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Biomedical subjects

Cheryl Anderson

Publications and source records attributed to Cheryl Anderson.

12 recordsLinked to original sources
PubMed2005

Combined effects of venlafaxine, nicotine replacement, and brief counseling on smoking cessation.

In this study, 147 smokers were randomly assigned to receive either venlafaxine or placebo in conjunction with behavioral counseling (9 weekly sessions) and transdermal nicotine replacement therapy (22 mg/day). Patients began medication 2 weeks before quitting and continued for 18 weeks after quitting, with the daily dose titrated from 150 to 225 mg. in response to symptoms of negative affect and relapse. The results showed no main effect of treatment on abstinence. Post hoc analysis revealed that both at the end of treatment and at the 1-year follow-up smokers consuming less than a pack of cigarettes a day benefited from the addition of venlafaxine to the treatment regimen. Venlafaxine also reduced negative affect for all smokers for up to 6 weeks postcessation. The findings suggest that venlafaxine could have some role to play in the treatment of lighter smokers, in addition to the expected benefits of nicotine replacement therapy and behavioral counseling.

Administration, Cutaneous↗
PubMed2005

Trauma system structure and viability in the current healthcare environment: a state-by-state assessment.

OBJECTIVE: Anecdotal reports suggest that some state trauma systems are struggling to remain solvent while others appear stable in the current health care environment. The purpose of this research is to characterize the current structure and viability of state trauma systems in the U.S. METHODS: Expert panels were convened in all 50 states to characterize the current structure of trauma care and to identify strengths, weakness, opportunities and threats facing trauma care delivery in each state. RESULTS: States continue to value the formalization of trauma systems. System operations, evaluation/research methods and trauma leadership are highly valued by states with mature systems. However, all states consider their trauma system severely threatened by inadequate funding and difficulty recruiting and retaining physicians and nurses. CONCLUSION: Trauma care systems are valued and demonstrate potential for future expansion. However, economic shortfalls and retention of medical personnel threaten the viability of current systems across the U.S.

Health Services Research↗
PubMed2003

Report of workplace violence by Hispanic nurses.

Workplace violence (WPV) against nursing professionals is common. This pilot study explored the association between WPV and victim characteristics including the interpersonal risk factor of prior childhood or adult violence and gender characteristics among 90 Hispanic nurses practicing in Texas. Personal factors such as the nurses' age, clinical setting worked, years of experience, and basic education were not found to be associated with WPV. Gender and a history of violence were found to be significantly associated with WPV. Recommendations include recognition of history of childhood and/or adult violence and gender as risk factors in orientation and health care-training programs for violence prevention.

Adult↗
PubMed2003

Evolving out of violence: an application of the Transtheoretical Model of Behavioral Change.

Ending violent relationships can be a difficult and lengthy process. Women use a variety of coping activities, with change generally proceeding in a non-linear direction. Nurses may not recognize this behavior pattern and may expect more from a woman experiencing violence than she is currently able or willing to achieve, thereby hampering change. Studying behavioral patterns of change by women experiencing intimate partner violence (IPV) was explored through the stages and processes of change conceptually defined within the Transtheoretical Model (TTM). Using a Delphi technique, the TTM was tested with four White, professional women reporting past IPV. Original stages and processes of change were reviewed and modified to fit the woman's experience. Research findings supported the TTM as a useful guide to alert health care professionals of the readiness level of women experiencing IPV and determine effective interventions.

Adaptation, Psychological↗
PubMed2002

Workplace violence: are some nurses more vulnerable?

Workplace violence pervades the healthcare setting. This study describes workplace violence events (WPVE) by type, frequency, perpetrator, and contributing factors and explores the relationship between WPVE and a history of childhood/adult abuse. Sixty-seven randomly selected registered nurses responded to the study. Both closed and open-ended responses were obtained. The majority of nurses experienced WPVE, typically emotional and verbal events. Physicians were commonly the perpetrators. Contributing factors included drugs, poor staffing, hospital location, gangs, easy access to triage, long hours worked, no training, power/control, stress, and negative characteristics of perpetrators. Over half of the nurses reported being victims of childhood or adult abuse; this abuse history was found to influence type (sexual and physical), frequency, and timing of WPVE. In an effort to prevent and reduce the frequency of WPVE, risk assessments of all health care environments should be made, followed with education discussing prevalency, type of WPVE, perpetrators, and contributing factors, including past victimization.

Adult↗
PubMed2002

Past victim, future victim?

To effectively reduce and prevent workplace violence, nurse managers can offer training sessions that include assessing risk for past and current victimization.

Adult↗
PubMedDate not supplied

Training efforts to reduce reports of workplace violence in a community health care facility.

The objective of this study was to measure reports of workplace violence (WPV) after an online training program on WPV for health care workers. Recognition of the prevalence of WPV (physical, emotional-verbal, and sexual) suggests a great need for employers to provide training to all health care workers as a first-line effort to reduce or prevent WPV. A 3-hour online training program for WPV was offered to 43 workers attending an informational session. Volunteers included 22 participants designated for training and 21 volunteers designated to serve as control subjects. Pretraining WPV work area assessments were completed by all participants and compared between training participants and control subjects. At 6 months, comparisons were made between 3 groups: Group A, those who completed the training; Group B, control subjects; and Group C, those who did not complete the training within the designated period. Group C was defined as a separate group because some participants within this group were workers from the same work areas as were Group A participants. Comparisons of preassessments and postassessments of WPV for Group A and assessments of WPV across the three groups were made. Participants reported 200 WPV events over a 6-month period before training. Pretraining reports of WPV were statistically different between training participants and control subjects for total and emotional-verbal WPV events. At 6 months after the training, a reduction in sample size and reports of all types of WPV was noted across the three groups (i.e., those who completed the training, those who did not complete it, and control subjects). Owing to the small number of reported physical and sexual WPV events, only total and emotional-verbal WPV events were examined. No difference was noted between the three groups for total events; however, emotional-verbal abuse was statistically significant between the groups. In addition, a statistically significant difference was noted among participants before and after the completion of the online training. Despite the reported prevalence of WPV, a significant number of health care workers did not make training a priority. Participants who were designated for training and who subsequently completed it reported the most number of events before and after training. Proportionately per number of participants after training, fewer total WPV events were reported; however, because of the attrition rate and group sample size, significance was not reached. Reports of emotional-verbal abuse remained high after training, which could suggest a heightened awareness of this type of WPV with a personal redefinition of WPV or a heightened staff and administration sensitivity to reporting. Although differences existed among training participants and control subjects before training, significance could not be achieved among the three groups owing to validity threats, including subject mortality, diffusion between groups, selection bias, and small sample size. However, the finding that training can make a difference is important and encourages replication of this study with a larger sample size and a larger setting. Finding high rates of emotional-verbal abuse across work areas and support for training benefits enhance the need for training programs with an increased focus on emotional-verbal WPV.

Adult↗
PubMedDate not supplied

Public health preparedness for mass-casualty events: a 2002 state-by-state assessment.

INTRODUCTION: The ongoing threat of a terrorist attack places public agencies under increasing pressure to ensure readiness in the event of a disaster. Yet, little published information exists regarding the current state of readiness, which would allow local and regional organizations to develop disaster preparedness plans that would function seamlessly across service areas. The objective of this study is to characterize state-level disaster readiness soon after September 2001 and correlate readiness with existing programs providing an organized response to medical emergencies. METHODS: During the first quarter of 2002, a cross-sectional survey assessing five components of disaster readiness was administered in all 50 states. The five components of disaster readiness included: (1) statewide disaster planning; (2) coordination; (3) training; (4) resource capacity; and (5) preparedness for biological/chemical terrorism. RESULTS: Most states reported the presence of a statewide disaster plan (94%), but few are tested by activation (48%), and still fewer contain a bioterrorism component (38%). All states have designated disaster operations centers (100%), but few states have an operating communications system linking health and medical resources (36%). Approximately half of states offer disaster training to medical professionals; about 10% of states require the training. Between 22-48% of states have various contingency plans to treat victims when service capacity is exceeded. Biochemical protective equipment for health professionals is lacking in all but one state, and only 10% of states indicate that all hospitals have decontamination capabilities. States with a functioning statewide trauma system were significantly more likely to possess key attributes of a functioning disaster readiness plan. CONCLUSION: These findings suggest that disaster plans are prevalent among states. However, key programs and policies were noticeably absent. Communication systems remain fragmented and adequate training programs and protective equipment for health personnel are markedly lacking. Statewide trauma systems may provide a framework upon which to build future medical disaster readiness capacity.

Bioterrorism↗
PubMedDate not supplied

Benefits of comprehensive inpatient education and discharge planning combined with outpatient support in elderly patients with congestive heart failure.

Multidisciplinary disease management programs for congestive heart failure have been shown to substantially reduce readmission rates, resulting in a reduction of costs. These interventions, however, have typically included changes in medical management, making it difficult to quantitate the key elements of a successful program involving education, discharge planning, and transitional care in the outpatient setting. The investigators utilized an experienced cardiac nurse educator to coordinate a targeted inpatient congestive heart failure education program coupled with comprehensive discharge planning and immediate outpatient reinforcement through a coordinated nurse-driven home health care program. The comprehensive intervention resulted in a marked reduction in 6-month readmission rates, from 44.2% to 11.4% (p=0.01). The average total cost saving for each subject in the interventional group was $1541, based on the decreased utilization of both skilled nursing services and home health care during outpatient follow-up. The costs to implement an inpatient education program were negligible, at $158 per subject. There was no difference in discharge medications or medical management protocols that would have influenced these results.

Aged↗