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Biomedical subjects

C Michaels

Publications and source records attributed to C Michaels.

11 recordsLinked to original sources

Leading beyond traditional boundaries: a community nursing perspective.

As a nursing leader, I frame my personal and professional life from the perspective of community. I place high value on health, relationship and the art of nursing. As Director of Community Outreach for an integrated delivery network, I use these values to strengthen nursing's contribution to an integrated delivery network and managed care contracts. Most recently, my personal and professional life has been shaped by traditional Indian medicine and my 10-year experience in Carondelet's community-focused nursing practices.

Case Management↗

Measuring beliefs about orthodontic treatment: a questionnaire approach.

OBJECTIVES: Few studies have examined what parents and orthodontists expect from and value about orthodontic treatment. In this study, we designed and tested a questionnaire to outline what drives consumer demand for children's orthodontic care. Further, we present data from the questionnaire to illustrate how expectations and values pertaining to orthodontic treatment relate to sociodemographic variables. METHODS: Subjects were 220 Pennsylvania orthodontists and 220 parents at a university orthodontic clinic who were administered a questionnaire designed to assess what parents and orthodontists value about and expect from orthodontic treatment. Items for the questionnaire were developed via a qualitative, telephone interview process. Data were analyzed using factor analysis and reliability analysis for scale development, and analysis of variance for preliminary validity assessment. RESULTS: Through factor analysis, the questionnaire was reduced from 84 to 52 items, and eight scales were examined: expected treatment benefits, expected treatment risks (short- and long-term), expected treatment inconveniences, value of treatment benefits, value of risks (short- and long-term), and value of treatment inconveniences. For parents, the reliability for all scales was in the acceptable range. For orthodontists, only the "short-term risks" scale failed to attain an acceptable reliability. Preliminary validity was assessed through examining relationships between demographic variables and subscale scores. For parents, income, father's education level, and sex of respondent were related to treatment expectations and values. For orthodontists, age, sex, and patient volume were related to treatment values. CONCLUSIONS: The questionnaire developed in the present study was found to be practical and reliable for use with providers and consumers of orthodontic care and can be used to explore factors affecting the demand for orthodontic care. Implications of possible unrealistic treatment expectations on the part of orthodontists and parents also are discussed.

Adolescent↗

Advanced practice nursing in community: nursing's opportunity.

This article explicates the concept of community as the relational processes that constitute a coming togetherness and explores the role of advanced practice nursing in community. Community as process and health as process are described from the theoretical perspectives of Parse's nursing theory of human becoming and Newman's theory of health as expanding consciousness. Advanced practice nurses, in engaging with community, participate in a nurse-person-community-health process. This engagement occurs in the reality of managed health care. The focus of advanced practice nursing in community is health, wholeness, and quality of life. To participate with presence in the nurse-person-community-health process is viewed as nursing's opportunity.

Community Health Nursing↗

Word skills of children normal and impaired in communication skills and measures of language and speech development.

Results from two related investigations are reported, one using 60 normal language learners, ages 3-5 and one using 34 children with communication disorders, ages 5.4-8.5. Tasks involving the sequential recall of words from five categories (nouns, verbs, adjectives, adverbs, and prepositions) were given to the subjects in each investigation, thus providing an opportunity to compare group performances. A hierarchy of recall strengths of words from different categories and the organizational pattern of scores was determined for each group. Each group's word category scores were used as independent variables in regression analyses to predict scores from a battery of language tests and a test of phonology. The results were anticipated to be capable of contributing to descriptions of children's mental dictionaries, have implications for word category differences in normal and impaired language learners, and clinical relevance. Comparisons of the word recall accuracy of skills of children from each group revealed that the younger normal Ss had word scores equal to the older language and speech impaired children. However, the hierarchy of word category strengths and the patterns of organization within each group's mental dictionary were essentially the same in both groups. Word category scores predicted language and speech scores in both investigations, but the prediction was stronger in the children having impaired language or speech.

Child↗

Carondelet St. Mary's nursing enterprise.

We began our nursing enterprise believing that nurses could enhance their contribution to health care. Our first step was charging for nursing services within Carondelet St. Mary's hospital walls. Across the country, few nursing departments bill separately for service. We believed this change was a bold step, but given our professional practice foundation, we also felt prepared to take that step. Our enterprise has expanded to a nursing network linked by NCMs. We offer professional nursing services within and beyond the hospital walls. Our boldest step has been to create the nursing HMO, which enables nurses to design and implement a full range of community nursing service, be reimbursed on a capitation basis, and demonstrate high-quality and cost-effective service for people at risk in managing their health concerns. Reflecting on our experience in creating a nursing enterprise, we find ourselves rooted in the essence of nursing. True to our professional mandate, we based our endeavor on service, not on profiting as a business. At the same time, we honored our holistic underpinnings. We matched our services to health needs expressed by people in the hospital and community, not on what we thought they should need. Founded on a belief in health as an expression of body, mind, and spirit, we believe that our approach has helped people to assume greater responsibility for themselves. Bringing us full circle, from service to outcomes, we believe that our enterprise, overlaying the business of nursing on the service of nursing, has enabled us to orchestrate our professional nursing services with nurses as conductors, as well as players.

Arizona↗

Nurse case management. The coming together of theory and practice.

Newman proves that theory can be a practical approach to nursing care delivery by applying a theory to the new nursing role of the case manager. The illustration applies Newman's theory of health and nursing and looks at its implications for various aspects of provider interface.

Continuity of Patient Care↗

Some viscoplastic characteristics of bovine and human cortical bone.

Multiple cycle tensile creep tests were performed on human and bovine cortical bone specimens. The tests enabled total strain to be decomposed into elastic, linear viscoelastic, creep and permanent plastic components. The results indicate that a stress threshold exists; above which time dependent effects dominate material response and below which the behavior is primarily linear viscoelastic, with time effects playing only a secondary role. A constant stress above the threshold produces a constant steady state creep rate, with the magnitude of the creep rate being an exponential function of the stress magnitude. Additionally, it was found that a major portion of the inelastic strain is always recovered on unloading and that the accumulation of creep strain increases the material compliance on subsequent loadings below the threshold. These two factors suggest that a damage mechanism is responsible for the nonlinear behavior.

Adult↗