bluuebunny/crossref_metadata_2025 huggingface dataset:
Phytic acid–trace element (Zn, Cu, Mn) interactions
Authors: Lönnerdal Bo
Published: March 2003

Summary Studies in animals and human subjects have shown that diets high in phytic acid can cause zinc deficiency, and that the phytate content is negatively correlated to zinc absorption. Suboptimal zinc status has been shown to cause increased morbidity, poor pregnancy outcome, impaired growth, immune competence and cognitive function, emphasizing the need to optimize zinc bioavailability. Reducing the content of phytate in the diet is one way of improving zinc absorption and this can be achieved by novel precipitation methods during processing, food preparation methods that activate endogenous phytase (e.g. baking, fermentation, malting and hydrothermal processing), or addition of exogenous phytase. During the action of phytase on phytic acid, the hexaphosphate is hydrolysed into inositol phosphates with lower degrees of phosphorylation. Because only the penta‐ and hexaphosphates have been shown to inhibit zinc absorption, it is often essential to analyze the individual forms of phytate in the diet when evaluating zinc bioavailability. Phytic acid does not inhibit copper absorption, but has a modest inhibitory effect on manganese absorption.
The use of spray drying to microencapsulate 2‐acetyl‐1‐pyrroline, a major flavour component of aromatic rice
Authors: Apintanapong Muanmai , Noomhorm Athapol
Published: March 2003

Summary Different ratios of gum acacia and maltodextrins were used to investigate the appropriate wall materials for encapsulation, by spray drying, of 2‐acetyl‐1‐pyrroline (ACPY). This compound, which is the major flavour component of aromatic rice, was extracted from pandan (Pandanus amaryllifolius) leaves by steam distillation. The amounts of ACPY before and after spray drying encapsulation were not significantly different (P < 0.05). Better retention of ACPY was obtained by encapsulation. In its liquid form ACPY degraded quickly as 63% reduction occurred in a basic solution after 7 days; however, only 30% reduction was found in acidic solution after 35 days of storage. After 72 days of storage, the amount of ACPY in encapsulated powders made with differing amounts of gum acacia and maltodextrin decayed as follows: ratios of gum acacia:maltodextrin of 70:30, 60:40, 50:50, 40:60, 30:70 and 0:100 gave the following amounts of degradation of 27.7, 33.4, 43.2, 35.7, 30.6 and 32.6% respectively. Encapsulation in 70:30 gum acacia:maltodextrin gave the best retention of ACPY.
Heat resistance of Escherichia coli O157:H7 in cook‐in‐bag ground beef as affected by pH and acidulant†
Authors: Juneja Vijay K. , Novak John S.
Published: March 2003

Summary The heat resistance of a four‐strain mixture of Escherichia coli O157:H7 was tested. The temperature range was 55–62.5 °C and the substrate was beef at pH 4.5 or 5.5, adjusted with either acetic or lactic acid. Inoculated meat, packaged in bags, was completely immersed in a circulating water bath and cooked to an internal temperature of 55, 58, 60, or 62.5 °C in 1 h, and then held for pre‐determined lengths of time. The surviving cell population was enumerated by spiral plating meat samples on tryptic soy agar overlaid with Sorbitol MacConkey agar. Regardless of the acidulant used to modify the pH, the D‐values at all temperatures were significantly lower (P < 0.05) in ground beef at pH 4.5 as compared with the beef at pH 5.5. At the same pH levels, acetic acid rendered E. coli O157:H7 more sensitive to the lethal effect of heat. The analysis of covariance showed evidence of a significant acidulant and pH interaction on the slopes of the survivor curves at 55 °C. Based on the thermal‐death–time values, contaminated ground beef (pH 5.5/lactic acid) should be heated to an internal temperature of 55 °C for at least 116.3 min and beef (pH 4.5/acetic acid) for 64.8 min to achieve a 4‐log reduction of the pathogen. The heating time at 62.5 °C, to achieve the same level of reduction, was 4.4 and 2.6 min, respectively. Thermal‐death–time values from this study will assist the retail food processors in designing acceptance limits on critical control points that ensure safety of beef originally contaminated with E. coli O157:H7.
Modelling flavour release from a chewed bolus in the mouth: Part II. The release kinetics
Authors: Wright Kevin M. , Hills Brian P.
Published: March 2003

Summary A computer simulation of the time course of flavour release from foods in the mouth is presented which takes into account individual differences in mastication behaviour. Pearson type IV distributions of chewing and swallowing times, sphericity and mass loss changes determined by electromyography and spit‐out experiments for each panellist are used to simulate mastication runs which are combined with the mass transfer kinetics to predict the time course of flavour concentration in the headspace for each panellist. These predictions are compared with the corresponding sensory time‐intensity measurements.
Retention of two fluoride pit‐and‐fissure sealants in comparison to a conventional sealant
Authors: Morphis  , Toumba
Published: March 2003

Aim. The aim of this investigation was to study the retention rates in children of two fluoride fissure sealants, an experimental fluoride‐glass formulation and a commercial one, in comparison to a conventional sealant, at 3, 6 and 12 months.Design. The study was performed in a randomized double‐blind fashion.Setting. The investigation was carried out in the Children’s Clinic at Leeds Dental Institute.Methods. A total of 74 first and 29 second permanent molars in 25 children aged 6–16 were assigned randomly to one of the three sealant‐groups using a table of random numbers. During sealant application occlusal pits and fissures were cleaned with a three‐in‐one syringe and a blunt probe, etched for 20 seconds, washed, dried and light‐cured for 30 seconds. Retention of the sealants was assessed as either completely retained, partially retained or missing at 3, 6 and 12 months.Results. The results showed that complete retention for fluoride‐glass sealant, Delton Plus and Delton was: at 3 months 69·69%, 81·25% and 80·64% respectively, at 6 months 64·51%, 74·19% and 76·66% respectively, and at 12 months 61·29%, 67·74% and 70% respectively.Conclusions. No significant difference (P>0·05) was found among the three materials in retention rates at each follow‐up period.
Endodontic treatment of immature tooth with dens invaginatus: a case report
Authors: Tarján I , Rózsa N.
Published: March 2003

The endodontic treatment of a dens invaginatus in an immature permanent upper lateral incisor of a 9‐year‐old boy is presented. Root canal treatment was performed using calcium hydroxide paste as a temporary root canal filling in order to achieve apexification. This was replaced after closure of the apex with a final root canal filling using gutta‐percha and AH 26 as the sealer. The follow‐up radiographic control demonstrated the effectiveness of nonsurgical treatment in a case of incomplete root formation in a tooth with dens invaginatus.
Comparison of electrosurgical and formocresol pulpotomy procedures in children
Authors: Dean J. A. , Mack R. B. , Fulkerson B. T. , Sanders B. J.
Published: March 2003

Summary. Objectives. Although previous studies have examined the electrosurgical pulpotomy technique for primary teeth, no well‐controlled, clinical human trials have been published. The purpose of this study was to prospectively compare electrosurgical pulpotomies vs. formocresol pulpotomies in human vital primary molar teeth.

Design. Fifty children were randomly divided into two groups, 25 receiving an electrosurgical pulpotomy and 25 receiving a formocresol pulpotomy.

Results. After at least 5 months postoperative observation time, the clinical and radiographic success rates for the electrosurgical groups were 96 and 84%, respectively; and for the formocresol group, 100 and 92%, respectively.

Conclusion. There were no statistically significant differences between the success rates for the two groups at the P < 0·05 level as tested by Fisher’s exact test. This study failed to demonstrate a difference in the success rate between the electrosurgical and formocresol pulpotomy techniques.
Eruption of a permanent mandibular canine in a 5‐year‐old boy
Authors: Turnbull N. R. , Lai N. N.
Published: March 2003

Summary. The premature eruption of a mature mandibular permanent canine is described in a healthy 5‐year‐old boy with developmental absence of the primary predecessor. The effects of early loss or missing primary teeth on eruption timing of the permanent successors are discussed. The very early maturation of the permanent canine appears to be a unique oddity, and there are no reports in the literature of eruption of this type of secondary tooth at such an early chronological age.
Research testing theory: a selective review of Orem's self‐care theory, 1986–1991
Authors: Spearman Sharon A , Duldt Bonnie W , Brown Sylvia
Published: March 2003

The purpose of this study was to determine the extent to which theory testing may have increased in the 5 years since Silva's initial investigation Using the criteria established by Silva, a review of five major research journals in nursing was used to investigate the degree to which Orem's self‐care theory of nursing was being empirically tested Hand and computer searches yielded 31 studies purporting to use Orem's theory as the basis for research Of these studies, however, only four (13%) met the criteria for appropriately testing the theory The findings indicate that little change has occurred in using research to test Orem's theory appropriately Implications for research and practice are discussed
Teaching behaviours of clinical instructors: an audit instrument
Authors: Mogan Judith , Warbinek Ethel
Published: March 2003

This article describes the development and initial psychometric testing of an instrument that permits the observation and recording of teaching behaviours exhibited by clinical instructors while supervising nursing students Observations of Nursing Teachers in Clinical Settings (ONTICS) consists of 44 items grouped into nine categories of desirable and undesirableteaching behaviours questioning method, responding style, method of giving feedback, teaching skill, method of demonstration, interaction with patient/family, interactions with health team, undesirable teaching behaviours, undesirable questioning/responding method The instrument was refined on several occasions based on input from expert judges Construction validity, internal consistency reliability and test‐retest reliability were found to be acceptable ONTICS appears to capture an aspect of clinical teaching not readily identified by other, more subjective, instruments
Health promotion: the emerging frontier in nursing
Authors: King Patricia M.
Published: March 2003

Health promotion is gaining recognition as a health care strategy The major premise of this paper is that the nature of health promotion is emerging Rising into view, health promotion offers many challenges and opportunities to all health care professionals Many of the influences that health promotion will have on nursing have not yet been fully explored What is health promotion? What concepts are inherent in health promotion? Are there models of health promotion that are specific to nursing7 What will be nursing's role in health promotion? What changes are required by the nursing profession to enable nurses to emerge within this new frontier? These are central questions for nurses as health promotion professionals to ponder, and attempts are made in this paper to answer these questions
The special needs of children
Authors: Price Sue
Published: March 2003

British literature related to the care of children in hospital states that they have ‘special needs’ This concept is not defined, neither are different writers in total agreement about what these needs may be This paper attempts to define needs, concluding that they are‘requirements that should be met’Children are seen as dynamic beings because they are in a state of constant development, both physically and psychosocially It is this state of development that makes their needs special to them They have special requirements, which should be met in specific ways Through the presentation of indicators of behaviours which would enable such needs to be met, it can be demonstrated that children should be cared for by people with the appropriate knowledge and understanding When children are admitted to hospital there may be a number of different people involved in determining how a need should be met An important part of this process should be nurses who have been specially educated for work with this age group
When your patient is silent
Authors: Davidhizar Ruth , Giger Joyce Newman
Published: March 2003

In the process of caring for patients, nurses encounter patients who are silent A number of problems may arise when silence occurs in an interpersonal situation Among these problems is the different meanings that silence may have from culture to culture This paper describes the meaning that silence may have across cultures and delineates guidelines for the nurse in responding to the patient who is silent
The measurement of nurse performance and its differentiation by course of preparation
Authors: Fitzpatrick Joanne M , While Alison E , Roberts Julia D
Published: March 2003

This paper addresses the concept of nurse performance, its measurement and its differentiation by programme of preparation It is evident from the research conducted to date that a variety of methodologies have been used to explore and compare nurse performance The process of direct observation, however, has been selected to a lesser degree, and it is argued that its potential has yet to be realized Further, in recognition of the methodological challenges inherent within research of this nature it is suggested that nurse performance should be explored from a variety of perspectives, using a multi‐method research design Significantly, educational preparation as a potential discriminator of performance has been explored only to a limited extent and studies carried out in the United States predominate In view of recent nurse education changes in the United Kingdom and the introduction of Project 2000, empirical work comparing outcomes of the different courses of pre‐registration preparation is urgently required The authors are currently engaged in a comparative study of outcomes of pre‐registration nurse education programmes funded by the English National Board for Nursing, Midwifery and Health Visiting This paper draws upon the literature reviewed to date
Staff attitude and experience in dealing with rational nursing home patients who refuse to eat and drink
Authors: Mattiasson Anne‐Cathrine , Andersson Lars
Published: March 2003

This paper describes the personal attitudes of nursing home staff and their experience of coping with rational nursing home patients who refused to eat and drink Professional caregivers in 13 nursing homes and nursing home units in the county of Stockholm, Sweden, were asked to judge an ethical conflict involving a situation in which a patient of sound mind refused to eat and drink Two questions were raised (a) What would your unit's decision be in this case? (b) What is your personal opinion in this case? Answers to question (a) showed that 20% believed that the patient's autonomy would be respected, i e the patient would be allowed to die without medical intervention Concerning question (b), the results showed that approximately 50% believed that the patient's wishes regarding food refusal must be respected Furthermore, the results suggested that both professional category and number of years’ service made a difference to the staff views on patient autonomy Finally, the findings indicated that the nursing homes included in the study did not show any distinct policy with regard to the autonomy of elderly nursing home patients in refusing to eat and drink
Contra biology: a polemic
Authors: Dawson Paul J
Published: March 2003

The philosophical basis of the prevalent biological model of psychiatry is examined critically, with particular reference to the reductionism inherent in such an approach The pharmacological response initiated by the biological approach is then considered, and the perfidious nature of the complicity between psychiatry and the pharmacological/industrial nexus drawn out Biological psychiatry is then situated within the prevailing political and economic ideology of the 1990s, and the move towards more community‐based psychiatry examined from this perspective Finally, the stresses necessitated by the incompatibility of many nursing models with the biological paradigm are addressed This is, as the title suggests, a deliberately polemical and provocative paper, which is offered to stimulate debate both on the future of psychiatric/mental health nursing as a soundly theory‐based speciality, and also on the uncritical acceptance of the biological paradigm Wholesale adoption of this paradigm is considered to be inimical to many of the values notionally espoused by nursing, as well as posing dangers in the larger social field, in terms of the culturally acceptable notions of how we define ourselves, and how such definitions affect our conceptions of freedom, free will and agency
Nurses’ knowledge and beliefs about continence interventions in long‐term care
Authors: Palmer Mary H
Published: March 2003

Incontinence in nursing homes is a prevalent condition requiring a programmatic approach due to its diverse aetiology Awareness of antecedent factors, such as knowledge and beliefs about incontinence and its treatment by the individuals responsible for establishing and maintaining a continence programme, is important prior to implementation A questionnaire was administered to licensed nurses who attended a workshop on urinary incontinence in nursing homes One purpose of the questionnaire was to elicit information about beliefs regarding the effects of continence programmes on residents and staff and potential staff reaction to implementation of a continence programme in then‐ facility Responses by licensed practical nurses (LPNs) were compared to the responses of registered nurses (RNs) Attribution for causes of incontinence differed between LPNs and RNs There were no significant differences in the report of current routine nursing care which included scheduled toileting, changing clothing when necessary, and use of adult briefs and underpads Most nurses anticipated a favourable reaction by the staff to the implementation of a continence programme However, at least 20% responded that the nursing staff would be apathetic or resistant to a programme Administrative support was infrequently chosen as the most important factor in the implementation of a programme. The implications of these findings to continence programmes that are integrated into the organization and provide comprehensive services, including preventive interventions, are discussed
In health visiting, a routine visit is one that has passed
Authors: Cowley Sarah
Published: March 2003

Pressure on British health workers to be more explicit in articulating the function, purpose and outcome of their role has increased with the introduction of general management and shift to a market‐place orientation, since implementation of the NHS and Community Care Act (1990) However, a recurring theme in the history of health visiting has been the difficulty which practitioners experience in trying to explain exactly what it is that they do This has often been portrayed as a major failing, and possibly even a reason to discontinue the service This paper will offer a potential explanation for this difficulty, and suggest that the management of uncertainty and ambiguity are central to the role It will draw on a grounded theory study which explored how health visitors choose which approach to use in any particular situation encountered in their work The analysis suggested that health visiting's central focus is on situations which are unpredictable, ambiguous or anomalous The study revealed an approach to health promotion which requires a highly developed ability to cope in a safe and therapeutic way with shifting, uncertain and ill‐defined health needs, and to recognize and respond to complex, potentially risk‐filled situations Drawing on examples which illustrate the implications of these concepts in practice, the paper suggests that, much as midwives have long claimed that a‘normal delivery is one that is over, so in health visiting a‘routine visit’can only be recognized as such once it has taken place Nevertheless, it will be contended that the particular approach to practice revealed in this study represents a valuable and necessary aspect of health promotion, which has the potential to ensure relevance and acceptability, and which maximizes unexpected opportunities for prevention
The relationship of health locus of control and cardiac rehabilitation to mastery of illness‐related stress
Authors: Younger Janet , Marsh Kelly J , Grap Mary Jo
Published: March 2003

The study examined the relationships among participation in outpatient rehabilitation, health locus of control, and mastery of stress with coronary artery disease A sample of 111 persons who had been hospitalized for coronary artery disease completed the Master of Stress Instrument (MSI) and the Multidimensional Health Locus of Control Scale One fourth of the sample had participated in the hospital's cardiac rehabilitation programme Results showed no difference between cardiac‐rehabilitation participants and nonparticipants on mastery, internal locus of control or stress Demographic characteristics of age, education, race and gender revealed no significant correlation with either the total MSI score or its component measures However, internal locus of control was significantly and positively correlated to both growth and total mastery A stronger relationship was found between internal locus of control and change This finding supports the hypothesis that health‐internals achieve higher levels of mastery
Drug‐taking behaviours of pregnant substance abusers in treatment
Authors: Higgins Patricia Grant , Clough Dorothy Hendel , Wallerstedt Cheryl
Published: March 2003

The purpose of this research was twofold to describe the types of drugs and alcohol abused by pregnant multisubstance abusers enrolled in a substance abuse and treatment programme, and to describe the types of changes in drug‐taking behaviours during pregnancy An exploratory study, including interviews and chart reviews, was conducted with 31 pregnant multisubstance abusers Drug‐taking behaviours, demographic factors of age, ethnicity, marital status, education, and pregnancy characteristics of gravida, living children, level of prenatal care and trimester of pregnancy were measured Most of the women were in their twenties, Hispanic, single, and had some high school education Most of the women were multiparas to grand multiparas, yet they had only one or two living children, and all were receiving prenatal care Their self‐reports were validated by urine screening Generally, the women reported that they did change their drug‐taking behaviours, and many women decreased their substance abuse
Joint nursing appointments: a vehicle for influencing health care change
Authors: Tamlyn Deborah , Myrick Florence
Published: March 2003

With the rapid pace of health care change nurses need to organize and respond quickly to the debate on future health care policy Nurses from practice and academia working together can capitalize on their unique knowledge and expertise to influence the development of consumer‐ and health‐oriented policies In the past joint appointments have served to unite nurses in the education and research domains These appointments must evolve to encompass policy‐focused activities that will enable nurses to make a significant contribution to the transformation of the health care delivery system
The professional paradigm of qualified psychiatric nurses
Authors: Luidstrom Unni Å
Published: March 2003

The main purpose of this research was to determine the professional paradigm of the qualified psychiatric nurse and the factors influencing the formation of this paradigm The research was both explorative and descriptive, and both qualitative and quantitative methods were used The research approach was deductive and based on the theory of paradigm of Tornebohm The test persons comprised three groups Swedish‐speaking Finns, Swedes and Finns In each group there were eight students in the final stages of their psychiatric nursing training A total of 40 questionnaires were distributed to each group The research revealed four different characteristic types of qualified psychiatric nurses caring science oriented, partly caring science oriented, general humanist and finally the personality‐ and experience‐oriented The results also indicate that there is a discrepancy between will and ability within caring This can partly be interpreted as an expression of the discrepancy between philosophical and ideological impressions and real acts but it may partly indicate a lack of information Many informants had difficulty naming a theoretical frame of reference for their work and stating aspects of psychiatric caring that would be important to know but on which no information so far exists Many informants expressed the need for more research and development but did not indicate the subjects
An investigation into whether nursing students alter their attitudes and knowledge levels regarding HIV infection and AIDS following a 3‐year programme leading to registration as a qualified nurse
Authors: Snowden Lynette
Published: March 2003

The purpose of this study was to examine whether a 3‐year programme of nursing studies enabled nursing students to graduate from the course with greater knowledge and more positive attitudes towards HIV infection and AIDS than when they began the course. Students on a maths and information technology course were used as controls. The study involved the use of a questionnaire which gathered information about students' experience, knowledge, attitudes and moral judgement regarding HIV infection and AIDS. The experimental hypothesis stated that nursing students show a greater increase in knowledge and positive attitude change towards HIV infection and AIDS than maths students. The results showed significant differences between third year nursing students' knowledge about HIV and AIDS when compared with other groups but it was noted that knowledge levels for all groups was quite low. There was no difference between first and third year nursing students' attitudes and moral judgement about HIV and AIDS but there was a significant difference between nursing students and maths students. It was suggested that there is a need to modify nurse education programmes in order to have greater impact on this topic area.
The relationship of self‐perception of illness and compliance with health care regimens
Authors: Wichowski Harriet Conley , Kubsch Sylvia M.
Published: March 2003

Concern over the degree of non‐compliance among chronically ill patients promoted the development of a survey based on the premise that there is a correlation between self‐perception of health and compliance with health care regimens. Survey results determined that there was a significant relationship between self‐perception of health and compliance with health care regimens for 106 chronically ill subjects. There was a significant difference in self‐perception of illness between adults and children surveyed. There was no difference in compliance rates between the two groups. Techniques to aid patients in altering their self‐perceptions regarding their illnesses are discussed.
Methodological issues in the evaluation of the quality of public health nursing: a case study of the maternal and child health centres in Hong Kong
Authors: Twinn Sheila
Published: March 2003

The demand for the evaluation of the quality of patient and client care has increased in public health nursing as in all disciplines of nursing. In Hong Kong this demand led to the development of a collaborative study with the Department of Health to evaluate the quality of public health nursing in the maternal and child health centres. A multiple case study design was developed to undertake the research using both qualitative and quantitative methods of data collection. The findings from the study demonstrated not only implications for clinical practice which have been reported elsewhere, but also methodological issues for the evaluation of care. These findings indicate three major issues for consideration. The first issue is that of the cultural context of care which includes perceptions of care such as demands on the service and expectations of care. The second issue is the use of health data, including both the methods of recording as well as the sources of data. The final issue is that of the method of data collection, in particular the implications of the use of language in data collection tools. The findings suggest that both the use of professional language and the need for translation have implications for data collection methods. Indeed in the author's view the development of methodologies for the evaluation of care must address culturally specific issues, particularly where English is not the first language of subjects in the study. In addition the use the use of language in the method of data collection highlights more general issues raised by the use of translation in the collection and analysis of qualitative data.
Assimilating sociology: critical reflections on the 'Sociology in nursing’debate
Authors: Mulholland Jon
Published: March 2003

We are witnessing the emergence of a ‘new nursing’. In part, this has been associated with the adoption of a ‘holistic’ model of health and a commitment to a holistic curriculum within nurse education. The role of sociology within the nursing enterprise has been the subject of much debate. This paper seeks to further this debate by arguing that sociology is invaluable to nursing for many reasons but that its value may be undermined as a consequence of being overly constrained within the nursing arena, at the mutual expense of both sociology and the long term interests of nursing itself. This paper will suggest that central to an understanding of how this 'surplus constraint’ of sociology occurs is an understanding of the manner in which the holistic model has been adopted in much of nursing and nurse education. The‘indeterminacy’ of the holistic model is such that it has empowered a questionable eclecticism, marginalized philosophical controversies within nursing theory, disguised difficult epistemological and ontological conflicts associated with competing claims to truth and facilitated the operation of a form of power whereby sociology has been excluded, at the very moment of its apparent inclusion. This paper goes on to argue that the value of sociology to nursing is dependent upon: firstly, a more systematic and rigorous discussion of its relationship to, and role within, nursing and secondly, a movement away from an implicit ‘assimilation’ model regarding the incorporation of sociology into nursing towards a more ‘multicultural’ approach. Only under such circumstances may sociology's value to nursing be realized but in a manner that places an importance on maintaining the ontological and epistomological integrity of the sociological tradition.
Development through self‐assessment: strategies used during clinical nursing placements
Authors: Crawford Mary W. , Kiger Alice M.
Published: March 2003

The question asked for this small research project was ‘how do senior students judge their progress towards being a ‘‘good nurse’’?’ A qualitative approach was taken and a convenience sample of 10 student midwives identified. Interviews were the main source of data collection. Since the method of analysis was that of grounded theory, the interviews became more focused as themes emerged. Results demonstrated that each student developed a range of self‐assessment strategies which were used in any clinical placement. Some techniques were used only at a certain stage in a clinical placement while others were used throughout. Cyclical techniques were related to the achievement of short‐term goals; strategies used for the duration of the placement had more long‐term significance. Highlights of the findings were explored in the literature. These features included models of professional development, the need to feel part of a team, the necessity of identifying a role model, and the significance of the length of a clinical placement. Conclusions related to the duration of a clinical placement and the necessity for the student to have the opportunity to complete the cycle. The value of acquainting new students with self‐assessment strategies is suggested.
The role of personal tutor in nurse education: towards an understanding of practice in a college of nursing and midwifery at a particular point in time
Authors: Richardson Rosemary
Published: March 2003

This paper describes an inquiry to increase understanding of the role of personal tutor in a college of nursing and midwifery. Concepts of tutor and role are discussed in relation to their historical influences and an over view is provided of the research process which included document analysis and reflective audio‐taped interviews with student nurses, teachers and education managers. Five conceptual categories are identified and critically analysed in relation to personal, institutional and social contexts and the factors which influence them. The first two categories identified reflect the concepts discussed in the literature. The third category reflects the uncertainties and confusion which surround differing perceptions of the role. The fourth category suggests the misunderstandings which may occur through taking for granted apparently shared concepts. The fifth category suggests the significance of personal theory in practice and the extent to which roles are taken or made. Traditional values concerning theory and practice are thus challenged. The reflective evidence provided by the participants suggests a theory, generated by them through the meanings they give to their views and actions, concerning their roles and the situation in which they find themselves at a particular point in time.
Playing the power game for qualitative researchers: the possibility of a post‐modern approach
Authors: Stevenson Chris , Beech Ian
Published: March 2003

The later work of Wittgenstein (1953) takes language and meaning as arising in use. A local ‘grammar’ is created. Ethical/research awarding committees have developed, and clashing, meanings about what constitutes ‘good’ research. The fixed rule language game of the committee is implicitly powerful because it is part of well‐rehearsed societal narratives which equate science and knowledge. This creates a force on the qualitative researcher to conform to the authoritative grammar which it is difficult to counter. In these circumstances, qualitative researchers may choose to inhabit two, parallel research universes by ‘storying’ their research proposal according to the audience. But a question arises as to whether ethical approval has been gained when a ‘Trojan horse’ approach is used. Moving between worlds involves the researcher living with a dual identity. The postmodernist movement away from structure, form and singular truth is seen as setting a context for a new archaeology of knowledge which transcends good/bad dichotomies in relation to research. The qualitative researcher is encouraged to enter into dialogical communication with committees with the hope that a shared grammar may emerge.
The effectiveness of ‘nursing beds’: a review of the literature
Authors: Griffiths Peter , Wilson‐Barnett Jenifer
Published: March 2003

A literature search was conducted to identify ‘nursing led in‐patient units’ where the nurse is the designated leader of the clinical team. The review concentrates on studies which have attempted to measure the impact of nursing‐led in‐patient units and reviews both the methodology and outcomes. Three major bodies of work were identified. Lydia Hall’s evaluation of the Loeb Center for Nursing and Rehabilitation (USA) is reviewed in some detail. This work was the model for ‘nursing beds’ at the two Oxfordshire Nursing Development Units (UK) in the 1980s. Studies evaluating these centres are reviewed and reports of similar UK units discussed. A third body of work evaluates a nurse‐managed critical care environment. Common features include a case mix based on nursing need with nurses having authority to admit and discharge patients. While results are generally favourable, with improved patient independence, fewer readmissions, lower mortality and cost savings reported in some or all of the studies, all studies reviewed demonstrate the difficulties of applying an experimental model to real life clinical services. Methodological limitations render firm conclusions difficult. Techniques adopted from studies in field settings, the so‐called ‘quasi‐experiment’, are advocated as a remedy, as is further study of the process of care in investigating this model of care delivery.
The role of the triage nurse practitioner in general medical practice: an analysis of the role
Authors: Reveley Shirley
Published: March 2003

A 2‐year pilot study was undertaken in a group general practice to evaluate the nurse practitioner triage role. The study was undertaken in several stages which included a patient satisfaction questionnaire survey, follow‐up interviews with 30 patients from the questionnaire survey, and analysis of the nurse practitioner’s work at different points over the 2‐year study period. This paper describes the work of the nurse practitioner in comparison with that of seven general practitioners in a group general medical practice over a 5‐day period in February 1996 and included patients’ perceptions of their consultation. In this particular group medical practice, as in others throughout the country, many patients request same day appointments, often for self‐limiting conditions, social advice and health education. This study demonstrates that the nurse practitioner can deal with such patients effectively and is undertaking an expanded and extended role in order to provide an holistic service to patients with which they are highly satisfied. It can be concluded that given the right kind of education and training and a supportive framework within the practice, the nurse practitioner undertaking a triage role can provide a highly effective service to patients and is a valuable member of the primary health care team.
Evolutionary principles can guide nursing’s future development
Authors: Gottlieb Laurie N. , Gottlieb Bruce
Published: March 2003

Evolutionary principles can guide nursing’s future development¶Health care reform has resulted in a unique opportunity for nursing to develop and expand its role in future health care environments. We discuss why we think nursing’s time has come, as well as the forces in present health care environments that threaten nursing’s progress. We have used modern evolutionary principles to elucidate seven key conditions required for nursing to survive and flourish in the new health care environments. These conditions include the need for nurses to: be relevant; be accountable; be visible; be innovators; have a global impact; retain their uniqueness, while functioning in␣multidisciplinary settings; and be exceptionally competent, while striving for␣excellence.
Therapeutic touch as a nursing intervention
Authors: Meehan Therese C.
Published: March 2003

Therapeutic Touch (TT) is being proposed as a nursing intervention. Its proponents claim that it is integral to the art of nursing practice and can facilitate comfort and healing in a wide range of patients. However, the practice of TT is also controversial, primarily because it does not usually involve physical contact and is based on energy field theoretical frameworks. The development of TT and its conceptualization as an energy field interaction are reviewed, and points of controversy discussed. The method of practice is described. Review of controlled efficacy studies indicates limited and inconclusive scientific support for its proposed effects. The intrinsic relationship between TT and the placebo phenomenon is discussed. The potential of TT to enhance the placebo effect requires further exploration but should not be discounted in seeking to relieve discomfort and distress and facilitate healing. For some patients, TT may serve as a beneficial adjuvant nursing intervention.
Paradigm dialogues and dogma: finding a place for research, nursing models and reflective practice
Authors: Heath Helen
Published: March 2003

Debates within nursing can take the form of useful discussion and critique or verbal conflict generated from inflexible paradigm positions intolerant of differing stances perceived to be of no value. It is suggested that the most profitable process is debate that generates understanding of the strengths and limitations of various tools and techniques and helps identify suitable usage rather than uncritical advocacy or outright rejection. Suggested uses will thus themselves become subject to further debate and practitioners will be encouraged to adopt a use that suits their practice setting and role. The quantitative‐qualitative research debate, criticisms of the nursing process and nursing models and reflective practice are examined. Dogmatic positions are highlighted and uses that are potentially controversial are identified.
The captive market in nurse education and the displacement of nursing knowledge
Authors: Corbett Kevin
Published: March 2003

This paper develops a framework of empowerment within which to examine the commissioning process for nurse education arising from market reform of the British National Health Service (NHS). The paper argues that an imbalance in this commissioning process favours theoretical products, such as the diploma‐level nursing curricula (Project 2000). Also, the university setting of nurse education is seen as clinically de‐skilling both nurse teachers and student nurses as well as influencing the discourses on clinical skills. The paper further argues that the effects of such trends are a captive market in nurse education contracting and a displacement of nursing knowledge. An approach to commissioning nurse education is described which may counter such trends and positively impact on NHS organizational development and quality. Further reform of the commissioning process is described in context of pragmatic health legislation.
Unwanted sexual experiences reported by nursing students: implications for nurse education and training
Authors: Hardman Anne , Jones Janet , Scott David A. , Stevens Joan
Published: March 2003

Unwanted sexual experiences reported by nursing students: implications for nurse education and training¶This study examined the nature and frequency of unwanted sexual experiences in childhood and adulthood reported by nursing students, using a questionnaire developed from the Sexual Events Questionnaire (
Calam & Slade). The questionnaire was distributed to 109 second‐year nursing students (90 female and 19 male) for anonymous completion. At the same time a further short questionnaire asked students about their perceptions of the first questionnaire, and how far their course had, up to the present, included consideration of issues related to sexuality. A high level of unwanted sexual experiences was reported. For example: 49 (45·0%) reported having witnessed indecent exposure; 27 (24·8%) reported someone having ‘tried unsuccessfully to have sexual intercourse with you against you will’; 14 (12·8%) reported someone having ‘succeeded in having sexual intercourse with you against your will’. In the second questionnaire, 74·1% thought that consideration of human sexuality had so far been included in their course either ‘not at all’ or ‘a little’, with 19·4% responding ‘quite a lot’ or ‘very much’. It is argued that there is a particular need, for personal and professional reasons, for nursing students to have opportunities to address any unresolved effects of unwanted sexual experiences, and that within the formal curriculum there should be greater consideration of issues related to human sexuality.
Evidence‐based practice in Health Visiting. National conference organized by the Royal College of Nursing Health Visitors Forum, held at the Business Design Centre, Islington, London, England, 30 May 1998
Authors: Smith James P.
Published: March 2003

The message that was conveyed throughout this conference, which attracted delegates from the four countries of the United Kingdom (UK), was that health visiting evidence‐based practice was welcomed but it had to be tempered by information gleaned from clients’ views and choices and professional experiences.
The impact of higher education for post‐registration nurses on their subsequent clinical practice: an exploration of students’ views
Authors: Wildman Stuart , Weale Alan , Rodney Clinton , Pritchard Jackie
Published: March 2003

The impact of higher education for post‐registration nurses on their subsequent clinical practice: an exploration of students’ views¶ In recent years there has been a large increase in the number of qualified nurses in the United Kingdom, who have raised the academic level of their nursing qualification to diploma level or above. Correspondingly, there has been little research that assesses the value of post‐registration education offered by universities. In particular, there is a paucity of research regarding the effects of courses on the subsequent clinical practice of participants. Studies of post‐registration education appear to be small scale and limited in scope. This paper examines the views of diplomates as to the effect of a Diploma in Professional Studies in Nursing course on clinical practice. A questionnaire was sent to all nurses (n = 169), from the first seven cohorts, who successfully completed the course. A response rate of 66·8% (n = 113) was achieved. The respondents reported themselves to be more questioning, more able to apply research findings and to have a wider knowledge for practice following completion of the course. The findings are discussed, limitations of the study addressed and recommendations for further research are made.
Health beliefs and their influence on United Kingdom nurses’ health‐related behaviours
Authors: Callaghan
Published: March 2003

Health beliefs and their influence on United Kingdom (UK) nurses’ health‐related behaviours¶Background: Because there is a demonstrated empirical link between nurses’ personal health habits and their tendency to raise health issues with clients, researchers suggest that nurses can improve their health promotion role if they adopt health‐related behaviours. Few researchers, however, have identified the factors that influence nurses’ health‐related behaviours. Aims: To describe nurses’ beliefs about the importance of health‐related behaviours, and investigate the relationship between these beliefs and their health‐related behaviours. Design: A cross‐sectional survey from which nested‐case control comparisons were made. Sample: One hundred and thirteen nurses attending tertiary level education courses in London and Essex. Measures: Health Behaviour Survey and a scale measuring nurses’ beliefs about the importance of health‐related behaviours. Results: Nurses’ health beliefs significantly influenced the practice of 14 health‐related behaviours. Conclusions: The findings from this study support the view that nurses’ practice of many behaviours linked to health and longevity are influenced significantly by their beliefs about the importance of these behaviours. Changing nurses’ beliefs about the importance of health‐related behaviours through specific health promotion sessions are meaningful as they may improve nurses’ health promotion role.