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Biomedical subjects

Nancy Anderson

Publications and source records attributed to Nancy Anderson.

9 recordsLinked to original sources
PubMed2006

Developing a Web-based education and counseling program for heart failure patients.

This paper describes a 2-phase method utilized to develop and evaluate the feasibility of a Web-based program targeted to the specific learning needs of elderly patients with heart failure. In the first phase, informational resources specific to the needs of elderly patients were identified using aspects of participant-focused research. Data from 69 patients were obtained through a structured interview and later reviewed with health care providers and patient representatives. Items deemed important by the patients and health care providers were incorporated into the Internet-based program that was drafted for the study. The second phase of the process entailed obtaining data to support the acceptability and feasibility of the intervention by providing 12 patient volunteers access to the Internet-based program that was developed. After 2 weeks, the authors contacted the volunteers and asked them about their experiences with accessing and navigating the Web page. The authors found that elderly persons with limited computer skills can and will use Web resources to obtain information when given adequate instructions on how to access the Web pages.

Aged↗
PubMed2006

Ethanol-induced regulation of GABA-A subunit mRNAs in prefrontal fields of cynomolgus monkeys.

BACKGROUND: Recent evidence indicates that functional impairment of the orbital and medial fields of the prefrontal cortex may underlie the deficits in executive control of behavior that characterize addictive disorders, including alcohol addiction. Moreover, previous studies have indicated that alcohol alters GABA neurotransmission and one substrate of these effects may be through the reconfiguration of the subunits constituting the GABA(A) receptor complex. Given that GABAergic transmission has an integral role in cortical processing, influencing local and interregional communication, understanding alcohol-induced alterations in GABA(A) receptors in prefrontal fields of the primate brain may provide insight into the functional impairment of these brain regions in the alcohol-addicted state and extend our understanding of the molecular consequences of long-term use in these critical brain regions. METHODS AND RESULTS: To address this problem, the effects of chronic ethanol self-administration in male cynomolgus monkeys on GABA(A) receptor subunit mRNA expression was studied in 3 frontal cortical fields: orbitofrontal cortex (OFC; area 13), anterior cingulate cortex (ACC; area 24), and the dorsolateral prefrontal cortex (DLPFC; area 46). Quantitative polymerase chain reaction revealed significant alterations in GABA(A) subunit mRNA expression in the OFC and DLPFC but not in the ACC. Specifically, expression of the alpha2, alpha4, beta1, beta3, and gamma1 to gamma3 subunit mRNAs was significantly less in the OFC, whereas the expression of beta1, beta2, gamma1, and delta subunit mRNAs was less in the DLPFC of alcohol-treated monkeys. CONCLUSION: These findings suggest that ethanol-induced alterations in GABA(A) function may be due to alterations in GABA(A) subunit mRNA levels and subunit-specific alterations are selective to particular cortical fields.

Alcohol Drinking↗
PubMed2005

Good laboratory practices for waived testing sites: survey findings from testing sites holding a certificate of waiver under the clinical laboratory improvement amendments of 1988 and recommendations for promoting quality testing.

Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), simple, low-risk tests can be waived and performed with no routine regulatory oversight in physicians' offices and various other locations. Since CLIA was implemented, waived testing has steadily increased in the United States. Surveys conducted during 1999-2004 by the Centers for Medicare & Medicaid Services and studies funded by CDC during 1999-2003 evaluated testing practices in sites holding a CLIA Certificate of Waiver (CW). Although study findings indicate CW sites generally take measures to perform testing correctly, they raise quality concerns about practices that could lead to errors in testing and poor patient outcomes. These issues are probably caused, in part, by high personnel turnover rates, lack of understanding about good laboratory practices, and inadequate training. This report summarizes study findings and provides recommendations developed by the Clinical Laboratory Improvement Advisory Committee for conducting quality waived testing. These recommendations include considerations before introducing waived testing, such as management responsibility for testing, regulatory requirements, safety, physical and environmental requirements, benefits and costs, staffing, and documentation. They also cover good laboratory practices for the three phases of testing: 1) before testing (test ordering and specimen collection), 2) during testing (control testing, test performance, and result interpretation and recording), and 3) after testing (result reporting, documentation, confirmatory testing, and biohazard waste disposal). They are intended to be used by those who would benefit from improving their knowledge of good laboratory practices. Continued monitoring of waived testing, with a focus on personnel education and training, is needed to improve practices and enhance patient safety as waived testing continues to increase.

Certification↗
PubMed2005

The diabetes experiences of Aboriginal people living in a rural Canadian community.

OBJECTIVE: To optimise participation with Aboriginal people by sharing experiences of living with the challenges of diabetes in rural south-western Canada, and how these could be addressed. DESIGN: Qualitative content analysis of semi-structured and conversational interviews. SETTING: Diabetes health services in the Bella Coola Valley, British Columbia, Canada. SUBJECTS: Eight Nuxalk Nation participants, five women and three men, living with type 2 diabetes, were interviewed. Four of these participants, three women and one man, were engaged in six follow-up conversational interviews. MAIN OUTCOME MEASURES: The descriptive research explored experiences of Nuxalk people living with the challenges of diabetes, and how these could inform diabetes health services in culturally specific ways. RESULTS: Challenges included understanding the connections between (i) diabetes and western or traditional medicines; (ii) dietary changes, exercise and weight loss; (iii) how health professionals communicate and the relevance of what is said; (iv) having many life choices and the responsibility to choose; and (v) a belief in living day by day and an awareness of life cycles that may need to be broken. CONCLUSION: The study substantiated the fundamental necessity for diabetes health services to be inclusive of Aboriginal perspectives.

British Columbia↗
PubMed2005

Does having cesarean section capability make a difference to a small rural maternity service?

OBJECTIVE: To determine whether having cesarean section capability in an isolated rural community makes a difference in adverse maternal or perinatal outcomes. DESIGN: Retrospective study comparing population-based obstetric outcomes of two rural remote hospitals in northwestern British Columbia. One hospital had cesarean section capability; one did not. SETTING: Bella Coola General Hospital (with cesarean section capability) in Bella Coola Valley (BCV) and Queen Charlotte Islands General Hospital (without cesarean section capability) in Queen Charlotte City (QCC). PARTICIPANTS: Women who carried pregnancies beyond 20 weeks' gestation and who gave birth between January 1, 1986, and December 31, 2000. INTERVENTIONS: British Columbia Vital Statistics Agency data was used to compare obstetric outcomes in the two communities. A chart audit of local births at BCV and QCC was done to validate the vital statistics data. MAIN OUTCOME MEASURES: Perinatal death, newborn transfer to a tertiary care facility, birth weight, gestational age at delivery, mode of delivery, and Apgar score. RESULTS: The rate of preterm deliveries in QCC was higher (relative risk 1.41, 95% confidence interval 1.00 to 1.99; P = .047) than the rate in BCV. Otherwise, there were no differences in adverse maternal or perinatal outcomes in the two populations. In BCV, 69.8% of women delivered locally compared with 50.2% of women in the southern Queen Charlotte Islands (P < .001). CONCLUSION: Having local cesarean section capability is associated with a greater proportion of local deliveries and a lower rate of preterm deliveries.

Adolescent↗
PubMedDate not supplied

Health disparities among vulnerable populations: evolution of knowledge over five decades in Nursing Research publications.

BACKGROUND: Considerable attention has been focused recently on conducting research on the health disparities experienced by some Americans as the result of poverty, ethnicity, and/or marginalized social status. Nursing research has a major role to play in developing this body of knowledge. PURPOSE: The purpose of this paper is to review the contributions that Nursing Research made through its publications over the last five decades in developing the body of tested knowledge about health disparities in vulnerable groups and to analyze the progress made. METHODS: Criteria for reviewing the literature were established. All Nursing Research publications between 1952 and 2000 were searched manually, indexes of each year's bound volumes were reviewed, and computer searches were conducted. Included in the review were research reports, research briefs, and methodology articles. RESULTS: Seventy-nine papers were found that met basic criteria for inclusion. The number of relevant publications increased each decade, with a sizable increase in numbers since 1990, and may be related to the social, political, and economic climate of each decade. The research questions asked and the methods used became more complex over time. CONCLUSIONS: Nursing Research has made a significant contribution in disseminating the body of tested knowledge related to the health disparities experienced by vulnerable populations and the methodologies associated with vulnerable populations research. Areas for future research are community-based studies, intervention studies that provide tangible resources, and methodologic approaches that involve participants in the research process.

Attitude to Health↗
PubMedDate not supplied

Emergency department use and perceived delay in accessing illness care among children with Medicaid.

BACKGROUND: Children covered by Medicaid are at increased risk of emergency department (ED) utilization.Objective.-To examine whether an association exists between ED use and perceived delay in accessing acute care. DESIGN AND SETTING: Cross-sectional study. We used data from the Consumer Assessment of Health Plans Survey collected by Washington State Medicaid in 2000. We used multivariate logistic regression to determine the odds of any ED use, using a model that included whether the parent reported not always receiving illness care for the child as soon as wanted (perceived delay), age, gender, race/ethnicity, health status, presence of a special health care need, primary language, needing an interpreter, parental education, and having a regular provider. SUBJECTS: Parents of a random sample of children from 9 Medicaid managed care plans were surveyed if their children were <15 years old and enrolled at least 6 months. MAIN OUTCOME MEASURES: Any ED use in the past 6 months. RESULTS: The response rate was 56.3%, yielding 5142 subjects. Of children with illnesses in the previous 6 months, 69.1% of parents reported that their child always received care as soon as they wanted; 19.9%, 8.2%, and 2.8% reported usually, sometimes, and never, respectively. Not always (vs always) receiving illness care as soon as wanted was significantly associated with increased odds of any ED use (adjusted odds ratio: 1.79; 95% confidence interval: 1.35- 2.36). CONCLUSION: Children with managed care Medicaid are more likely to use the ED if parents perceive any delay in receiving illness care.

Child↗