bluuebunny/crossref_metadata_2025 huggingface dataset:
Mass Higher Education and the search for standards: reflections on some issues emerging from the ‘Graduate Standards Programme’
Authors: Wright Peter
Published: August 2007

This paper sets out to explore the meanings and implications of academic standards in mass higher education. It attempts this in the context of the rapid expansion that has recently taken place in the UK. In doing so it draws on, and examines, selected themes that have emerged from the Higher Education Quality Council's ‘Graduate Standards Programme’ (though it does not attempt to give a full account of the findings of that work).

It begins by discussing some of the implications of the ways in which UK HE has become a mass system. It then moves on to consider the roles of explicitness and professionalism in the establishment and assurance of academic standards, and their relationship to issues of public accountability. Having explored the possible tensions between professionalism and accountability, the paper questions whether it is helpful to frame discussions of standards in terms of a notional opposition between subjective and objective. It concludes by proposing another way of conceptualising standards, and discusses their possible future development in UK higher education.
The Research Challenge Faced by the New Universities in the UK
Authors: McKenna P. Gerald
Published: August 2007

The 1991 Government White Paper which abolished the binary divide in British universities brought the former polytechnics (new universities) into direct competition with the traditional (old) universities for research funds from the Funding Councils based on periodic Research Assessment Exercises (RAEs). The outcome of the 1992 RAE showed a predictable gap in research performance between the two groups of institutions. The challenge facing the new universities will be for some, at least, to narrow the gap and/or develop a small number of centres of research excellence and thus challenge the long standing research hegemony enjoyed by the old universities. This will almost certainly involve intense selectivity in the allocation of available research resources and will be influenced by the‘missions’of the institutions involved, the extent of underlying support for such developments and the management structures and style employed.
Is there a role for higher education in initial teacher training? A consideration of some of the main issues in the current debate
Authors: Evans Linda , Abbott Ian , Goodyear Rosalind , Pritchard Alan
Published: August 2007

This article contributes towards the current debate over the role of higher education in initial teacher training. It begins by outlining the background to the debate, and then focuses upon two of the main issues; that of contestability, which concerns whether or not schools significantly challenge, or threaten, the pivotal role in initial teacher training which higher education has traditionally held, and that of financial costs, which concerns whether or not student teachers can be trained cheaper outside of the higher education sector.

The article presents findings of the authors’research, a study comparing teacher training carried out by higher education institutions, in partnership with schools, with a newly established model of training provided by consortia of schools. The implications of these findings for the role of higher education in initial teacher training are examined, and recommendations are made for policy which would allow schools and higher education institutions to work together to provide improved teacher training.
Peer Observation of Teaching & Staff Development
Authors: Blackwell Richard
Published: August 2007

Peer Observation of Teaching (POT) is a little used way of stimulating reflection on and improvement of teaching. It is an unusual form of staff development [SD] that emphasises continuous processes and peer feedback rather than course attendance. This paper describes the principles and practice of POT, including potential benefits and drawbacks and discusses the conditions necessary for it to flourish in departments and institutions. It argues that POT overcomes the problem of staff ownership’of SD by connecting with peer culture but may be promoted, implemented and supported by SD functions linked to personnel departments. Thus SD functions may play a more substantial role in their organisations’development than hitherto.
Audit, Assessment and Academic Autonomy
Authors: Alderman Geoffrey
Published: August 2007

The current preoccupation in British higher education with quality assessment, quality assurance and the monitoring of academic standards is traceable to a set of government policies which constitute an agenda for the radical overhaul of the ideals by which higher education has operated in Britain hitherto. Intent on overturning the collegial ethos of British higher education, and determined to replace the notion of a self‐justifying and self‐regulating academic community with a system in which universities operate primarily as pan of the national wealth‐creating process, the Conservative government has used the quality debate to impose upon the universities a culture of compliance with norms of its own choosing. The net result of this process has been a deliberate undermining of academic autonomy.
Spurs to Higher Things? Mission Statements of UK Universities*
Authors: Davies Stuart W. , Glaister Keith W.
Published: August 2007

Mission statements have been the subject of much discussion in the managerial literature and have recently been adopted by most British universities. This paper reports the results of an investigation into how mission statements have been introduced by British universities and reviews the appropriateness of their use in this sector. Based on a questionnaire survey, an analysis of the degree of commitment to mission statements as a valuable management tool is offered and recommendations suggested for their more effective application. The authors conclude that although there is generally a positive attitude towards mission statements, senior managers within universities tend not to consult widely when formulating them and have put little effort into communicating them to the university's staff. Their importance seems to be perceived in terms of meeting the requirements of an external stakeholder rather than offering the opportunity to develop a real sense of purpose within the organisation.
Resource Utilization, Cost, and Health Status Impacts of Coronary Stent Versus “Optimal” Percutaneous Coronary Angioplasty: Results from the OPUS‐I Trial
Authors: NEIL NANCY , RAMSEY SCOTT D. , COHEN DAVID J. , EVERY NATHAN R. , SPERTUS JOHN A. , WEAVER W. DOUGLAS
Published: August 2007

In the OPUS‐I trial, primary coronary stent implantation reduced 6‐month composite incidence of death, myocardial infarction, cardiac surgery, or target vessel revascularization relative to a strategy of initial PTCA with provisional s tenting inpatients undergoing single vessel coronary angioplasty. The purpose of this research was to compare the economic and health status impacts of each treatment strategy. Resource utilization data were collected for the 479 patients randomized in OPUS‐I. Itemized cost estimates were derived from primary hospital charge data gathered in previous multicenter trials evaluating coronary stents, and adjusted to approximate 1997 Medicare‐based costs for a cardiac population. Health status at 6 months was assessed using the Seattle Angina Questionnaire (SAQ). Initial procedure related costs for patients treated with a primary stent strategy were higher than those treated with optimal PTCA/provisional stent ($5,389 vs $4,339, P<0.001). Costs of initial hospitalization were also higher for patients in the primary stent group ($9,234 vs $8,434, P<0.01) chiefly because of the cost differences in the index revascularization. Mean 6‐month costs were similar in the two groups; however, there was a slight cost advantage associated with primary stenting. Bootstrap replication of 6‐month cost data sustained the economic attractiveness of the primary stent strategy. There were no differences in SAQ scores between treatment groups. In patients undergoing single vessel coronary angioplasty, routine stent implantation improves important clinical outcomes at comparable, or even reduced cost, compared to a strategy of initial balloon angioplasty with provisional stenting.
Application of a Cardiac Arrest Score in Patients with Sudden Death and ST Segment Elevation for Triage to Angiography and Intervention
Authors: MCCULLOUGH PETER A. , PRAKASH RAJAT , TOBIN KENNETH J. , O'NEILL WILLIAM W. , THOMPSON RICHARD J.
Published: August 2007

The aim of this study was to test a previously validated, prognostic, cardiac arrest score in patients with ST segment elevation acute myocardial infarction (AMI) who suffereda witnessed cardiac arrest and survived to emergency department admission. A consecutive series constructed retrospectively from a sudden death database (n= 22) of patients with ST segment elevation AMI resuscitated from cardiac arrest underwent angiography and angioplasty of the culprit vessel within 24 hours of presentation. A cardiac arrest score was assigned to each case by explicit criteria present on evaluation. Primary outcomes were survival to hospital discharge and the degree of neurological recovery during the hospitalization. All patients underwent successful coronary angioplasty and 77% received adjunctive intraaortic balloon counterpulsation. The overall rate of survival to discharge was 41%. For cardiac arrest scores of 0, 1, 2, and 3, respectively, the rates of neurologic recovery were 0 (0%) of 4 (95% CI 0–53%), 3 (50%) of 6 (95% CI 15–85%), 2 (67%) of 3 (95% CI 13–98%), and 9 (100%) of 9 (95% CI 72–100%), and the rates of survival to discharge were 0(0%) of 4, (95% CI 0–53%), 2 (33%) of 6 (95% CI 6–74%), 2 (67%) of 3 (95% CI 13–98%), and 9 (100%) of 9 (95% CI 72–100%), P<0.01 for both outcomes over ascending scores. These results suggest appropriate patients for primary angioplasty after cardiac arrest are those with ST segment elevation AMI and an emergency department cardiac arrest score of ≥2, thus predicting a11 (92%) of 12 (95% CI 65–100%) chance of survival to discharge.
Is Direct Stent Implantation Without Predilatation Safe? Acute and Long‐Term Outcome
Authors: RAHEL BRAIM M. , SUTTORP MAARTEN JAN , BERG JURRIËN M. TEN , BAL EGBERT T. , ERNST SJEF M.P.G. , MAST E. GIJS , KELDER JOHANNES C. , PLOKKER H.W. THIJS
Published: August 2007

Direct stenting could potentially lead to a reduction in dissections, time, and restenosis at 6‐month follow‐up. Using the premounted Palmaz‐Schatz Crown stent elective stenting was performed without predilatation in 61 consecutive patients who were compared with a control group of provisional stenting. All patients underwent clinical and angiographic follow‐up at 6 months. Direct stenting was successful in 81% of patients. In 16% of the patients predilatation was needed. In 3% the stent could not be implanted despite predilatation. Stent dislodgment occurred in 2% of patients, without embolization. Six‐month angiographic follow‐up was performed in 51 (84%) of 61 patients. In the direct stenting group the mean preprocedural minimal luminal diameter (MLD) increased from 0.96 ± 0.47 to 3.09 ± 0.54 mm directly after the procedure. At 6‐month follow‐up the MLD measured 2.32 ± 0.79 mm. In the provisional stenting group the mean MLD increased from 0.92 ± 0.51 to 2.44 ± 0.58 mm and was 1.84 ± 0.70 mm at 6‐month follow‐up. Restenosis, defined as a diameter stenosis > 50%, occurred in 8% of the direct stenting group compared with 28% in the provisional stenting group (P<0.001). Direct coronary stent implantation can be attempted safely and efficaciously. The risk of stent loss is low. The initial and long‐term angiographic results are significantly better as compared with provisional stenting. The risk of restenosis is significantly lower.
Restenosis Rates with Flexible GFX Stents (REFLEX): Clinical and angiographic Results
Authors: UNVERDORBEN MARTIN , REIFART NIKOLAUS , DEGENHARDT RALF , BACH ROLAND , HENNEN BENNO , DAHM JOHANNES , MATHEY DETLEF , PFEIFFER DIETRICH , BERTHOLD HEINER K. , VALLBRACHT CHRISTIAN
Published: August 2007

The objective of this prospective, multicenter, observational trial was to evaluate the procedural results and longterm outcomes of the flexible AVE GFX coronary stent in native coronary lesions. The trial included 137 consecutive patients (111 [81 %] men, age 63. ± 9.2 years) with one vessel disease (n= 76 [55.5%]), two vessel disease (n= 31 [22.6%]), and three vessel disease (n= 30[21.9%]) with ischemia secondary to a significant denovo lesion (diameter ≥ 3 mm. length ≤ mm) in a native coronary artery. Stent deployment was successful in 97.8% (134/137) of patients. Angiographic follow‐up at 6.1 ± 1.2 months was available in 111 (82.8%) of 134 patients. All angiographic images were analyzed by an independent core lab. The primary endpoint was the binary restenosis rate. In‐hospital major cardiac events occutred in 3.7%. No postdischarge major adverse cardiac events occurred, except for one abrupt closure (0.7%). Angiographic restenosis was documented in 22 (19.8%) of 111 patients. The GFX stent is easy to handle with high success and low restenosis rates in patients with simple lesions in native coronary arteries and, thus, compares favorably with other sophisticated stents.
Anterior Myocardial Infarction, Acute Aortic Dissection, and Anomalous Coronary Artery
Authors: PENNEY SEAN P. , WASSERMAN HAL S.
Published: August 2007

Acute dissection of the ascending aorta has, on rare occasions, been accompanied by myocardial infarction due to the compression of the ostium of a coronary artery. Rarer still is the presence of an aortic dissection, myocardial infarction, and an anomalous coronary artery. A case is described of a patient who survived an acute aortic dissection complicated by anterior myocardial infarction due in part to the presence of an anomalous circumflex artery. The anatomy, diagnosis, and consequences of aortic dissection are discussed.
Septic Coronary Embolism1
Authors: BELDNER STUART , BAJWA AJAY , KAPLAN BARRY , ROSEN STACEY , STEINBERG BART , CACCIABAUDO JEAN
Published: August 2007

This report describes a case of a 31‐year‐old woman with mitral valve endocarditis complicated by a septic embolus to a coronary artery.
Distal Occluder and Rheolytic Thrombectomy of a Saphenous Vein Graft Lesion with a Large Associated Thrombus
Authors: HELDMAN ALAN W.
Published: August 2007

Percutaneous intervention in thrombus‐containing lesions is frequently associated with complications, including distal embolization and no‐reflow. In saphenous vein bypass grafts (SVG), friable atheroma and associated thrombus make interventions particularly difficult. Distal protection strategies are in development, but complete protection with removal of all potentially embolic material is challenging. This case illustrates a novel technique using a distal occluder balloon and rheolytic thrombectomy followed by stent deployment to treat a SVG lesion. This combination therapy was technically feasible, resulted in no angiographic complications and normal creatine kinase levels throughout follow‐up, and can be used during high risk SVG interventions.
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting: Clinical Outcomes in Multivessel Coronary Artery Disease
Authors: LEDFORD C. SAMUEL , GRINES CINDY L.
Published: August 2007

Revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is superior to medical management in reducing symptoms and prolonging exercise duration in patients with coronary artery disease (CAD). Ten randomized trials have compared the outcomes in percutaneous and surgically treated patients with multivessel CAD. The purpose of this article was to summarize the results of those trials to make recommendations regarding appropriate revascularization strategy.
Sacraments : Natural and Supernatural
Authors: Biddle George Edgar
Published: August 2007

Few more saddening confessions of religious change have ever been made than those of Renan, in his Souvenirs d’Enfance et de feunesse. The emotional appeal of his forsaken Faith was never silenced, although he came to regard its foundations as unsound. He felt cut off from those social acts of worship which mean so much to most of us.

“Quellien,” says he, speaking of a young friend— “Quellien a tres bien compris ce qui fera toujours defaut a mon Eglise, c’est I’enfant de choeur. Ma vie est comme une messe sur laquelle pèse un sort, un éternel Introibo ad altare Dei, et personne pour répondre : Ad Deum quil aetificat juventutem meam. Ma messe n’aura pas de servant. Faute de mieux, je me la repondrai a moi-même; mais ce n’est pas la même chose.”

It can never be the same thing to a nature naturally religious, exiling itself from a Community with worldwide activities, and sustaining its life by practices in force during centuries. Leaving the great Family of Faith he paid the penalty entailed.

He goes to the Eucharist to find an illustration of his companionlessness. He cries—but catches no response. He intones the prayer ; but that prayer has been emptied of the meaning which alone can call forth the swift reply of an answering love.
Theories of Asceticism
Authors: D'Arcy M. C.
Published: August 2007

Within the last year two, at least, valuable books have appeared on the spiritual life— Abbot Butler’s Benedictine Monachism and Mr. Watkin’s Philosophy of Mysticism. The first of these has been so much noticed that I need not stay over it, save to remark on its sweet reasonableness on the question of mortification and austerities. Herein the Abbot contrasts with Mr. Watkin, who explains and defends with enthusiasm the path of utter detachment up Carmel. This difference, at first sight merely one of emphasis, does, I think, depend ultimately on divergent philosophies, and therefore raises several problems. Does, for instance, a philosophy of mysticism or sanctity require one definite way to God, and is that way necessarily one of ruthless austerity and detachment?

That this question is worth asking is proved by the fact that nowadays there is a desire to portray saints as gracious and lovable persons—not after the manner of the Oratorian lives, which even in the fifties were ill received—but as intensely human and aided to love of their fellowmen by a passionate love of God. A good example is the life of Soeur Thérèse. On the other hand, no amount of explanation can disguise the severity of a St. Gerard Majella, a Père Ginhac or a Father Doyle. The life of the fatter is especially interesting because his biographer quite clearly loves the human element in Father Doyle, but is too sincere to hide the extremes which his asceticism adopted, extremes which might have come straight out of the pages of Surius and are somewhat at variance with the ideal cherished by Abbot Butler.
Cheap Divorce: Cheaper Religion
Authors: Pope Hugh
Published: August 2007

A Great controversy must always leave its aftermath. Hence it is to be feared that recent discussions in and out of Parliament and Convocation will be found to have left in the minds of many the impression that somehow or other there is room for doubt as to what Christ really did teach on the subject of divorce. Indeed this is hardly to be wondered at when even the Archbishop of York declared that while “he personally was of opinion that marriage was dissoluble only by death” he yet acknowledged that others thought that adultery was a legitimate reason for divorce. And who can help feeling like Alice in Wonderland when he hears Lord Phillimore saying that “the Christian Church had taught that marriage was almost indissoluble until death”? The “almost” is piquant and delightful ! One would “almost” prefer the cynical frankness of the Lord Chancellor, who does not mince his words but says out plainly that “the arguments of those who oppose divorce are the whisperings of the abandoned superstitions of the Middle Ages.” One is even tempted to a sneaking admiration of the Archbishop of Canterbury who—when challenged by the same Lord Chancellor to say whether the innocent party in a divorce committed adultery by re-marrying—answered with an emphatic “No !” At least we have here definite and consistent views.

Still from all this a man logically concludes that there must be some reason why some hold that the innocent party should be free to re-marry and that adultery should be regarded by some as a legitimate ground for divorce.
How I have Studied the Social Question
Authors: McDonald Walter
Published: August 2007

Gentlemen,—You wish, I understand, to get some advice as to how you should set about studying the Social Question. I do not know how to meet your wishes better than by telling how I have myself proceeded ; though this, of course, exposes me to the risk of seeming to pose not only as an expert but as a model. Hence I must begin by saying that I know very little of the question on its economic side. There is, however, another side, the ethical, to which I have given some attention ; and as it is this alone which you are called on to study, perhaps it may help you to know how one who lays no claim to very special knowledge has proceeded in his investigations.

I began, like yourselves, with the treatise on Justice, as set forth in the class-book of this College ; which, in my time, was Gury. I do not know of any better way of beginning, except, perhaps, to devote more attention than we did to the title of Occupation ; which I now regard as the key to much of the question at issue between extreme Socialists and ourselves.

Well, three years after the close of my College course, the Land League was started ; and it was not very long till we heard it argued that there could be no private property in land, as “the exertion of labour in production is the only title to exclusive possession.”
John Gay
Authors: Burdett Osbert
Published: August 2007

It is much to be hoped that the revival of The Beggar's Opera will do neglected justice to the reputation of John Gay, and that the numerous patrons of the Lyric Theatre, Hammersmith, will study the text of the opera. The songs and the dialogue are excellent testimony to his gifts as a lyrist and a wit, and invite the discriminating reader to make closer acquaintance with his essays on “Dress” and “Reproof and Flattery” (which appeared in The Guardian, Nos. ii and 149, 1712-13), and with his ballads and verse in other pieces beside the popular Fables. It is odd that, though Gay has found friendly critics and devoted editors in John Underhill and Mr. Austin Dobson, neither speaks of his reputation without much apology nor gives any convincing reasons for the original success of The Beggar's Opera. For example, John Underhill attributes the success of the opera to “two causes ; the opera was the first specimen of a new species of composition, and it was well stored with satire. The satire, moreover, was not merely general : it was personal and particular. No one could fail to see that Robin of Bagshot—alias Whiff Bob, alias Carbuncle, alias Bob Booty—was designed to represent Sir Robert Walpole’s unrefined manners, convivial habits, and alleged robbery of the public. Macheath was provided in the play with both a wife and a mistress, to indicate to the public that Lady Walpole had a rival in Miss Skerrett.”
Self‐concept of Children of Alcoholics: Part I. Family Influences
Authors: KILLEEN MAUREEN R.
Published: August 2007

This paper focuses on the processes by which alcoholic parents affect their children's self‐esteem. The impact of families on children's self‐concept and self‐esteem is examined within the framework of a transactional model of self‐concept development. Next, a model of self‐esteem for children of alcoholics, including risk factors and protective factors for self‐esteem, is proposed. It is suggested that alcoholic parents influence their children's self‐concepts so that their children judge themselves on unique dimensions, and use atypical standards to interpret their behaviors. The result is that the children do not learn to realistically assess their strengths and abilities. Finally, the role of social support, within families and from other persons, is explored in relation to self‐esteem.
Children, Adolescents and Nuclear War Anxiety
Authors: VALENTE SHARON MCBRIDE
Published: August 2007

Researchers have reported that 45–50% of American and European youth aged 10‐19 worry about the negative impact of nuclear war on their lives. For some, the fear of nuclear war was associated with troubling feelings of sadness, powerlessness, and rage. Fearing they have no future, many teens rated fear of nuclear war as their second greatest worry. However, research has not identified those children or adolescents who are at high risk for nuclear anxiety (NA) or the impact of NA and developmental problems. Young Americans, who do not mention nuclear anxiety unless asked about it, were less optimistic and less knowledgeable about nuclear war than Soviet youth. Theory, implications for assessment, interventions, and research related to NA are examined.
The Prosecution of Child Sexual Abuse CasesLegal Issues Related to Child Advocacy
Authors: YORKER BEATRICE CROFTS
Published: August 2007

Sexual abuse of children has recently been recognized as a social and legal problem, although the phenomenon has probably been present throughout the history of humankind. Child and adolescent psychiatric and mental health nurses must be aware of the legal implications of assessing, diagnosing or treating child victims of sexual abuse. The focus of this paper is on the legal implications of protecting children from sexual abuse, procedures for prosecuting perpetrators of child sexual abuse, and the constitutional implications of reform.
The Latency‐Aged Child in Out‐of‐home Placement: Treatment Considerations
Authors: PEARSON GERALDINE S.
Published: August 2007

Outpatient psychiatric care of the latency‐aged child in out‐of‐home placement is discussed. A review of the literature is followed by a discussion of variables which influence the planning of care. These include reason for referral, stage of placement at referral, degree of family and caseworker involvement, and the presence or absence of permanency planning. A thorough assessment of the child, clear differentiation between short‐ versus long‐term treatment indications, and use of community resources are discussed.
Adolescent Suicide: Assessment and Intervention
Authors: VALENTE SHARON McBRlDE
Published: August 2007

Understanding how to prevent suicide, the third leading cause of adolescent death, is the focus of this article. To prevent suicide, the nurse assesses risk factors, covert messages, overt suicide clues, and intervenes with the adolescent and family. Suicide risk and hopelessness decrease as suicidal youths learn to clarify problems, rally significant others, expand resources and use safe coping strategies. Interventions include a no‐suicide contract, family therapy and school suicide prevention programs. Nurses can identify the youth at risk for suicide awl, in many cases, provide the therapy that helps prevent suicide. Vignettes illustrate strategies that effectively reduce suicide risk.
Autism: Psychobiological Perspectives
Authors: DALTON SANDRA T. , HOWELL CAROL C.
Published: August 2007

The purpose of this article is to discuss the syndrome of autism and review current research findings related to this disorder. Emphasis is placed on autism as a disorder of brain function. In this context, theory and treatment approaches, including new pharmacological interventions, are explored. Implications for nursing practice also are discussed.
America's Invisible Children Need Visible Services: An Executive View
Authors: Garrison Preston J.
Published: August 2007

JCPN Commentary presents a series of observations, opinions, and analyses of issues and trends in education and practice in psychiatric and mental health nursing, and social policy factors that influence, families, or the delivery of health services to youth and their families.
A School‐based Primary Prevention Group for Children with Alterations in Health Status
Authors: CONLEY JOHN F. , KENDALL JUDY
Published: August 2007

The implementation of primary prevention measures for the positive mental health of children has been identified by psychiatric nursing leaders as a priority for child psychiatric nurses. Promoting positive mental health behaviors in school‐aged children is facilitated by establishing a helping relationship within the context of small‐group activity situated in the child's natural school setting. The authors describe the theory and process of establishing a time‐limited, closed group in a school setting, for 10 children who were experiencing some alteration in health status.
Comparison of Child Adaptation to Epilepsy and Asthma
Authors: AUSTIN JOAN KESSNER
Published: August 2007

Self‐concept, home behavior and school behavior of 128 children with epilepsy and 126 children with asthma were measured in order to compare and contrast differences in psychosocial adaptation. Results indicated that children with epilepsy were experiencing significantly poorer psychosocial adaptation (p<.001) in all three areas. An exploration of gender differences across groups indicated that girls were more at risk for the home behavior problems of depression, somatic complaints, social withdrawal and hyperactivity than boys. Clinical implications for interventions with these two populations are discussed.
Child Psychiatric Nursing and the Family
Authors: KENDALL JUDY
Published: August 2007

Within the growing body of nursing literature, a relatively new method of inquiry, critical theory, has emerged. Critical theory is used as a framework toward understanding the social realities in which child psychiatric nurses must act when negotiating with family systems. Nursing's predominant view of the family, structural‐functionalism, is examined by the use of the dialectic and Habermasian critique.
Disclosure of Sexual Abuse
Authors: STANLEY SARAH R.
Published: August 2007

The sexual abuse of a child is a well‐kept secret. Disclosure creates difficulties for the child, the family, and sometimes for the professionals working with them. A multidisciplinary, multiagency model is one method to facilitate care and recovery for the child victim. Each agency and service has a different purpose and goal. Cooperative coordination and communication are the keys to case management with reduced psychological trauma for the child end family. Child psychiatric nurses can be effective members of the child abuse health team model. Advocacy roles also can be developed by nurses who work with sexual victimization through the avenues of media, writing, committee membership and research.
Clinical Forum
Authors: Harden Anita
Published: August 2007

The Clinical Forum Department presents brief reports focused on discussion of clinical issues or innovative practice ideas and programs.
Book Reviews
Authors: Hirschmann Mark J.
Published: August 2007

Living with a Brother or Sister with Special Needs: A Book for Sibs. Donald J. Meyer, Patricia F. Vadasy, and Rebecca R. Fewell.
Perceived Life Changes for Children and Adolescents following Disclosure of Father‐Daughter Incest
Authors: HUBBARD GRACE B.
Published: August 2007

Eleven families comprised the sample for this qualitative study. The daughters in these families had allegedly been abused by a father or father‐figure. The study showed four major life changes occurred for these girls. They were loss of father, placement away from home, alteration in familial roles, and participation in the investigation of sexual abuse. These interventions required to stop the abuse were viewed as further traumatizations. Implications of the study for child and adolescent psychiatric nursing practice are discussed.
Ethical Issues in the Behavioral Treatment of Children and Adolescents
Authors: FREITAS LORRAINE , MSN VINCENT R. PIERANUNZI.
Published: August 2007

This article addresses a need to assess the acceptability and evaluation of behavioral treatment as it is applied in child and adolescent inpatient settings. The choice of when and how to use behavioral interventions and the implications of these choices may present the nurse with certain ethical dilemmas related to ethical principles of autonomy, beneficence, and maleficence. In addition, the inpatient milieu structure is examined relative to possible ethical dilemmas.
Correlates of Maternal Depression Among Mexican‐American Migrant Farmworker Mothers
Authors: SIANTZ MARY LOU de LEON
Published: August 2007

This study examined correlates of maternal depression among Mexican‐American migrant farmworker mothers. One hundred Mexican‐American migrant farmworker mothers of preschoolers who participated in the Texas Migrant Council's Headstart program were interviewed. The results suggested that this sample of mothers was at risk for depression. Those mothers who had child care support available and whose problems were taken seriously when shared were less likely to become depressed than mothers who did not have such support.
Pediatric Psychopharmacologic Uses of Propranolol: Review and Case Illustrations
Authors: SIMS JENNIFER , GALVIN MATTHEW R.
Published: August 2007

This article introduces child and adolescent psychiatric nurses to the use of propranolol for aggression in children and adolescents. The use of propranolol is relatively new in the area of psychiatry. A retrospective chart review of patients who had received propranolol was conducted in an intermediate care hospital. Case illustrations are presented.
Play Therapy with an Abused Child: A Case Study
Authors: Post Caroline A.
Published: August 2007

The Clinical Forum Department presents brief reports focused on discussion of clinical issues or innovative practice ideas and programs.
Young People and AIDS Mental Health Promotion in Action
Authors: SCHARER KATHLEEN , CHALLBERG CAROL , REARICK TERRI
Published: August 2007

This article describes the development and implementation of a two part health promotion and primary mental health prevention program developed for junior high students. AIDS education was used as a vehicle for promoting the development of a responsible decision‐making framework in the students. Both cognitive and affective learning strategies were used in the program. The reactions of the students, their parents, and the educational system are described.
The Role of the Psychiatric/Mental Health Nurse Clinical Specialist in an Adolescent Coping Skills Group
Authors: PUSKAR KATHRYN R. , LAMB JACQUELINE , MARTSOLF DONNA S.
Published: August 2007

The psychiatric/mental health nurse clinical specialist is a professional who brings unique skills to the area of mental health prevention. Adolescents are an at‐risk population in need of preventive mental health services. This article describes the unique features of a nurse‐led adolescent prevention program. A specific Adolescent Coping Skills Group format, which uses the skills of the master's prepared psychiatric nurse, is presented.
Developmental History Collection on a Child Psychiatric Inpatient Service
Authors: SCAHILL LAWRENCE , SIPPLE BETH
Published: August 2007

This retrospective study was the first step of a larger project aimed at constructing a data collection tool to be used by child psychiatric nurses on an acute psychiatric inpatient service. A sample of 41 records was reviewed by a single reviewer using explicit criteria to determine the quality of data currently being gathered. The sample was randomly selected from 180 records of children admitted to an acute child psychiatric inpatient service in a major teaching institution. Of the 41 records reviewed, 14 had little or no information concerning the child's developmental course, and in about 50% of the charts similar information was recorded by different team members. It was noted that this service is fairly new, and no assessment tool that reflects a consensus of the multidisciplinary team is currently in use. Without a systematic method of gathering data upon admission, data collection will continue to be inconsistent and incomplete.
Anorexia Nervosa Fluid‐Electrolyte and Acid‐Base Manifestations
Authors: DARDIS PATRICIA O'BRIEN , HOFLAND SHARON LEECH
Published: August 2007

Psychiatric nurses need to know about the biologic, psychologic, and social implications of anorexia nervosa; however, the current nursing literature presents little information regarding the physiologic aspects of the syndrome. The pathophysiologic basis for the clinical manifestations of acid‐base and fluid‐electrolyte disturbances associated with anorexia nervosa are examined, and, when appropriate, the implications for nursing assessment are discussed.
Bulimia A Review of Nutritional and Health Behaviors
Authors: LARAIA MICHELE T. , STUART GAIL W.
Published: August 2007

Nurses working with adolescents need an understanding of the clinical syndrome of bulimia in order to identify individuals at risk for this disorder and implement preventive and therapeutic interventions. The epidemiology, early precipitants, physiology, and biochemistry of bulimia nervosa are reviewed. From this integrated framework, implications for treatment are explored with an emphasis on holistic nursing care including health education.
Enhancing the Coping Skills of Mothers with Developmentally Delayed Children
Authors: BAWDEN MILLIE , RALPH JOAN , A. HERRICK CHARLOTTE
Published: August 2007

Recent studies have shown that mothers of developmentally delayed children are at risk for depression. During weekly psychoeducational group meetings, Roy's adaptation model was used to identify the focal, contextual, and residual stimuli that contributed to the mothers' depression. Nursing interventions that encouraged adaptation in the four modes were implemented by group facilitators providing parent education and emotional support. Implications for nurses in a variety of settings are given.
The Delivery of Mental Health Services to Children
Authors: Daniel Ann , Dashiff Carol J.
Published: August 2007

JCPN Commentary presents a series of observations, opinions, and analyses of issues and trends in education and practice in psychiatric and mental health nursing, and social policy factors that influence families, or the delivery of health services to youth and their families.
Trends in Adolescent Psychiatric Hospitalization
Authors: CARBRAY JULIE A. , PITULA CAROL ROGERS
Published: August 2007

This article explores the recent increase in adolescent psychiatric inpatient admissions. Factors fueling the tendency to hospitalize are discussed, and the concept of medicalization of adolescent behavior problems is related to this trend. Reflecting the medicalization concept, several questions and hypotheses regarding parental decision‐making as it is related to adolescent hospitalization are presented. Through further investigation, a better understanding of the factors influencing or determining need for adolescent psychiatric hospitalization can be gained.
Marital Strife, Social Support, and the Development of Mentally Retarded Toddlers
Authors: DASHIFF CAROL
Published: August 2007

The birth of a mentally retarded child is a stressful experience for the family. Research exploring the differences between these families based on the child's developmental competence is sparse. This study examined marital strife and social support within two groups of retarded toddlers. Data were collected through observation, an interview, and questionnaires. The focus of marital agreement and disagreement differed between the groups, as did social support. However, birth order and family life cycle stage were found to be important confounding variables.
School‐based Adolescent Mental Health Project Survey of Depression, Suicidal Ideation, and Anger
Authors: LAMB JACQUELINE , PUSKER KATHRYN R.
Published: August 2007

This study on adolescent mental health was conducted in a school setting. Sixty‐nine subjects, aged 16‐18 years, were surveyed to provide data on anger, depression, and suicide ideation. Suicide ideation was present in 15.9% of subjects and depression in 14.1%. Subjects with suicidal ideation demonstrated greater levels of anger and poorer anger control. Recommendations are made for psychiatric nurses to collaborate with school administrators to develop programs with specific evaluation criteria to promote adolescent mental health in the schools.
Intuition in Psychiatric‐Mental Health Nursing
Authors: REW LYNN
Published: August 2007

A descriptive study was done to explore how psychiatric‐mental health nurses define and act on intuition in clinical practice with children and adolescents, and to identify supports for and barriers to taking such action. Interviews of 16 nurses were tape‐recorded, transcribed, and analyzed for manifest and latent content. Findings support previous studies about intuition in nursing practice and have implications for psychiatricmental health nurses working with high‐risk populations of children and adolescents.
Infant‐Toddler Mental Health An Emerging Concern
Authors: Hartsfield Barbara
Published: August 2007

JCPN Commentary presents a series of obsenations, opinions, and analyses of issues and trends in education and practice in psychiatric and mental health nursing, and social policy factors that influence families, or the deliver of health services to youth and their families.
Communication Techniques for Allaying Anxiety and Providing Support for Hospitalized Children
Authors: Thompson Sharon W.
Published: August 2007

The Clinical Forum Department presents brief reports focused on discussion of clinical issues or innovative practice ideas and programs.
Perceived Seriousness of Children's Surgery and Family Adaptability and Cohesion
Authors: BENTER SANDRA E.
Published: August 2007

This study investigates the relationship between the family's perception of the seriousness of a child's surgery and the level of family adaptability and cohesion before and after the surgical event. Research hypotheses are based on the Family Crisis and Circumplex models of marital and family systems. Forty‐one families were included in the pretest/posttest single group design in which a child underwent a tonsillectomy. Study findings do not consistently support the conceptual models, and implications for the testing of middle range family theories are described.
Group Play Therapy Using an Interaction Model with Delayed Regressed Behaviors in Children
Authors: HUBBARD GRACE B.
Published: August 2007

This article gives an overview of individual play therapy and relates the concepts of individual play therapy to group play therapy. A new model of group play therapy, an interactional model, is introduced. The article provides basic guidelines for beginning play therapists. An actual group is described and specific interventions for problems are suggested.
Genetic Epidemiology in Child Psychiatric Nursing Tourette's Syndrome as a Model
Authors: SCAHILL LAWRENCE , ORT SHARON , HARDIN MAUREEN
Published: August 2007

Recent discoveries in the field of molecular biology and increased attention to genetic epidemiology have stimulated renewed interest in the genetics of psychiatric disorders. Tourette's syndrome, a neuropsychiatric disorder characterized by motor and phonic tics, is used as a model to describe the research strategies employed in the genetic epidemiology of child psychiatric disorders. The relevance of genetic research findings to child psychiatric nursing is also discussed.
Sibling Incest A Descriptive Study of Family Dynamics
Authors: GILBERT CHARLOTTE M.
Published: August 2007

This study investigates the characteristics of families in which a member was identified as a victim of sibling incest. Four agencies in a southeastern city provided a convenience sample of 14 family case records from November 1986 through April 1988 for review. Sixteen children were identified as victims of sibling incest, including three boys and 13 girls between the ages of 2 and 10 years (mean = 6.75 years). Perpetrators included 1 girl and 14 boys between the ages of 13 and 17 years (mean = 15.06 years). The incestuous relationship had a major impact on families, especially the children. Many offenders and victims, in addition to experiencing emotional, school, and legal problems, were removed from their homes.
Nursing in Child Psychiatric Milieus Part II: Mapping Conceptual Footholds
Authors: DELANEY KATHLEEN R.
Published: August 2007

In the first part of this paper, child inpatient nursing practice was organized into five therapeutic processes (safety, structure, support, involvement and validation). Using this organization of nursing care, three specific practice question are now addressed. One, how will nursing blend their traditional psychosocial orientation with biological psychiatry? Two, how might nurses best respond to the pressure to reduce the length of hospitalization yet still effectively intervene with troubled children? Three, does the traditional milieu therapy model have clinical utility for child inpatient nurses in the 1990's. It is suggested that nursing practice is best supported by multiple midrange theories which clarify children's behavior and give theoretical support to specific nursing interventions.
The Effect of a Bereavement Group Experience on Bereaved Children's and Adolescents' Affective and Somatic Distress
Authors: OPIE NANCY D. , GOODWIN TRENA , FINKE LINDA M. , BEATTEY JACQUELYN M. , LEE BARBARA , VAN EPPS JOAN
Published: August 2007

Losing loved ones through death is a common experience for children. Children living in urban centers may be at greater risk for death of family members as a result of increased daily stress and poverty. Children who experience permanent loss of family members without support to grieve are at greater risk for mental health problems. Manifestations of grief that frequently occur in children are psychosomatic complaints and affective distress. This study investigates the prevalence of loss by death among two groups of inner city youths, and the impact of a bereavement group experience on subjects' affective distress and somatic complaints. A significant difference was found between pretest and post‐test scores on somatic complaints for the elementary school aged group.
Children's Concepts of the Mentally III
Authors: Poster Elizabeth C.
Published: August 2007

One hundred sixty‐eight children in grades three through six were asked to read vignettes describing the problematic behaviors of mentally ill children and adults. Vie schoolchildren then labeled the characters, attributed causes and motivations to their behaviors, and suggested possible treatments. Although only 27% of the children labeled vignette diameters as mentally ill and 11 % recommended psychiatric interventions, all the children recommended some kind of intervention. While slightly fewer than one‐third (29%) of the children suggested that an adult intervene in some nonpsychiatric manner, 60% recommended some kind of child‐initiated activity as an intervention. A developmental trend was evident in children's attribution of mental illness labels and recommendations for both psychiatric and adult nonpsychiatric interventions.
The Attending Nurse: A New Role for the Advanced Clinician
Authors: Niemela Katherine , Poster Elizabeth C. , Moreau Diane
Published: August 2007

The Attending Nurse Model as a unique role for the advanced practitioner was implemented and evaluated in an acute care psychiatric setting with an adolescent patient population. Program evaluation results demonstrated that the Attending Nurse role increased general satisfaction and role clarity while decreasing role tension. In addition, the role increased communication with patients' family members. Comparisons are made between the traditional primary nurse and the Attending Nurse roles.