bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy Consumption, Economic Development and Environmental Improvement in China
Authors: He Jiaxin , Zhuang Tianhui , Xie Xingmei
Published: December 2014

As the biggest developing country in the world, China is facing more and more pressure to reduce emissions. However, can growth in energy consumption, economic output and environmental protection be achieved simultaneously in China? To solve the problem, this paper presents an analysis of the long-run and causal relationship between energy consumption, economic growth and environmental pollution in China from 1983–2010. The methodology uses is the Johansen cointegration test and Granger causality test based on a multivariate vector error correction model. Empirical results show that there are correlations between energy consumption, economic growth and environmental pollution in the long-term. The results of causality test indicate that economic growth is the cause for both energy consumption and environmental pollution, while energy consumption is the cause of environmental pollution and vice versa. The policy implication would be that energy conservation and pollution reduction policies may be undertaken without impeding economic growth.
The Rationale behind Turkey's High Gasoline Prices
Authors: Biresselioglu Mehmet Efe , Demir Muhittin Hakan , Ozyorulmaz Evrim
Published: December 2014

As oil prices increase, companies experience rising costs and falling profits, leaving governments to deal with the increasing interest rate, inflation and unemployment. However, on the consumer side, the key concern of increasing oil prices is their direct impact on the gasoline pump prices. Consequently, oil price rises have always been an important part of the public debate, especially in countries experiencing high prices for gasoline, such as Turkey. After decades of high prices, Turkey has the most expensive gasoline in the world, at 2.64 $s/litre as of Quarter 2 of 2013. The aim of this paper is to reveal which factors are most important in determining gasoline pump prices in Turkey. In addition, a comparison of the periods with different pricing regimes is presented in order to demonstrate the actual effects of policy changes imposed by the government. The results show that, rather than the market variables, retail pump prices are primarily determined by variables that are more of a macroeconomic nature. This conclusion suggests that these market variables are utilized by companies in the market as tools for regulating prices that can be perceived an informal automatic price regulation mechanism.
Effect of Decision Variables in the Steam Section for the Exergoeconomic Analysis of TCCGT Power Plant: A Case Study
Authors: Abdalisousan Ashkan , Fani Maryam , Farhanieh Bijan , Abbaspour Majid
Published: December 2014

In advanced combined-cycle power plants, significant improvements in the thermodynamic performance are mainly achieved by the development of more efficient gas-turbine systems. This paper evaluates the effect of selected decision variables in the steam system for optimization of Thermal Combined Cycle Gas Turbine (TCCGT) power plant using an iterative exergoeconomic. The design variables were the thermodynamic parameters that establish the configuration both of the steam and gas systems. The design data of an existing plant (Damavand power plant in Tehran-Iran) is used. Two different objective functions are proposed: one minimizes the total cost of production per unit of output, and the other maximizes the total exergetic efficiency. The analysis shows that the total cost of production per unit of output is 2% lower and exergy efficiency is 4% higher with respect to the base case. It demonstrates that selected decision variables have suitable results for the exergy analysis and cost effectiveness. Since, environmental pollution and energy shortage are the two factors limiting the development of the society; nevertheless, this analysis tends to optimally find the design parameters which result in a decrease in the fuel mass flow rate. Also, this reduction (about 5%) in the mass flow rate and increasing exergetic efficiency can decrease the environmental impacts.
Energy Efficiency in Buildings in Hot Humid Climatic Regions Using Phase Change Materials as Thermal Mass in Building Envelope
Authors: Madhumathi A. , Sundarraja M.C.
Published: December 2014

Air conditioning energy consumption in summer represents a challenge in many areas with hot and humid climates. Passive cooling with thermal storage in phase change materials (PCMs) is a very effective way to improve thermal stability of the rooms with light-weight envelope. The main objective of this research is to demonstrate experimentally that it is possible to improve the thermal comfort and reduce the energy consumption of a building without substantial increase in the weight of the construction materials with the inclusion of PCM. This work aims at presenting an overview of the key researches in the field of use of PCMs in buildings and presenting a green approach for their uses in building envelopes with specific implementation on the case of hot humid regions. Thermal behaviour of wall integrated with two different types of PCMS Polyethylene glycol (PEG) E600 and Capric Acid (C10 H20 O 2) was compared by measurements and calculations. Three test cells were built for comparative investigation of the efficiency of passive cooling with the use of the PCMs. This paper deals with the results of experiments carried out in the test cells and possibilities of activation of PCMs for effective passive cooling.
Energy Efficiency of Existing Buildings: Optimization of Building Cooling, Heating and Power (BCHP) Systems
Authors: Pagliarini Giorgio , Rainieri Sara , Vocale Pamela
Published: December 2014

The enhancement of the energy efficiency of existing buildings represents an important task, specifically addressed by the European Directives. Among the currently available technologies to achieve this issue, the combined generation of heat and power (CHP) is found. Its higher efficiency with respect to the separate production of heat and power mainly depends on the occurrence of a profitable use of the cogenerated heat. This technology is now rapidly spreading because of its benefit from both the energy and the environmental sustainability points of view. However, in order to properly size the CHP system capacity and operation strategy, some specific design rules have to be identified. In particular, the CHP systems optimal design requires the building energy loads to be known on a hourly time scale. In the present paper a simplified procedure for estimating the hourly energy load for space heating and cooling of existing buildings is applied to the assessment of building cooling, heating and power systems energy performance. The results, obtained for a complex nine storey building located in six representative climates, point out that the suggested method allows to estimate the primary energy savings index with an approximation error, averaged over the considered combined generation system capacity range, less than 2.8% and 3.3% in continuous and time scheduled plant operation, respectively.
Calculation of Atmospheric Radiative Forcing (Warming Effect) of Carbon Dioxide at Any Concentration
Authors: Lightfoot H. Douglas , Mamer Orval A.
Published: December 2014

The Beer-Lambert law does not apply strictly to the relationship between radiative forcing (RF) of CO2 and concentration in the atmosphere, i.e., ΔRF = 5.35ln(C/Co). It is an approximation because water vapour competes unevenly with CO2 over the IR absorption wavelength range. We propose a quadratic model as an improved approximation. It links concentration to RF thereby allowing RF calculation at any concentration, not just ΔRF. For example, at 378 ppmv of CO2, the level in 2005, it calculates RF = 8.67 W m−2, or approximately 2.7% of the total RF of all the greenhouse gases. A second and independent method based on worldwide hourly measurements of atmospheric temperature and relative humidity confirms this percentage. Each method shows that, on average, water vapour contributes approximately 96% of current greenhouse gas warming. Thus, the factors controlling the amount of water vapour in the air also control the earth's temperature.
Influence of Sunspots on Global Mean Surface Temperature
Authors: Pangburn Dan
Published: December 2014

The influence of variations in solar activity on earth's surface temperature is a key question in climate-change attribution. On the basis of natural cyclic sea surface temperatures and the annual mean daily sunspot number as a proxy for variability in solar influence on the energy retained by the planet, a predictive equation derived from well-understood physical principles proves capable of reproducing observed anomalies in annual global mean surface temperature since before 1900 with 90% accuracy (R2 = 0.9049). This accuracy results even where a zero-contribution from changes in greenhouse-gas concentrations is assumed. Here we show that the cumulative influence of the unusually elevated solar activity in the 64 years 1941–2005, as calculated using the time-integral of sunspot number anomalies (with a proxy factor) might have been a primary cause of the global warming observed through 2001. After 2001 the low solar activity is consistent with the observed flat average global temperature trend. The physically-based predictive equation, with the widely-projected decline in solar activity, moderated by the substantial effective thermal capacitance of the planet, especially the oceans, projects a downtrend steeper than 0.1K/decade.
Improving the Oxidation Stability of Karanja Oil Biodiesel
Authors: Kapilan N. , Birdar Chandra Sekar
Published: December 2014

Biodiesel is an alternative fuel to diesel and is seeking wider acceptance because of its claimed environmental and socio-economic benefits. The fuel properties of biodiesel are similar to those of fossil fuel. However, one of its main obstacles remains its lower oxidative stability. This problem may be overcome by the addition of suitable antioxidant. In India, biodiesel is produced from non-edible karanja oil, which has considerable potential. Because karanja oil biodiesel contains a higher amount of unsaturated fatty acids, it is necessary to find a suitable method for improving its oxidation stability. We report a study on the effect of antioxidants on the stability of the fuel. The addition of antioxidants improves oxidation stability of karanja oil biodiesel.
Forecasting Sea Water Levels at Mukho Station, South Korea Using Soft Computing Techniques
Authors: Kisi Ozgur , Karimi Sepideh , Shiri Jalal , Makarynskyy Oleg , Yoon Heesung
Published: December 2014

The accuracy of three different data-driven methods, namely, Gene Expression Programming (GEP), Adaptive Neuro-Fuzzy Inference System (ANFIS) and Artificial Neural Networks (ANN), is investigated for hourly sea water level prediction at the Mukho Station in the East Sea (Sea of Japan). Current and four previous level measurements are used as input variables to predict sea water levels up to 1, 24, 48, 72, 96 and 120 hours ahead. Three statistical evaluation parameters, namely, the correlation coefficient, the root mean square error and the scatter index are used to assess how the models perform. Investigation results indicate that, when compared to measurements, for +1h prediction interval, all three models perform well (with average values of R = 0.993, RMSE = 1.3 cm and SI = 0.04), with slightly better results produced by the ANNs and ANFIS, while increasing the prediction interval degrades model performance.
A Field Study of Atmospheric Icing Analysis in a Complex Terrain of the High North
Authors: Rashid Taimur , Mughal Umair N. , Mustafa Mohamed Y. , Virk Muhammad S.
Published: December 2014

Analyses of atmospheric icing events hold the key for computing the significant parameters leading to icing load calculations. In the cold regions of the high north, atmospheric icing loads on structures become important when it comes to design and safety of infrastructures. Furthermore, icing load calculations over a certain period of time provide a vital input for designers to improve the safety of structures. Patterns of icing events can be evaluated in correlation with other meteorological parameters such as atmospheric temperature, relative humidity and wind speed to better estimate icing loads. A field study has been performed in the complex terrain of northern Norway, by the atmospheric icing research team of Narvik University College, where customized meteorological atmospheric ice monitoring stations were installed to study atmospheric icing events in relation with the associated weather parameters. The meteorological parameters of three different sites in the vicinity of Narvik ( 68°25′ 14′ N17°33′ 36′ E) were collected, sorted, averaged to standardized timeline and further validated with recordings of weathers parameters obtained from the national weather forecasts, where a good agreement was found. Analyses were mainly performed between accreted ice loads and associated meteorological parameters. The results presented can be used as base for the development of more detailed mathematical models for the better prediction of atmospheric icing events in complex terrains.
Experimental Studies on a Scaled Model of a Tension Based Tension Leg Platform under Combined Mooring and Tether Conditions
Authors: Rao D.S. Bhaskara , Selvam R. Panneer , Srinivasan Nagan
Published: December 2014

Tension Based Tension Leg Platform (TBTLP) is an innovative concept wherein a Tension Leg Platform (TLP) designed for a certain depth can be extended to operate in deeper waters by mounting the surface structure (TLP) on a buoyant closed box structure, Tension Base. The motion control of Tension Base is very important for satisfactory performance of the mounted TLP. In this paper, the concepts are briefly introduced and experiments conducted on a 1:150 scaled model of the TBTLP in 3 m water depth with three different combinations of tether and mooring stiffnesses are presented. Experiments were also conducted on the same TLP (without Tension Base) in two different water depths (3 m and 1 m). Results are presented in terms of Response Amplitude Operators (RAOs) in the surge, heave and pitch degrees of freedom of TBTLP and are compared with RAOs of TLPs in 3 m and 1 m to highlight the efficacy of the new concept.
Management of Coastal Erosion Using Remote Sensing and GIS Techniques (SE India)
Authors: Saravanan S. , Chandrasekar N. , Rajamanickam M. , Hentry C. , Joevivek V.
Published: December 2014

World wide, coastal erosion is recognized as a great threat for beach environment. Total control of coastal erosion is not feasible but it should not be ignored and needs timely management. Erosional activities have been significantly noticed along the coastal tract of Vembar and Kallar (Kallurani), South India. An attempt has been made here to delineate different zones based on their sand budget and erosion rate. Linear Imaging Self Scanning Sensor (LISS) III 2001 and Linear Imaging Self Scanning Sensor III and PAN merged data of the year 2001 have been utilized to identify the coastal geomorphological features, shoreline changes and river course changes. A Geographic Information System (GIS) software namely ArcGIS (9.1) has been used as a tool to delineate the coastal erosion hazard for proper planning and management of coastal developments. Beach profile studies have shown significant variation in the beach morphology. The study area has been categorized into five different zones in the GIS analysis based on the degree of coastal erosion and sediment dynamics namely (i) very high - Kalaignanapuram, (ii) high - Sippikulam (iii) medium - Periyasamypuram (iv) low - Vembar and Kallar (Kallurani) (v) very low - Pachayapuram.
Estimation of Significant Wave Heights Using Numerical and Neural Techniques and Comparison with Buoy and Satellite Observations
Authors: Vimala J. , Latha G. , Venkatesan R.
Published: December 2014

Short term significant wave heights have been evaluated using the numerical WAM model and the results are compared with satellite (Jason-2) and moored buoy measurements. Additionally artificial neural network (ANN) is used to predict significant wave heights over a future time step and such predictions are also compared with corresponding satellite and buoy measurements. The observations from moored buoys monitored by India's National Institute of Ocean Technology for a period of about four and a half years at three locations in the Arabian Sea and three in Bay of Bengal covering the west as well as east coast of India are involved. The buoy recorded largest waves during the cyclonic condition, and this was confirmed at a location code named: BD11 by the satellite measurements as well as the WAM and ANN based evaluations. The evaluation accuracy reflected in the coefficient of correlation is found to be high in the Arabian Sea than the Bay of Bengal.
Wave Forecasting Using Neuro Wavelet Technique
Authors: Dixit Pradnya , Londhe Shreenivas N. , Dandawate Yogesh H.
Published: December 2014

In the present work a hybrid Neuro-Wavelet Technique is used for forecasting waves up to 6 hr, 12 hr, 18 hr and 24 hr in advance using hourly measured significant wave heights at an NDBC station 41004 near the east coast of USA. The NW Technique is employed by combining two methods, Discrete Wavelet Transform and Artificial Neural Networks. The hourly data of previously measured significant wave heights spanning over 2 years from 2010 and 2011 is used to calibrate and test the models. The discrete wavelet transform of NWT analyzes frequency of signal with respect to time at different scales. It decomposes time series into low (approximate) and high (detail) frequency components. The decomposition of approximate can be carried out up to desired multiple levels in order to provide more detail and approximate components which provides relatively smooth varying amplitude series. The neural network is trained with decorrelated approximate and detail wavelet coefficients. The outputs of networks during testing are reconstructed back using inverse DWT. The results were judged by drawing the wave plots, scatter plots and other error measures. The developed models show reasonable accuracy in prediction of significant wave heights from 6 to 24 hours. To compare the results traditional ANN models were also developed at the same location using the same data and for same time interval.
Real Time Wave Forecasting Using Wind Time History and Genetic Programming
Authors: Kambekar A.R. , Deo M.C.
Published: December 2014

The significant wave height and average wave period form an essential input for operational activities in ocean and coastal areas. Such information is important in issuing appropriate warnings to people planning any construction or instillation works in the oceanic environment. Many countries over the world routinely collect wave and wind data through a network of wave rider buoys. The data collecting agencies transmit the resulting information online to their registered users through an internet or a web-based system. Operational wave forecasts in addition to the measured data are also made and supplied online to the users. This paper discusses operational wave forecasting in real time mode at locations where wind rather than wave data are continuously recorded. It is based on the time series modeling and incorporates an artificial intelligence technique of genetic programming. The significant wave height and average wave period values are forecasted over a period of 96 hr in future from the observations of wind speed and directions extending to a similar time scale in the past. Wind measurements made by floating buoys at eight different locations around India over a period varying from 1.5 yr to 9.0 yr were considered. The platform of Matlab and C++ was used to develop a graphical user interface that will extend an internet based user-friendly access of the forecasts to any registered user of the data dissemination authority.
The Accentual Structure of Estonian Syllabic-Accentual Iambic Tetrameter
Authors: Lotman Maria-Kristiina , Lotman Mihhail
Published: December 2014

This paper is part of a project aimed to analyse the rhythm of Estonian binary verse metres. It is the first complex analysis of Estonian syllabic-accentual iamb. The analysis is comprised of poetry by 20 prominent authors from the end of the 19th century and the beginning of the 20th century, and, all in all, more than 9000 verse lines. In order to find out which regularities are specific to poetry in general or to a particular poet, these data were compared with pseudoiambic segments extracted from prose. Differently from the earlier studies, stress is treated as a phenomenon of gradation, with altogether five different degrees of stress distinguished. The performed study showed that the rhythmical structure of iambic poems allows the clear distinction between two groups of poets, whom we conditionally call Traditionalists and Modernists.
Role of the theatre nurse in minimal access surgery
Authors: McDonnell Eileen , Willmer Sue
Published: December 2014

Operating department nursing practice involves a diversity of skills in conjunction with a specialist and multidisciplinary knowledge base. This article explores the emergence of minimal access surgery (MAS) and what occurs during the perioperative period. The authors argue that perioperative care of the MAS patient requires not only technical competence but also a high order of interpersonal skill allied to specialist nursing knowledge.
Nutrition and the rheumatoid patient
Authors: Ryan Sarah
Published: December 2014

This review examines the dietary requirements of patients with osteoarthritis and rheumatoid arthritis, evaluates why their requirements are not being met and assesses ways in which the ward environment can affect eating habits.
Working with women in mental health: a feminist perspective
Authors: Jebali Chris A
Published: December 2014

This article examines the deconstruction of current beliefs concerning women and mental health and considers how such deconstruction could lead to a reconstruction of psychiatric practice which would benefit everyone concerned with the helping services.
Sources of knowledge in nursing
Authors: Behi Ruhi , Nolan Mike
Published: December 2014

This article provides a brief overview of the various sources and types of nursing knowledge, highlighting their similarities and differences. The authors investigate the underlying principles and the strengths and weaknesses of such knowledge. This should enable the professional to decide which is the most appropriate source (both to the patient/client and the professional) to meet a particular demand.
Responding to the challenge of chronic illness
Authors: Nolan Mike , Nolan Janet
Published: December 2014

The management of chronic illnesses represents a major health challenge with interventions still being dominated by approaches that are more appropriate to acute conditions. Nurses have a key role to play in meeting the health needs of people with chronic illnesses and yet place little value on this type of care. This article reviews the Corbin and Strauss model of nursing which has proved effective in the management of a wide range of chronic illnesses.
Nursing a person who had suffered a myocardial infarction
Authors: Rowe Kathleen
Published: December 2014

Jim, a 41-year-old man, was admitted to the coronary care unit following an acute inferior myocardial infarction. He is married to Ann and they have three children. He described himself as an active, healthy person who had never previously been ill. On admission, he was pale and clammy and complained of severe central chest pain. His blood pressure was 90/60 mmHg and his pulse rate was 60/min. He was not breathless but was anxious regarding his condition.
Use of physical restraints 1: consequences
Authors: Molasiotis Alexander
Published: December 2014

The use of physical restraints, e.g cot-sides, has become a routine procedure in many UK geriatric wards. However, it is associated with numerous adverse physical and/or psychological effects. Although restraints may be indicated in some cases, the nurse should be aware of the possible consequences. Ethical dilemmas may arise. This article, the first in a two-part series, discusses the conequences of restraint use, so that the nurse can balance the potential benefits and risks before deciding upon their use.
Occupational stress and cognitive style in nurses: 2
Authors: Riding Richard J , Wheeler Herman H
Published: December 2014

The first part of this two-part article described cognitive styles and their possible influence on occupational performance and stress. This part describes a study whose aim was to investigate the relationship between cognitive style and occupational stress in nurses. Possible interactions with type of nursing, grade, age and number of clients were examined.
Common problems in wound care: overgranulation
Authors: Young Trudie
Published: December 2014

Overgranulation in wounds causes a delay in wound healing and often produces an increase in wound exudate and is therefore difficult to dress. This article suggests non-traumatic methods of removal in order to preserve the granulation of tissue required for healing.
Coban
Authors: Williams Clare
Published: December 2014

This article describes Coban, a self-adherent bandage, which forms the final layer in the Charing Cross 4-layer bandage system used in the treatment of venous leg ulcers. Coban also has several other applications, such as support of soft tissue injuries.
Correspondence
Authors: Iles Ian , Morgan H
Published: December 2014

The Baroness Cox puts forward arguments for the further establishment of so-called ‘village communities’ (British Journal of Nursing Vol 4(19): 1130–4). In her article, she makes a case for utilizing the terminology ‘mental handicap’ and ‘the mentally handicapped’. It is my view that she has failed to make the case for either, set against her own stated standards.
Stroke units: centres of nursing innovation
Authors: O'Connor Stephen E
Published: December 2014

The results of a survey of stroke units in the English regions of the NHS are reviewed. A total of 43 units were identified and contacted of which 34 responded. The article briefly discusses the nature and development of stroke Units and considers features of stroke units that reflect the level of nursing development such as ward nursing philosophy, model of nursing used, method of ward organization, unit. manpower and educational attainment. The overall results indicate that the respondent units have achieved a high level of development which has, until now, gone generally unnnoticed.
Parent participation 2: findings and their implications for practice
Authors: Neill Sarah J
Published: December 2014

A qualitative exploratory study was undertaken to examine parents' views and experiences of participation in the care of their child in hospital and to identify factors that inhibit or facilitate participation. Parents of children aged 2–5 years of age were interviewed within 2 months of discharge, using tape-recorded, semi-structured interviews. The findings demonstrate that parents clearly wish to participate in their children's care at a level of their own choosing. However, they preferred professionals to be responsible for their children's clinical care, while they continue to be responsible for the children's normal day-to-day care. Problems were identified in the area of relationships between parents and professionals, centred on communication and the continuing paternalistic nature of these relationships. Parents of children who experienced single, short hospital admissions found involvement in their children's care particularly difficult. Guidelines were developed from the results, to facilitate parent participation in the care of children in this age group.
The Egerton Convertible 11 and the Elite 3 bed system
Authors: Lowthian Peter
Published: December 2014

Low air loss bed systems have proved successful in the management of severe pressure sores but they tend to be expensive. The Convertible 11 promises to provide many of the features of a low air loss bed at a much reduced cost. It is essentially a mattress replacement that can be used for various beds, including contouring-base beds. It is a component of the Elite 3 bed system which comprises an electrically powered contouring bed (with its own air pump) and three different mattresses: the mattress of the Convertible 11 is Mattress 3 of this system; Mattress 2 is an alternating-pressure air mattress; and Mattress 1 is a static air mattress with a foam envelope. The advantages and disadvantages of these products are discussed and it is suggested that the allocation of patients to the various supports can be facilitated by using a pressure sore risk-assessment score.
Do we need physician assistants in the UK?
Authors: Castledine George
Published: December 2014

The concept of the physician assistant (PA) arose in North America in the 1960s as a response to the shortage of physicians in rural areas. The first PA training of three ex-military corpsmen was initiated by Dr Eugene Stead of Duke University in 1965, following a collaborative project with the nursing faculty on the training of nurse practitioners.
Peripherally inserted central catheters: expanding UK nurses' practice
Authors: Gabriel Janice
Published: December 2014

Peripherally inserted central catheters (PICCs) are a group of single- and double-lumen central venous access devices, ranging in size from 2 to 6 FG. In the USA, these devices have been used to establish central venous access since the late 1970s, but they are only just beginning to be introduced into the UK. In the USA, suitably skilled nurses assume responsibility for the placement of the majority of PICCs, both in the hospital and home-care settings (Coulter, 1993).This article will explain how suitably skilled nurses in the UK could expand their clinical practice to include the placement of PICCs, and thereby improve the quality of intravenous access for many patients requiring parenteral therapies.
Urinary incontinence management in the USA: the role of the nurse
Authors: Newman Diane Kaschak
Published: December 2014

Urinary incontinence (UI) is a prevalent medical problem in the USA. Approximately 12 million Americans are incontinent of urine. Hu et al (1994) estimate that the costs of managing the problem are $10 billion annually. In persons aged 65 years and older, the incidence of UI is 30% or more. It is estimated that more than 60% of people with UI never mention their problem to a doctor or nurse. This is a sad fact considering that UI is a highly treatable, if not curable, problem. In the USA, advanced practice nurses, nurse practitioners and clinical nurse specialists who have advanced educational and master's degrees and clinical practice requirements are making a significant impact on the management of UI. This article outlines the role of advanced practice nurses in the diagnosis and behavioural management of UI.
Helping people with learning disabilities to grieve
Authors: Read Sue
Published: December 2014

Historically, it was believed that people with a learning disability did not grieve. Today, however, new and creative ways of working with and supporting the bereft individual who has a learning disability are being sought. This article addresses the current issues for both the individual with a learning disability who has experienced a bereavement and his/her carers. It advocates the importance of competence in the carer to enable effective support, acknowledges proactive educational approaches to enable the individual to cope more healthily with loss, addresses the education and training forum from a pre- and postregistration perspective, and explores the current deficits and potential research areas within this specialist field.
The ‘in-between’ times: video analysis of peer interactions
Authors: Couchman Wendy
Published: December 2014

Research into day services for adults with severe learning disabilities continues to place great emphasis on the importance of structured activities (Seed, 1988). As a result, the policy for a service user's day tends to consist of timetabled activity with formal periods of learning and communication with staff (Social Services Inspectorate, 1992). In reality, however, there can be quite long gaps between activities, which are equally deserving of research interest. These are the ‘in-between’ times: times of the day when service users are waiting for an activity to be initiated by staff, or simply waiting for something to happen. It is suggested that the ‘in-between’ times offer similar potential for promoting learning and communication, through more informal and natural interaction.
Self-advocacy skills workshop: a report
Authors: McNally Steve
Published: December 2014

This article is a report on a 3-day workshop for adults with a learning disability. The group work described formed part of the annual Self-Advocacy Skills Workshop held at the Hayes Conference Centre, Swanwick, Derbyshire. This year's workshop took place on 7–10 January 1996. It is suggested that user-oriented events have a number of benefits, including the opportunity to share ideas and work together on important issues. There is considerable value for users in meeting people from other parts of the country. Opportunities for users to share experiences and develop their own self-advocacy and social networks should be encouraged.
Treatment of continence in people with learning disabilities: 3
Authors: Stanley Robert
Published: December 2014

Behaviourism is a model of Intervention for people with a learning disability which focuses on observable behaviour and methods of changing it. The behaviourist strategies do not typically place high value on some of the diagnostic labels that have been considered in the first two articles of this series (Vol 5(6): 364–8; Vol 5(8): 492–8). Rather, the behaviourist is concerned with the behaviours a particular individual shows. Behaviour modification is a particular methodology within psychotherapy that has many interpretations, ranging from a rigid orthodoxy through to an eclectic ecumenicism of theoretical models. The third article in this series on the management of continence in people with a learning disability examines the behavioural strategies that have been historically and are currently available to practitioners. The legacy of behaviour modification (1970s style) means that staff do sometimes perceive such strategies as treatment, whereas in fact the treatment is a combination of designing the environment, designing individual programmes and designing specific ways of developing more valuing forms of continence management.
Minimizing hospitalization: children with newly diagnosed diabetes
Authors: Lowes Lesley , Davis Ruth
Published: December 2014

Children's recognized vulnerability to the adverse effects of hospitalization has resulted in the firm belief that minimization or avoidance of hospitalization is in children's best interests. For children with newly diagnosed diabetes, minimal hospitalization may be achieved through the flexibility of the paediatric diabetes specialist nurse role, which crosses the boundary between hospital and community. This study was undertaken to evaluate the effectiveness of a paediatric diabetes specialist nurse in reducing the length of hospitalization for newly diagnosed children. Using a quantitative approach, a quasi-experimental research design was chosen, measuring the length of hospitalization at diagnosis for 40 children diagnosed in the 2 years preceding, and 16 children diagnosed in the 9 months following, the commencement of the paediatric diabetes specialist nurse post. The study findings showed a significant reduction in the length of hospitalization, suggesting that paediatric diabetes specialist nurses, by minimizing or avoiding hospitalization for newly diagnosed children, can make a substantial contribution to their emotional wellbeing.
Parents' views of caring for children with gastrostomies
Authors: Chaplen Caroline
Published: December 2014

Gastrostomy feeding devices are becoming increasingly popular. With their increased use in the paediatric surgical unit, it became apparent that care and information given to children and their families were in need of review. Following a literature review, a self-report questionnaire was developed to assess areas for change, based on parents' perceptions. The findings suggested that information given to all those involved in the child's care needed to be improved, and identified the most common problems experienced by parents when caring for a child with a gastrostomy. The findings had implications for future practice and highlighted the need for paediatric nurses to keep pace with change in order to ensure optimum care for children and their families.
Day case cataract surgery in the UK and USA: a comparative study
Authors: Cooper Jean M
Published: December 2014

This study is a comparison of healthcare provision for day case cataract surgery in the UK and the USA. It commences with a brief history and the political influences on the development of healthcare in the USA and the UK, identifying recent changes. The high cost of the health system in the USA and the small amount of resources consumed by the NHS in the UK are examined. The service offered to patients requiring cataract surgery in the UK and the USA are compared and the increasing demand for this operation and the challenge of differing styles of nursing that day surgery requires are discussed. The study concludes by pointing out the consistent exansion of day surgery in both countries in recent years, and predicts that, in view of the patient satisfaction and economic benefit, the growth of day surgery in the future appears almost unlimited.
Strategies for reducing stress and burnout in nursing
Authors: Farrington Andy
Published: December 2014

Three models of stress — the stimulus model, the response model and the cognitive-phenomenological-transactional (CPT) model — have been described in detail elsewhere (Farrington, 1995), and the notion of accepting occupational stress as an industrial disease has been suggested (Nursing Times, 1995). This article focuses on the nursing experience of stress and describes strategies for reducing stress and burnout on a personal and organizational level. It concludes by presenting a small-scale research study which examined the nature and impact of events perceived by postregistration nurses to cause personal psychological distress. The findings of the research show that certain stimuli are consistently perceived as being psychologically traumatizing in the daily working life of the student nurse. Nursing clearly remains an emotionally demanding occupation and more work is needed to examine the way in which events and microstressors are cognitively processed by nurses.
The rights of the fetus against the mother
Authors: Dimond Bridgit
Published: December 2014

Reports that two women have been compelled to have Caesarean sections have raised concerns among not only mothers and midwives but also the public at large (Gibb, 1996). The question of whether pregnant women are in a different category to other adults when issues relating to the right to consent and the right to refuse treatment arise has been discussed elsewhere (Dimond, 1996). This comment piece discusses the rights of the fetus against the mother.
Healthcare litigation: working towards a culture change
Authors: Tingle John
Published: December 2014

This article discusses two recently published documents: the Department of Health's (DoH's) Executive Letter EL(96)ll (DoH, 1996); and the Woolf Report (Woolf, 1996). These documents will have an Important impact on healthcare litigation and will strongly Influence the way in which clinical negligence claims are conducted and managed. The documents will influence clinical risk management strategies and the avoidance of clinical negligence.
Political awareness in nursing in 1997
Authors: Castledine George
Published: December 2014

This is going to be an interesting year, especially as there is going to be a general election. What better way, therefore, than to start this year's series of columns with a review of political awareness in nursing.
A practical framework for wound assessment 2: methods
Authors: Flanagan Madeleine
Published: December 2014

Accurate measurement and documentation of wound healing are essential if practitioners are to effectively evaluate the benefits of various treatment approaches. Increasingly, sophisticated wound measurement techniques are evolving, but many are impractical and costly. The physiology of healing and the relationship of each stage of this delicate process to the complex task of wound assessment were reviewed in part one of this article (Vol 5(22): 1391–7) to help improve practitioners' clinical assessment skills. Part two will discuss ways in which the accuracy of simple, non/invasive measurement approaches may be improved so that overall alterations in wound dimension can be effectively monitored.
Mental health is at the centre of social change
Authors: Morris Mervyn
Published: December 2014

The election of ‘new’ Labour for a new millennium raises expectations for social progress, The Labour Party manifesto, however, sheds little light on its ambitions in the area of mental health.
Patient management following suprapubic catheterization
Authors: Peate Ian
Published: December 2014

This article considers the issue of suprapubic catheterization and the subsequent care of the client. The conditions and situations where suprapubic catheterization may be used are outlined. A review of the literature on this important subject suggests that there is little research/evidence-based practice to support some current-day practices. The review addresses such issues as what suprapubic catheterization is and how it is carried out. Key issues such as avoidance of infection, the need for dressings and care of the insertion site are discussed. In particular, the gynaecological field is explored to highlight concern about variations and discrepancies in approaches to care of the patient with a suprapubiccatheter in situ. Finally, a call is made for practitioners to base their care on research findings or evidence-based practice rather than tradition, ritual or heresy.
Managed care strategy for mental health services
Authors: Jones Adrian
Published: December 2014

In the UK, managed care is beginning to be recognized as a cost-effective, quality-driven system which can be used to structure patient care. This article examines the potential use of managed care pathways in mental health services, focusing on clients with schizophrenia. The strengths of managed care include the effective coordination of healthcare resources, the clear accountable audit of mental health practice and the re-engineering of mental health practice to improve patient outcomes. Problems in designing representative can pathways and encouraging healthcare providers to implement care pathways ate some of the disadvantages of this system.
Work stress among community psychiatric nurses
Authors: McLeod Terry
Published: December 2014

This article examines the findings of a research study on the levels and sources of stress among 60 community psychiatric nurses (CPNs) from six health authorities in the midlands area. This three-way comparative study explores the stress levels experienced by CPNs working with primary clients. The hypothesis that higher levels of stress is experienced by CPNs working with the severely mentally ill is supported. The stress levels experienced did appear to vary with the type of clients catered for. Using a questionnaire designed to measure individual variables, CPNs working with the severely mentally ill reported higher caseloads, less training, lack of respect and understanding of their role by others and the need for more supervision and support. Forty per cent of CPNs were found to be stressed according to the General Health Questionnaire (GHQ 28). While there is debate about where CPNs should focus their interventions and which clients should be prioritized, it appears that working with the severely mentally ill is less attractive and more stressful to CPNs. The results and suggestions for further research are highlighted in this article.
Clinical electives: the challenges and benefits of student choice
Authors: Shailer Barbara
Published: December 2014

Traditionally, students have not had the opportunity to exercise choice over the specialty and location of their clinical placements. This is now changing but it requires the wholehearted commitment of students, their lecturers and all those in the institutions concerned. The innovation has to sit coherently within the largely externally prescribed curricula approved by the National Boards, the professional arm of conjoint validation processes. The challenges are many, but the benefits can be immeasurable. This article describes the experiences of one university in managing and planning these initiatives and examines students' responses to them. Significant questions are raised about developments for the future.
The role of the midwife in perineal wound care following childbirth
Authors: Grundy Lynne
Published: December 2014

Midwives have an important role to play in the care of perineal wounds following childbirth. A wide variety of practices are carried out in this area. However, some current practices may not be beneficial to the promotion of wound healing. Midwives must realize the relevance of their care and potential impact, both positive and negative, of advocated treatments in wound healing. The maintenance of effective pain relief must be balanced with the need to promote wound healing. It is important that midwives recognize the need for research-based practice and that an audit is set up nationally to evaluate the efficacy of treatments and practice. Research, audit and evaluation of services are the central processes involved in providing effective and efficient care, as advocated by the Department of Health (3.993).
Medical investigations 4: Bronchoscopy
Authors: Bassett Christopher
Published: December 2014

Flexible fibreoptic bronchoscopy has largely superseded rigid bronchoscopy. It allows direct visualization of the respiratory mucosa and detailed examination of the upper airways and tracheobronchial tree (Figure 1). By passing instruments through the endoscope local and transbronchi al biopsies and mucus/sputum samples can be taken for histological, cytological and microbiological examination.
Nurses' documentation of infection control precautions: 1
Authors: Finn Lesly
Published: December 2014

Inadequate nursing records may contribute to untoward incidents and yet advised precautions for the control of infection can be poorly documented. The infection control nurse must promote a safe environment for the patient and ensure that an effective control policy is carried out. The literature suggests that nurses may lack the necessary knowledge and skills with which to assess, plan and evaluate appropriate care for safe infection control. This article, the first of two parts, discusses these issues together with various strategies at the infection control nurse's disposal that may influence nursing practice and the documentation of care.
Preventing complications in people who wear contact lenses
Authors: Martin Siobhan , Barr Owen
Published: December 2014

The number of contact lens wearers has steadily increased over the past 1.0 years. Convenience, efficiency and availability of different types of lenses have made them popular. The rise in the use of contact lenses has increased the number of people at risk of contact lens-related complications. Studies have highlighted the consequences of poor contact lens care. Acanthamoeba keratitis is one of the most devastating complications of contact lens wear and can be avoided by adhering to the recommended contact lens regimen. This article reviews the literature on the complications of contact lens wear and stresses the need to educate the wearer. It examines the nurse's role in relation to health promotion and the basic principles for successful long-term contact lens wear. This Information is relevant to all nurses caring for people with contact lenses and will be of particular interest to the nurse who wears contact lenses.