ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The Centers for Disease Control and Prevention and the American College of Sports Medicine have issued a recommendation for physical activity to achieve health promotion and disease prevention. The recommendation signals a shift in the exercise-fitness paradigm to emphasize the relationship between physical activity and health. A distinction is made between scheduled vigorous exercise and intermittent moderate physical activity. Moderate physical activity, which can include occupational, household, and recreational activity, is recommended for all Americans. Contrary to previous beliefs, one no longer needs to adhere to a rigid schedule of vigorous exercise to achieve health benefit. Through the promotion of physical activity, primary care practitioners have an opportunity to significantly impact the nation's public health. Strategies to help clients achieve the desired activity levels are needed. Careful assessments and creative strategies will help clients meet the physical activity objective.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Obesity is a common nutritional disturbance of children and affects 25% to 30% of children and adolescents. This paper examines obesity in childhood, the measurement of obesity in children, and the relationship of obesity to coronary heart disease risks and discusses weight reduction issues in children. Clinically useful definitions of obesity in children have not been established, although the body mass index, together with anthropometric measurements, may provide the practitioner with useful assessment parameters. Discussions of weight in children must acknowledge the nutritional requirements of the normally occurring growth process. Because growth (and subsequently weight) varies widely among children even of the same age, measurement, classification, and control of weight must take into account the growth process and growth requirements. Interventions in childhood obesity should be directed toward family involvement in the chosen strategy and nutritional prudence coupled with typical activity.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Coronary heart disease remains the number one cause of death In the American population. The Framingham Heart Study and other epidemiologic studies have demonstrated a direct relationship between elevated total and low-density lipoprotein cholesterol in the development of cardiovascular disease. This article focuses on secondary prevention, demonstrating that decreased cholesterol has a wide range of benefits in patients with cardiovascular disease. Emphasis is placed on the Scandinavian Simvastatin Survival Study which reported a 30% reduction of total mortality in a population of 4,444 patients with coronary heart disease who were treated with an HMG-CoA reductase inhibitor. The National Cholesterol Education Program guidelines for cholesterol risk reduction are reviewed. The Impact of the health care provider as related to adherence and medication is discussed. Outcome issues of cost-effectiveness and resource utilization relating to cholesterol reduction are emphasized.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Although heart failure secondary to left ventricular systolic dysfunction remains a serious disease with high morbidity and mortality, pharmacologic Intervention has been shown to be associated with improved survival and a decreased number of hospitalizations. Primary-care providers must be aware of the potential benefits of recent therapeutic advances and current treatment recommendations for patients with heart failure to receive optimal care. Important aspects of nonpharmacologic care are dietary restrictions, exercise training, and thorough patient education and counseling. Pharmacologic therapy includes diuretics, angiotensin-converting enzyme inhibitors(ACE) and other vasodilating agents, and digoxin. ACE Inhibitors are currently recommended for all patients with left ventricular dysfunction in whom use of these agents is not contralndicated. The mortality and morbidity from heart failure even with ACE inhibitors remain high, however. Promising clinical findings with such investigational agents as vesnarinone and pimobendan and the new-generation beta-blocker carvedilol suggest future new treatments to further improve the prognosis of these patients.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This article provides a thorough update of second licensure for advanced practice nurses. The National Council of State Boards of Nursing (NCSBN) has proposed new requirements for legislation and licensure for advanced practice nurses. This proposal could have major repercussions for all advanced practice nurses, depending on whether the state boards of nursing adopt the council's recommendation. A review of the historical aspect and the development of nursing licensure is reported. Both the 1992 and 1995 second licensure proposals are analyzed. Support for and dissent against the proposals by nursing organizations and Individuals in the nursing community are included. The current status of the proposal for second licensure by the National Council of State Boards of Nursing is highlighted.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Primary care providers are faced with numerous challenges when prescribing drugs for elderly patients. Multiple drug use, coexisting Illness, and normal physiologic changes associated with aging place older persons at increased risk for adverse drug reactions (ADRs). Sample selection bias in drug clinical trials and inappropriate prescribing of contraindicated drugs contribute to the risk profile. Because multiple drug use and ADRs are relatively common in the elderly, special caution should be used when prescribing for this population. The primary care provider should have a good understanding of the factors that put the elderly at increased risk for ADR, the classes of drugs inappropriate for elderly patients, the physiologic changes of aging that may produce an altered pharmacologic response, and the issues associated with adherence to drug therapy. This article Identifies factors that contribute to ADRs In the elderly and proposes strategies to reduce or avoid risk. Identifying and preventing ADRs in older Americans is a Healthy People 2000 health protection goal, perhaps more important given projected demographics over the next 20 to 30 years.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID