Background Challenges to women's health in the context of COVID-19 is based on their unique e... more Background Challenges to women's health in the context of COVID-19 is based on their unique experience shaped by sex/gender. Purpose To provide clinical practice-, research- and policy-related commentary on key COVID-19 pandemic factors impinging on women's sexual/reproductive health and care access, particularly in the context of pregnancy, childbirth, sexual/gender variations and concurrent chronic conditions. Key Points Women tend to have less severe outcomes from COVID-19 than men but certain sub-groups are more vulnerable than others. Yet few U.S. studies have disaggregated the data accordingly. Forming a basis for well-informed policy generation, needed is more research specific to COVID-19 vulnerability/risk factors and outcomes for groups of women by age, race and socioeconomic and cultural determinants. Access to SRH-related clinical services has been diminished during the pandemic, making a priority for restoring/preserving inclusive SRH care for women, e.g. family planning, healthy pregnancies, age-related disease screening and treatment and health/wellness promotion. Sexual/reproductive Health Amid COVID-19 Important concerns include severity of the disease, morbidity in pregnant and postpartum women, increased risk to the fetus, virus transmission to fetus or newborn, and impact of lack care access. Uncertainty in current knowledge is heavily related to lack of sex specific data.
The concepts of individual adaptations, environmental, and person factors have been suggested as ... more The concepts of individual adaptations, environmental, and person factors have been suggested as components of a framework for considering existing and potential investigations of enteral feeding as a therapeutic modality. Much of the work regarding adaptations to enteral feeding have described the pathophysiological and experimental responses of individuals--that there is less emphasis on the physiological and behavioral responses is evident in the literature. Also, little investigation has been focused on the environmental risk factors or the person vulnerability factors that are associated with less than optimal adaptations to enteral feeding. However, it is the understanding of all three of these aspects that will lead to comprehensive strategies for promoting satisfactory adaptations. To date, the majority of clinical therapeutic studies have focused on obviating or managing untoward reactions to enteral feeding by manipulating environmental physical factors. Certainly, more needs to be done, particularly with respect to temporal and rhythmicity considerations. However, there is an obvious lack of information about manipulating social circumstances or person factors (such as, knowledge deficit) for therapeutic ends. Examination of the multiple dimensions of patient responses to enteral nutrition modalities, the interaction of these various dimensions (concentrating on the social and person), and the physical elements is congruent with the holistic and caring nature of nursing practice and should guide future study.
Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidenc... more Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects
Dr. Kojima, Dr. Maehara, my fellow scientists, special guests and friends : I especially bring yo... more Dr. Kojima, Dr. Maehara, my fellow scientists, special guests and friends : I especially bring you greetings from the faculty at the University of Illinois College of Nursing where I have the honor of knowing emeritus professor, Dr. Virginia Ohlson-a person well known to nurses in Japan and she is attending this meeting. A special warm greeting to our UIC Japanese alumna. I also bring you greetings from the American Academy of Nursing , for which I sit on the Governing Council . I wish to thank-you for the invitation to speak before the members of the Japan Academy of Nursing Science at the Third International Research Conference. You are to be commended for the energy and dedication to enhancing nursing knowledge through such an impressive conference. It is so important that all of us as scientists join together in the search for the best nursing practices to improve the health of all people. It is through the search for understandings of human health that we discover effective int...
Journal of the American Association of Nurse Practitioners, 2021
Background: Often developed for acute care and less frequently for primary care, care bundles are... more Background: Often developed for acute care and less frequently for primary care, care bundles are clusters of evidence-based practices for improving care delivery and patient outcomes. Care bundles usually arise when ineffective or costly outcomes are identified, are meant to make care more reliable, and require superb teamwork and communication. Local problem: Patients using the highest proportion of health care services are those living with complex health conditions and challenging sociocultural lives, statistics corroborated within our primary care clinic. In our nurse practitioner (NP)-led, interprofessional, team-based primary care program serving mainly low-income patients, we noted that many patients with multiple chronic conditions had an excess of clinic encounters, emergency department visits, and hospitalizations. Methods: To improve health status for these patients and reduce costly care inefficiencies, we developed a unique bundle of care practices for embedding within...
American Journal of Physiology-Gastrointestinal and Liver Physiology, 1986
The effects of three doses (5, 100, and 250 micrograms/kg) of pentagastrin on the activities of c... more The effects of three doses (5, 100, and 250 micrograms/kg) of pentagastrin on the activities of choline acetyltransferase (ChAT) and acetylcholine esterase (AChE), the neurotransmitter enzymes that synthesize and degrade acetylcholine, and monoamine oxidase (MAO), the degradation enzyme for catecholamines, were investigated. Enzyme activities were assayed in 6 gastrointestinal segments of 21- and 28-day-old and adult rats. All animals were injected intraperitoneally for 7 days with pentagastrin, and the results were compared with age-matched controls receiving saline for 7 days. Plasma and adrenal corticosterone levels were measured. No consistent differences in adrenocortical variables existed between pentagastrin- and saline-treated animals. Similarly, no consistent pentagastrin dose responses of ChAT, AChE, and MAO activities were evident. However, at the highest dose pentagastrin generally produced increases in ChAT activities in 21- and 28-day-old rats, while producing decrease...
Fever is a common problem in the critically ill that is often treated by nurses. Decisions regard... more Fever is a common problem in the critically ill that is often treated by nurses. Decisions regarding treatment of fever would be more informed if based upon research related to fever. The authors, in this article, present an individual adaptation framework for conceptualizing the components of the febrile state important to practice, and review some of the existing research related to development, assessment, and treatment of fever
Study Objectives: To describe self-reported nap behavior and relationships among nap history, nap... more Study Objectives: To describe self-reported nap behavior and relationships among nap history, nap behavior during the study, indicators of subjective and objective insomnia, and self-reported daytime sleepiness from data previously obtained in a week-long field study of sleep in midlife women with and without insomnia. Design: Descriptive/comparative secondary analysis. Setting: Individual homes of the participants. Participants: Midlife women (mean age 46±4 years) with self-reported insomnia (n=101) and women with adequate sleep (n=30). Interventions: N/A Measurements and Results: Sleep patterns were assessed by polysomnography (PSG), daily diaries, and a sleep history form. Although all women were requested not to nap, 47% of the women reported nap behavior during the study. Strong relationships were observed between a history of daytime naps and nap behavior (c2=25.63, p≤.001), and a history of feeling sleepy or struggling to stay awake during the daytime (i.e., sleepiness) and n...
Background Challenges to women's health in the context of COVID-19 is based on their unique e... more Background Challenges to women's health in the context of COVID-19 is based on their unique experience shaped by sex/gender. Purpose To provide clinical practice-, research- and policy-related commentary on key COVID-19 pandemic factors impinging on women's sexual/reproductive health and care access, particularly in the context of pregnancy, childbirth, sexual/gender variations and concurrent chronic conditions. Key Points Women tend to have less severe outcomes from COVID-19 than men but certain sub-groups are more vulnerable than others. Yet few U.S. studies have disaggregated the data accordingly. Forming a basis for well-informed policy generation, needed is more research specific to COVID-19 vulnerability/risk factors and outcomes for groups of women by age, race and socioeconomic and cultural determinants. Access to SRH-related clinical services has been diminished during the pandemic, making a priority for restoring/preserving inclusive SRH care for women, e.g. family planning, healthy pregnancies, age-related disease screening and treatment and health/wellness promotion. Sexual/reproductive Health Amid COVID-19 Important concerns include severity of the disease, morbidity in pregnant and postpartum women, increased risk to the fetus, virus transmission to fetus or newborn, and impact of lack care access. Uncertainty in current knowledge is heavily related to lack of sex specific data.
The concepts of individual adaptations, environmental, and person factors have been suggested as ... more The concepts of individual adaptations, environmental, and person factors have been suggested as components of a framework for considering existing and potential investigations of enteral feeding as a therapeutic modality. Much of the work regarding adaptations to enteral feeding have described the pathophysiological and experimental responses of individuals--that there is less emphasis on the physiological and behavioral responses is evident in the literature. Also, little investigation has been focused on the environmental risk factors or the person vulnerability factors that are associated with less than optimal adaptations to enteral feeding. However, it is the understanding of all three of these aspects that will lead to comprehensive strategies for promoting satisfactory adaptations. To date, the majority of clinical therapeutic studies have focused on obviating or managing untoward reactions to enteral feeding by manipulating environmental physical factors. Certainly, more needs to be done, particularly with respect to temporal and rhythmicity considerations. However, there is an obvious lack of information about manipulating social circumstances or person factors (such as, knowledge deficit) for therapeutic ends. Examination of the multiple dimensions of patient responses to enteral nutrition modalities, the interaction of these various dimensions (concentrating on the social and person), and the physical elements is congruent with the holistic and caring nature of nursing practice and should guide future study.
Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidenc... more Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects
Dr. Kojima, Dr. Maehara, my fellow scientists, special guests and friends : I especially bring yo... more Dr. Kojima, Dr. Maehara, my fellow scientists, special guests and friends : I especially bring you greetings from the faculty at the University of Illinois College of Nursing where I have the honor of knowing emeritus professor, Dr. Virginia Ohlson-a person well known to nurses in Japan and she is attending this meeting. A special warm greeting to our UIC Japanese alumna. I also bring you greetings from the American Academy of Nursing , for which I sit on the Governing Council . I wish to thank-you for the invitation to speak before the members of the Japan Academy of Nursing Science at the Third International Research Conference. You are to be commended for the energy and dedication to enhancing nursing knowledge through such an impressive conference. It is so important that all of us as scientists join together in the search for the best nursing practices to improve the health of all people. It is through the search for understandings of human health that we discover effective int...
Journal of the American Association of Nurse Practitioners, 2021
Background: Often developed for acute care and less frequently for primary care, care bundles are... more Background: Often developed for acute care and less frequently for primary care, care bundles are clusters of evidence-based practices for improving care delivery and patient outcomes. Care bundles usually arise when ineffective or costly outcomes are identified, are meant to make care more reliable, and require superb teamwork and communication. Local problem: Patients using the highest proportion of health care services are those living with complex health conditions and challenging sociocultural lives, statistics corroborated within our primary care clinic. In our nurse practitioner (NP)-led, interprofessional, team-based primary care program serving mainly low-income patients, we noted that many patients with multiple chronic conditions had an excess of clinic encounters, emergency department visits, and hospitalizations. Methods: To improve health status for these patients and reduce costly care inefficiencies, we developed a unique bundle of care practices for embedding within...
American Journal of Physiology-Gastrointestinal and Liver Physiology, 1986
The effects of three doses (5, 100, and 250 micrograms/kg) of pentagastrin on the activities of c... more The effects of three doses (5, 100, and 250 micrograms/kg) of pentagastrin on the activities of choline acetyltransferase (ChAT) and acetylcholine esterase (AChE), the neurotransmitter enzymes that synthesize and degrade acetylcholine, and monoamine oxidase (MAO), the degradation enzyme for catecholamines, were investigated. Enzyme activities were assayed in 6 gastrointestinal segments of 21- and 28-day-old and adult rats. All animals were injected intraperitoneally for 7 days with pentagastrin, and the results were compared with age-matched controls receiving saline for 7 days. Plasma and adrenal corticosterone levels were measured. No consistent differences in adrenocortical variables existed between pentagastrin- and saline-treated animals. Similarly, no consistent pentagastrin dose responses of ChAT, AChE, and MAO activities were evident. However, at the highest dose pentagastrin generally produced increases in ChAT activities in 21- and 28-day-old rats, while producing decrease...
Fever is a common problem in the critically ill that is often treated by nurses. Decisions regard... more Fever is a common problem in the critically ill that is often treated by nurses. Decisions regarding treatment of fever would be more informed if based upon research related to fever. The authors, in this article, present an individual adaptation framework for conceptualizing the components of the febrile state important to practice, and review some of the existing research related to development, assessment, and treatment of fever
Study Objectives: To describe self-reported nap behavior and relationships among nap history, nap... more Study Objectives: To describe self-reported nap behavior and relationships among nap history, nap behavior during the study, indicators of subjective and objective insomnia, and self-reported daytime sleepiness from data previously obtained in a week-long field study of sleep in midlife women with and without insomnia. Design: Descriptive/comparative secondary analysis. Setting: Individual homes of the participants. Participants: Midlife women (mean age 46±4 years) with self-reported insomnia (n=101) and women with adequate sleep (n=30). Interventions: N/A Measurements and Results: Sleep patterns were assessed by polysomnography (PSG), daily diaries, and a sleep history form. Although all women were requested not to nap, 47% of the women reported nap behavior during the study. Strong relationships were observed between a history of daytime naps and nap behavior (c2=25.63, p≤.001), and a history of feeling sleepy or struggling to stay awake during the daytime (i.e., sleepiness) and n...
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Papers by Joan L Shaver