bluuebunny/crossref_metadata_2025 huggingface dataset:
The performance of different propensity score methods for estimating marginal odds ratios
Authors: Austin Peter C.
Published: December 2006

The propensity score which is the probability of exposure to a specific treatment conditional on observed variables. Conditioning on the propensity score results in unbiased estimation of the expected difference in observed responses to two treatments. In the medical literature, propensity score methods are frequently used for estimating odds ratios. The performance of propensity score methods for estimating marginal odds ratios has not been studied. We performed a series of Monte Carlo simulations to assess the performance of propensity score matching, stratifying on the propensity score, and covariate adjustment using the propensity score to estimate marginal odds ratios. We assessed bias, precision, and mean‐squared error (MSE) of the propensity score estimators, in addition to the proportion of bias eliminated due to conditioning on the propensity score. When the true marginal odds ratio was one, then matching on the propensity score and covariate adjustment using the propensity score resulted in unbiased estimation of the true treatment effect, whereas stratification on the propensity score resulted in minor bias in estimating the true marginal odds ratio. When the true marginal odds ratio ranged from 2 to 10, then matching on the propensity score resulted in the least bias, with a relative biases ranging from 2.3 to 13.3 per cent. Stratifying on the propensity score resulted in moderate bias, with relative biases ranging from 15.8 to 59.2 per cent. For both methods, relative bias was proportional to the true odds ratio. Finally, matching on the propensity score tended to result in estimators with the lowest MSE. Copyright © 2006 John Wiley & Sons, Ltd.
Self‐assessed symptoms in chronic heart failure — Important information for clinical management
Authors: Ekman Inger , Kjörk Ewa , Andersson Bert
Published: December 2006

Aim:

To compare the patients' self‐assessment of the severity of their symptoms with a physicians assessment and to evaluate the ability of self‐assessed symptoms and ejection fraction (EF) to predict long‐term survival in heart failure patients.

Method:

Patients (n=332) evaluated symptoms using a self‐administered functional classification scale (Specific Activity Scale, SAS), which is equivalent to the NYHA scale. EF and NYHA functional class was also recorded. All patients were followed over a 3‐year period.

Results:

Approximately 50% of patients classified themselves into SAS class I. In contrast, the cardiologists classified only 9% of the patients as NYHA class I. In patients with severe left ventricular dysfunction (EF≤0.35) SAS score (HR 1.48, 95% CI [1.03−2.12] p=0.03) and ACE inhibitor treatment (0.23 [0.11−.51], p=0.0003) independently predicted 3‐year mortality in a multivariable analysis. EF was not predictive of mortality in the low EF group. Only age predicted long‐term outcome in patients with preserved systolic function.

Conclusion:

Patients' self‐assessed symptoms and NYHA classification are not coherent. Left ventricular EF is of less importance in comparison with symptoms in chronic heart failure. Patients reporting less severe symptoms had a favourable 3‐year prognosis, regardless of EF.
Favorable outcome following emergency second trimester cerclage
Authors: Debby A. , Sadan O. , Glezerman M. , Golan A.
Published: December 2006

Background: To evaluate the outcome of midtrimester emergency cerclage with or without bulging of membranes. Methods A retrospective cohort study of 99 women who underwent emergency second trimester cerclage (16–27 gestational weeks). In 75 women the cervix was dilated and effaced but without bulging of membranes (group 1), and in 24 women the dilation and effacement of the cervix were accompanied by bulging of membranes into the vagina in an hourglass formation (group 2). McDonald technique was applied in all patients. Results Prolongation of pregnancy was significantly longer in group 1 compared to group 2 (14.3 ± 6.5 vs 9.3 ± 4.8 weeks, p = 0.007). The mean gestational age at delivery was significantly higher in group 1 compared to group 2 (34.6 ± 4.6 vs 29.5 ± 3.2 weeks, p = 0.001). The incidence of chorioamnionitis was higher in group 2 compared to group 1 but statistically insignificant (25% vs 15%, p = 0.2). The overall neonatal survival was 83% (82 out of 99 neonates), without statistical difference between the two groups (86% in group 1 and 71% in group 2, p = 0.2). Conclusions Favorable neonatal outcome may be accomplished in patients with cervical incompetence in the second trimester of pregnancy following cervical emergency suturing even performed when the membranes are bulging through the cervix into the vagina.
Populations of epiphytic lichens under stress conditions: survival strategies
Authors: MIKHAILOVA Irina N.
Published: December 2006

The effect of a copper-smelting plant on populations of Hypogymnia physodes and Tuckermanopsis sepincola was studied in the Middle Urals. A different population response was found between the two lichen species due to different life strategies. The pollution appears to decrease growth and developmental rate of H. physodes (a vegetatively reproducing strongly competitive species), resulting in a shift of population structure towards smaller, esorediate to low sorediate thalli. The background population of the sexually reproducing Tuckermanopsis sepincola consisted mainly of young, small thalli of a low fertility as a result of strong inter-species competition with H. physodes. At the polluted site, the sharp decrease in the abundance of H. physodes led to a shift in structure of the T. sepincola population towards larger and more fertile thalli. It may be concluded that T. sepincola benefits from air pollution by an indirect effect of the removal of a strong competitor, i.e. H. physodes.
Nanoparticle‐Mediated Drug Delivery and Gene Therapy
Authors: Jin Sha , Ye Kaiming
Published: December 2006

Biomedical application of nanotechnology is a rapidly developing area that raises new prospect in the improvement of diagnosis and treatment of human diseases. The ability to incorporate drugs or genes into a functionalized nanoparticle demonstrates a new era in pharmacotherapy for delivering drugs or genes selectively to tissues or cells. It is envisioned that the transfer of nanoengineering capability into disease therapy will provide constant and concentrated drug delivery to targeted tissues, minimizing systemic side effects and toxicity. We have in this article highlighted the recent state of the art in nanomedicine, focusing particularly on the achievement of nanotechnology in nanoscale drug and gene delivery in vitro and in vivo. In addition, a specific emphasis has been placed on the use of nanotechnology to improve controlled drug release and sustainable drug delivery in solid tumors and on new drug therapies for age‐related neurodegenerative disorders.
Objective and Subjective Responsibility in a Judicial Context
Authors: Bordel Stéphanie , Guingouain Gérard , Somat Alain
Published: December 2006

This article concerns itself with the existence of two dimensions of responsibility proposed by Fauconnet (1928) : objective responsibility and subjective responsibility. Participants were asked to judge the case of a defendant accused of a crime. The defendant was presented as either internal, external, self-serving, or humble (manipulation of explanatory style). Furthermore, participants had the testimony of the defendant in which she either admitted to having struck the victim (“confession condition”) or to having only paid her a visit (“non-confession condition”). First, participants assessed information pertaining to the association, causation, previsibility, intentionality, and justifications of the defendant (with reference to Heider’s five levels of responsibility), then they attributed a degree of responsibility and sanction to the defendant. Factor analysis (ACP) supported the assumption of two dimensions of responsibility and ANOVA showed the differential effect of variables on both types of responsibility. Thus, subjective responsibility is affected neither by the explanatory style of the defendant nor by his or her declarations; inversely objective responsibility is sensitive to these variables. These results support the relevance of the distinction between objective responsibility and subjective responsibility and have theoretical and practical implications.
Mapping protein collapse with single-molecule fluorescence and kinetic synchrotron radiation circular dichroism spectroscopy
Authors: Hoffmann Armin , Kane Avinash , Nettels Daniel , Hertzog David E. , Baumgärtel Peter , Lengefeld Jan , Reichardt Gerd , Horsley David A. , Seckler Robert , Bakajin Olgica , Schuler Benjamin
Published: December 2006

We have used the combination of single-molecule Förster resonance energy transfer and kinetic synchrotron radiation circular dichroism experiments to probe the conformational ensemble of the collapsed unfolded state of the small cold shock protein Csp
Tm
under near-native conditions. This regime is physiologically most relevant but difficult to access experimentally, because the equilibrium signal in ensemble experiments is dominated by folded molecules. Here, we avoid this problem in two ways. One is the use of single-molecule Förster resonance energy transfer, which allows the separation of folded and unfolded subpopulations at equilibrium and provides information on long-range intramolecular distance distributions. From experiments with donor and acceptor chromophores placed at different positions within the chain, we find that the distance distributions in unfolded Csp
Tm
agree surprisingly well with a Gaussian chain not only at high concentrations of denaturant, where the polypeptide chain is expanded, but also at low denaturant concentrations, where the chain is collapsed. The second, complementary approach is synchrotron radiation circular dichroism spectroscopy of collapsed unfolded molecules transiently populated with a microfluidic device that enables rapid mixing. The results indicate a β-structure content of the collapsed unfolded state of ≈20% compared with the folded protein. This suggests that collapse can induce secondary structure in an unfolded state without interfering with long-range distance distributions characteristic of a random coil, which were previously found only for highly expanded unfolded proteins.
Sequential structure of neocortical spontaneous activity
in vivo
Authors: Luczak Artur , Barthó Peter , Marguet Stephan L. , Buzsáki György , Harris Kenneth D.
Published: December 2006

Even in the absence of sensory stimulation, the neocortex shows complex spontaneous activity patterns, often consisting of alternating “DOWN” states of generalized neural silence and “UP” states of massive, persistent network activity. To investigate how this spontaneous activity propagates through neuronal assemblies
in vivo
, we simultaneously recorded populations of 50–200 cortical neurons in layer V of anesthetized and awake rats. Each neuron displayed a virtually unique spike pattern during UP states, with diversity seen amongst both putative pyramidal cells and interneurons, reflecting a complex but stereotypically organized sequential spread of activation through local cortical networks. Spike timing was most precise during the first ≈100 ms after UP state onset, and decayed as UP states progressed. A subset of UP states propagated as traveling waves, but waves passing a given point in either direction initiated similar local sequences, suggesting local networks as the substrate of sequential firing patterns. A search for repeating motifs indicated that their occurrence and structure was predictable from neurons' individual latencies to UP state onset. We suggest that these stereotyped patterns arise from the interplay of intrinsic cellular conductances and local circuit properties.
Amyloid precursor protein overexpression depresses excitatory transmission through both presynaptic and postsynaptic mechanisms
Authors: Ting Jonathan T. , Kelley Brooke G. , Lambert Talley J. , Cook David G. , Sullivan Jane M.
Published: December 2006

Overexpression of the amyloid precursor protein (APP) in hippocampal neurons leads to elevated β-amyloid peptide (Aβ) production and consequent depression of excitatory transmission. The precise mechanisms underlying APP-induced synaptic depression are poorly understood. Uncovering these mechanisms could provide insight into how neuronal function is compromised before cell death during the early stages of Alzheimer's disease. Here we verify that APP up-regulation leads to depression of transmission in cultured hippocampal autapses; and we perform whole-cell recording, FM imaging, and immunocytochemistry to identify the specific mechanisms accounting for this depression. We find that APP overexpression leads to postsynaptic silencing through a selective reduction of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor-mediated currents. This effect is likely mediated by Aβ because expression of mutant APP incapable of producing Aβ did not depress transmission. In addition, although we eliminate presynaptic silencing as a mechanism underlying APP-mediated inhibition of transmission, we did observe an Aβ-induced presynaptic deficit in vesicle recycling with sustained stimulation. These findings demonstrate that APP elevation disrupts both presynaptic and postsynaptic compartments.
Molecular refinement of gibbon genome rearrangements
Authors: Roberto Roberta , Capozzi Oronzo , Wilson Richard K. , Mardis Elaine R. , Lomiento Mariana , Tuzun Eray , Cheng Ze , Mootnick Alan R. , Archidiacono Nicoletta , Rocchi Mariano , Eichler Evan E.
Published: December 2006

The gibbon karyotype is known to be extensively rearranged when compared to the human and to the ancestral primate karyotype. By combining a bioinformatics (paired-end sequence analysis) approach and a molecular cytogenetics approach, we have refined the synteny block arrangement of the white-cheeked gibbon (Nomascus leucogenys, NLE) with respect to the human genome. We provide the first detailed clone framework map of the gibbon genome and refine the location of 86 evolutionary breakpoints to <1 Mb resolution. An additional 12 breakpoints, mapping primarily to centromeric and telomeric regions, were mapped to ∼5 Mb resolution. Our combined FISH and BES analysis indicates that we have effectively subcloned 49 of these breakpoints within NLE gibbon BAC clones, mapped to a median resolution of 79.7 kb. Interestingly, many of the intervals associated with translocations were gene-rich, including some genes associated with normal skeletal development. Comparisons of NLE breakpoints with those of other gibbon species reveal variability in the position, suggesting that chromosomal rearrangement has been a longstanding property of this particular ape lineage. Our data emphasize the synergistic effect of combining computational genomics and cytogenetics and provide a framework for ultimate sequence and assembly of the gibbon genome.
Global analysis of functional surfaces of core histones with comprehensive point mutants
Authors: Matsubara Kazuko , Sano Norihiko , Umehara Takashi , Horikoshi Masami
Published: December 2006

The core histones are essential components of the nucleosome that act as global negative regulators of DNA‐mediated reactions including transcription, DNA replication and DNA repair. Modified residues in the N‐terminal tails are well characterized in transcription, but not in DNA replication and DNA repair. In addition, roles of residues in the core globular domains are not yet well characterized in any DNA‐mediated reactions. To comprehensively understand the functional surface(s) of a core histone, we constructed 320 yeast mutant strains, each of which has a point mutation in a core histone, and identified 42 residues responsible for the suppressor of Ty (Spt‐) phenotypes, and 8, 30 and 61 residues for sensitivities to 6‐azauracil (6AU), hydroxyurea (HU) and methyl‐methanesulfonate (MMS), respectively. In addition to residues that affect one specific assay, residues involved in multiple reactions were found, and surprisingly, about half of them were clustered at either the nucleosome entry site, the surface required for nucleosome–nucleosome interactions in crystal packing or their surroundings. This comprehensive mutation approach was proved to be powerful for identification of the functional surfaces of a core histone in a variety of DNA‐mediated reactions and could be an effective strategy for characterizing other evolutionarily conserved hub‐like factors for which surface structural information is available.
Polarized exocytosis and transcytosis of Notch during its apical localization in Drosophila epithelial cells
Authors: Sasaki Nobuo , Sasamura Takeshi , Ishikawa Hiroyuki O. , Kanai Maiko , Ueda Ryu , Saigo Kaoru , Matsuno Kenji
Published: December 2006

Notch (N) and its ligands, Delta (Dl) and Serrate (Ser), are transmembrane proteins that mediate the cell–cell interactions necessary for many cell‐fate decisions. In Drosophila, N is predominantly localized to the apical portion of epithelial cells, but the mechanisms and functions of this localization are unknown. Here, we found N, Dl, and Ser were mostly located in the region from the subapical complex (SAC) to the apical portion of the adherens junctions (AJs) in wing disc epithelium. N was delivered to the SAC/AJs in two phases. First, polarized exocytosis specifically delivered nascent N to the apical plasma membrane and AJs in an O‐fut1‐independent manner. Second, N at the plasma membrane was relocated to the SAC/AJs by Dynamin‐ and Rab5‐dependent transcytosis; this step required the O‐fut1 function. Disruption of the apical polarity by Drosophila E‐cadherin (DEcad) knock down caused N and Dl localization to the SAC/AJs to fail. N, but not Dl, formed a specific complex with DEcad in vivo. Finally, our results suggest that juxtacrine signaling in epithelia generally depends on the apicobasally polarized structure of epithelial cells.
Low Gleason score prostatic adenocarcinomas are no longer viable entities
Authors: Berney D M
Published: December 2006

Gleason scoring is the most powerful predictor of the behaviour of prostatic adenocarcinoma. It was devised more than 30 years ago and is used by pathologists worldwide. However, advances in immunochemistry and the understanding of the biological potential of some tumours have made the diagnosis of tumours of grades 1 and 2, and hence low score (2–4), a rarity. It is suggested that Gleason score 2(1 + 1) tumours, if they do exist, are so rare and so benign that they are a redundant entity and should not be identified as a malignancy. Similar problems revolve around the diagnosis of Gleason score 4(2 + 2) tumours and the criteria for their diagnosis are difficult to evaluate and revolve around reference to the score 2(1 + 1) lesion. The continued presence of low‐grade tumours in the Gleason grading system leads to diagnostic confusion, potential error and, more importantly, confusion for patients diagnosed with score 6(3 + 3) tumours. I suggest that Gleason grade 1 (and therefore scores of 2 and 3) should be removed from the Gleason grading system. Gleason grade 2 (and therefore score 4 and 5) tumours require serious re‐evaluation if they are to remain clinically useful diagnoses.
The use of sociological theories and models in nursing
Authors: Chapman Christine M.
Published: December 2006

In that nursing and sociology arc both concerned with people and the way they intereact, it is likely that theories developed in either discipline will provide insights for the other. The theory of social‐exchange is therefore viewed in the light of the nurse and patient seeking to meet their own needs and goals and a model is suggested which may indicate levels of satisfaction. Organization theories and patterns of power and compliance are considered in the context of their effect on goal achievement and tentative explanations are offered for behaviour by nurses and patients that might be considered deviant.
Nurses in the therapeutic community
Authors: Dietrich Gunna
Published: December 2006

This article shows advantages of therapeutic communities in psychiatric hospitals over traditionally run institutions; it does not deal with the disadvantages of therapeutic communities when compared with treatment regimes such as family‐centred therapy or community care. Advantages are considered in relation to both patients and nurses. Some generalizations are made and a number of pertinent questions are posed; answers are suggested where this was deemed possible, i.e. not very often.
Patients' emotional reactions to hospitalization: an exploratory study
Authors: Wilson‐Barnett Jenifer
Published: December 2006

This paper describes how exploratory interviews were conducted with two hundred medical inpatients in order to identify specific aspects of hospital life which evoked anxiety or depression or affected patients negatively in other ways. The schedule of items used for these interviews included routine ward events and also listed implications of hospitalization, such as ‘being away from work’ which might affect the emotional state of patients, either positively or negatively. The majority of items elicited positive replies, predominantly negative replies being given to only six of sixty items. Negative responses were particularly frequent among females of not more than forty years of age. Implications of these results are discussed.
The role of research and the development of nursing theory*
Authors: McFarlane Jean K.
Published: December 2006

The profession of nursing searches for a theory base for its practice, but there are problems inherent in defining the nature of concepts and in building them into testable hypotheses and theories. Some concepts are derived from everyday experience, some from the conventional wisdom of the profession. Some are developed by deductive methods from related sciences, some inductively from nursing practice itself. Although a few embryonic theories have been developed, little has been developed at the prescriptive level nor has any unifying model satisfied all thinkers. For the present there is a need to isolate concepts from conventional professional wisdom, for factor isolating research, for the testing of hypotheses against nursing practice.
Quantity and quality of patients' sleep and sleep ‐disturbing factors in a respiratory intensive care unit
Authors: Hilton B. Ann
Published: December 2006

This descriptive study using continuous polygraphic recording, observation and interview attempted to identify the quantity and quality of sleep and the factors which disturbed the sleep of selected patients in a respiratory intensive care unit. Documentation of behaviour which might be related to sleep deprivation and identification of factors which the patients perceived as interfering with rest and sleep were also recorded. It was concluded that patients had difficulty meeting their ‘normal’ needs for sleep due to frequent interruptions and possible sleep‐disturbing factors. Behavioural changes related to sleep deprivation were observed.
Locked doors in the management of disturbed psychiatric patients
Authors: Cobb J. P. , Gossop M. R.
Published: December 2006

The temporary closure of the locked ward within a psychiatric hospital provided an opportunity for the investigation of the attitudes of nursing and medical staff to patient management, and of the changes in staff and patient behaviour on the wards. Violent and aggressive behaviour places special stresses on nursing staff and appears to be an important variable leading to locking the ward door. The relationship of absconding, and staff/patient ratio to locked doors is also discussed.
Developing a theory of nursing: the relation of theory to practice, education and research
Authors: McFarlane Jean K.
Published: December 2006

The relevant literature is reviewed and it is held that the relationships between nursing theory, practice, education and research are close and reciprocal relationships. Each is related to the other but it is argued that the hub of the relationships is nursing practice as nursing is a practice discipline.

This paper is based on an address delivered on 10 July 1976 at the annual conference of the Association of Integrated and Degree Courses in Nursing held at the University of Hull, England.
Justification and use of research in nursing
Authors: Roper Nancy
Published: December 2006

In 1976 100 nurses, mainly from the National Health Service, attended a study day organized by the Nursing Research Advisory Group for Scotland. The object was to create interest in published nursing research reports so as to generate critical thinking followed by activity on return to work. The theme for the day was ‘Justification and use of research in nursing’. It was postulated that research can be justified on the grounds of originality leading to a substantial addition to the nursing profession's body of knowledge and also on the grounds of replication which can provide credence to generalization from the original study. The subjects—prevention of pressure sores and nosocomial infection among others–were used to illustrate a possible financial justification. Each year several British health authorities are sued by patients who have developed a pressure sore in hospital. Should such a case be tried in open court it is highly debatable if a particular nurse's ignorance of well‐known research work would be defensible in court.

Other justifications were thought to be economy of effort for nurses as well as patients, economy of material resources, research‐based nursing practice, improvement in the nursing curriculum and in manpower planning. The objective of all nursing research is directly or indirectly to improve the quality of nursing–but how is this measured?
The unit nursing officer: manager of nursing care
Authors: Smith James P.
Published: December 2006

This paper describes how the author obtained information in 1972 from a small pilot study on the role and functions of hospital unit nursing officers, in an attempt to challenge his own opposition to the creation of clinical nurse specialist/consultant posts. Data was obtained from an analysis of comments made and questionnaires completed by 40 nursing officers, from the same hospital nursing organization, at a review study day organized by their chief nursing officer. Later in 1973, other information about clinical nurse/specialist/consultant posts, and about unit management schemes, was obtained during a 15‐week study tour in North America. The author illustrates how the information, gleaned from both the pilot study and the North American tour, was used as a basis and rationale for a new nursing service organization, introduced in the Brent Health District following the reorganization of the National Health Service in 1974.
Religion and patient care: the functionalist approach
Authors: McGilloway F. A. , Donnelly The Rev. Liam
Published: December 2006

Religion and patient care: the functionalist approach This paper offers an ideal type process which considers any patient, his intimates and hospital chaplain in the wider setting of personal care. It calls attention to an important aspect of patient care which offers a starting point from which to begin assessing the needs of any patient from a complementary perspective. The paper reveals two important consequences of the features of any patient situation for the structuring of whole patient care. The first is that the ill person can be susceptible to certain fundamental characteristics which bring him face‐to‐face with situations in which established practices display an insufficiency for providing mechanisms of adjustment. The second is that spiritual support can be a most important mechanism of adjustment to the aleatory and frustrating facts of these basic characteristics of the patient's existence. Also, it is not only that the ill person may have a need to be helped in this way, but that the appropriate general pattern of action in regard to the source of help is often related to evaluation by nursing and other health service personnel–who are inexpert in this field of care–of the general requirements of any patient situation. This evaluation may have important consequences regarding the completeness of patient care.
The use of case histories to assess nurses' ability to solve clinical problems *
Authors: Boreham N. C.
Published: December 2006

The use of case histories to assess nurses’ability to solve clinical problems Nurses’performance in written examinations often bears little relationship to their level of clinical proficiency in the ward. This paper describes a method of making written examinations more relevant to the clinical situation. It describes the development of a case history test which confronts students with the kind of information they have to interpret and act upon in the ward, and which requires them to recall the principles of nursing care and apply them in a way similar to real life. Evidence is presented that tests of this type are more closely linked to clinical performance than are conventional written examinations, and guidelines are given for constructing case history tests.
The future nurse: selection and training; autonomy; should her health‐care role be modified for future patient demands?*
Authors: Hockey Lisbeth
Published: December 2006

This paper was presented in the context of an international interdisciplinary conference on Priorities in Health Care. The focus of the paper is the relationship between the nurse's role and the demands of patients, now and in the future. The incongruence between patients' needs and their demands is discussed and the question is raised as to whether the nurse's skills and knowledge currently acquired will be appropriate to meet patients' needs and demands in the future.

Future patient needs and demands are not the only external pressures on changes in the nurse's role; advances in medical treatment and technology and changing roles of other health professionals are others. The paper highlights the dilemma between the profession having to give way to such external pressures or the risk of preparing nurses for irrelevant roles. A case is made for greater interchangeability of first level health care workers through a common portal of entry. It is suggested that diversion into the various professional fields should occur after the foundation course to health care and suitable counselling.

Among the top level professionally qualified nurses should be both generalists and specialists. A speciality of nursing generalism, as a parallel with general medical practice, is advocated. A plea is made for a liberating rather than a restricting interpretation of professionalism so that necessary changes in the nurse's role can be initiated and directed by the profession rather than being forced upon it by external pressures.
Patients'emotional responses to barium X‐rays
Authors: Barnett Jenifer Wilson
Published: December 2006

This paper describes an experiment testing the effect of informing patients about barium X‐rays on their emotional reactions before and during the procedure. A self‐report scale of emotions was used to compare the level of anxiety reported by the informed patients with that of control subjects who did not receive this information.

The barium meal study showed no differences in anxiety scores between informed and control subjects, most of whom reported low levels of anxiety. The enema study, however, showed significant differences in these scores. Informed patients reported less anxiety during the X‐ray than controls, who frequently reported high levels prior to and during X‐ray.
Violence in a psychiatric unit
Authors: Campbell W. , Mawson D.
Published: December 2006

The aim of this paper is to discuss violence in a modem purpose‐built psychiatric unit, with a view to a better understanding of the associated problems of patient care and their management.

The unit was built in 1965 and since then certain changes In its design have been necessary. Some modification of philosophy of care has also been introduced and these changes have benefited the majority of patients, but a plea is made for a ‘small area that is lockable’.

The paper makes a valuable contribution to the current discussions into violence in psychiatric hospitals.
Absence and wastage in trained nurses: a selective review of the literature*
Authors: Redfern Sally J.
Published: December 2006

This review is concerned widi two kinds of withdrawal from work in trained British nurses, absence and wastage, and, since these areas have not been widely or reliably researched in nursing, some reference is made to studies into the withdrawal behaviour of other, mainly industrial, workers. A descriptiorl of the incidence of absence and wastage is given and the problems of definition and measurement outlined. The factors associated with both forms of withdrawal are considered and, for clarity, these are grouped into three categories–person/personality, work context and external variables.

Although the review of the factors, related to absence in nurses, suggests certain associations, firm generalizations cannot be made from the results and conclusions reported here. Comparisons between many of the studies are impossible because of inconsistent definitions and measurement techniques, unrepresentative sampling methods and different time periods employed. Furthermore, many authors have relied heavily on well‐informed, subjective impressions rather than objectively collected and analysed data. These studies have provided useful information for the individual organizations concerned and have raised interesting issues, but their contribution to understanding the phenomenon of absence is more limited.

There is no doubt from the literature that absence, that is the frequency of absence spells, short‐term absence or uncertificated absence, is increasing for nurses as well as for other workers and is giving managers more cause for concern than longterm absence (more than 3 days duration) or certificated absence. It is more difficult, however, to reach a definite conclusion about the incidence of wastage in trained nurses, but the present trends suggest that mobility is not excessive and may even be too low. This could present as great a problem to nurse management as excessive wastage if it results in a degree of ‘in‐breeding’, ‘stagnation’ and ‘complacency’. The optimum level of mobility is presumably one which strikes a balance between innovation, fresh ideas, etc., and a necessary cohesive core of staff. That optimum level is likely to vary between units and organizations.

Differing views on the nature of the relationship between absence and wastage are outlined and some suggestions for further research are made. It is outside the scope of this paper to discuss theories and models of ‘withdrawal’, but the reader is referred to several writings should he wish to pursue this.
Some patterns of disturbed behaviour in a dosed ward environment
Authors: Weaver Susan M. , Broome Annabel K. , Kat Bernard J. B.
Published: December 2006

This article is concerned with identifying some of the causes of disturbed behaviours which are related to the psychological environment in a locked ward of a mental hospital. As part of a research project concerned with reducing the frequency of disturbed and disruptive behaviour, such incidents have been monitored and analysed with a view to better understanding their antecedents and thus establishing more effective management policies. Of special interest has been a group of disturbed forms of behaviour which appear to be related to each other by what we have termed ‘psychological factors’ in the closed setting. Specifically, these arise from and are maintained by the expectations that staff and patients have regarding normative behaviour in a locked ward.

It is suggested that the closed setting implicitly defines certain disturbed behaviour as acceptable and that there are direct links between these norms and the level and particular variety of disturbed behaviour on the ward. The dangers of failing to recognize the relationship between disturbed behaviour and the psychological implications of security and illness and particularly of over‐reacting to apparent increases in disturbance are discussed.
Attitudes and beiiefs versus study resuits: exempiified hy attrition in a school of nursing in Israei during 1968–1974
Authors: Patten Mary E.
Published: December 2006

Head nurses and faculty members have their own beliefs on and attitudes towards the process of selecting candidates to schools of nursing. Many times these are based on impressions and/or everyday experiences that might have a crucial influence on perception of the issue. These impressions are not always verified when a study is conducted.

This article reports on some of the issues and fmdings regarding attrition in one school for registered nurses in Israel during the years 1968–1974. It also describes what head nurses and faculty members thought to be valid criteria in the selection process, though findings revealed that things are not always as they are believed to be. For example, psychological tester recommendations were thought to be crucial in selecting candidates and preventing attrition, but no significant correlation was found between the recommendations and attrition. Head nurses thought that the main reason for attrition was dissatisfaction, although this was not found to be a stated reason. This belief of the head nurses should evidently be investigated.

Findings support the author's belief that local studies are important and that faculty members and head nurses should communicate on the issue of student nurse selection and education.
Implementation of a personalized clothing policy for long stay psychiatric patients: a study of communication
Authors: Long Anne
Published: December 2006

This study raises the following question. Should the policy maker be responsible for ensuring adequate monitoring of policy implementation? A policy lays down a course of action for achieving a particular end. Implementation of a policy implies adherence to the course of action stated in the policy.

This study was concerned with the relationship between a policy of personalized clothing and the implementation of a particular scheme. Divergence from the original policy occurred because of inadequate communication between those who formulated the policy, those who implemented the policy and the staff who were reponsible for day‐to‐day management associated with the policy. The finding of this study was that the way policy was implemented did not relate to the original objective of the policy.

Policy relating to a particular area of health cannot progress scientifically unless evaluation of the implementation of formulated policy occurs. This research therefore advocates that the policy maker should be responsible for ensuring adequate monitoring of the policy when it is implemented.
Reassurance: a nursing skill?
Authors: French Heinz‐Peter
Published: December 2006

The proposition of this paper is principally that if the term ‘reassurance’ is used by nurses its meaning should be clearly stated and the methods by which it may be achieved should be clearly identified.

The author begins by attempting to identify a workable definition of the term and by arguing a case for taking the approach that it is a nursing interpersonal skill rather than a nursing psychotherapy. Using this as the basis for the rest of the discussion he then suggests that as an interpersonal skill it is open to analysis and behaviours can be identified which help to achieve a restoration of the patient's confidence. Further to this, learning objectives are stated in the hope that the concept of reassurance can be seen as a skill which can be enhanced by educational processes. Full competence in the use of interpersonal skills is not a stable feature in all human beings; in every individual nurse there is scope for the development and training of interpersonal skills.

Finally, the author attempts to achieve the major aim of the paper‐stating nursing actions which may be employed in order to achieve this reassurance of the patient.
The problems of nursing patients with advanced multiple sclerosis at home
Authors: Davies Gwenda M.
Published: December 2006

This study, prepared by the author during her nurse training, examines the main problems encountered by 14 sufferers from multiple sclerosis living in the community, and the difficulties of those involved in their home care.
Mobilizing nursing skills*
Authors: Tiffany Robert
Published: December 2006

The author argues that the practice of nursing should be based on the ‘nursing model’ related to care, not the ‘medical model’ related to cure. Using the nursing model entails making an assessment of the patient's needs and an individualized nursing care plan to meet them.

It is conceded that the historical development of nursing practice as a series of stereotyped, ritualized activities within a hierarchical profession militates against implementing the nursing model; but the author illustrates how the Royal Marsden Hospital, a specialist hospital for the treatment of cancer patients, has innovated and developed the concept, as well as creating specialist roles for nurses who maintain continuity of patient care from the first appointment in the hospital's outpatients’ clinic through to his after‐care following his discharge home.
Applications to undergraduate nursing courses
Authors: Jones Daniel C. , Keighley A. C.
Published: December 2006

Education of nurses has in recent years developed in centres of higher education, but with a rapid rise in courses offered concern has been expressed that too few suitable applicants may be available. This study has attempted to ascertain actual demand for the courses available by cross‐referencing applications to a sample of courses, and has demonstrated a downward trend of suitable applications over the two years 1975 and 1976. A cautionary approach to establishing new courses or increasing numbers on existing courses may be advisable and further comparable work will be carried out to assess the validity of the trends already found.
The inability to transfer classroom learning to clinical nursing practice: a learning problem and its remedial plan
Authors: Wong Julia
Published: December 2006

The inability to transfer classroom knowledge to clinical nursing practice is a common learning problem encountered by many nursing students. Manifestations of this problem may involve both the academic performance and personal development of the students: inability to solve problems in nursing situations; inflexibility and rigidity in the exercise of nursing care; fragmentation of nursing care; and apathy towards clinical practice.

Because of the seriousness of this learning problem, a plan must be formulated to rectify it. This plan is developed with major emphasis on the teaching process, the student and the curriculum. One of the important roles of a teacher is to help students understand many widely useful relationships, principles or generalizations. In order to enhance transfer, nursing students must be given ample opportunities to apply the learned principles in a variety of nursing situations.

Learning is a self‐active process; an ideal transfer demands the students' conscious realization that transfer is possible. Students need to be committed to the belief that particular facts in the classroom study are pertinent in other situations. To promote transfer, the curriculum must be designed in such a way so that it has transfer value in terms of the students' goals and purposes. Furthermore, proper sequence of curricular activities is crucial if transfer of classroom knowledge to clinical practice is to occur.
Nursing theory: the comparison of four theoretical proposals
Authors: McFarlane Elizabeth A.
Published: December 2006

The purpose of this study was twofold: (1) to describe theory and its relationship to nursing knowledge and practice, and (2) to compare the theoretical proposals of Imogene King (1975), Dorothea Orem (1971), Martha Rogers (1970) and Sister Calista Roy (1970).
Differences in stress perceived by headnurses across nursing specialities in hospitals*
Authors: Leatt Peggy , Schneck Rodney
Published: December 2006

The main purpose for this research was to specify empirically the sources and frequency of stress experienced by headnurses working in different types of specialities in hospitals. Headnurses (n—153) from nine specialities: paediatrics, obstetrics, medicine, surgery, rural, auxiliary, psychiatry, rehabilitation and intensive care participated. Data were collected by a 21 item questionnaire. Findings suggested five types of stress for headnurses relating to their administrative role, type of patients, task ambiguity, staffing problems and physician contact. Headnurses from different specialities perceived these types of stress to occur with differing frequency.
Effectiveness of self instructional units in post‐basic nursing education: with special reference to the use of nursing care plans unit
Authors: Ogundeyin Winifred M.
Published: December 2006

A self instructional unit (SIU) on nursing care plans was tested to demonstrate its effectiveness on the cognitive performance of three different student achievement groups. Two other text formats: Question Text Type (QTT) and Information Text Type (ITT) were utilized to demonstrate their effect on the cognitive performance of the three achievement groups. The expectation was that the SIU would successfully improve the subjects’ knowledge on nursing care plans, and that the post test scores would be related to the text types used during the study. The subjects were 48 B.Sc. (Nursing) degree students in the first year of a post‐basic nursing degree programme who were divided into high, middle and low achievement groups, according to the results of a pretest on the theory related to nursing care plans. The results showed that the SIU significantly improved the basic knowledge of subjects on nursing care plans. Furthermore, the SIU and the QTT appeared to be superior to the ITT formats. On the whole there appears to be a relationship between text type and cognitive performance whilst students try to accumulate or review information.
A weight reduction model for mildly retarded adults iiving in semi‐independent care facilities
Authors: Rotatori Anthony F. , Fox Robert , Parish Phyllis
Published: December 2006

A behavioural weight reduction treatment model for use with retarded adults is discussed. The model describes five stages of the treatment programme. Instructional components and techniques are reviewed. The model was designed for implementation by nurses, dieticians, and other nutritional health educators.
Obtaining access to data sources: an exploration of method, problems and possible solutions
Authors: Cormack Desmond F.S.
Published: December 2006

A method, route and problems relating to the gaining of access to research data or respondents in discussed. In seeking permission to gather data from patients and staff in Scottish psychiatric hospitals, using Flanagan's Critical Incident Technique, a number of problems were encountered, viz. (i) the varying administrative levels to which the first formal request for entry had to be made; (ii) the varying routes which had to be followed in order to gain permission, and (iii) the time taken to obtain access to data sources. The problems, their possible consequences, and a number of long and short term recommendations are made. If implemented, these may go some way toward minimizing the difficulties associated with gaining access to data sources. The long term recommendations, including improved nurse representation on existing research and ethical committees, are directed to those who shape and influence policies relating to research practice generally. The short term recommendations are directed to the nurse researcher who is seeking access to field sites, with a view to minimizing problems relating to this aspect of planning and carrying out research activity.