified by estimated proximity to HD diagnosis (far, mid, near) and compared with a non-gene-expanded comparison group. Persons in the mid group had the highest stress scores. A significant interaction between age and time since HD genetic testing was also found. Secondary analyses using data from a different data collection point and including a diagnosed group showed the highest stress scores in …
Developing Strategic Interventions To Reduce Cardiovascular Disease Risk Among Law Enforcement Officers: The Art And Science Of Data Triangulation, Sandra Ramey, Nancy Downing, A. Knoblauch
Developing Strategic Interventions To Reduce Cardiovascular Disease Risk Among Law Enforcement Officers: The Art And Science Of Data Triangulation, Sandra Ramey, Nancy Downing, A. Knoblauch
Nancy R Downing
The purpose of this study was to use data triangulation to inform interventions targeted at reducing morbidity from cardiovascular disease (CVD) and associated risk factors among law enforcement officers. Using the Precede-Proceed Health Promotion Planning Model, survey data (n = 672) and focus group data (n = 8 groups) from the Milwaukee Police Department were analyzed. Narrative transcripts disclosed that law enforcement officers encounter potential barriers and motivators to a healthy lifestyle. Survey results indicated rates of overweight (71.1% vs. 60.8%) and hypertension (27.4% vs. 17.6%) were significantly (p < or = .001) higher among Milwaukee Police Department law enforcement officers than the general population of Wisconsin (n = 2,855). The best predictor of CVD was diabetes (p = .030). Occupational health nurses are uniquely positioned to identify health risks, design appropriate interventions, and advocate for policy changes that improve the health of those employed in law enforcement and other high-risk professions.
Couples' Attributions For Work Function Changes In Prodromal Huntington Disease, Nancy Downing, Janet Williams, J. Paulsen
Couples' Attributions For Work Function Changes In Prodromal Huntington Disease, Nancy Downing, Janet Williams, J. Paulsen
Nancy R Downing
People who have tested positive for the expanded Huntington disease (HD) gene who are not yet diagnosed (pre-HD) and their companions report subtle changes in ability of people with pre-HD to do their jobs. However, it is not known whether they attribute these changes to HD. Semi-structured telephone interviews were analyzed from seven persons with pre-HD at different estimated points from diagnosis and six companions. Data were analyzed using qualitative analysis methods. Participants made attributions related to health, work, and temperament. Only one participant attributed a change to HD. The process of forming attributions was demonstrated through symptom monitoring and …
Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke
Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke
Nancy R Downing
This study explored the self-reported prevalence of cardiovascular disease (CVD) and accompanying risk factors among 165 male retirees 43 years and older (M = 56.2, SD = 7.1) from the Milwaukee Police Department (MPD) compared to 671 individuals of similar age and income who responded to the 2005 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS). CVD and other risk factors were more prevalent in the MPD retirees than the general population (CVD 15.2% vs. 9.5%, p = .036; hypertension 51.5% vs. 36.2%, p = .001; hypercholesterolemia 62.4% vs. 44.4%, p = .001; overweight and obesity 85.1% vs. 74.7%, p = …