bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of different cooking methods on the formation of food mutagens in meat
Authors: Skog Kerstin , Eneroth Åsa , Svanberg Maria
Published: March 2003

Hamburgers and chicken fillets were cooked in convection ovens, deep‐fried or contact fried and analysed for mutagenic activity using the Ames test. For the three different convection ovens, the cooking parameters studied included the presence of steam, air velocity, air temperature and holding time. For deep‐frying and contact frying, the cooking parameters included cooking temperature and cooking time. In cooked hamburgers, mutagenic activity was only detected in those that had been deep‐fried. In chicken fillets, mutagenic activity was detected in samples prepared with all cooking methods, being highest in the deep‐fried samples. Factorial analysis indicated that heat transfer was the most important factor affecting mutagenic activity. High temperature and high air velocity in the convection ovens enhanced mutagenic activity. The presence of steam reduced the mutagenic activity, except when high temperature was used in combination with high air velocity. In chicken fillets, high mutagenic activity correlated to high weight loss during cooking. Pan‐fried chicken fillets were analysed using high performance liquid chromatography (HPLC) and the mutagenic/carcinogenic heterocyclic amines 2‐amino‐3,8‐dimethylimidazo[4,5‐f ]‐quinoxaline (MeIQx), 2‐amino‐1‐methyl‐6‐phenylimidazo‐[4,5‐b]‐pyridine (PhIP) and the co‐mutagenic heterocyclic amine Norharman (9H‐pyrido[3,4‐b]‐indole) were identified. The HPLC fractions were tested for mutagenic activity and, apart from the mutagenic fractions corresponding to MeIQx and PhIP, several mutagenic fractions were detected that did not correspond to known heterocyclic amines.
Holes in the head: parietal foramina, a developmental anomaly seen during a routine orthodontic assessment
Authors: Luker  , McNamara  , Sandy
Published: March 2003

Parietal foramina (Catlin marks) are developmental anomalies which affect approximately 1 in 25,000 people. They are thought to be inherited as an autosomal trait and may be associated with other skeletal anomalies such as cleft lip or palate. The majority of enlarged parietal foramina are usually completely asymptomatic.
Whither paediatric dentistry?
Authors: Murray J.J.
Published: March 2003

The objective of the British Society of Paediatric Dentistry is to promote the oral health of children. This objective is discussed from four different aspects. First, it is necessary to quantify the dental needs of children and to appreciate how these needs have changed over the last 20 years. Using information from national dental surveys, changes between 1973 and 1993 in the prevalence of dental caries, periodontal disease, accidental damage to anterior teeth and occlusal problems, are summarized. Secondly, the development in consultant posts and the specialty of paediatric dentistry are discussed. The impact of research gradings given to Dental Schools in Britain is the third aspect to be considered and its possible effect on research topics directly relevant to improving the oral health of children. Lastly the effect of public perceptions on our specialty must be considered. Although paediatric dentists may not hit the headlines, the public must be convinced that good oral health is the birthright of every child and that we are dedicated to preventing and treating oral disease in children.
An investigation of language used by children to describe discomfort during dental pulp‐testing
Authors: Toole R.J. , Lindsay S.J.E. , Johnstone S. , Smith P.
Published: March 2003

Aim. Studies of the descriptions of pain by children have neglected their linguistic development, therefore estimates of dental pain in children may not be accurate. This study sought (1) to identify words chosen by children to describe dental pain and (2) to establish the effect of linguistic development on that description.

Sample. Seventy‐eight consecutive children between the ages of 5 and 13 years attending a paediatric dental clinic.

Method. Each child completed the WORD reading comprehension test. They then underwent a pulp test and a simulated pulp test, administered by a dentist in a counterbalanced order, of a healthy primary canine or permanent incisor, according to the child’s age. To describe each test, the children had to (1) select words from a list of 58 read by the experimenter and (2) give ratings on scales representing ‘sore’ and ‘tingly’.

Results. Analysis of variance confirmed that the children chose more words for the pulp test than for the simulated test (P < 0·001); the former also elicited higher ratings for ‘sore’ and ‘tingly’. The numbers of words chosen were transformed by a square root constant to ensure a normal distribution. Multiple regression analysis then showed that (1) the better the children’s reading comprehension, the fewer words they chose, possibly because they were less inclined to choose unfamiliar words, and (2) the older they were, the more words they chose, possibly because of having more experience of pain. There were similar findings for ratings of ‘sore’ and ‘tingly’.

Conclusions. To assess children’s experience of pain (1) they need to be presented with a list of words like the ones in this study, (2) the numbers of words chosen by them would represent the severity of pain, and (3) those numbers need to be adjusted for the children’s reading comprehension and age.
‘Ilko dacowo:’ canine enucleation and dental sequelae in Somali children
Authors: Rodd H.D. , Davidson L.E.
Published: March 2003

Objective. To assess the prevalence of primary canine enucleation and associated dental sequelae in Somali children resident in Sheffield.

Design. Cross‐sectional survey.

Setting. Somali religious education classes and homework groups, selected primary and secondary schools, and the Charles Clifford Dental Hospital, Sheffield (1998–99).

Subjects and methods. The target population were all Somali children aged between 4 and 17 years. Subjects were interviewed to obtain background sociodemographic data and an oral examination was performed. The status of the canine in each quadrant was noted, in addition to the presence of any dental anomalies in adjacent teeth. Features indicative of a history of attempted canine enucleation included: absence of primary canines, localized developmental defects affecting primary or permanent canines and lower lateral permanent incisors, and retention of lower primary lateral incisors with distal eruption of permanent lateral incisors.

Results. A total of 260 children were included in the study, comprising 56·5% of the target population. The mean age of the subjects was 9·7 years with an equal male and female distribution. According to the criteria devised, 82 (31·5%) of the subjects were considered to exhibit one or more of the dental features suggestive of a previous history of canine enucleation. There was no significant difference in prevalence according to gender or birthplace (UK, Somalia or another country), but a positive history was greater in subjects whose mother did not speak English. In addition to anomalies involving canines, lower permanent incisors were commonly missing (5·0% of children aged over 9 years).

Conclusion. The suspected continuation of canine enucleation in UK‐born Somali children raises important oral health issues. Culturally sensitive education is indicated to discourage this harmful ritual practice.
Therapeutic and economic implications of traumatic dental injuries in Denmark: an estimate based on 7549 patients treated at a major trauma centre
Authors: Borum Mette Kit , Andreasen Jens Ove
Published: March 2003

Aim. To analyse the type and extent of injuries presented by patients seeking treatment for traumatic dental injuries at a major trauma centre. Furthermore, to analyse acute and subsequent treatment demands and treatment costs.

Methods. A therapeutic and economic analysis was performed of 7549 patients treated for traumatic dental injuries in a major trauma centre located at the University Hospital in Copenhagen, Denmark. Cases were divided into uncomplicated (concussion, subluxation, enamel and enamel‐dentine fractures) and complicated cases (crown fractures with exposed pulps and crown‐root fractures, luxation injuries with displacement of the tooth and bone fractures).

Results. Primary tooth injuries were found in 2874 patients, involving 5443 teeth, among which 62·8% had complicated injuries. Permanent tooth injuries were found in 4525 patients, involving 10673 teeth, among which 40·4% had complicated injuries. The cost of treatment (including acute trauma service, follow‐up and subsequent restoration) was estimated to be 0·6–1 mill USD a year for the patients treated in this trauma centre. If this figure is transferred to the estimated trauma population in Denmark, a yearly cost of traumatic dental injuries appears to range from 2 to 5 mill USD per 1 mill inhabitants per year according to the treatment scenario.

Conclusion. Thus, treatment of traumatic dental injuries comprises an expensive part of the health services in Denmark.
Critical pH in resting and stimulated whole saliva in groups of children and adults
Authors: Anderson P. , Hector M.P. , Rampersad M.A.
Published: March 2003

Objective. The concentrations of calcium and phosphate in saliva have significant influence on the protective mechanisms of dental hard tissues within the oral environment. A lower calcium concentration means: 1) a lower thermodynamic driving force for hydroxyapatite precipitation at normal oral pH; 2) a higher driving force for hydroxyapatite dissolution at low pH; 3) a lower critical pH. The aims of this study were to: 1. determine the calcium and phosphate concentrations 2. calculate the critical pH for enamel and 3. determine the driving forces for demineralization and remineralization in a group of children and adults.

Methods. In this comparative study, calcium and phosphate concentrations were measured in the resting and stimulated saliva of child and adult volunteers using a spectrophotometric system used in routine blood analysis. Salivary flow rates were also measured in each group.

Results. The calcium concentrations were lower in children than adults, but the phosphate concentrations were not significantly different. The critical pH was significantly higher for children than adults in both resting and stimulated saliva. Therefore, the thermodynamic driving forces for; (1) demineralisation at low oral pH, is greater, and (2) for remineralisation at normal oral pH, is lower, in children compared to adults.

Conclusion. The results of this study show that from thermodynamic considerations alone, there is increased risk of demineralization in children compared with adults.
Histological investigation of physiologically resorbing primary teeth using Ag‐NOR staining method
Authors: Eronat Cemal , Eronat Nesrin , Aktug Mecla
Published: March 2003

Summary. Objective. The aim of this study was to investigate pulpal tissue of primary teeth in early and late stages of physiological resorption by means of silver‐binding nucleolar organizer region (Ag‐NOR) staining.

Study design. Ten primary teeth in early, ten in the late stage of resorption and five sound premolar teeth pulps as the control group were investigated by means of silver‐binding nucleolar organizer region (Ag‐NOR) staining.

Results. The mean number of Ag‐NOR’s per nucleus increased with the continuing of the resorption process. The difference in the mean number of Ag‐NORs was statistically significant both in the early and late stage of resorption compared with controls (P > 0·001). In the early stage of resorption calcific plates in the apical part of the pulps were observed. Odontoclasts, as well as inflammatory cells, were observed in the late stages of resorption.

Conclusions. The increase in the mean number of Ag‐NORs per nucleus with the progression of the resorption process in primary teeth suggests that metabolic cell activity in the early stages of resorption is enhanced and increased with the continuing of the process, thus showing the importance of the pulp tissue in the resorption process.
Influence of parents’ oral health behaviour on oral health status of their school children: an exploratory study employing a causal modelling technique
Authors: Okada M. , Kawamura M. , Kaihara Y. , Matsuzaki Y. , Kuwahara S. , Ishidori H. , Miura K.
Published: March 2003

Objectives.

The aim of this study was to examine the simultaneous interrelationships between parents’ oral health behaviour and the oral health status of their school children.

Sample and methods. Subjects comprized 296 pairs of parents (mother or father) and their children at an elementary school in Hiroshima. The child’s dental examination was performed using the World Health Organization (WHO) caries diagnostic criteria for decayed teeth (DT) and filled teeth (FT). The Oral Rating Index for Children (ORI‐C) was used for the child’s gingival health examination. Hiroshima University Dental Behavioural Inventory (HU‐DBI) was used for the assessment of the parents’ oral health behaviour. A parent–child behavioural model was tested by the linear structural relations (LISREL) programme.

Results. There was a significant correlation between DT and ORI‐C (r = – 0·168; P < 0·01). Correlation was found between ORI‐C and oral health behaviour in children (OHB‐C) (r = 0·182; P < 0·01). OHB‐C was significantly associated with the HU‐DBI (r = 0·251; P < 0·001). The hypothesized model after some revisions was found to be consistent with the data (χ2 = 1·3, d.f. = 6, P = 0·97; Goodness of Fit Index = 0·999). Parents’ oral health behaviour affected their children’s oral health behaviour (P < 0·001). Children’s oral health behaviour affected their DT through its effect on gingival health level. Parents’ oral health behaviour also had a significant direct effect on their children’s DT (P < 0·05). Children’s grade affected both DT and their oral health behaviour.

Conclusions. Parents’ oral health behaviour could influence their children’s gingival health and dental caries directly and/or indirectly through its effect on children’s oral health behaviour.
Determinants of self‐rated oral health status among school children in northern Tanzania
Authors: Åstrøm A. N. , Mashoto K.
Published: March 2003

Summary. Objective. This study aimed to assess the perceived oral health status and to explore its relationship with clinically assessed dental fluorosis among school children in Arusha town, Tanzania.

Methods. A total of 478 students (mean age 15·7 years) completed questionnaires administered in the schools during May to July 2000. Clinical photos of the upper and lower incisors were taken under field conditions. A total of 461 slides were rated under laboratory conditions. The severity of dental fluorosis in the permanent maxillary central incisors was assessed using the Thylstrup & Fejerskov Index (TFI).

Results. The prevalence of dental fluorosis at TFI score ≥ 2 was 74%. A total of 67% of boys and 70% of girls rated their teeth as yellow to brown, 58% of boys and 68% of girls (P < 0·05) confirmed dissatisfaction with their dental appearance. Kappa values of 0·40–0·44 were obtained between dental fluorosis (TFI ≥ 2) and self‐reported discoloration. The proportion of school children reporting dissatisfaction with oral condition and dental appearance increased with increasing TFI scores. Stepwise multiple logistic regression analysis explained 21% and 32% of the variance in the dissatisfaction with oral condition and dental appearance scores; TFI scores 11% and 15% of variation in points, and social and psychological variables 11% and 17%.

Conclusion. Whereas dental fluorosis at different diagnostic cut‐off points impacts self‐rated oral health negatively, social and personal factors are as important in shaping the responses of school children to oral condition and dental appearance.
Caries reductions between 1995, 1997 and 1999 in preschool children in Diadema, Brazil
Authors: Bönecker M. , Marcenes W. , Sheiham A.
Published: March 2003

Summary. Aims. This study aimed to assess changes in caries prevalence and severity in preschool children in Diadema, Brazil.

Methods. Three cross‐sectional surveys were conducted, using the same protocol, in 1995, 1997 and 1999. The first survey included children aged 5–35 months, and the second and third, children aged 5–59 months. Participants were selected from all children attending a National Day of Children’s Vaccination; 548, 992 and 690 in 1995, 1997 and 1999, respectively. This approach was sound as uptake rates for all years studied were above 90% for children aged between 1 and 59 months in all three surveys. Caries experience was measured using the World Health Organization (WHO) def index. Time‐lag and quasi‐longitudinal analysis were carried out.

Results. Time‐lag analysis showed a marked and statistically significant decline in the prevalence and severity of coronal and rampant caries between 1995 and 1999. There were reductions of 36·5% in the prevalence of caries in 2‐year‐olds between 1995 and 1997 (P < 0·002) and 36·0% between 1997 and 1999 (P = 0·041). The mean def‐s at the same age decreased from 2·0 in 1995 to 1·1 in 1997 (P < 0·001) and to 1·0 in 1999 (P > 0·05). The quasi‐longitudinal analysis showed a statistically significantly increase in the percentage of children with caries between 1995 and 1997 and 1997 and 1999 (P < 0·001), but not for 2‐year‐old children between 1995 and 1997 (P > 0·05). The same pattern was observed for severity of dental caries.

Conclusion. Oral health in preschool children in Diadema improved markedly during 1995–99.
Feeding and oral hygiene habits of preschool children in Hong Kong and their caregivers’ dental knowledge and attitudes
Authors: Chan S. C. L. , Tsai J. S. J. , King N. M.
Published: March 2003

Summary. Objectives. This study was designed to gather data on infant feeding habits and oral hygiene practices of Hong Kong preschool children, on the dental knowledge and attitudes of their caregivers and on the oral health status of the same group of children.

Design. Cross‐sectional study.

Sample and methods. Data was gathered for a total of 369 boys and 297 girls (207 1‐year‐olds, 269 2‐year‐olds and 190 3‐year‐olds) with a mean age of 20·19 (± 0·38) months. Information related to children attending six randomly selected Maternity and Child Health Centres. It was obtained by examining the children and by interviewing the attending caregivers and completing a questionnaire. Each child was given an oral examination using a torch, disposable mirror and wooden tongue spatula.

Results. Only 7% of the children were exclusively breast‐fed. More than 98% (656/666) of infants used a nursing bottle for at least some drinks. Over 62% (411/656) had used a nursing bottle to take fluids other than water and infant formula. At bedtime, 56% (361/656) were given a nursing bottle prior to sleep and 96% (340/361) of these bottles contained formula milk. Of these children, only 37% (131/361) finished the contents of the bottle before falling asleep. Over 73% (139/190) of the children continued to use a feeding bottle after 2 years of age. Non‐nutritive sucking habits were practised by 35·6% (237/666) of the children. Visible plaque, on the labial surface of at least two maxillary incisors, was found in 19·5% (120/615) of the children. Oral cleansing habits were practised for 66·2% (441/666) of the children. Toothbrushing habits were reported for 42·3% (260/615) of the dentate children, of whom 19% (49/260) had their teeth brushed twice daily. Toothpaste was used by 49·23% (128/260) of the children and 57·3% (149/260) brushed their own teeth. Caries was seen in 7·6% of the infants (47/615). Of the caregivers, 67·7% said they did not think carious primary teeth needed to be restored. Among the mothers, 12·6% (43/342) did not know the oral condition of their child. Reportedly, 82% (417/510) and 87·5% (446/510) of the mothers had not received any oral health care information during the ante‐ or postnatal periods. Nearly all, 97%, of the respondents said that they would like to receive more information on oral health care.
The power of children over adults when obtaining sweet snacks
Authors: Roberts B. P. , Blinkhorn A. S. , Duxbury J. T.
Published: March 2003

Summary. Background. There is evidence to suggest that the family is becoming a more democratic unit and that children are spending more on sweet snack items than ever before. A study was thus undertaken to investigate the influence of children on parental decision‐making in relation to the use of sugary snacks.

Methods. A cross sectional interview study; children aged 7–8 years from 20 inner‐city Manchester primary schools were asked about their sweet eating, their pocket money and their perceived levels of influence or autonomy within the household. The parents of these children were also asked to fill in a questionnaire that mirrored the children's questions.

Results. There was a moderate but significant correlation between the opinion of the parents and that of the children on the extent of influence (Pearson coefficient r = 0·25, P = 0·001). When the adults (n = 181) were split into age groups, ≤ 29 years (n = 33), 30–35 years (n = 61) and ≥ 36 years (n = 87), the study showed that the older the adult, the less the child seemed to get his or her own way. Spearman's rho = 0·16, P = 0·03 (children's view) and rho = 0·17, P = 0·02 (adult's view). The dominant factors were related to money in the children's opinion, although the adults’ data suggested that older mothers (≥ 36 years) may be trying to limit their children's access to sweet snacks.

Conclusions. Adults’ efforts to limit their children's intake of sweet snacks and drinks are being undermined by earlier and earlier influences in the child's life and by access to money, which allows the child to out‐manoeuvre his or her parents. This is compounded by the provision of additional income, mostly from grandparents.
Feminism: a concept analysis
Authors: Allan Helen Therese
Published: March 2003

The purpose of this paper is to analyse the concept of feminism in order to clarify a sociological concept for its use in nursing theory and practice This analysis is earned out using the Walker & Avant (1988) model It includes a literature review, an overview of the uses of the concept drawn from the literature, the defining attributes and the justification of their choice, the cases to demonstrate the concept, and the concept criteria The concept was chosen out of an interest in developing a feminist nursing theory and desire to enhance nursing practice The literature search proved most fruitful in the sociological literature The nursing sources were fewer and concerned with practice rather than articulating any feminist nursing theory Many of these sources were sociologists and nurses The concept of feminism was denned as the concern with gender equality and the promotion of equal rights for men and woman, the expression of these concerns through theory or action, and the valuing of individuals for their contributions to society rather than their biological or sexual characteristics or roles Although the concept of feminism was defined and analysed within the model suggested by Walker & Avant, the author found that the concept became oversimplified, losing much of the richness of the literature The author felt that, for any development of theory or practice, this analysis would have to be expanded It is argued that their model is too restrictive as it is based on positivist philosophy which seeks to establish divisions where, in fact, there is a blurring of meaning Contrary to Walker & Avant, it is argued that if concepts overlap this does not necessarily diminish the potential usefulness of the concept in theory or practice
The determinants of psychiatric nursing practice: a comparison of sociological perspectives
Authors: Porter Sam
Published: March 2003

This paper commences by observing that psychiatric nurses tend not to interact with their clients in a therapeutic fashion It is not clear, however, whether this is due to the nature of psychiatric institutions or to the attitudes of individual nurses Contrasting social theories which posit either the importance of social structures, or of individual interpretations as determinants of behaviour, are outlined These are then applied to the problem of psychiatric nursing practice It is argued that while there are strengths in both theoretical positions, neither on their own can adequately characterize the complexity of the problem Rather than attempting to explain influences upon psychiatric nursing practice in terms of either structure or action, we should appreciate the importance of, and relationship between, both factors Given the rapid changes occurring in mental health nursing, research into factors influencing practice will become increasingly important In order to explain developments adequately, researchers will need to take account of the duality of structure and action
The knowledge base of health visitors and district nurses regarding products in the proposed formulary for nurse prescription
Authors: While Alison E , Rees Karen L
Published: March 2003

The background to the legalization of nurse prescribing is reviewed and a small questionnaire survey of health visitors and district nurses described Significantly more district nurses than health visitors wanted to become nurse prescribers Health visitor knowledge of some parasiticidal lotions and antifungal agents was found to be variable and the recommended dose of paracetamol for post‐immunization pyrexia was recognized by less than two‐thirds of the sample District nurse knowledge of lactulose was limited in comparison to their knowledge of alginate and hydrocolloid dressings, however, their knowledge of factors other than dressing type which enhance or delay healing was variable The mean knowledge scores of both the health visitors and district nurses were unacceptably low for prescribing purposes The majority of the total sample stated that they would like further training, with a preference for such provision in the form of study days
Putting theory into practice: problems and prospects*
Authors: Kim Hesook Suzie
Published: March 2003

The apparent gap between theory and practice in nursing seems to be widening as it is becoming increasingly difficult for nurses to manage multiple theories and conflicting knowledge claims for their use in practice Scientific pluralism in nursing provides, on the one hand, a rich array of knowledge about human phenomena and ways of dealing with nursing problems, while on the other a set of theoretical choices available for knowledge‐use in practice This paper presents four ideal‐type modes of theory application as viable forms for nurses in practice to deal with theoretical pluralism
The discipline of nursing: historical roots, current perspectives, future directions
Authors: Shaw Maureen C
Published: March 2003

As advances in nursing science and research impact upon nursing education and clinical practice, new ways of looking at phenomena have led to a re‐examination and refinement of the traditional concepts person, environment, health and nursing This evolving pattern of intellectual growth holds promise for the discipline of nursing through the advancement of knowledge based upon scientific inquiry into the practice of nursing This paper discusses nursing as a discipline by examining the development of a unique body of knowledge from three viewpoints historical past, current perspectives and future direction
The impact of nursing care in Latin America and the Carihbean: a focus on outcomes1
Authors: Holzemer William L
Published: March 2003

A systems model is presented that has the potential to expand understanding of the complex nature of health‐related outcomes The horizontal axis is a systems axis of context, process and outcome and the vertical axis consists of the client, provider and setting Examples from outcome research in Latin America and the Caribbean are provided Each section is explored from the perspective of primary health care research and some of the issues of design, measurement and analysis are raised The systems model is offered as a framework for conceptualizing research on the impact of nursing care on client, provider and setting outcomes
Method and methodology in feminist research: what is the difference?
Authors: King Kathryn E
Published: March 2003

Feminism and nursing have historically travelled separate paths Nursinghas only recently begun to embrace feminist philosophy, and consequently nurse researchers are just beginning to undertake truly feminist research There appears to be little consensus between feminist researchers' interpretations of the concepts of method and methodology Prior to embarking on the development of a feminist research proposal it is imperative to differentiatebetween these two concepts This paper explores the concepts of method and methodology and explains their interrelationship Feminist research methodology, with its emphasis on a non‐hierarchical, reflexive, interactive approach is highlighted and its impact on the researcher's choice of an appropriate method is discussed It is only through addressing these issues that nurseresearchers will be effective in pursuing truly feminist research that can act as a catalyst for the emancipation of women and the nursing profession
Quality of life in long‐stay institutions in England: nurse and resident perceptions
Authors: Oleson Marjone , Heading Carol , McGlynn Kathleen , Bistodeau Jo Ann
Published: March 2003

Quality of life (QOL) of older persons living in institutions is a critical consideration in international economic policies and health care decisions Yet, there is little relevant research to support decisions about culturally acceptable and effective nursing care for this population This qualitative study explored and compared perceptions of older residents and nurses in three long‐stay institutions in south‐west England It addressed issues viewed as important to a good QOL for residents and ways in which nurses promote QOL A convenience sample of 10 residents aged 65 and older (80% female) and nine nurses (n=five registered general nurses and four enrolled nurses) were interviewed using a semi‐structured schedule Interview data were analysed using an analytic induction method of content analysis While theme frequency and examples differed, themes common to both residents and nurses were individuality, professionalism, connectedness, and physical functioning Resident responses tended to be personal, succinct, and sometimes negative Nurses' responses were more positive, detailed, and reflective of general professional responsibilities Implications for nursing education, research, and practice are discussed Improvement in QOL will be addressed differently based on social and cultural settings However, there may be commonalities that are applicable across cultures
Elderly patients’and their informal caregivers’perceptions of care given: the study‐control ward design
Authors: Laitinen Pirjo
Published: March 2003

This preliminary study is part of an ongoing action research project Elderly patients (n=45) and their informal caregivers (n =147) completed a questionnaire The purpose of this study was to evaluate the quality of care from both the patients' and their informal caregivers’points of view and to compare differences in perceived quality of care between study and control wards in different hospitals Results indicated that the great majority of elderly patients were satisfied with the fulfilment of their needs Informal caregivers evaluated the quality of care more critically than did the patients Statistically significant differences were found between the control and the study wards in acute‐care settings, however, differencesbetween the wards in long‐term care settings were non‐significant Nurses and researchers must better understand the needs of an increasing population of elderly patients Informal caregivers are in a key position to help nursing professionals to cope with the future challenges of elderly people's care Their perceptions must also be taken into account
The views and values of community nurses and their managers: research in progress ‐ one person's pain, another person's vision
Authors: Traynor Michael
Published: March 2003

This paper presents preliminary findings from research being earned out into how community nurses in three first‐wave community trusts are responding to changes stemming from recent legislation A Measure of Job Satisfaction was devised for the study for administration to the entire nursing workforce in the participating trusts and semi‐structured interviews were carried out with managers at all levels in each of the trusts This paper concentrates on the textual data arising from the study dealing with how nurses understood the values of managers and how managers viewed nurses’values Nurses tended to express then‐ beliefs about managers as a series of us‐them oppositions while the comments of managers can be seen within a rational/irrational dualism Some possible theoretical frameworks in which these texts can be further explored are briefly discussed, including Foucault's power/knowledge concept and the literature of‘colonization’
Living with diabetes: issues for nursing practice
Authors: Callaghan Doris , Williams Anne
Published: March 2003

Discussion in this paper is based on findings drawn from research undertaken within a qualitative framework of analysis, and with the purpose of exploring people's perceptions of living with diabetes, including the nursing care they receive A major theoretical concern is to demonstrate the importance of placing patients’and clients’experiences at the centre of nursing interest and practice It is argued that understanding a disease process should of necessity include an understanding of the concerns of those who live with it Findings related to the following research questions are discussed first, what are the challenges of living with diabetes? and second, what are people's perceptions of the nursing care they receive?
Humour in nursing care
Authors: Åstedt‐Kurki Paivi , Liukkonen Arja
Published: March 2003

Humour is an integral part of everyday life and therefore also a component of the care and treatment of patients in the modern health care system This paper looks at the role of humour in practical nursing in the light of earlier research literature on the subject It also describes some preliminary results of our studies on the meaning of humour to professional nurses We opted to use a qualitative approach in this study because the focus of interest was on an issue that has received only little attention in earlier research Nurses were presented with a set of unstructured, open‐ended questions requiring short, essay‐type answers The data obtained were analysed using the qualitative method of content analysis In the light of our findings here, humour can be described as a joie de vivre which is manifested in human interaction in the form of fun, jocularity and laughter Humour is a meaningful factor, both with regard to the patient's well‐being and to coping, and also with regard to the interaction of nurse and patient Humour also allows for more job satisfaction and better motivation Research should be continued and intensified into the role and use of humour in everyday life and particularly in nursing care
Linking the parts: an exemplar of philosophical and practical issues in holistic nursing
Authors: Cribb Alan , Bignold Sarah , Ball Stephen J
Published: March 2003

This paper offers an analysis of some of the challenges of holism, particularly the challenges relating to co‐operation and role indeterminacy It uses the work of one group of nurses (specialist paediatric oncology nurses) to exemplify these issues, and it draws upon some empirical research into their work These nurses work to provide a link between hospital and home for families with children with cancer, but it is suggested that the fundamental issues they face, (a) in linking the parts of the system, and (b) in linking the parts of care as it is experienced, are shared by anyone who subscribes to holistic nursing Issue (a) raises questions of professional boundary crossing, and calls upon diplomatic and micro‐political skills Issue (b) raises questions about the boundaries of health care, and calls upon skills of‘translation’and emotional labour The value of holism is not questioned but the paper illustrates how aiming for holistic care inevitably opens up philosophical and practical problems and concerns
Depression and issues of control among elderly people in health care settings
Authors: Barder Louise , Slimmer Lynda , LeSage Joan
Published: March 2003

This descriptive study investigated the relationship between both demographic characteristics and type of health care setting and elderly people's attributions for control, functional status, mood, type of helplessness, and perception of self‐efficacy Results of the study demonstrate that elderly people in long‐term care settings are more vulnerable to experiencing learned helplessness and depression than elderly people in acute or rehabilitation settings The findings indicate that the critical penod for the development of learned helplessness and depression is for subjects with a length of stay of 7 weeks to 6 months The study supports other research which concludes that depression in elderly people is better explained by the original learned helplessness theory rather than being related to attributions about the cause of loss of control
The psychosocial needs of patients who have attempted suicide by overdose
Authors: Camgan James T
Published: March 2003

This is an exploratory study using qualitative methods to investigate and highlight psychosocial needs as perceived by individuals who have survived an attempted suicide through self‐poisoning Respondents consisted of a convenience sample of six people (three male and three female) Data were collected through interviews and analysed using the principles of content analysis devised by Field and Morse Major needs identified include the need to be loved, the need to maintain a high level of self‐esteem, the need to have control of one's life and the need to be supported Findings indicate that these needs are not being met by the current mental health care delivery system In addition, nurses must begin to pay greater attention to assessment and planning of care for this group of patients A wider use of psychosocial therapies such as crisis intervention and family therapy are urgently required Above all there is a need for more in‐depth understanding and improved communication with patients who have attempted suicide by self‐poisoning
Expert: a discussion of the implications of the concept as used in nursing
Authors: Jasper Melanie A
Published: March 2003

The concept‘expert’ has become common in the nursing literature since Benner's (1984) work more than a decade ago Whilst the term has a common meaning, it is apparent that when used in nursing it refers to a multitude of attributes and lacks clear definition This paper uses the strategy for concept analysis developed by Walker & Avant (1988) to seek an operational definition for the concept of ‘expert’, and suggests the denning attributes of possession of a specialized body of knowledge and skill, extensive experience in a field of practice, highly developed levels of pattern recognition, and acknowledgement by others These are discussed in relation to nursing practice and the circumstances under which the concept is used Development of cases is carried out to exemplify the concept, and the antecedents and consequences of the attributes are discussed, suggesting that the concept lacks clarity, both in conceptualization, and in use A first definition of the concept is posed to open debate concerning the relevance of the term for the future The conclusions reached suggest that whilst an operational definition is unlikely to be found, because of the problems of definition and measurement, it is possible, through various strategies, to recognize expert practice and use it to further develop nursing Furthermore, it is likely to become increasingly important to recognize and reward expert practitioners, given the political and economic constraints in health care today
Community nursing in Belgium, Germany and the Netherlands
Authors: van der Zee Jouke , Kramer Klarieke , Derksen Anneke , Kerkstra Ada , Stevens FCJ
Published: March 2003

This paper contains a comparative study on community nursing in the Netherlands, Belgium and Germany, carried out in the region around Maastricht, where the borders of the three countries meet The well‐known problem of comparative studies (the incomparability of concepts and data) has been solved by using the same measuring instruments in the three countries The comparison between the countries was on three aspects the level of care dependency of the patients, the type and number of services provided and the nurses'job interpretation and job satisfaction During 1 week in June or September 1991, 89 community nurses made records of all their home visits and nursingactivities In total the community nurses paid 5165 home visits to provide care to 1796 patients The results indicate that both the level of care dependency of the patients as well as the type of care provided differs between the three countries Belgian community nurses have the highest number of patients with a high level of care dependency Curative services like technicalnursing care and domestic care are most frequently provided by the German and Belgian community nurses Informing, educating and supporting care is most frequently provided by the Dutch community nurses The German community nurses spend less time on administration activities With respect to job
Quality nursing care: a qualitative enquiry
Authors: Hogston Richard
Published: March 2003

In spite of the wealth of literature on quality nursing care, a disparity exists in defining quality The purpose of this study was an attempt to seek out practising nurses' perceptions of quality nursing care and to present a definition of quality as described by nurses Eighteen nurses from a large hospital in the south of England were interviewed Qualitative analysis based on a modified grounded theory approach revealed three categories described as ‘structure, process’ and ‘outcome’ This supports previous work on evaluating quality care but postulates that structure, process and outcome could also be used as a mechanism for defining quality The categories are defined by using the words of the informants in order to explain the essential attributes of quality nursing care The findings demonstrate how more informants cited quality in terms of process and outcome than structure It is speculated that the significance of this rests with the fact that nurses have direct control over process and outcome whereas the political and economic climate in which nurses work is beyond their control and decisions over structure lie with their managers
A sociological analysis of the extent and influence of professional socialization on the development of a nursing identity among nursing students at two universities in Brisbane, Australia
Authors: du Toit Denise
Published: March 2003

Professions make extraordinary demands on its practitioners Professionals are required to master substantive theory and technical skills They also develop their own unique subcultures, demanding specific normative standards from their members, which are symbolized by professional ethical codes In the health professions, ethical codes include strong altruistic elements Professiona normative standards are learnt on a formal level (for example, at a university) and informal level (during the process of professional socialization and contact with the peer group, as well as informal sanctions) The transformation process of a novice to a professional is essentially an acculturation process during which the values, norms and symbols of the profession are internalized Acculturation can be so strong that it may cause personality transformation, which the French refer to as ‘deformation professionelle’, usually displayed by stereotypes, which are almost always exemplified by members of professions as ideal professionals, those who have internalized the profession's culture completely The question is, what is the extent of normative standards and professional characteristics that nursing students are exposed to during professional socialization, and to what extent are these standards and characteristics internalized so that a nursing ‘deformation professionelle’ develops9 A reliable Likert‐type measurement scale was developed to measure this phenomenon One of the most important findings of this study was that students at both universities are highly professionally socialized
Nursing: empowerment and the problem of power
Authors: Gilbert Tony
Published: March 2003

The concept of empowerment is one which is often invoked in discussions over the nature of nursing practice in a range of health and welfare services A short excursion through the Cumulative Index to Nursing and Allied Health Literature reveals that over the last 10 years 378 papers are identified which list empowerment as one of the topics discussed In 1993, the number is 55 These papers cover a diverse range of health related issues health promotion and HFV, breast feeding, mental health, management and leadership, change, training and education, feminism and women's issues, sexual abuse and violence, advocacy and working with immigrants, professionalism, and nursing theory However, few of these papers discuss the relationship between empowerment and the notion of power itself This gives rise to particular problems for nursing practice, for without a clear conceptualization of what is meant by power it is difficult to convincingly argue that one form of practice is more or less empowering than another Alternatively, this dilemma may be stated in the following question how do we work to empower others when we have no clear notion of what power is? This paper demonstrates that the concept of power demands a very specific consideration In order to illustrate this it briefly identifies problems within two models of power which are drawn upon in nursing It also demonstrates the way in which the work of Michel Foucault can be drawn upon to inform nursing in the analysis of the relationship between power and health
Interviews in qualitative nursing research: differing approaches for ethnographic and phenomenological studies
Authors: Sorrell Jeanne Merkle , Redmond Georgine M
Published: March 2003

Interviews form an essential part of data collection for many qualitative nursing studies Information about how to individualize interview formats to meet the purpose and style of specific qualitative research approaches, however, is not readily accessible to the researcher This paper offers an overview of use of the interviewer as an instrument in qualitative research, as well as ways in which the differing purposes and styles of ethnographic and phenomenological research approaches affect the format for the interview
Clinical support and the Project 2000 nursing student: factors influencing this process
Authors: Wilson‐Barnett Jenifer , Butterworth Tony , White Edward , Twinn Sheila , Davies Sue , Riley Liz
Published: March 2003

This paper reports on research commissioned by the English National Board for Nursing, Midwifery and Health Visiting into mentorship and clinical support arrangements for Project 2000 nursing students in the adult and mental health branches Interviews and observation data were gathered from staff and students in three of the demonstration centres Findings showed that the terms ‘mentorship’, ‘assessor’ and ‘supervisor’ were used interchangeably and covered diverse roles in both clinical and community settings Generally there was an impression that staff were willing to help students learn from their experience but felt unprepared for the ‘new nursing students’ Several factors emerged which seemed either to promote satisfactory experiences for students or inhibit their learning and enjoyment of the placement These are discussed under the themes ‘supernumerary status’, ‘team spirit’, ‘theory and practice’, ‘diploma level practice’ and ‘organization of nursing teams’