bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic Resonance Imaging Contrast Agents and the Nuclear Pharmacist
Authors: Clanton Jeffrey A.
Published: June 2007

The nuclear pharmacist works with a very specific group of drugs. These drugs generally exhibit no toxic effects and are used almost exclusively for diagnosis. In the past these have been the radioactive drugs used in nuclear medicine and the iodinated contrast agents used in radiology. However, with the advent of magnetic resonance imaging (MRI), there is an additional class of drugs used in radiology, the magnetopharmaceuticals. These drugs are designed especially for increasing diagnostic sensitivity with MRI. This article is intended to provide topical insight into the basics of MRI and magnetopharmaceuticals.
Adverse Drug Reactions and the Food and Drug Administration
Authors: Pearson Kay C. , Kennedy Dianne L.
Published: June 2007

The monitoring of adverse drug reactions (ADRs) after a drug is marketed is an important mission for the US Food and Drug Administration (FDA). Currently, the FDA receives and computerizes nearly 60,000 ADR reports each year. The FDA has an active postmarketing surveillance system in place to effectively triage, tabulate, analyze, and evaluate these reports. Of highest priority to FDA are the discovery of serious reactions that were not observed before a drug was marketed and the detection of increased occurrence of serious reactions that are known to occur with the drug. All reactions for new moieties marketed in the United States during their first 3 years are of interest. Pharmacists are in a unique position to be aware of adverse reactions because of their knowledge of drugs, their close working relationships with other health care providers, and their direct interactions with patients. By participating in FDA's ADR reporting system, pharmacists can actively contribute to drug safety and help improve patient care.

This is a US government work. There are no restrictions on its use.
Implementing a Hospital-Based Adverse Drug Reaction Reporting Program
Authors: Miwa Linda J.
Published: June 2007

All hospitals should have a formal adverse drug reaction (ADR) reporting program in place in order to meet their professional obligation as members of the health care community and to help ensure quality of care within their institution. Although ADR reporting is the responsibility of all health professionals, in actuality it belongs to the hospital pharmacy department. Implementation of an ADR reporting program is similar to that of other quality assurance programs in that it needs to be tailored to the needs and resources of the individual hospital. However, the following steps are integral to any ADR reporting program: defining ADRs ; developing mechanisms for the identification and investigation of ADRs ; designing means for maintaining the program: and designating personnel to carry out the program. This article will discuss each of these steps and make suggestions to assist readers in implementing an ADR reporting program in their hospitals.
Cutaneous Manifestations of Adverse Drug Reactions
Authors: West Dennis P. , Rumsfield Jean A.
Published: June 2007

immune-mediated cutaneous reactions to drugs are usually categorized into four distinct types: Type 1, immediate; Type 11, cytotoxic; Type III, immune-complex: and Type IV, cell-mediated. Nonimmunologic skin reactions are also recognized. Beyond immune vnonimmune classifications, cutaneous drug reactions are generally described according to morphologic patterns of reaction. Common types of reactivity usually include maculopapular and urticarial eruptions. In addition, less common reactions include fixed drug eruption, hyperpigmentation, vasculitis, erythema multiforme, toxic epidermal necrolysis, photosensitivity, and alopecia. The drugs most frequently associated with these reactions can be identified and the pharmacist, by accomplishing a thorough systematic drug history, may play a significant role in determining likelihood of drug cause.
The Nuclear Pharmacist as a Consultant and Drug Information Specialist
Authors: Gregorio Ned , Hladik William B. , Kavula Michael P.
Published: June 2007

The provision of cognitive services, including drug information, is an extremely important function of the nuclear pharmacist. As pharmacy continues to evolve as an information-oriented, knowledge-based profession, nuclear pharmacists must maintain an active role in the dissemination of information related to the use of radiopharmaceuticals and other drugs associated with the broad area of radiology. Several examples are given to illustrate how nuclear pharmacists serve as clinical consultants and, in doing so, provide expertise in drug information. © 1989 by W.B. Saunders Company.
NRC and FDA Regulations Affecting Nuclear Pharmacy Practice
Authors: Petry Neil A.
Published: June 2007

Radiopharmaceuticals are radioactive drugs that are used in nuclear medicine practice for diagnosis and treatment of disease. Nuclear pharmacy practice is a patient-oriented pharmaceutical service that promotes the safe and efficacious use of radiopharmaceuticals and other drugs used in nuclear medicine, and is regulated jointly by a variety of federal, state, and local agencies. Given that the medical use of radiopharmaceuticals is highly regulated at multiple levels of government, it is not surprising that nuclear pharmacy practice is conducted in a complex regulatory environment. The purpose of this article is to provide a brief overview of this regulatory environment, primarily in terms of two important regulatory agencies involved (Nuclear Regulatory Commission and Food and Drug Administration), their primary authority and activities, and the regulations that must be satisfied in order to assure the safe and efficacious use of radiopharmaceuticals.
Nuclear Pharmacy and the National Association of Boards of Pharmacy (NABP)
Authors: Hammes Richard J. , Laven David L. , Catizone Carmen
Published: June 2007

The challenges and opportunities involved in the emergence and regulation of pharmaceutical specialties are discussed in relationship to the historical and current developments regarding nuclear pharmacy. The issues of the state board of pharmacy v federal regulation of the practice of pharmacy, drug use control in institutions, and education and training of specialists are explored. The interaction of the National Association of Boards of Pharmacy (NABP) with professional nuclear pharmacy groups in addressing these issues is described.

This is a US government work. There are no restrictions on its use.
Anticoagulation: Practice Focus in an Ambulatory Clinic
Authors: Engle Janet P.
Published: June 2007

Pharmacy practice is in an era of change. Opportunities for clinical practice are not only available in the inpatient setting but also in the ambulatory milieu. Anticoagulation is an excellent area for pharmacist involvement in patient care in the outpatient setting. This article describes the rationale and steps necessary for developing and maintaining a pharmacist-managed warfarin anticoagulation clinic. A discussion of the methodology necessary for justification and implementation of such services is presented. Salient points regarding warfarin use will also be covered.
Pharmacodynamics and Cancer: Practical Aspects of Dose Intensity for Pharmacists
Authors: Stewart Clinton F.
Published: June 2007

Recent clinical studies have suggested that dose or dose intensity may be a critical factor in achieving an optimal effect from cancer chemotherapy in tumors that are chemosensitive. This article reviews the rationale for the importance of drug dose in cancer chemotherapy and methods of expressing dose intensity. Several clinical studies that provide evidence of the importance of dose intensity are reviewed. The concept of systemic intensity of cancer chemotherapy is discussed. Finally, the practical aspects of dose intensity for the pharmacist are addressed, including dosage calculation, drug preparation and administration, and compliance. The pharmacist plays an integral role in assuring the patient with cancer receive the appropriate dose of cancer chemotherapy.
Aspects of Investigational Antineoplastic Agents
Authors: Fortner Clarence L. , Vilk Paul J.
Published: June 2007

Investigational drugs are regulated by the Food and Drug Administration (FDA) and are not available for widespread patient use. They are screened and evaluated extensively before they are administered to humans in clinical trials. The clinical development process is divided into three phases: phase I, II, and III. Protocols for the investigational agent in each of these phases must be approved by an institutional review board and the patient must be informed of the risks of the study and sign an informed consent document. Once adequate clinical data are collected and analyzed, the information is submitted to the FDA for their review and approval for marketing. Prior to that approval, the FDA may approve broader distribution of the drug for specific indications under a Treatment Investigational New Drug (IND) or the National Cancer Institute's (NCI) group C mechanism. Pharmacists can play a unique role during development of the Treatment IND by contributing to design of the protocol and screening patient qualifications. The investigator of the clinical trial has responsibility for the conduct of the clinical trial and must comply with FDA regulations and sponsor policies.

This is a US government work. There are no restrictions on its use.
Discourse analysis: a critical view
Authors: Widdowson H.G.
Published: June 2007

Discourse analysis is in vogue as a field of enquiry, particularly in the guise of critical discourse analysis, which employs procedures not essentially different from literary criticism to identify ideological bias in texts. This article argues that, perhaps as a consequence, there is a good deal of conceptual confusion in the field. One example is the uncertainty of the scope of description, which is reflected in the ambiguity of the term 'function' and the failure to distinguish between text and discourse. Another is the tendency to equate social and linguistic theory with political commitment which raises the question of the relationship between analysis and interpretation. It is argued that this confusion makes suspect some of the principles and practices of critical discourse analysis, and calls into question the validity of the notion of authentic language currently prevalent in language pedagogy.
Telling our story: on 'we' literary narratives
Authors: Margolin Uri
Published: June 2007

In this article I seek to outline some of the distinctive features of the narrative 'we', both as speech position or narrative voice and as a narrated entity, that is, a collectivity defined by a bond of some kind, and engaged in a series of activities. From a linguistic perspective, 'we' does not designate multiple 'I's, but rather an individual 'we'-sayer, together with one or more co-utterers and/or hearers and/or others, all of whom belong to the reference class of this 'we'. Salient properties of literary 'we' narratives of the twentieth-century on the level of narration are as follows: there is precisely one 'we' sayer on the highest level of embedding; the nature of the 'we' group is defined by features belonging to the narrated domain; what the 'we' sayer asserts about his/her group concerns its identity, actions, and states in the narrated domain; the 'we' sayer is not a designated spokesman for the group - he or she speaks about, but not for it- and the literary 'we' narrative is therefore not a group speech act. On the level of the narrated, a discussion of the 'we' as topic entity includes at least the following three dimensions: group actions, especially joint actions; the group's sense of 'we'-ness; the group's self awareness and self image. Literary 'we' narratives are, however, not completely collectivistic. They maintain a balance between individual and group records of action, especially with respect to verbal and mental actions. They consequently include passages in the 'I', 'you', or 'he or she' mode, and the narrator often refers to himself/herself as a distinct, identifiable 'I', not just the impersonal 'we' sayer of official pronouncements. I conclude with some probable reasons for the rarity of literary 'we' narratives.
What is critical discourse analysis and why are people saying such terrible things about it?1
Authors: Toolan Michael
Published: June 2007

Increasingly, discourse makes and sustains the worlds we live in. Critical discourse analysis (CDA) is one form of a justifiably reflective and suspicious inspection of how discourses shape and frame us; and it is explicitly intent on making a difference, and not merely describing extant conditions. Why, then, has it met with some resistance from language analysts? For CDA to make more of a difference, I argue it needs to critique some of its own theoretical distinctions (e.g. between description and interpretive explanation), it needs to be more critical and more demanding of the text linguistics it uses, it must strive for greater thoroughness and strength of evidence in its argumentation while pursuing simplicity of presentation, and it must not shrink from prescribing correction or reform of particular hegemonizing discourses.
'It's good to talk'?1 An analysis of a telephone conversation from Evelyn Waugh's Vile Bodies
Authors: Thomas Bronwen E.
Published: June 2007

In the days of email and the intemet, the alienating effects of the 'instrument' of the telephone may appear minimal. Yet a form of communication which proceeds without any visual aid and is subject to all kinds of mechanical distortion can still present its own confusions and sources of embarrassment. Literary representations of the medium have tended to focus on the muddles and misunderstandings, often exploiting their comic potential. Employing terms and models derived from conversational analysis, this article analyses a telephone conversation from Vile Bodies by Evelyn Waugh, published in 1930. I will argue that while Waugh exploits to the full the comedy of the communicative situation he represents, he is also sensitive to the extent to which the constraints and the freedoms of the medium affect his characters' ability to interact with one another.
Women beware women: detective fiction and critical discourse stylistics
Authors: Clark Urszula , Zyngier Sonia
Published: June 2007

This article examines the work of four contemporary writers of detective fiction (P.D. James, Amanda Cross, Sara Paretsky and Ruth Rendell/Barbara Vine) from a critical discourse stylistics perspective with the objective of raising the reader's awareness of the ideological processes that are manifested in the language of these texts. It considers how these writers deal with stereotypical assumptions, how they cope with socially determined traditional roles and verify whether their choices result in the articulation of an alternative discourse. The investigation arrives at some identifiable cultural and linguistic characteristics which may be singular to this new group of writers. We suggest that by challenging traditional representations of women, these writers may be offering a reconstruction of the genre.
A college Olympian
Authors: Nash Walter
Published: June 2007

Charles Stuart Calverley (1831-1884), wit, parodist, classical scholar, translator, athlete, pipe-smoker, beer-drinker, enjoyed considerable popular fame in his own brief day. He had what might now be called 'star quality'. The fame has long since died- not many people have even heard of him - but Calverley's accomplishment stands: as a master of light verse, to the prosodic techniques of which he made important contributions, and as a gifted translator of the classical poets, notably Horace and Virgil. His work, as displayed in this article, suggests an affinity between the mimetics of parody and the stylistics of translation, a common factor being an insight into the relationship between phrasing and prosodic form. It raises, however, the question of whether linguistic/mimetic ability, however great, can ever be more than a component of creative power. For Calverley it was never quite enough; his friends and colleagues saw him as a man whose youthful promise was not to be wholly fulfilled, a college Olympian who never scaled the heights of poetic achievement.
Through the Lens of the Artist-Scientist: Reflections for the Pediatric Oncology Nurse
Authors: Updike Phyllis A.
Published: June 2007

Science and art need not be in conflict because both require use of imagination, cognitive Insight, discipline, and creative application. Conceptual shifts in neuroscience have offered new validity to intuitive beliefs regarding the mind-body unit. One example is the articulation of a neuroimmunomodulatory mechanism of tumor growth. Another critical scientific advancement is the delineation of human physiologic circadian rhythmicity. This emergent discipline asserts the time-based pattern of dynamic physiologic functioning, and thereby embraces the changing, unique, yet predictable human condition. A chronobiology of cancer is now documented and merits the clinician's attention. The nature of time creates a natural bridge between this leading edge endeavor of science and the arts; this bridge is most notably found in music. Each of these paradigms witnesses to the reality that the experience of time is frequently nonlinear. Expression of form and symbolism characterize art and serve as its vehicle. If we dare to become more aware of our experience and the tools of mind, body, spirit, and senses in ourselves and in others, we will come to view our sensate selves as possessing stature equal to that of such biologic measurements as pressure and white blood count.
Nursing Considerations in Caring for the Child With Vincristine-Induced Neurotoxicities
Authors: Young Stacey B.
Published: June 2007

Vincristine is a highly effective cell-cycle specific chemotherapeutic agent used in the treatment of most pediatric malignancies. The major dose-limiting side effect of this drug is neurotoxfcity, which can present in the form of peripheral, autonomic, or cranial nerve deficits. Conditions such as liver dysfunction can increase the risk for vincristine neurotoxicity. The only treatment for severe toxicity is to decrease the drug dose or to discontinue the drug. Many of the symptoms of neurotoxicity are subjective and therefore adequate assessment is often difficult. Baseline data is obtained before starting vincristine and with each subsequent clinic visit so that the appropriate drug dose can be determined to maximize tumor response with the fewest side effects. Nursing interventions are directed at symptom management. Patient-family education centers on relating informing of the potential and symptoms of neurotoxicity, with an emphasis on safety precautions.
A Theory for Pediatric Oncology Nursing Practice and Research
Authors: Hymovich Debra P.
Published: June 2007

This article describes the development and application of a theoretical framework that can be used to guide pediatric oncology nursing practice and research. The framework's six dimensions provide the nurse with an approach to comprehensive assessment and intervention with families of children with cancer. These dimensions are: systems (individual, family, community, society); mediating variables (identifying characteristics, orientation to life); time; adaptation variables (stressors, coping strategies); level of functioning (tasks, capabilities, needs); and intervention.
Measles Epidemic: Impact on Pediatric Oncology Patients
Authors: Meeske Kathleen , Chamberlin Karen , Cipkala-Gaffin Janet A. , Harlander Christine , Reed Kelly
Published: June 2007

Measles, a preventable disease, is again epidemic in the United States and is a threat to the immunocompromised pediatric oncology patient. In response to this latest epidemic, the Immunization Practices Advisory Committee has revised its recommendations for controlling an outbreak and has changed childhood immunization to a two-dose schedule. Full understanding of measles management is needed to effectively protect the pediatric oncology patient during the current epidemic. This article reviews the epidemiology, clinical presentation and management of measles, including recommendations for vaccinations, exposures, isolation, and patient and family education.
An Investigation of the Safety of the Blood Reinfusion Step Used With Tunneled Venous Access Devices in Children With Cancer
Authors: Hinds Pamela S. , Wentz Tori , Hughes Walter , Pearson Ted , Sims Amy , Mason Bonnie , Pratt Michael , Austin Bradford A.
Published: June 2007

Infection has been identified as the most serious potential complication of the indwelling catheter. As a result, the primary nursing goal using the catheters is to prevent infection. Nurses must frequently manipulate the catheters when securing blood specimens and are concerned that this manipulation may serve as a source of infection for the immunocompromised pediatric oncology patient. One particular step in catheter manipulation during blood sampling is blood reinfusion, ie, residual blood in the catheter is withdrawn and set aside while a second sample is collected for laboratory analysis but is subsequently returned to the patient through the catheter. The purpose of this study was to examine this nursing procedure for its potential of contaminating the blood sample that was to be reinfused, or for the potential of reinfusing a sample that contained preexisting pathogens independent of the procedure itself. An experimental design was used with 21 patients randomly assigned to an experimental group (unclean procedure to exaggerate the potential to incur pathogens during the process), and 21 randomly assigned to a control group (usual clean procedure followed with the reinfusion sample). The usual blood sampling procedure was altered for all participants as the typical amount of blood that normally constitutes the reinsertion sample was not reinserted, but was instead used to complete certain microbial analyses. Of the 42 participants, 17 were male and 25 were female; 35 were white and seven were black; 22 were diagnosed with leukemias and 20 with solid tumors. The age range for participants was 2 to 20 years (x = 9.4 years, SD = 4.8). The two groups of participants did not differ for age, diagnosis, phase in treatment, hematologic indicators, or other demographic variables. No colony-forming units were noted in any of the collected samples for either of the two groups. The study findings may be interpreted as an indication that the current institutional procedure for collecting blood samples, when carefully followed, is not serving as a potential source of infection for nonneutropenic pediatric oncology patients.
The Effects of Different Central Venous Line Dressing Changes on Bacterial Growth in a Pediatric Oncology Population
Authors: Freiberger Dawn , Bryant Jeri , Marino Barbara
Published: June 2007

Central venous lines are now common in children who need a permanent form of intravenous access. These lines frequently become infected. This study compared the effects of different antiseptics (Hibiclens [chlorhexadine 4%; Stuart Pharmaceutical, Wilmington, DE] and Betadine [povidone-iodine, Clini Pad Corp, Guilford, CT]) used to clean the skin as well as the dressings used to cover the exit site (Tegaderm [3-M Medical-Surgical Division, St Paul, MN] and gauze) on microorganism growth on the skin in a pediatric oncology population. Sixty subjects were recruited from the oncology and bone marrow transplant units of Children's Hospital in Boston, MA. The subjects were randomly assigned to one of four dressing groups. These included: 1, Betadine and Tegaderm; 2, Betadine and gauze; 3, Hibiclens and Tegaderm; and 4, Hibiclens and gauze. Dressings were done on a Monday-Wednesday-Friday basis. Quantitative cultures were obtained before the first and after the fifth dressing changes. There were no significant differences in incidence of bacterial growth between dressing groups (F = 1.05, P = .377). Redness (F = 3.01, P = .037) and swelling (F = 2.75, P = .051) were more frequently seen in Betadine groups. Boys were more often infected than girls. (χ 2 = 4.075, P = .044)
Nutritional Support of the Child With Cancer
Authors: Hanigan Mary Jo , Walter Georgia A.
Published: June 2007

The purpose of this article is to outline how the disease, treatment, and psychological state of a child with cancer impact on the child's nutritional status. The methods of assessing nutritional status, including anthropometric measurements, laboratory indices, clinical observation, dietary assessment, and psychosocial evaluation, are summarized. After nutrition assessment, the pediatric oncology nurse and the dietitian, along with the oncologist, the family, and the child, develop a plan of care. The specific roles of the pediatric oncology nurse and dietitian in the nutrition intervention are described.
Pediatric Brain Tumors: Diagnosis and Management
Authors: Shiminski-Maher Tania , Shields Marysue
Published: June 2007

Pediatric brain tumors are the most common solid tumor and the second most common neoplasm in childhood. Confirmation of diagnosis is made by visualization of the tumor on a computed tomographic or magnetic resonance imaging scan. Treatment includes surgery followed by observation or chemotherapy and/or radiation therapy, depending on the amount of tumor removed and its histological characteristics. Recent advances in neuroradiology, neurosurgical techniques, and neuro-oncology have begun to impact the length and quality of survival of children diagnosed with brain tumors. A multidisciplinary approach in the treatment of these children is necessary with the nurses and/or nurse practitioners as the consistent members of the team often coordinating the care. © 1995 by Association of Pediatric Oncology Nurses.
The Silent Ones: A Review of Sampling Issues and Biases Pertinent to the Area of Pediatric Oncology Procedural Pain
Authors: Williams Holly Ann
Published: June 2007

Pain related to procedures for pediatric oncology patients is a salient topic. Although these procedures can cause much distress, this area has been neglected in research. Previous research has suffered from serious sampling problems, such as using small, nonrepresentative, biased samples. In addition, little is known about the influence of sociocultural factors on the phenomena of pain in children. This article presents the results of a review of the past 10 years of pertinent literature, argues that sociocultural influences on pain need to be studied, and offers suggestions for improving sampling designs.
Weak Nations, Political Repression, and Punishment
Authors: Ruddell Rick , Urbina Martin Guevara
Published: June 2007

This study examines the influence of political repression on the use of punishment in 100 of the world's richest nations. Consistent with earlier empirical work, high levels of violent crime and population heterogeneity is associated with the use of imprisonment. Five different indicators of political freedoms are included in a series of ordinary least squares (OLS) regression models, including civil liberties and political rights, two indicators of democracy, and censorship of the press. Controlling for crime, population heterogeneity, and development, the authors find that autocratic nations punish more harshly. Examination of the correlates of detained (remanded) populations produces less consistent results, suggesting that the factors that contribute to detention may be different than those related to imprisonment. These findings suggest that the relationships between political repression be scrutinized more closely, especially the use of punishment in weak nations.
The Potential of Grounded Theory for Health Education Research: Linking Theory and Practice
Authors: Dolan Mullen Patricia , Reynolds Richard
Published: June 2007

This paper offers a critique of present research methods used in the literature drawn upon by health education practitioners, students, and teachers. Weaknesses of deductive methods and of theory which is highly general are noted in terms of their implications for the advancement of health education theory and practice, and in terms of their consistency with traditional principles of practice.

The grounded theory method—an inductive approach usually used with participant observation and interview data—is described, and the major arguments for its value are presented. In particular, the empirical generation of middle-range theory can provide a strong link between more general theory and situations faced by practitioners, and definitions of problems are not prematurely closed to reinterpretation from other perspectives. Several recommendations are given for changing the research orientation of health education.
Integrating Occupational Health and Safety into the Health Education Classroom
Authors: Finn Peter
Published: June 2007

Given the startling number of job-related illnesses and injuries which occur every year, occupational health and safety, a hitherto neglected topic, deserves significant attention in the school health education curriculum. Youngsters need to be exposed to this field before they become indifferent or callous toward diseases and accidents in the workplace and while the opportunity still exists to weigh health and safety considerations in selecting a career. In addition, when students take up regular employment, they cannot rely on industry, government, or organized labor to protect them fully from occupational illnesses and accidents; they must possess the skills and attitudes necessary to safeguard themselves. Occupational health and safety education in the schools can focus on general awareness, skill development, and job- specific information. The field can be easily and appropriately integrated with a number of current health education topics. Examples of integration are provided for eleven typical areas of a school health education curriculum.
Developing corporate business for hotels through conferences and exhibitions
Authors: Richards Greg , Richards Bill
Published: June 2007

The aim of this paper is to review the conference and exhibition market for UK hotels drawing on research undertaken over the last ten years. It examines the market segmentation, underlying market trends and future trends.
Marketing Singapore as an international destination
Authors: Singh Amrik , Chon Kaye-Sung
Published: June 2007

Singapore has emerged in the 1980s as a major tourist destination in Asia due to a combination of favourable economic conditions and well-orchestrated marketing programmes. After experiencing a rapid growth of tourism, the country is now facing new challenges and opportunities in further positioning itself as a major 'gateway to the East'. This paper provides an in-depth look at the problems, current trends and issues in the country's tourism industry.
Individualised nursing care
Authors: Butterworth Tony
Published: June 2007

Individualised patient care has become 'bracketed' with the idea of good quality care. But what is the evidence to support this tenet? A review of some of the literature follows
Getting a job and growing in confidence
Authors: Maggs Christopher , Rapport Frances
Published: June 2007

Pre-registration midwifery education prepares as midwives those who are not already qualified as nurses. It replaces and develops the 'direct entry' system and links midwifery to higher education through joint validation and award. This report covers the early experiences of the first group of midwives who qualified by this route and explores their views about their courses, their professional work relationships and experiences in practice. Findings suggest that hostility to them as a group because of their preparation route to become midwives is replaced by an acceptance of their role in developing the professional ideology and hegemony. In practice, most are confident with clients although there is some evidence that they need greater experience and support in working with sick neonates. The respondents suggest improved attention to the issue of shared learning and experiences, especially as these concern experiences in non-midwifery nursing areas [ NT Research 1996; 1 : 1, 68-78]
Networking for research dissemination: Collaboration between education and practice
Authors: French Beverley
Published: June 2007

Current initiatives in the central production of rigorous reviews of the evidence for effectiveness in health care require efficient mechanisms for dissemination to individual practitioners. Nursing needs to ensure that sources of information about 'effectiveness' are routinely accessed, and that the skills to find, evaluate and utilise systematic reviews are available to improve care delivery and develop practice. A collaborative approach between education and practice is proposed, using a network of 'link practitioners' to ensure continuous awareness and dissemination of research. Working together to access the best currently available evidence for practice reduces duplication, shares costs, and ensures that the benefits of combined collaborative participation are greater than the individual contribution of each participating organisation. [ NT Research 1: 2, 113-118]
The effective mentor: A model for student-centred learning in clinical practice
Authors: Spouse Jenny
Published: June 2007

This paper is concerned with the relationship between student and clinical supervisor (known as a mentor) and its influence on nursing students' development of professional knowledge during their clinical practice. The paper is based on the results from a longitudinal naturalistic study of eight nursing degree students during their four-year programme. The study was concerned with investigating and describing how nursing students develop their professional knowledge while working in clinical areas. During the data collection and analysis it became evident that the influence of the clinical mentor and the nature of the relationship were central to students' knowledge growth. By undertaking a content analysis for the relevant data and using an inductive approach, five key aspects of the student-mentor relationship emerged. These five aspects will be presented and discussed along with the implications for nurse education and the role of clinical staff [ NT Research 1996; 1, 2, 120-133]
Nursing research ethics
Authors: Glenister David
Published: June 2007

Uncertainty exists in the strategies adopted to ensure nursing research is ethical. Currently available codes and guidelines demonstrate some limitations. Local research ethics committees (LRECs) appear to be medically dominated, biased against nursing research, uncertain of the criteria by which they make judgements and, in some cases, harmful to those who make submissions. There is some evidence of a lack of equity in the treatment of nursing research and of research methods. Two strategies adopted to scrutinise nursing research are explored: nursing research ethics committees in higher education and in health service settings (trusts or hospitals). The limitations of these strategies in tackling the basic problems of LRECs are indicated, and alternatives are discussed. [ NT Research 1996; 1: 3, 184-190]
The anachronism of policy for nursing in general practice: Conceptualising a way forward
Authors: Yerrell Paul , Reed Anita
Published: June 2007

This paper reviews the current rhetoric on changing professional role boundaries and mixing skills in general practice, particularly in relation to the general practice nurse. The issues relating to the effectiveness and efficiency of the general practice nurse role and to the professional development of general practice nurses, can be placed in a matrix, represented by parameters which relate to teamworking and to the 'doctoring/nursing relationship'. The question is asked: 'How can the reality of current nursing roles within general practice meet the rhetoric of the current NHS (Primary Care) Bill?' By providing conceptual matrices which place the key issues of general practice nursing in contingent relation, questions which relate to, for example, changing professional roles and the appropriateness of a general medical services infrastructure for primary health care can be explored — a process of contingent quality improvement.
Should the baby live? The role of nurses in decision-making
Authors: McHaffie Hazel E. , Forrlie Peter W.
Published: June 2007

Withdrawing and withholding treatment is an emotive issue, especially when it comes to infant patients who cannot reveal their own preferences. The Institute of Medical Ethics carried out a study exploring the perceptions of doctors and nurses involved in such decisions and found that nurses are reluctant to articulate their opinions. This results in practices taking place and decisions being made with which they are not always totally in agreement. Recommendations have been made for better preparation in ethical reasoning, improved communication and team effort.
The performance of nursing in the research stakes: Lessons from the field
Authors: Mead Donna , Moseley Laurie , Cook Richard
Published: June 2007

There have been many complaints in recent years that nursing research has not developed as fully as it should have, together with a suggested explanation that this is largely due to a lack of success in obtaining funding. This lack of success has been attributed to a domination of funding bodies by doctors, who, it is claimed, do not understand or value nursing research. We have examined such claims in two ways. First, a brief historical overview shows that, although there is still a way to go, nursing research has, in recent years, produced useful information, and that this refutes the idea that it is completely undeveloped. Second, a report on a case study on the progress of 217 grant applications to a regional R&D office in the UK challenges the suggested explanation. The limited number of funded proposals from nurses was not due to medical prejudice. Rather it was due to very few nurses putting forward proposals and to many of those proposals being withdrawn voluntarily, usually after the receipt of insensitively-worded referees' commentaries. When nursing proposals were pursued vigorously, they received higher scientific ratings than medical-led proposals, and were, proportionately, more likely to gain funding.
Language for research and practice: The English experience
Authors: Meerabeau Liz , Casey Anne , Old Simon
Published: June 2007

This paper draws on the authors' experience in developing policy on nursing informatics, nursing languages, and research management. It considers the UK approach to nursing terminology, language development and classification, and discusses the merits and demerits of developing systematic and standardised vocabularies of patient/client problems and interventions. Some nurses are vehemently opposed, seeing nursing research and practice as humanistic, and the patient/client as a unique entity who cannot be captured in standardised terms. However, if this view is taken it would seem to militate against any large scale research in nursing, or research on outcomes. The paper explores the links between language, the concept of the patient/client, and the implications for the organisation of research.
Developing the capacity of nursing and midwifery research: The view from higher education
Authors: Watson David
Published: June 2007

Focusing in particular on the 'five-strand' model of support for research proposed in the Dearing report (National Committee of Inquiry into Higher Education, 1997), the author explores the problems and prospects for institutional support of nursing and midwifery research. Responses from various sources are then compared. These include: Funding Councils; the NHS; professional bodies; medical charities; and industry.

The paper concludes with thoughts on the priorities for management of nursing and midwifery research within universities and colleges. These include: the development of an agenda of agreed problems and perspectives (for example, inter-professionalism and community health); issues of communication and dissemination (especially at the border with other subject cultures and programmes); and the requirements of a 'methodological mix' (from ethnography to traditional statistical analysis).
Funding for evidence-based nursing practice in the UK
Authors: Curzio Joan
Published: June 2007

Evidence-based practice requires the continuing generation of new knowledge, that is, evidence. The funding to produce this new information is obtainable from a number of sources but has quite limited availability. There are slightly differing arrangements for distribution in each of the countries of the UK, although there are some programmes that are UK-wide. All of these include money previously identified for research, audit or practice development. The Culyer report, Supporting Research and Development in the National Health Service (DoH, 1994), has had an effect on funding across the countries of the UK. With increasing rigour expected, proposals for the development of evidence should be critically appraised. By identifying the methods, the sources and limitations of obtaining the resources for producing evidence, nurses are in a better position to take their practice forward.
The teaching, learning and use of infection control knowledge in nursing
Authors: Courtenay Molly
Published: June 2007

A study was undertaken to determine the theoretical principles of infection control and the related practices that were taught to qualified nurses, students, both RGN and Project 2000, and health care assistants. The aim was to understand how they applied this knowledge to practice. It was found that what they were taught was different for each of the four groups and that in the case of the nurse education programmes the teaching lacked application to practice.

The study revealed that an understanding of how infection spread was frequently inaccurate. The ward sister and charge nurse were shown to have a powerful influence on the infection control practices of ward staff. Key issues involve the structure and organisation of nurse education programmes and management practices at ward level.
Power analysis and sample size estimation
Authors: Ingram Richard
Published: June 2007

Determining appropriate sample size is often a difficult decision in the process of developing quantitative research proposals. The novice researcher may well understand that the need for an adequate sample size is an important issue, but lack the knowledge to make an informed decision. Often the sample size will be based on the constraints of practical considerations, such as time or cost, but with little confidence that the sample is adequate in any statistical sense. This paper explores power analysis as an approach to sample size estimation that can be used even by novice researchers to provide a more rational basis for such decisions. The principles underpinning power analysis and the factors that contribute to statistical power are discussed, with an example of power analysis applied to a simple experimental design. Some arguments against a perceived over-emphasis on power analysis are raised. Finally, relevant literature, computer software and World Wide Web resources are included (see Bibliography page 139).
Quality of care in nursing homes for older people: Providers' perspectives and priorities
Authors: Bartlett Helen , Burnip Stephanie
Published: June 2007

The long-term care of older people is increasingly characterised by a mixed economy model and independent nursing homes have become an important contributor to this form of provision. Concerns about the quality of care in this sector have, however, focused attention on a number of policy issues. There are proposals to revise existing legislation, modify inspection processes, introduce national standards and consider alternative models of funding. Within this changing policy context, little is known about the challenges facing homes in providing quality care. This paper draws on the findings of a Delphi survey of 196 clinical nurse managers in the Anglia and Oxford region of the NHS Executive. The aim of the study was to identify and prioritise the challenges facing nurse managers in the delivery of quality care. A wide range of clinical nursing issues and 'indirect' nursing issues was identified. The findings highlight the demands of increasingly dependent residents of advanced age, including their needs for physical and psychosocial care. Funding constraints, recruitment and retention of staff, and education and training were priority issues believed by nurse managers to influence the quality of care they could deliver. The implications of these findings for policy and practice are considered.
Research, audit and networking activity in nursing development units
Authors: Redfern Sally , Murrells Trevor
Published: June 2007

This paper compares the progress made by NDUs, in comparison with matched units without NDU status, on research, audit and networking activities. We focus on two activities: (a) for research: involvement by staff in research, resources acquired and dissemination activity through publication and conference presentation and (b) for audit and networking: information on completed and current audits, and details of visits made by staff to and from other organisations. The data are drawn from questionnaires and interviews to the clinical leaders and staff and reports prepared by NDU-comparator pairs. Research and dissemination activity, though not high, are significantly greater (p<0.01) in NDUs than comparators. NDUs have a more widespread research culture as measured by involvement in research by all grades of staff. Research in NDUs focuses on local attempts to improve practice and has some way to go before it can be generalised into healthcare settings beyond the unit where it was carried out.

There is no difference in number of audits undertaken by NDUs and comparators but NDUs carried out more audits to evaluate nursing work and comparators did proportionately more on practice topics and user issues. There is no association between research and audit activity; more audit does not result in less research. Networking activity by staff is significantly greater (p<0.01) for NDUs, suggesting they are seen as a resource to other centres.

NDUs are active in research and networking — significantly more so than comparators. We suggest that audit can act as a conduit for implementing research findings and monitoring evidence-based practice.