Papers by Patricia Alpert
Biological Research For Nursing, Jul 1, 2004
Heart disease is the leading cause of death in both men and women in industrialized countries. De... more Heart disease is the leading cause of death in both men and women in industrialized countries. Despite the tremendous gains made in decreasing the number of deaths due to cardiovascular disease, it still is health care's greatest challenge. Traditional risk factors account for only 50% of the incidence of cardiac disease. In fact, many individuals who develop heart disease have normal cholesterol and blood pressure levels. This suggests that other less well-studied risk factors may also play a role. The purpose of this report is to examine the role that recently suggested risk factors may play in the development of heart disease: coronary artery infection, specifically from Chlamydia pneumoniae, and elevated iron levels. Both initiate an inflammatory response, which might explain the elevated C-reactive protein levels frequently found in those who suffer from cardiac disease.
Journal of Nursing Education and Practice, Dec 20, 2016
Objective: Nurses are charged with providing quality care to all patients. In part, as a result o... more Objective: Nurses are charged with providing quality care to all patients. In part, as a result of current and projected demographic changes in the United States, as well as the varying needs and circumstances of individual patients, nurses are faced with the challenges of providing culturally competent care. Preparing to care for a culturally diverse population begins during the teaching/learning process in the nursing curriculum. The aim of the study was to determine which teaching method(s) (stand-alone course on culture, integration of cultural concepts, cultural immersion) is/are the best predictor(s) of cultural competence after graduation. Methods: This study utilized a national sample. The target population was recent nursing graduates from programs accredited by the CCNE and ACEN in the U.S. A total of 126 cases (n = 126) were included in the final analysis. A survey method was used to collect data at one timepoint within 12 months of graduation. This study explored the difference between specified demographic variables and perceived level of cultural competence. This study also explored the differences in perceived level of cultural competence with and without a stand-alone course, integration of cultural concepts versus no integration, and with and without cultural immersion. Additionally, each variable was examined for their predictive ability and all study variables were analyzed simultaneously to assess their unique contribution to explaining the variance of perceived level of cultural competence. Results: Findings revealed variables that had a significant effect on perceived level of cultural competence were race/ethnicity, number of months practicing as a graduate nurse, and participation in a cultural immersion experience. Conclusions: Implications for nursing education include: (a) enabling faculty members to plan teaching methods pertaining to cultural content; (b) preparing graduates who are better able to serve the needs of current health care consumers with diverse backgrounds; and (c) determining a starting point for further research related to cultural competence.
Home Health Care Management & Practice, Jun 8, 2014
Annually, approximately 40,000 individuals die from vaccine preventable diseases such as influenz... more Annually, approximately 40,000 individuals die from vaccine preventable diseases such as influenza, pneumococcal, and hepatitis B infections. Based on the Healthy People 2020 goals, vaccination rates for adults aged 19 years and older are abysmal. Barriers to immunizing adults are identified and evidence-based strategies to improve vaccination rates are addressed.
Home Health Care Management & Practice, Dec 8, 2014
Polypharmacy is being practice in greater force today than it was 20 years ago. There are many re... more Polypharmacy is being practice in greater force today than it was 20 years ago. There are many reasons for this practice, including (1) the availability of a greater number of newer medications to treat a wider range of conditions, (2) aging population that is notorious for taking multiple medications, and (3) practice guidelines that advocate for the use of more than one drug to treat recalcitrant conditions. A closer look at the issues surrounding the practice of polypharmacy is discussed here.
The journal of doctoral nursing practice, 2016
Purpose:To discuss hypoplastic left heart syndrome (HLHS) and inform nurse practitioners (NPs) wo... more Purpose:To discuss hypoplastic left heart syndrome (HLHS) and inform nurse practitioners (NPs) working in primary care settings of this rare congenital heart deformity. This case study also examines the ethical issues advancements in medicine poses and illustrates issues NPs face when caring for a child with HLHS.Data Source:Large databases such as PubMed and CINAHL were accessed to obtain evidence-based articles for the specific heart condition and latest treatments. The data from the case was derived from an actual case, but the identity of the patient was changed to assure confidentiality.Conclusion:HLHS is a rare congenital heart deformity. Many treatment options are available, but a new treatment, the hybrid palliation, has offered new hope for many patients and their families.Implication for Practice:Patients with congenital heart conditions, including HLHS are living longer with new procedures being undertaken. The NP is likely to provide primary care to patients with congenital heart conditions, specifically HLHS. Patient care may be guided by awareness of this condition and the latest advancements in treatment.
The journal of doctoral nursing practice, 2016
Purpose: To provide information on how the stages of change theory can be initiated using a case ... more Purpose: To provide information on how the stages of change theory can be initiated using a case study of a 64-year-old African American woman with metabolic syndrome. A questionnaire on lifestyle modifications operationalizes the stages of change theory and the case patient illustrates the process of change using this questionnaire. Data Source: An exhaustive literature review was conducted on the stages of change theory. The questionnaire used in the clinical setting presented as part of this case study encapsulates the stages of change theory after being modified from a similar tool used by the Ohio Department of Health Fresh Start Program. Conclusion: Using an objective tool to assess progress made by this case patient demonstrates the value of being able to monitor lifestyle modifications for patients with chronic diseases. Significance for Practice: This questionnaire provides a means to assess change over time and can help both patient and provider identify outcomes of treatment.
Home Health Care Management & Practice, Jul 8, 2016
A common debilitating condition in older adults which impact their level of independence involve ... more A common debilitating condition in older adults which impact their level of independence involve conditions interfering with the ability to walk freely. Podiatric conditions develop over decades of wearing ill-fitted shoes, heels or as a result of chronic systemic conditions which impact the feet. This article will discuss the most common podiatric conditions frequently observed in older adults and steps that home health care providers should take to eliminate the threat of impaired mobility
Home Health Care Management & Practice, May 12, 2015
Food as medicine is as old as the beginning of time but somehow as we moved into the modern era, ... more Food as medicine is as old as the beginning of time but somehow as we moved into the modern era, foods were no longer looked upon as healing elements until the resurgence in natural healing took hold several decades ago. Here we examine three foods that suggest potential medicinal properties validated by immerging research.
Home Health Care Management & Practice, Sep 1, 2017
La presente investigación tuvo como objetivo explorar si está presente el sentimiento de soledad,... more La presente investigación tuvo como objetivo explorar si está presente el sentimiento de soledad, en adultos mayores de Molas, Yucatán, asà como conocer la percepción y significado que tiene para ellos. Se consideraron aspectos como la familia, relaciones interpersonales, cultura, sentimientos, emociones, situación laboral como posibles factores involucrados en la percepción del sentimiento de soledad. Se realizaron entrevistas a 25 personas para la recolección de información. En los resultados obtenidos, se encontró que el sentimiento de soledad no se encuentra presente en los participantes debido a la cultura de la localidad y la cercanÃa de sus familiares y amigos.
Biological Research For Nursing, Jul 1, 2004
Heart disease is the leading cause of death in both men and women in industrialized countries. De... more Heart disease is the leading cause of death in both men and women in industrialized countries. Despite the tremendous gains made in decreasing the number of deaths due to cardiovascular disease, it still is health care’s greatest challenge. Traditional risk factors account for only 50% of the incidence of cardiac disease. In fact, many individuals who develop heart disease have normal cholesterol and blood pressure levels. This suggests that other less well-studied risk factorsmay also play a role. The purpose of this report is to examine the role that recently suggested risk factors may play in the development of heart disease: coronary artery infection, specifically fromChlamydia pneumoniae, and elevated iron levels. Both initiate an inflammatory response, which might explain the elevated C-reactive protein levels frequently found in those who suffer from cardiac disease.
Home Health Care Management & Practice, Jun 6, 2017
It has long been recognized that individuals living in poverty who suffer from malnutrition are m... more It has long been recognized that individuals living in poverty who suffer from malnutrition are more susceptible to infections and certain diseases due to deficiencies in macronutrients such as proteins, lipids, and carbohydrates. More recently, it has come to light that micronutrients such as several vitamins and minerals also play major roles in boosting the immune system to protect against certain infections, inflammation, and possibly some cancers. This article discusses the various immune boosting properties of several micronutrients.
Home Health Care Management & Practice, Sep 18, 2015
With the advances made in modern medical treatments older adults are living longer. Approximately... more With the advances made in modern medical treatments older adults are living longer. Approximately 80% have at least one chronic disease condition, which can affect their independence and quality of life if not managed appropriately. Much of chronic disease care centers on patients attending to lifestyle modifications and sustaining non-medical care routines. Consistent self-management is difficult to sustain. This article discusses some of the most frequently used integrative approaches to help patients manage their own disease condition.
Home Health Care Management & Practice, Jul 8, 2008
Clinical Nursing Research, Jul 30, 2014
Knee osteoarthritis (OA) affects approximately 1 in 10 adults in the United States, with higher p... more Knee osteoarthritis (OA) affects approximately 1 in 10 adults in the United States, with higher prevalence in women, aggravated by increased weight. This quasi-experimental pilot study implemented an online self-management (SM) program for older overweight and obese women with knee OA combined with a two-arm progressive exercise trial (walking and stepping groups). After the 10-week intervention using an interprofessional approach, activation to SM scores were significantly higher in all participants (N = 16) and between groups, with a higher increase in the stepping group. Those with higher activation scores pre-intervention obtained higher scores post-intervention. Activation levels also increased significantly among all participants with majority at the highest activation level. Follow-up data at 6 weeks and 6 months showed sustained SM and health-directed behaviors. These findings, although preliminary, highlight the value of combined SM and progressive exercise intervention using an interprofessional approach. Further investigations are essential toward potential practice and policy changes.
Home Health Care Management & Practice, Jul 14, 2015
Many older adults across all settings are on antipsychotic medications; all too frequently for lo... more Many older adults across all settings are on antipsychotic medications; all too frequently for long periods of time. There are very few studies about the long-term effects of these medications, especially when used in those with declining physiological ability to metabolize medications. This paper looks at the three most commonly prescribed classes of antipsychotic medications used in older adults. A second purpose is to increase knowledge and potential strategies home health nurses can use to help their patients.
Home Health Care Management & Practice, Dec 7, 2015
The discovery of the prostate specific antigen (PSA) was a landmark achievement of the 20th centu... more The discovery of the prostate specific antigen (PSA) was a landmark achievement of the 20th century according to the American Cancer Society. As a result of this discovery, the PSA screening test was developed. Over the past few years, the mounting controversy over the specificity of this test led to revisions of the screening guidelines by several organizations. This article reviews the new PSA screening guidelines.
Home Health Care Management & Practice, Jul 9, 2016
Until recently, palliative care was synonymous with hospice care and as such was initiated when t... more Until recently, palliative care was synonymous with hospice care and as such was initiated when treatments were terminated because all alternatives are exhausted. In the past few years, early initiation of palliative care has demonstrated positive outcomes in terms of treatment cost, improved quality of life, and longer survival rates for patients with serious illness. This article discusses the issues surrounding the concept of early initiation of palliative care.
Home Health Care Management & Practice, Oct 7, 2015
The majority of deep vein thrombosis or pulmonary embolus occur in older adults with cardiovascul... more The majority of deep vein thrombosis or pulmonary embolus occur in older adults with cardiovascular risk factors. The case study presented is significant because it involves a 23-year-old African male who presented at our federally qualified health center after he was discharged from the hospital with a second episode of pulmonary embolus and a non-occlusive thrombus in his right common femoral vein. His only risk factors were his ethnicity and inconclusive lupus anticoagulant test result.
Home Health Care Management & Practice, Jul 22, 2014
Recently, the new hypertension guidelines were revealed. It raised much conversation and controve... more Recently, the new hypertension guidelines were revealed. It raised much conversation and controversy about what might happen to older individuals who fall into the "gray zone" and should treatment be held for older adults aged 60 years and older until a blood pressure reading of 150/90 mmHg is reached? Arguments supporting this change point to the strong evidence that supports this new change. In fact, flexing the old guidelines may improve quality of life through the reduction of hypertensive medication side effects. Those adamantly against this change fear that relaxing the guidelines may undo the progress made in lowering cardiovascular disease, particularly strokes. This article discusses these viewpoints after discovering the new hypertension guidelines.
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Papers by Patricia Alpert