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Biomedical subjects

M Ireland

Publications and source records attributed to M Ireland.

81 records · Page 5Linked to original sources
PubMedDate not supplied

New challenges, new answers: pediatric nurse practitioners and the care of adolescents.

INTRODUCTION: Since the 1950s, patterns of morbidity and mortality among adolescents have shifted to social and environmental causes. This study examines pediatric nurse practitioners' (PNPs') self-assessed competencies in addressing the common health concerns of adolescents. METHOD: The analysis used a sample of 257 PNPs drawn from a larger national data set of 637 nurses randomly sampled from 3 nursing organizations. Factors associated with self-perceived knowledge or skill and interest in training for 28 common health concerns of adolescents were analyzed using Chi square, t test, and Pearson's correlation. Barriers and attractions to working with adolescents were also investigated. RESULTS: The greatest deficits in self-perceived knowledge or skill, as well as low interest in training and low perceived relevance to practice, were around issues of gangs, gay/lesbian/bisexual/transgender youth, HIV/AIDS, and counseling about a positive pregnancy test. Also, PNPs identified the lack of resources appropriate for adolescent referrals as the greatest barrier to working with this population. DISCUSSION: PNPs assessed their lowest competencies in some of the areas that present the greatest threats to adolescents' health and well-being. These deficits suggest needed curricular shifts in entry-level and advanced-level preparation of PNPs, as well as new priorities for continuing education.

Adolescent↗
PubMedDate not supplied

Therapeutic touch with HIV-infected children: a pilot study.

In this pilot study, 20 HIV-infected children, 6 to 12 years of age, were randomly assigned into therapeutic touch (TT) and mimic TT groups. The effectiveness of TT in reducing anxiety was evaluated. The self-report measure, the A-State Anxiety subscale of the Spielberger State-Trait Anxiety Inventory For Children, was administered before and immediately after interventions. As predicted, the TT intervention resulted in lower overall mean anxiety scores, whereas the mimic TT did not. These findings provide preliminary support for the use of TT in reducing the state anxiety of children with HIV infection.

Analysis of Variance↗
PubMedDate not supplied

Pressor effect of moderate alcohol consumption in man: a proposed mechanism.

Ingestion of alcohol was associated with a highly significant increase in systolic blood pressure and heart rate which occurred before the blood alcohol reached its peak concentration of 16.9 (s.e.m. = 1.1) mol/1. Drinking non-alcoholic cold liquids caused a marked but transient fall in adrenaline and a rise in noradrenaline concentration. Alcohol prevented this fall in adrenaline and led to a sustained increase in noradrenaline concentration. These changes may be implicated in the elevation of blood pressure associated with alcohol consumption.

Adult↗
PubMedDate not supplied

After hours care--a qualitative study of GPs' perceptions of risk of violence and effect on service provision.

BACKGROUND: Workplace violence in general practice has been found to be an important problem in the United Kingdom. No research has been undertaken in this area in Australian urban practice. METHOD: Four focus groups involved 18 urban general practitioners and over 9 hours of taped responses were transcribed. The transcripts were coded and subjected to thematic analysis. RESULTS: General practitioners expressed a wide range of risks relating to the provision of after hours care. This makes them apprehensive about participating in it. Those who had experienced violence, or perceived its risk, had limited their participation in after hours care; sometimes completely. DISCUSSION: Structures may be needed to support provision of after hours general practice services.

Adult↗
PubMedDate not supplied

Taking health status into account when setting capitation rates: a comparison of risk-adjustment methods.

OBJECTIVE: To compare performance of different health status measures for risk-adjusting capitation rates. DESIGN: Cross-sectional study. Health status measures derived from 1 year were used to predict resources for that year and the next. SETTING: Group-network health maintenance organization in Minnesota. PARTICIPANTS: Sample of 18- to 64-year-old (n=3825) and elderly (aged > or = 65 years; n=1955) members enrolled in a network-model health maintenance organization in Minnesota. MAIN OUTCOME MEASURES: Total expenditures in the year concurrent with the health status survey (July 1991 through June 1992) and total expenditures in the year following the survey (July 1992 through June 1993). RESULTS: Capitation adjustment based on demographic measures performed least well. Both self-reported health status measures and diagnoses predicted future expenditures twice as well as demographics. When predicting costs for groups of patients rather than individuals, the demographic model worked well for average groups but tended to overpredict healthier groups and underpredict sicker groups. Ambulatory Care Groups based on diagnoses performed better than self-reported health status both in the retrospective models and across healthier and sicker groups. CONCLUSIONS: Without risk adjustment, capitation rates are likely to overpay or underpay physicians for certain patient groups. It is possible to improve prediction using health status measures for risk adjustment. When selection bias is suspected and administrative data are available, we recommend a risk-adjustment method based on diagnostic information. If diagnostic data are not available, we recommend a system based on simple self-reported measures, such as chronic conditions, rather than complex functional status measures.

Adult↗
PubMedDate not supplied

Women find their voices. The success of community outreach and case finding.

Families in transition (FIT), a joint program between Beth Israel Medical Center (BIMC) and National Development and Research Institutes, Inc., uses indigenous neighborhood women, Compañeras (companions), to conduct street outreach in a New York City neighborhood where HIV infection is rampant. The outreach workers inform people that, not only will they be assisted in talking about HIV and guardianship for their children, but that they will be provided information concerning access to food stamps, housing, health care, and other basic needs. Through community participation, the Compañeras empower themselves through knowledge making and sharing and, in the process, create conditions in which other women can began to effect changes in their individual lives and families. The ultimate goal of the project is to support HIV-infected women in finding their voices so that they can talk with their children and plan for their futures.

Community Health Nursing↗