Home About us Contact
|
Home About us Contact | ||
|
|
||
Focus Areas (focus + area)
Selected AbstractsPrimary care health issues among men who have sex with menJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2006Royal Gee MSN Abstract Purpose: The purpose of the article is to examine "appropriate" health care for men who have sex with men (MSM), which is not to suggest "special" health care. As a group, MSM are at increased risk for sexually transmitted infections, anal cancer, and mental health disorders. Focus areas in this article will address health issues that the primary care nurse practitioner (NP) may encounter in clinical practice: anal carcinoma, sexually transmitted diseases (STDs), high-risk sexual practices, depression, and substance abuse were topics chosen for inclusion in this article. These topics were among those highlighted in the Healthy People 2010 Companion Document for LGBT Health, which served to examine the healthcare disparities and lack of access to needed services related to sexual orientation. Data source: Extensive literature review of research articles, journals, clinical practice guidelines, books, and public health department Internet Web sites. Conclusions: There are unique health disparities that exist for MSM related to social, emotional, and mental health factors, in addition to physical issues such as STDs. There is an increasing need for primary care providers to be aware of these disparities, as well as the factors that influence these disparities, in order to provide multidimensional care and health counseling that is unique to NP practice. Implications for practice: Both the primary care NP and the patient should be aware of the unique healthcare issues among MSM that should be incorporated into the patient's routine health maintenance program. As primary care providers, it is within the standards of practice for NPs to provide culturally competent care, along with health promotion and disease prevention for MSM. [source] Hydrological and biogeochemical processes in a changing Amazon: results from small watershed studies and the large-scale biosphere-atmosphere experimentHYDROLOGICAL PROCESSES, Issue 12 2006Christopher Neill Abstract The Amazon Basin is the world's largest tropical forest region and one where rapid human changes to land cover have the potential to cause significant changes to hydrological and biogeochemical processes. The Large-Scale Biosphere-Atmosphere Experiment in Amazonia (LBA) is a multidisciplinary, multinational research program led by Brazil. The goal of LBA is to understand how the Amazon Basin functions as a regional entity in the earth system and how these functions are changing as a result of ongoing human activity. This compilation of nine papers focuses on a central LBA question in the area of nutrient dynamics and surface water chemistry,how do changes in land use alter fluxes of dissolved and particulate materials from uplands across riparian zones and down the channels of river corridors? These papers cover work conducted in small watersheds on a wide range of topics within the spirit and geographical focus area of LBA: water balance and runoff generation, nutrient transformations in riparian zones and stream channels, carbon fluxes in water moving from land to water and the influence of soils on flowpath structure and stream chemistry. Important new insights can be gained from these and other studies. Forest clearing for pastures results in a decrease in soil hydraulic conductivity that forces water into surficial flowpaths throughout most of the rainy season across wide regions of the Amazon. Riparian zones along small forest streams appear to be very effective in removing nitrate arriving from the uplands, while forest streams take up nitrate at very low rates, allowing them to travel downstream for long distances. Although substantial, the contribution of dissolved organic C (DOC) to the carbon flux from forests to streams appears to be lower than the flux of dissolved inorganic C that is subsequently outgassed as CO2. Remaining key challenges within LBA will be to synthesize existing data sets on river networks, soils, climate, land use and planned infrastructure for the Amazon to develop models capable of predicting hydrologic and biogeochemical fluxes at a variety of scales relevant to the development of strategies for sustainable management of the Amazon's remarkable forest, soil and freshwater resources. Copyright © 2006 John Wiley & Sons, Ltd. [source] Nosocomial infection in a Danish Neonatal Intensive Care Unit: a prospective studyACTA PAEDIATRICA, Issue 8 2009Anne L Olsen Abstract Aim:, The aim of this study was to estimate the incidence and identify independent risk factors for nosocomial infections in a Danish Neonatal Intensive Care Unit and to compare these findings with international results. Methods:, The study was performed prospectively from January 1, 2005 to December 31, 2005 in the Neonatal Intensive Care Unit at Rigshospitalet, Copenhagen. Specific criteria for blood stream infection and respiratory tract infection adapted for neonates in our ward were worked out. Results:, Six hundred and eighty-three patients were included. The overall incidence of nosocomial infection was 8.8/1000 hospital days. Blood stream infection was the most frequent type of infection, with an incidence of 5.1/1000 hospital days. Multivariate analysis showed gestational age and heart disease to be significant independent risk factors for both first time blood stream infection and respiratory tract infection, and central venous catheter and parenteral nutrition risk factors for first time blood stream infection. Conclusion:, This first prospective study of nosocomial infection in a Danish Neonatal Intensive Care Unit found an overall incidence of 8.8/1000 hospital days, which is low or similar compared to other studies. Further Danish multicentre studies are needed, and we suggest that procedures related to central venous catheters should be a future focus area. [source] Case Management Workforce in the United StatesJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2009Eun-Jun Park RN Abstract Purpose: The purpose of this study was to investigate and compare characteristics of the case management (CM) workforce in the US by age, years of experience, and original profession. Design: This study was an exploratory, descriptive secondary analysis of demographic and job characteristics of 24,085 certified case managers (CCMs). Methods: Descriptive statistics, Chi-square tests, and correlation coefficients were calculated. Findings: The majority of the case-management workforce is made up of RNs (93.3%). The CCMs were older, with a mean age of 55.0 years, than were those in their original profession and started to work as CCMs late in their careers. The educational level of RN-CCMs was lower than that of CCMs from other professions. Also, job titles and work settings of CCMs were diverse, with different focus areas depending on clients' needs. The distribution of CCMs was associated with the number of managed-care enrollees. Conclusions: Profiles of CCMs in this study are valuable for clinical practice and can assist with deployment of the CM workforce. Clinical Relevance: To develop and deploy CCMs better matched to societal healthcare needs, characteristics of CCMs should be precisely understood. Managing the CM workforce is expected to be critical because of a shortage of RN workers and aging-of-the-workforce issues in the US. [source] Implementation of a Coordinated School Health Program in a Rural, Low-Income CommunityJOURNAL OF SCHOOL HEALTH, Issue 9 2007BSHRM, Lisa Cornwell RN ABSTRACT Background:, Coordinated school health programs (CSHPs) bring together educational and community resources in the school environment. This method is particularly important in rural areas like Kansas, where resources and trained health professionals are in short supply. Rural Stafford County, Kansas, struggles with health professional shortages and a low-income, high-need population. Methods:, In 2001, Stafford County's Unified School District 349 began a multiyear CSHP development process, which required adaptations for implementation in a rural area. First, a CSHP team was formed of community and administrative stakeholders as well as school system representatives. Next, the CSHP team assessed school district demographics so the program framework could be targeted to health needs. During a yearlong planning phase, the CSHP team determined 4 priority areas for program development, as limited staff and funds precluded developing programs in all 8 traditional CSHP areas. Program activities were tailored to the population demographics and available resources. Results:, Program outcomes were supported by School Health Index (SHI) data. Of the 8 CSHP focus areas, the SHI found high scores in 3 of the Stafford CSHP's priority areas: Health Services; Psychological, Counseling, and Social Services; and Physical Education. The fourth Stafford CSHP priority area, Nutrition Services, scored similarly to the less prioritized areas. Conclusions:, The process by which the Stafford school district modified and implemented CSHP methods can serve as a model for CSHPs in other rural, high-need areas. [source] Hypertext support for the information needs of software maintainersJOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 3 2004Jussi Koskinen Abstract Making changes safely to programs requires program comprehension and satisfaction of the information needs of software maintainers. In this paper we provide insights into improving hypertext-based software maintenance support by analyzing those information needs. There exists a series of four earlier, detailed-level empirical studies on the information needs of professional C program maintainers. We focus on these studies, synthesize their results and determine sources from which the required information might be attained. An experimental research tool, the HyperSoft system, is used to demonstrate the satisfaction of information needs and the system is analytically evaluated against the needs explored by the empirical studies. HyperSoft is based on our transient hypertext approach for software maintenance support. HyperSoft provides automatically generated hypertextual access structures and software visualizations. The results show that transient hypertext is a well-suited representational form of the typically required versatile information. The discussion also covers related tools and the main features for providing the information required by maintainers are identified. The results show that the focus areas of these tools vary considerably. Copyright © 2004 John Wiley & Sons, Ltd. [source] Bivalve Shellfish Quality in the USA: From the Hatchery to the ConsumerJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 2 2010Daniel P. Cheney Shellfish aquaculture has had a long tradition in Asia, Europe, and the western USA, but it is only within the past century that significant cultural and handling practices have been identified, developed, and introduced to improve and enhance shellfish food quality. Shellfish are now being marketed with an emphasis on product quality, product variety, reduced human health risk, and improved ease of preparation. Aquacultured bivalve shellfish products must now have the food quality characteristics of other high-quality seafood products and must meet accepted standards of taste, color, texture, and odor. This review summarizes current efforts within the shellfish industry to improve the food quality of aquacultured bivalve shellfish in the following focus areas: (i) genetic selection and controlled breeding; (ii) production tools; (iii) food safety protection and enhancement; and (iv) processing and creative marketing efforts, with major emphasis on the US shellfish aquaculture sector. [source] Public Health Rural Health Priorities in America: Where You Stand Depends on Where You SitTHE JOURNAL OF RURAL HEALTH, Issue 3 2003Larry Gamm PhD Methods: Analysis of responses to a mail survey sent to 999 rural health leaders, with 501 responses. Respondents were asked to rank importance to rural health of focus areas named in Healthy People 2010 Findings: There was substantial agreement on top rural health priorities among state and local rural health leaders across the 50 states. "Access to quality health services" was the top priority among leaders of state-level rural agencies and health associations, local rural public health agencies, rural health clinics and community health centers, and rural hospitals. It was the top priority across all 4 major census regions of the nation as well. The next 4 top-ranking rural priorities,"heart disease and stroke,""diabetes,""mental health and mental disorders," and "oral health",were selected as 1 of the top 5 rural priorities by one third or more of respondents across most groups and regions. At the same time, some observed differences in rural health priorities suggest opportunities for community partnership strategies or for regional multistate policy initiatives by states sharing similar rural health priorities. [source] The Use of Health Care Policy to Facilitate Evidence-based Knowledge Translation in Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 11 2007Charlene B. Irvin MD Health care policy can facilitate emergency medicine knowledge translation (KT). Because of this, the 2007 Academic Emergency Medicine Consensus Conference on KT identified a specific theme regarding issues of health care policy and KT. Six months before the Consensus Conference, international experts in the area were invited to communicate on health care policies regarding all areas of KT via e-mail and "Google groups." From this communication, and using available evidence, specific recommendations and research questions were developed. At the Consensus Conference, additional comments were incorporated. This report summarizes the results of this collaborative effort and provides a set of recommendations and accompanying research questions to guide development, implementation, and evaluation of health care policies intended to promote KT in emergency medicine. The recommendations are to 1a) involve appropriate stakeholders in the health care policy process; 1b) collaborate with policy makers when health care policy focus areas are being developed; 2) use previously validated clinical practice guideline development tools; 3) address implementation issues during the development of health care policies; 4) monitor outcomes with performance measures appropriate to different practice environments; and 5) plan periodic reviews to uncover new clinical evidence, new methods to improve KT, and new technologies. To advance the further development of these recommendations, a research agenda is proposed. [source] | ||||||||||