bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular detection of Y chromosome microdeletions: an Irish study
Authors: Friel A. , Houghton J. A. , Maher M. , Smith T. , Noël S. , Nolan A. , Egan D. , Glennon M.
Published: March 2003

The region of the Y chromosome most critical for male fertility is called the azoospermia factor (AZF) region and it is located within subintervals five and six on the long arm of the Y chromosome. Several genes, all residing here, contribute to spermatogenesis and deletions in these genes are thought to be pathogenetically involved in some cases of male infertility associated with azoospermia or oligozoospermia. The aim of this study was to establish the prevalence of microdeletions in the AZF region of the Y chromosome in an Irish male population undergoing fertility treatment. To do this, we applied and compared two independent polymerase chain reaction (PCR) based screening methods, namely, a PCR protocol using several sequence‐tagged site (STS) primer sets and a recently published multiplex PCR Y chromosome screening protocol. A total of 78 patients, attending the IVF unit at University College Hospital, Galway, were included in this study. Of them, 56 suffered from idiopathic azoospermic/oligozoospermic infertility. The remaining 22 patients had various conditions, which may have contributed to their infertility. A total of 50 age‐matched normospermic men were included as controls. Two microdeletions were found; one in the AZFa region and one in AZFb region. These deletions were observed among the truly idiopathic cases. Further analysis was performed to study the extent of the deletions and it was confirmed that each deletion encompassed the respective AZF region including the AZF candidate gene.
High incidence of single nucleotide substitutions in the mitochondrial genome is associated with poor semen parameters in men
Authors: Holyoake A. J. , McHugh P. , Wu M. , O'Carroll S. , Benny P. , Sin I. L. , Sin F. Y. T.
Published: March 2003

Single nucleotide polymorphisms (SNPs) in 7000 bp of the mitochondrial genome, encompassing 15 coding regions from COI to ND5, were characterized by single strand polymorphism analysis and confirmed by DNA sequencing. About 2.4% of normozoospermic men and 8.4% of men with poor semen quality had at least one nucleotide substitution. Most of the substitutions occurred in the third codon and did not change the amino acid. Hydrophobicity plots of the proteins with changes in an amino acid as a result of a nucleotide substitution suggested that they did not affect the function of the protein. The two most common substitutions at nucleotide (nt) 9055 and 11719 had significantly higher frequencies in men with reduced sperm motility. Eleven percent of the men with poor semen parameters and 1.3% of normozoospermic men had a 9055 substitution, 12% of the men with poor semen parameters had a substitution at nt 11719, but none of the normozoospermic men had this substitution. All the patients with these substitutions had reduced sperm motility and/or low sperm count. These SNPs in the mitochondrial genome were in a homoplasmic state. Thus, we propose that possessing these mitochondrial mutations compromises the semen quality of these men.
Update on medical treatment of ejaculatory disorders1
Authors: KAMISCHKE A. , NIESCHLAG E.
Published: March 2003

Among the treatment modalities for ejaculatory disorders pharmacological treatment is the least invasive option. In this review, medical treatments for retrograde ejaculation (RE) and anejaculation (AE) are discussed systematically. Thirty‐six studies dealing with patients with RE and 40 with AE evaluated the use of medical treatment and were included in this review. In addition four articles dealing with prostatic massage in anejaculatory patients were considered. Sperm quality in patients with retrograde and AE is often impaired. In patients with RE no differences in response to medical treatment could be detected between the different underlying diagnoses. Compared with ephedrine, imipramine and chlorpheniramine + phenylpropanalamine showed significantly higher reversal rates, while differences between the other treatments were not significant. Regarding the reversal of AE, the alpha agonistic drugs were significantly inferior to treatment with parasympathetic drugs. Of the different alpha agonistic medical treatments for the reversal of AE, milodrin showed significantly better rates than imipramine (p = 0.008), pseudoephidrine (p = 0.02) and ephedrine (p = 0.044), while all other treatments were not significantly different (p = 0.4). In conclusion, medical treatment for reversal of RE offers a realistic chance of conceiving offspring naturally and should be the treatment modality of first choice. In contrast, in AE, medical treatment cannot be recommended generally as treatment of first choice as it shows low overall success rates compared with electrovibration stimulation and electroejaculation. Under consideration of the mostly uncontrolled design of the majority of studies published, controlled clinical trials comparing different treatment options appear urgently warranted.
Oxytocin promotes spermiation and sperm transfer in the mouse
Authors: Assinder S. J. , Rezvani A. , Nicholson H. D.
Published: March 2003

Spermatogenesis is a complex process during which developing germ cells move from the base of the seminiferous tubule towards the lumen where they are shed. Studies in the rat suggest that seminiferous tubule contraction, induced by exogenous oxytocin, promotes spermiation. This study examines the role of testicular oxytocin in development of the testes, spermatogenesis and spermiation in the mouse. Groups of wild‐type (WT) mice, oxytocin knockout mice (OTKO) deficient in testicular oxytocin and mice containing an oxytocin transgene (bOT4.2) that over express testicular oxytocin were killed between days 5 and 45 post partum. The testes and epididymides were removed weighed and prepared either for histological and morphometric study by light microscopy, for sperm counts (epididymis), or extracted for determination of oxytocin content (testis – day 45 only). Testicular oxytocin concentrations were significantly greater (p < 0.05) in bOT4.2 mice than in WT or OTKO mice. No differences in testicular and epididymal weight, or in diameter and area of seminiferous tubules between the mice genotypes were found at any given time. Germ cell development was similar in all genotypes and was comparable with previous studies. The timing of spermiation between the groups was significantly different (p < 0.001) with bOT4.2 < WT < OTKO and the appearance of epididymal sperm was significantly different (p < 0.05) with bOT4.2 < WT < OTKO. There were significant correlations between the percentage of tubules containing residual bodies and epididymal sperm count (p < 0.05) and between the percentage of animals containing residual bodies and the percentage of animals containing epididymal sperm (p < 0.01). These data suggest that in the mouse oxytocin, whilst not involved in germ cell development, is important in the process of spermiation and sperm transfer in the mouse.
Hypoxia‐mediated regulation of gene expression in mammalian cells
Authors: Shih Shu‐Ching , Claffey Kevin P.
Published: March 2003

The molecular mechanism underlying oxygen sensing in mammalian cells has been extensively investigated in the areas of glucose transport, glycolysis, erythropoiesis, angiogenesis and catecholamine metabolism. Expression of functionally operative representative proteins in these specific areas, such as the glucose transporter 1, glycolytic enzymes, erythropoietin, vascular endothelial growth factor and tyrosine hydroxylase are all induced by hypoxia. Recent studies demonstrated that both transcriptional activation and post‐transcriptional mechanisms are important to the hypoxia‐mediated regulation of gene expression. In this article, the cis‐acting elements and trans‐acting factors involved in the transcriptional activation of gene expression will be reviewed. In addition, the mechanisms of post‐transcriptional mRNA stabilization will also be addressed. We will discuss whether these two processes of regulation of hypoxia‐responsive genes are mechanistically linked and co‐operative in nature.
Apoptosis is a pathway responsible for the resolution of endotoxin‐induced alveolar type II cell hyperplasia in the rat
Authors: TESFAIGZI JOHANNES , WOOD MARCY B. , JOHNSON NEIL F. , NIKULA KRISTEN J.
Published: March 2003

Previous studies showed that intratracheal instillation of endotoxin induces transient type II cell hyperplasia in the rat lung and described some of the mechanisms involved in the proliferative response of type II cells. The purpose of the present study was to investigate how long the type II cell hyperplasia persists and how it is resolved. The portion of epithelial cells in hyperplastic lesions of the rat lung expressing cyclin D1, an indicator for cells in the G1 phase of the cell cycle, was greatest at 3 d post instillation and decreased after 4 and 6 d. The fate of the proliferating epithelial cells was traced by injecting the rats with 5‐bromo‐2′deoxy uridine (BrdU) 2 d post instillation, the peak time point for maximum incorporation of BrdU. Exfoliated BrdU‐positive epithelial cells were detected in the alveolar spaces in tissue sections from rats 4, 5, and 6 d post instillation. BrdU‐positive epithelial cells showed flattened nuclei at 6 and 10 d post instillation. Expression of the 116 kD poly(ADP‐ribose) polymerase (PARP) was low in type II cells from control rats, and was increased at 3, 4, and 6 d post instillation. In cells obtained by lavage, only a 35 kD cleavage product of PARP was detected, which is an indicator of necrotic cell death. In isolated type II cells from rats 3, 4, and 6 d post endotoxin instillation, progressive cleavage of the PARP to its 89 kD residual fragment was detected, which is a direct evidence for the activation of caspases. Furthermore, apoptotic epithelial cells with condensed nuclei were identified by electron microscopy in rats 4 d post instillation. These results indicate that apoptosis is an additional mechanism for the resolution of endotoxin‐induced lung epithelial hyperplasias.
Synovial chondromatosis: the possible role of FGF 9 and FGF receptor 3 in its pathology
Authors: Robinson Dror , Hasharoni Amir , Evron Zoharia , Segal Michael , Nevo Zvi
Published: March 2003

Primary
synovial
chondromatosis (PSC) is a rare disorder of the synovium typified by cartilaginous nodule formation within the synovial membrane.
Fibroblast
growth
factor
receptor 3 (FGFR3) is a recently described specific marker of mesenchymal precartilaginous stem cells. Expression patterns of FGFR3 and its specific ligand,
fibroblast
growth
factor 9 (FGF 9), were evaluated both in situ and in cell cultures. Histologically, cells at the periphery of the cartilage nodules express FGFR3 and PCNA (
proliferating
cell
nuclear
antigen). Elevated levels of FGF 9, its specific ligand, have been found in synovial fluids of patients with synovial chondromatosis. Synoviocytes but not chondrocytes from affected patients express FGF9 in culture. This pattern is absent in normal synovium and cartilage. Downregulation of FGF9 may provide a possible nonoperative therapy for PSC.
Involvement of platelet activation in experimental osteonecrosis in rabbits
Authors: Masuhara Kensaku , Nakata Katsuya , Yamasaki Satoshi , Miki Hidenobu , Yoshikawa Hideki
Published: March 2003

Osteonecrosis (ON) was produced experimentally in rabbits by intravenous injection of platelet activating factor (PAF) in combination with lipopolysaccharides (LPS) on two occasions separated by a week‐long interval. Eleven of 15 rabbits (73%), with administration of both LPS (50 µg/kg) and PAF (10 µg/kg), exhibited microcirculatory injuries including extravasation of erythrocytes into sinusoidal spaces and formation of microthrombi in arterioles near regions of erythrocyte extravasation. Seven of 15 rabbits (47%), which received both LPS (50 µg/kg) and PAF (10 µg/kg), exhibited necrosis of trabeculae and 8 of 15 (53%) exhibited bone marrow necrosis. In addition, PAF receptor antagonist (0.3 and 3.0 mg/kg) significantly reduced the incidence of trabecular necrosis (0%) in this model. The findings of the present study suggest that platelet activation may play an important role in inducible ON, and that suppression of platelet activation may contribute prevention of ON.
Demographic characteristics, oral health knowledge and practices of mothers of children aged 5 years and under referred for extraction of teeth under general anaesthesia
Authors: Hood  , Hunter  , Hunter  , Kingdom
Published: March 2003

Aims. To examine the demographic characteristics, oral health knowledge and practices of mothers of children who required the extraction of teeth under general anaesthesia.

Design. Cross‐sectional study using questionnaires completed at interview.

Sample. 150 mothers of children aged 5 years and under who had been referred for extraction of teeth under general anaesthesia.

Setting. Dental School, University of Wales College of Medicine.

Results. Over three‐quarters of mothers had finished their full‐time education at or before the age of 16 years. Although generally well‐informed about the causes of caries, mothers were less sure of preventative methods. There was a widespread ignorance of the causes and prevention of periodontal disease, with just under half of the sample being unable to identify any causative or preventative factors. 40% of the sample admitted to attending a dentist only when in pain or not at all.
Morphology of dental enamel and dentine–enamel junction in osteogenesis imperfecta
Authors: Lindau B.M. , Dietz W. , Hoyer I. , Lundgren T. , Storhaug K. , NorÉn J.G.
Published: March 2003

Objectives. The aim of this study was to examine the morphology of primary and permanent human enamel, and the dentine–enamel junction, in individuals with osteogenesis imperfecta (OI) type I, III and IV in undecalcified sections using polarized light microscopy, microradiography and scanning electron microscopy (SEM), and to relate the findings to the type of OI.

Sample and methods. Extracted or exfoliated teeth from 15 patients representing the OI types I, III and IV (12 primary teeth from seven patients, and 11 permanent teeth from eight patients). Ten primary and nine permanent teeth from normal healthy patients served as controls. The teeth were serially cut longitudinally in a bucco‐lingual direction and contact microradiographs were made. The sections were examined in polarized light. Sections of primary and permanent teeth were examined by means of SEM.

Results. This study shows that the permanent enamel from patients with OI exhibits few structural changes. No relationships were found between enamel morphology and the types of OI (I, III, IV). Primary enamel appeared to be slightly more irregularly mineralized, especially in cases with the additional diagnosis dentinogenesis imperfecta. The major findings were deviations in association with the dentine–enamel junction, and locally a lower degree of mineralization.

Conclusions. The mesodermal disease OI might also be manifested in ectodermal enamel, probably because of suboptimal mesenchymal–ectodermal interactions during amelogenesis.
Vegetarianism and dental fluorosis among children in a high fluoride area of northern Tanzania
Authors: Awadia A.K. , Haugejorden O. , Bjorvatn K. , Birkeland J.M.
Published: March 2003

Objective. The purpose of this study was to compare the prevalence and severity of dental fluorosis among vegetarian and nonvegetarian children and adolescents living in an area where dental fluorosis is endemic.

Design. An analytical cross‐sectional retrospective study.

Sample and methods. Children (n = 165) aged 6–18 years, from five schools in Arusha town were examined. The children had a life‐long exposure to drinking water with 3·6 mg F/litre. The severity of dental fluorosis was assessed using the Thylstrup & Fejerskov Index (TFI).

Results. In the vegetarian group (n = 24), the prevalence of dental fluorosis (TFI score 1) was 67%, while 21% had severe fluorosis (TFI score 5). In the nonvegetarian group (n = 141) the prevalence of fluorosis and severe fluorosis was 95% and 35%, respectively. In bi‐variate correlation analyses age, vegetarianism and a series of other factors related to childhood nutrition (meals per day, the use of home‐made porridge, the use of fish, etc.) were significantly associated with the tooth prevalence of dental fluorosis (TPF, P < 0·05). Stepwise multiple linear regression analyses explained 30% of the variance in TPF; age 15% points and vegetarianism 13% points. Multiple logistic regression analysis showed that the risk of developing dental fluorosis was seven times higher among nonvegetarians than among vegetarians.

Conclusion. The significantly lower prevalence and severity of dental fluorosis among the vegetarian group compared to the nonvegetarians would seem to be related to diet.
Prostaglandin E2 and treatment outcome in pulp therapy of primary molars with carious exposures
Authors: Waterhouse P. J. , Nunn J. H. , Whitworth J. M.
Published: March 2003

Summary. Objectives. Prostaglandin E2 (PGE2) has been suggested as an indicator of irreversible pulpitis in permanent teeth [1]. There is scant information on the role of chemical mediators in primary molar pulp inflammation. The aim of this preliminary study was to investigate the levels of PGE2 in blood harvested from root pulp stumps following coronal pulp amputation in vital primary molar teeth with carious exposures.

Methods. Seventy‐nine cariously exposed primary molars underwent treatment by one of two vital pulp therapy techniques. Blood was harvested from 38 teeth and volume and concentration of PGE2 ([PGE2]) determined [2]. Treatment outcome was assessed from both clinical and radiographic evidence.

Results. PGE2 was detected in all samples, with a wide concentration range (1–2641 ng/mL). The distribution was skewed, requiring log transformation. The difference in the mean (log) [PGE2] for radiological success (3·12, SD 1·60) and failure (4·62, SD 1·80) was significant, t = 2·05, P = 0·047. The difference in the mean (log) [PGE2] for clinical success (3·24, SD 1·65) and failure (5·44, SD 1·43) was near‐significant, t = 1·84, P = 0·074.

Conclusion. [PGE2] correlated positively with radiological outcome following vital pulp therapy.
British nurses in behavioural psychotherapy: a 20‐year follow‐up
Authors: Newell Robert , Gournay Kevin
Published: March 2003

A postal survey was carried out of all nurse behaviour therapists trained on the English National Board for Nursing, Midwifery and Health Visiting course in adult behavioural psychotherapy (ENB 650) since its inception at Maudsley Hospital London, in 1972 All trained therapists currently in practice in the UK were surveyed, and 113 of 142 eligible respondents returned questionnaires These were examined to elicit the professional profiles and working practices of the therapists, and to identify similarities and differences between therapists trained in the four training centres in the UK It was found that the majority of nurse therapists remain in clinical practice after training, and continue to further their education and clinical expertise There has been a general shift towards cognitive and short‐term interventions, and towards practice based on primary care, with general practitioners providing most referrals There were significant differences between the centres in terms of a number of the therapeutic techniques used, diagnostic categones of clients seen, and several elements of working practice, including referral source and numbers of clients seen and treated The implications of the findings for clinical practice and for nursing in behaviour therapy are discussed
Time for clients: temporal aspects of community psychiatric nursing
Authors: Gibson David
Published: March 2003

Time is an integral element in all actions, organizations and relationships Temporality has an effect on people's lives, and in turn people manipulate temporality as a means of imposing social order From a semiotic perspective the amount of time spent on an action and the timing of it conveys messages about such things as importance and status This holds equally true of organizations as well as individuals This paper concentrates on a community psychiatric nursing department, its staff and clients Sections of speech taken from interviews with nurses and clients are presented and discussed from the perspective of temporality to show how relationships are managed on an individual level and how work is organized around different client groups at an organizational level
The phenomenology of comfort
Authors: Morse Janice M , Bottorff Joan L , Hutchinson Sally
Published: March 2003

From patient narratives, the phenomenological literature and reflection of patients' autobiographical accounts of illness, nine themes reflecting the phenomenological concept of corporeality were used to identify the ways patients achieve comfort The themes were the dis‐eased body, the disobedient body, the vulnerable body, the violated body, the resigned body, the enduring body, the betraying body and the betraying (neurotic) mind The process of achieving comfort is based on the patients' needs to live with illness or injury without being dominated by their bodies The authors argue that while the role of nursing is to provide comfort to the sick, the goal of total comfort is unattainable in patient care However, if the goal is to enhance comfort, to ease and to relieve distress, comfort remains central to the role of nursing
Using theory to plan appropriate interventions: cancer prevention for older Hispanic and non‐Hispanic white women
Authors: Sennott‐Miller Lee
Published: March 2003

Research on cancer prevention among Hispanics and non‐Hispanic whites (Anglos) has focused on identifying differential barriers they encounter Although the information has been helpful in adapting traditional interventions for Hispanic clients, changes have not generally been theory‐based This research explores the applicability of value‐expectancy theory, which holds that the likelihood of taking action is a function of the perceived value of the goal and the expectancy of achieving it, with 26 Anglo and 24 Hispanic women Value was operationalized as perceived effectiveness, and expectancy as perceived difficulty of adopting 11 specific recommended behaviours Likelihood of adopting or maintaining the behaviour in the coming year was the dependent variable Subjects used a direct ratio scaling method, magnitude estimation, to give estimates of the variables Substantial variation in likelihood was explained in both groups (adjusted R2 = 0 49 for Anglos and 0 53 for Hispanics), but only difficulty was significant for both Anglo and Hispanic groups The relationship between difficulty and likelihood was curvilinear, with likelihood decreasing rapidly as difficulty increased slightly Results suggest the theory can be used to develop interventions for both groups and that these should focus on decreasing the individual's perceived difficulty of adopting and maintaining cancer prevention activities
Breast augmentation surgery: a women's health issue
Authors: Oberle Kathleen , Allen Marion
Published: March 2003

Surgery to increase breast size is a common procedure In this paper we examine the reasons why women choose to undergo the procedure, the history of breast enhancement, current surgical approaches, possible complications and their treatment Driving forces behind the choice to have augmentation surgery appear to be related to feelings of low self‐esteem and self‐confidence Although there is a large literature related to breast augmentation, little of it is research‐based The research that there is focuses on complications and their treatment, with an emphasis on capsular contracture Few of the studies are long‐term, although complications have been noted as long as 25 years after initial implantation There is a need for research into the experience of women undergoing augmentation mammaplasty but, perhaps more importantly, there is also a need to examine ways in which women can be helped to accept themselves as they are
The effect of work role values on job satisfaction
Authors: Mitchell Mary Beth
Published: March 2003

The purpose of this study was to determine if a relationship exists between work roles, work role values and job satisfaction for registered nurses employed in the hospital setting in the USA A total of 201 nurses responded (33% response rate) to a survey instrument consisting of questions regarding work roles, work role values and the Minnesota Satisfaction Questionnaire Spearman's rank order and Pearson's product moment tests were earned out to determine the correlation between the three factors Although the resulting information was not statistically significant (r=0 12), the strength of this study lies in its conceptual and theoretical bases
Patient perceptions of nursing care: an emerging theory of interpersonal competence
Authors: Fosbmder Donna
Published: March 2003

Nurse‐patient interactions were examined to identify elements of interpersonal competence among nurses from the perspective of patients Forty patients and 12 nurses participated in this qualitative study at a private acute care hospital Two‐hundred and forty‐five observations were completed. Open‐ended questions were utilized in 85 audio‐taped semi‐structured interviews Data collection and analysis occurred simultaneously using the constant comparative method Four major processes emerged from the data to provide the framework for the themes ‘translating’, ‘getting to know you’, ‘establishing trust’, and ‘going the extra mile’ In the ‘translating’ theme, patients expressed satisfaction with the nurse‐patient interaction when nurses informed, explained and instructed on specific aspects of treatment, and taught general principles of care The nurses’ personal sharing, kidding and clicking appeared as important processes in ‘getting to know you’ Patients reported confidence and trust when nurses took charge and appeared to enjoy their work The theme of ‘going the extra mile’ included friendship and providing care beyond that expected The processes provide a framework for an emerging theory of interpersonal competence
Nurses' power in interactions with patients
Authors: Hewison Alistair
Published: March 2003

Power in interactions between nurses and patients, as mediated through language, is examined in this paper The findings from an observational study confirm much previous research in that the majority of nurse‐patient interactions were superficial, routinized and related to tasks It was found that nurses exert a lot of control over interactions and the linguistic devices used to achieve this are explored Links are established between macro‐level factors, such as the institution, and the micro‐level of nurse—patient encounters, to demonstrate how wider forces affect and are reflected in interactions Examination of the interactions also reveals issues of conflict arising from the caring and controlling functions that nurses perform It is suggested that the power dimension inherent in the relationship constitutes a barrier to open and meaningful communication between nurses and patients
Gender differences in care delivery and supervisory relationship: the case of psychogeriatric nursing
Authors: Gilloran Alan
Published: March 2003

In this paper the impact of gender differences within nursing is examined Previous work has highlighted the disproportionate number of men in senior managerial positions in nursing and the perceived benefits which more males entering the profession may bring, for example increased status and higher pay The present work addresses two domains where the impact of gender differences may importantly affect both policy and practice, first in the realm of care delivery and second in the area of supervisory relationships The care received by male and female patients is studied, with particular attention being given to mixed wards Differences between the care delivery of male and female ward staff are also discussed Finally, differences in the supervisory roles of male and female charge nurses are examined The research concludes that the inter‐relationships between male and female ward staff and the way in which these impact upon the care received by patients is, as yet, little understood However, as increasing numbers of males enter traditional female preserves within nursing, the need for a debate regarding the impact of gender differences is now essential
Parental participation in care: a critical review of the literature
Authors: Coyne Imelda T
Published: March 2003

The literature reviewed demonstrates that parental participation is a complex issue which has been viewed mainly in a fragmented manner which does not recognize the integrated holistic nature of parent‐nurse partnership There is a dearth of research which focuses upon parents' perspectives and expectations of participation Furthermore, there is an assumption that parental participation is unproblematic which precludes the identification of social and environmental constraints The current level of knowledge about nurses' attitudes regarding parental participation is limited There is an absence of clear indicators of how parental participation may be facilitated and supported in the institutional setting It is proposed that further research is required which determines the extent of parental participation and which considers the lived experiences of both the parents and nurses of parental participation Improved care for children and families could result fromefforts directed to those endeavours
Staff perceptions of organization change of treatment delivery on an addiction unit
Authors: Long Clive G , Williams Martin , Hollin Clive R
Published: March 2003

The Work Environment Scale was used to assess staff perceptions of a change in a treatment programme for problem drinkers A more cost‐effective 2‐week research‐based day‐patient programme, which included the concept of matching, replaced a 5‐week cognitive behavioural in‐patient programme The maintenance of a positive work environment was attributed to the meeting of staff expectations, a cognitive behavioural ideology, and the establishment of a research culture The study highlights the importance of the thorough preparation of staff for change, and their active involvement in the processin settings where work satisfaction is already above the average level for mental health facilities
An investigation into nurses' understanding of health education and health promotion within a neuro‐rehabilitation setting*
Authors: Davis Sally M
Published: March 2003

This qualitative study was undertaken at two neuro‐rehabihtation centres in England, with the aim of exploring the nurses' understanding of health education and health promotion and their role within it, and their perception of illness and wellness related to disability The principle of methodical triangulation was employed using questionnaires, group interviews and content analysis of client care plans Although the nurses had difficulty distinguishing between health promotion and health education, differences did emerge which were supported by the literature The nurses generally identified their role as being one of health promotion However, they tended to equate wellness with physical independence As a result of the study a health promotion model based on the principles of self‐empowerment is suggested, which could be used as a framework for rehabilitation nurses and other professionals to enable them to focus on health and wellness rather than illness and disability
Love is not a marketable commodity: new public management in the British National Health Service
Authors: Wilkinson Michael J
Published: March 2003

This paper describes the historical developments and current role of new public management (NPM) in the British National Health Service (NHS) It is argued that NPM concern for efficiency improvements has resulted in threats to equality and needs‐based service delivery The relevance of NPM values to health care and nursing is explored Finally, comments are provided on how nurses can advocate for a more loving NHS environment, and one which is therefore more conducive to nurse and patient health
Sleep in hospitals at night: are patients’ needs being met?
Authors: Southwell MT , Wistow G
Published: March 2003

Although the functions of sleep are not clearly understood, it is generally accepted that it is necessary for the maintenance of good health, and that the need for sleep increases with illness The findings of a study on the hospital in‐patient night show that many patients do not consider that they have sufficient sleep in hospital at night, that discomfort, worries and pain may contribute to their wakefulness, that the sleep of many is disrupted by a variety of sources of disturbances, that ward lights are dimmed for the night for no longer than required by the average, healthy person, and that patients continue to be woken early in the morning A variety of ways of tackling these problems is proposed Differences in the perceptions of nurses and patients about certain aspects of in‐patient care at night demonstrate the importance of systematically asking patients about their experiences Once viewed through patients’ eyes, the everyday procedures, routines and environments of the hospital become visible and tangible influences on patient care, rather than part of the taken‐for‐granted context in which patients receive that care
Technology and the lifeworld of critical care nursing
Authors: Walters Allan John
Published: March 2003

Traditionally, nursing scholars have concerned themselves with philosophies of science This perspective reflects the Platonic dominance of theory over practice The consequence of this view is that technology is conceived as an applied science Furthermore, technology is considered as a neutral instrument of science The primacy of theory was challenged by the philosopher Martin Heidegger, who argued that the correct relationship between these two concepts was a technology‐science one This reconceptualization suggests that practice precedes theory This paper examines the developing body of literature concerning the philosophy of technology Specifically, the philosophies of Martin Heidegger, Don Hide, Albert Borgmann and Langdon Winner are explored from a nursing perspective, and how they may offer nursing a way of conceptualizing the ever expanding technological environment of the intensive care unit is discussed
A review of the historical and social processes contributing to care and caregiving in Chinese families
Authors: Holroyd Eleanor A , Mackenzie Ann E
Published: March 2003

The purpose of this paper is to review the literature on caring and caregiving in Chinese families in relation to the contribution made by historical and social processes The beliefs and traditions of care appearing in the professional and popular literature are explored to enable comparison with recent research from Hong Kong, China and the United Kingdom Caring emerges as profoundly complicated and ambivalent, drawing on notions of morality, obligation, love, kinship and gender responsibility Furthermore, caring in contemporary Chinese families in Hong Kong appears to have more similarities than differences with western families, possibly due to changing kinship networks. Such conclusions have particular relevance for nursing in the light of recent policy directives in Hong Kong promoting the role of the families in caring for their dependent members based on the assumption that families can and will care
Approaches to community needs assessment: a literature review
Authors: Billings Jennifer Ruth , Cowley Sarah
Published: March 2003

In the light of the growing awareness of professionals in the community of the need to undertake health needs assessments of the population, this literature review sets out to explore, delineate and critically analyse the various approaches to community needs assessment, to facilitate a greater understanding of their strengths and weaknesses The review commences by highlighting its complex nature, and attempting to define what is meant by ‘needs assessment’ from the differing perspectives of three dominant approaches, namely sociology, epidemiology and health economics It continues by putting forward an argument for the use of the community health profile, being a multi‐focal approach to needs assessment, combining quantitative with qualitative data, and proceeds with a discussion of strengths and weaknesses related to its compilation, in particular factors relating to reliability and validity of data sources The consumer perspective is also reviewed, as are issues surrounding the ethics of data collection and problems concerning aggregation of the numerous data sources into meaningful policy Throughout the review, issues are discussed with reference to the current political context in the United Kingdom Equally important is the community nurse perspective, which is integrated into the arguments where appropriate
A review of cervical cancer and cervical screening: implications for nursing practice
Authors: Ibbotson Tracy , Wyke Sally , T IBBOTSON , S WYKE
Published: March 2003

In this paper we review epidemiological and other research evidence on cervical cancer and cervical screening We outline recent research evidence implicating sexually transmitted human papillomavirus as one of the causes of cervical cancer, but stress the uncertainty surrounding the causes and natural history of the disease We go on to discuss evidence on risk factors associated with increased incidence of and mortality from cervical cancer, including age, sexual behaviour, smoking, socio‐economic status and prolonged use of oral contraceptives Cervical screening has reduced mortality in some countries, and we outline the necessary features of a successful, effective screening programme before going on to describe why screening failed in Britain, at least until the late 1980s Current screening policy is designed to remedy this, and we discuss its implications, and those of previous research, for nursing practice
Cognitive behaviour therapy territory model: effective disputing approach
Authors: Lam Danny
Published: March 2003

This paper proposes a disputing model (territory model) which is particularly useful and effective for disputing clients who persistently hold on to their dysfunctional thinking and/or core irrational beliefs. Their 'stubbornness' to change is compounded by unhealthy negative emotions during sessions. The intense emotion makes it difficult to access the belief system, and therefore any attempt to dispute it often proves futile. This model advocates the shift of disputing onto a different ‘territory/ground’ where the client can be facilitated to acquire higher, abstract and objective thinking, and at the same time his/her emotional level is susceptible to rational and logical arguments. The new thinking would act as a catalyst for the client to reflect on his/her dysfunctional thought/irrational beliefs. In this paper, the author uses a case example to illustrate and discuss the ineffectiveness of the ‘traditional’ way of disputing the dysfunctional thinking/core beliefs of a difficult and emotional client. This is contrasted with the ‘territory’ model.
Sexual health promotion and nursing
Authors: Irwin Robert
Published: March 2003

The HIV epidemic provides continued impetus for effective sexual health promotion. Sexual health promotion in nursing practice has traditionally been equated to prevention at primary, secondary and tertiary levels. Increasing demands on practitioners to address the psycho‐social aspects of sexual health, together with a greater emphasis on primary prevention, is leading to the adoption of theoretical paradigms from the behavioural sciences and the increasing use of counseling skills. The limitations of individualist interventions for primary prevention are explored, and the assumption that health care professionals are effective promoters of sexual health is questioned. The importance of placing sexual health and nursing practice within a wider social, political and cultural context is emphasized.
Nursing and the health of the nation: schism or symbiosis?
Authors: Brown P.A. , Piper S.M.
Published: March 2003

In July 1992, the British government published its White Paper ‘The Health of the Nation, a Strategy for Health in England’ (HON). The authors contend that this initiative has largely been accepted by the nursing profession with critical responses to the HON being minimal.

The authors argue that the medicalized negative interpretation of health and the narrow individualistic lifestyle‐orientated definition of health promotion contained within the strategy ought to be rejected by nurses in favour of both a positive, holistic conception of health and a more humanistic health promotion methodology acknowledging the impact of structural‐material factors influencing individual health related behaviour.
British studies which measure patient outcome, 1990–1994
Authors: French Beverley
Published: March 2003

In order to assess the context and use of patient‐outcome measurement in nursing, British studies reported in Nursing Research Abstracts, published by the Department of Health in the 5‐year period between January 1990 and December 1994 which measured patient outcome were retrieved, and analysed in relation to the nursing specialty, intervention and outcome variables, and method of measurement used. A total of 228 studies which measured patient outcome were identified, which included 516 occurrences of patient‐outcome measurement. Fifty per cent of studies measured a single outcome variable. Physical health status and psychosocial functioning outcomes accounted for over half of the total number of variables used, with generic well‐being measures least frequently used; 38% of the studies utilized existing outcome measurement tools, or researcher‐constructed tools which had been tested for reliability and validity; 62% utilized tools constructed specifically for the study or physiological/biochemical measures. There was variation in the frequency of use of multiple outcome variables and existing measurement tools between different clinical specialties. The 228 studies included 119 different outcome‐measurement tools/instruments, with only 20 measurement tools used more than once. The analysis identified a large range of patient‐outcome variables and measurement tools included in nursing studies, but little coherence in definition and method of measurement between studies.
An exploratory study examining the influence of translation on the validity and reliability of qualitative data in nursing research
Authors: Twinn Sheila
Published: March 2003

Although the complexity of undertaking qualitative research with non‐English speaking informants has become increasingly recognized, few empirical studies exist which explore the influence of translation on the findings of the study. The aim of this exploratory study was therefore to examine the influence of translation on the reliability and validity of the findings of a qualitative research study. In‐depth interviews were undertaken in Cantonese with a convenience sample of six women to explore their perceptions of factors influencing their uptake of Pap smears. Data analysis involved three stages. The first stage involved the translation and transcription of all the interviews into English independently by two translators as well as transcription into Chinese by a third researcher. The second stage involved content analysis of the three data sets to develop categories and themes and the third stage involved a comparison of the categories and themes generated from the Chinese and English data sets. Despite no significant differences in the major categories generated from the Chinese and English data, some minor differences were identified in the themes generated from the data. More significantly the results of the study demonstrated some important issues to consider when using translation in qualitative research, in particular the complexity of managing data when no equivalent word exists in the target language and the influence of the grammatical style on the analysis. In addition the findings raise questions about the significance of the conceptual framework of the research design and sampling to the validity of the study. The importance of using only one translator to maximize the reliability of the study was also demonstrated. In addition the author suggests the findings demonstrate particular problems in using translation in phenomenological research designs.
Health promotion training needs analysis: an integral role for clinical nurses in Lanarkshire, Scotland*
Authors: Thomson P. , Kohli H.
Published: March 2003

Training needs analysis is considered essential to professional and organizational development, for continuing education and for incorporation into professional practice. Increasingly, nurses are encouraged to develop their health promotion role. Despite this there has been relatively little research in Scotland into the health promotion role of the hospital nurse. This study describes the results of a health promotion training needs analysis undertaken on qualified, hospital‐based nurses in Lanarkshire, Scotland. Information on the nurses' current health promotion practices, their attitudes and beliefs, their views on role development and priorities for further training were collated, analysed and discussed within the framework of the Health Action Model. This model was originally designed to assist understanding of the gap that exists between an individual intention to act and the eventual health action. However, in this study the ways in which ‘cognitive factors’ (knowledge and beliefs) and ‘motivational factors’ (considering values, attitudes and drives) and pressures from social norms and significant others assisted in the understanding of the nurse's orientation to, and beliefs about, health promotion practice. Fifty‐seven per cent of nurses in the study considered health promotion activities to be emerging in clinical care and 4% considered them to be advanced. The interest respondents have in role development and the further integration of health promotion activities into nursing practice was explored by ascertaining the nurses' attitudes and beliefs about their own health promotion role. Of 107 respondents, a majority 72 (67%) agreed health promotion interventions to be an important function of the nurse with 29 (27%) strongly agreeing (n=107). Sixty per cent stated they would be interested in developing their role and 30% were very strongly interested. Recommendations are therefore made for future planning and development strategies for the health promotion role of hospital nurses.
Developing a non‐aversive intervention strategy in the management of aggression and violence for people with learning disabilities using natural therapeutic holding
Authors: Stirling Christopher , McHugh Albert
Published: March 2003

This paper builds upon a previous piece of research regarding the development of ‘natural therapeutic holding’ as a non‐aversive alternative to control and restraint (C and R) in managing aggression and violence in people with learning disabilities. This paper represents aspects of an ongoing programme of research and explains the aims and values which underpin natural therapeutic holding by describing the theory, aims, values and practical application. The concepts of individual risk management and pro‐active intervention strategies are discussed with illustrations of practical application given by means of a case study. The case study shows that over a relatively short period of time, an individual with severe learning disabilities who is aggressive and violent, learns alternative coping strategies to aggression and violence through the application of natural therapeutic holding. The article concludes that natural therapeutic holding is a very effective intervention strategy in the management of violence in people with learning disabilities from two perspectives: (a) it provides staff with safe, professional and ethical skills with which they can manage aggressive and violent clients and (b) as a therapy, natural therapeutic holding gives clients the opportunity to learn coping strategies which are more effective than violence.