bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial Characteristics of a Group of Males with Ischemic Heart Disease and Extended Sick Leave
Authors: Währborg Lisbeth , Währborg Peter
Published: March 2013

A number of studies have been published indicating that psychosocial distress provides a significant predictor for outcome and even mortality among post‐myocardial infarction patients. In this study medical and psychosocial characteristics were examined in a group of males with ischemic heart disease (IHD) still on extended sick leave (23.4 months ± 17.5) after a cardiac event compared with a matched control group with considerably shorter sick leave time (2.7 months ± 0.8). Twelve men with IHD and extended sick leave were referred from the Regional Social Insurance Office and, after informed consent, were enrolled in the study. The matched controls were recruited from the Sahlgrenska University Hospitals out‐patient Heart Clinic. The two groups underwent medical examination including estimation of ejection fraction and ergometer bicycle stress test. Blood samples were drawn for analysis of blood lipids. Psychosocial characteristics were studied by a self‐administrative, reliable, valid and sensitive questionnaire. The two groups were comparable on matched variables. Significant differences were found between the groups concerning: memory, emotional control, sleeping habits, daily life, leisure time, sexual life, physical capacity and general health status. A factor analysis revealed an inferior functioning in the group with extended sick leave concerning the social, somatic, and control factor. It is concluded that differences in psychosocial characteristics are present in males with ischemic heart disease and with extended sick leave after a cardiac event, compared to a group with ‘normal’ sick leave time, suggestive of a need for further studies concerning these characteristics and an implementation of this knowledge in rehabilitation programmes.
The Use of Physical Restraints in Elder Care in Relation to Fall Risk
Authors: Karlsson Stig , Nyberg Lars , Sandman P. O.
Published: March 2013

Physical restraints are a frequently used but disputed method to prevent falls. The aim of the present study was to investigate how the use of restraints in institutional elder care relates to previous falls and to the estimated fall risk of the individual patient. A total of 1 142 patients, mean age 82 years, were included in the study. A questionnaire, the Multi‐Dimensional Dementia Assessment Scale (MDDAS), was used to measure motor function, vision, hearing, ADL performance, behavioral symptoms, psychiatric symptoms, cognitive impairment and use of medication. Questions concerning the use of physical restraints and known previous falls were added to the instrument. Based on data from the questionnaire (MDDAS), a score on the Downton Fall Risk Index was calculated for each patient. All in all, 248 (22%) of the patients had been subject to restraints and for 155 of them (14%) such measures had been taken to prevent falls. Only weak connections were found between the restraining of patients to prevent falls and the prevalence of known previous falls during hospital stay (ϕ = 0.05), and estimated fall risk (ϕ = 0.07). The results indicate that the use of physical restraints is poorly connected with the estimated fall risk. Therefore, this study may point to a possible overuse of these measures.
The Impact of Psoriasis on Psychosocial Life Domains
Authors: Wahl Astrid
Published: March 2013

Living with a chronic disease, such as psoriasis, is likely to have psychological as well as social implications. Hence, knowledge about the impact of psoriasis on patients' life situation is important for designing and selecting suitable health care programmes for this group of patients. A review of studies published between 1983 and 1995 shows that there are some common factors as regards the psychological distress and social and functional limitations this group of patients has to deal with. However, it is difficult to compare the findings on the psychosocial impact of psoriasis owing to the differences in methods, study design and patient samples. This suggests that further research is needed. A holistic perspective that includes patients' quality of life may represent a fruitful approach.
Social Activities in Elderly Patients with Severe Mental Illness
Authors: Dencker Karina , Dencker Sven Jonas
Published: March 2013

Mental hospitals offer their patients many different kinds of social activities/facilities. One‐hundred‐and‐twenty‐seven patients in the long‐term care unit at a mental hospital were included in the study. They were divided into three subgroups on the basis of diagnosis: dementia disorder (n = 65), chronic psychotic disorder (n = 38), and chronic non‐psychotic disorder (n = 24). An inventory was made of all possible activities/facilities offered to the patients by the mental hospital, with the objective of ascertaining whether participation in social activities/facilities discriminated between the three diagnostic groups. Sixteen activities/facilities were obtained from an inventory by nurses. Stepwise discriminant analysis identified length of stay in hospital, age and the social activities/facilities that separated the three diagnostic groups. The discriminant function analysis showed that participation in social activities, together with length of stay and age, discriminated very well between the demented and the chronic psychotic groups. The discriminant analysis also indicated that patients with chronic psychotic disorder were distinguishable by their frequent participation in social activities, long stay in hospital, and low age. The results obtained can be used when the social activities/facilities in a community care setting are being planned for the various diagnostic groups.
Outcome After Trans‐tibial Amputation for Vascular Disease
Authors: Hermodsson Y. , Ekdahl C. , Persson B. M.
Published: March 2013

All 112 patients (55 females and 57 males) with a primary unilateral trans‐tibial amputation for vascular disease performed in one year at all five hospitals in Malmöhus county, Sweden were examined at 6 months according to the prosthetic function and prospectively followed‐up 8 years after the amputation for survival, and prosthetic fitting. The prosthetic function was re‐examined among the survivors 8 years postoperatively. At 6 months 50% were fitted with a prosthesis and later (up to 8 years) a further 13%, in total 32 females and 39 males. The mortality at 6 months was 33%, at 2 years 47% and at 8 years 92%. Age at amputation (p = 0.015), to be amputated on the left leg (p = 0.0004), to be able to walk alone outdoors before the amputation (p = 0.007) and not using a wheelchair (p = 0.02) were all found to be statistically significant predictors for receiving a prosthesis. Predictors for good function with the prosthesis 6 months postoperatively was male sex (23 of 57 vs 8 of 55 females) (p = 0.006) and greater ability to walk alone outdoors before the amputation (p = 0.01). There was no significant age difference in this comparison. The finding that it is more favourable to be amputated on the left leg merits further study.
Nurses' Attitudes to the Use of Alternative Medicine in Cancer Patients
Authors: Damkier Anette , Elverdam Beth , Glasdam Stinne , Jensen Anders Bonde , Rose Carsten
Published: March 2013

This study reports results from a questionnaire study on nurses' attitudes to and experiences with alternative medicine, especially related to cancer patients' use of alternative medicine. Sixty nurses from a department of oncology and haematology participated in the study. The response rate was 62%. The nurses primarily perceived the use of alternative medicine as an individual choice which the nurses wanted to support. Sixty‐three percent of the nurses indicated that alternative medicine could be useful in the treatment of cancer patients, 32% would sometimes suggest alternative medicine to the patients, and 20% used alternative medicine in their nursing. One‐third of the nurses had experienced conflict in connection with alternative medicine and their patients, mostly when established treatment was delayed or refused in favour of alternative medicine. Fifty‐three percent of the nurses had tried alternative medicine themselves. This study reveals that nurses are in an ambiguous and complex situation: they are simultaneously professionals in the established health care system, caregivers supporting the patients, and individuals using alternative medicine.
Meals in Nursing Homes
Authors: Gastmans Chris
Published: March 2013

The ethical approach of artificial administration of food and fluids has been much enlivened in recent years. Nevertheless, the ethical implications of the day‐to‐day event of serving meals in nursing homes remain to be clarified. This paper has a double aim. First, 1 present a philosophical‐ethical clarification of mealtime care in nursing homes. Second, I suggest several ethical orientations related to the nutritional problem among nursing home residents. I argue that caregivers must not only have considerable knowledge and skill in nutritional matters; it is only by integrating as much as possible an attitude of caring with the competent performance of care activities that ‘good mealtime care’ can be achieved.
Caring Culture
Authors: Benkö Singa Sandelin , Sarvimäki Anneli
Published: March 2013

This study is part of a main investigation entitled The Efficiency of Care. The Importance of Work Environment and Climate', the purpose of which is an examination of the relationships between culture, climate and experiences of care providers and patients in different settings. The purpose of the present study was to investigate the perception care personnel had of themselves as reported on the Nurse Self‐Description Form (NSFD). Olsson and Gullberg have added two items to the original 19‐item form in the Swedish version. The research was conducted in all six wards of a geriatric hospital in Sweden, and the sample consisted of 67 head nurses, registered nurses, practical nurses and nursing assistants. It was assumed that a similar structure of factor dimensions would appear as in previous studies with the NSFD. The resulting three‐factor Varimax solution explained 63% of the variation. A different factor content emerged, however, which required factor names to be provisionally renamed Intuitive‐Resourceful Nurse, Ambitious‐Knowledgeable Nurse, and Reliable‐Considerate Nurse.
Longitudinal Study of Finnish Nursing Students' Preferences for Knowledge in Nursing Practice
Authors: Manninen Elsa
Published: March 2013

The curriculum of Finnish nursing education is based on nursing science. The aim is to educate nursing students to internalize the logic, concepts and major subject areas of nursing science. The purpose of this longitudinal study was to examine Finnish nursing students' knowledge base of nursing after 6, 18 and 30 months of education and at the end of the degree programme. The study group consisted of 158 students selected by means of stratified sampling from the six specialities of Finnish nursing education programs. Data were collected by means of a questionnaire from 26 institutes. A factor analysis of 21 items was done, where three factors emerged. The summarized variables based on the factors were subjected to one‐way analysis of variance to elucidate the differences between the six groups of students. The students prioritized biomedical knowledge. Knowledge of diseases and anatomy was preferred to the other knowledge areas. The students also valued psychological knowledge. Nursing knowledge was the least preferred knowledge area at every phase of education. The students of the different specialities preferred knowledge areas congruent with the nursing practice of their speciality.
Validity and Reliability of the Norwegian Version of the Ferrans and Powers Quality of Life Index
Authors: Rustøen Tone , Wiklund Ingela , Hanestad Berit R. , Burckhardt Carol S.
Published: March 2013

The purpose of this study was to examine the validity and reliability of the Norwegian version of the Ferrans and Powers Quality of Life Index in a sample of 131 men and women with newly diagnosed cancer. The Quality of Life Index was translated into Norwegian using a standardized international approach, including back‐translation. The findings showed high internal consistency reliability for the global score (alpha = 0.93 (test)) as well as for the following domains: health and functioning (alpha = 0.88), socio‐economic (alpha = 0.82), psychological/spiritual (alpha = 0.82) and family (alpha = 0.79). The test‐retest reliability after 3–4 weeks was 0.78 for the global score. A factor analysis partially confirmed the different subscales. In conclusion, the Quality of Life Index was found to be reliable and had sufficient validity to be used for measuring quality of life in Norwegian cancer patients.
Causes of Strain Affecting Relatives of Swedish Oldest Elderly
Authors: Herlitz Claes , Dahlberg Lena
Published: March 2013

We examined determinants of carer strain in a random sample of 170 relatives of dependent elderly persons in Sweden aged 80 years or more. These persons were interviewed at home by means of the Sickness Impact Profile (SIP). Carer strain was assessed in interviews with carers who bore the main responsibility for care of an elderly relative. The response rate was 92%. Multiple logistic regression showed that cohabitation of carer and recipient was the sociodemographic variable most significantly associated with various stress factors and consequences or manifestations of stress: strain connected with ADL assistance given to the elderly person, strain arising from the elderly person's uncooperative or recalcitrant attitude or behaviour, worsening of the elderly‐carer relationship, and encroachment on the carer's social life. Correlations between strain and various categories of physical and mental impairment were much lower, and in some respects were even negative. We conclude that support programs for relatives caring for dependent elderly persons should aim primarily at creating continuous relief for the carers and improving their opportunities for contact with other people generally.
Nurses' Well‐being in a Primary Nursing Care Setting in The Netherlands
Authors: Boumans Nicolle P. G. , Landeweerd Jan Albert
Published: March 2013

A study was conducted in a Dutch hospital to evaluate the effects of the implementation of a Dutch form of Primary Nursing on nurses' well‐being in the work situation. The variables used as indicators of well‐being at work were job satisfaction, experienced job significance, health complaints and absenteeism. The study included three measuring periods: one pre‐intervention (t1) and two post‐intervention periods (t2, 8 months after t1, and t3, 14 months after t1). Primary Nursing was implemented in group 1 (consisting of two nursing units) after t1. At this time no changes were introduced into group 2 (three nursing units) but after t2, Primary Nursing was also implemented in group 2. The research variables were measured by means of questionnaires. The results of the study indicate that most of the expected effects of Primary Nursing did not occur. Some methodological and practical explanations for this outcome are given.
Finnish Nurse Teachers' Perceptions of their ‘Scientific Thinking’ and its Development during Master's‐level Teacher Education at University
Authors: Hyrkäs Kristiina , Student Doctoral , Åstedt‐Kurki Päivi , Paunonen Marita
Published: March 2013

There are very few studies on nurse teachers' education, since the main interest has been on the demanding nature of a teacher's work. In Finland, the educational system of nursing care is developing rapidly and nurse teachers' education is changing as well. However, there is no research into academic nurse teacher education, even though this can be seen as important with regard to the educational system as well as to the nursing discipline. In this study, the objective was to describe 45 nurse teachers' perceptions of the development of their scientific thinking during Master's‐level studies at the university. Open‐ended questions were used in collecting the material with a questionnaire. The results of this phenomenographic research show that the need to increase one's scientific knowledge, as well as external demands, were the reasons for applying for admission to the university. Conceptions of the development of scientific thinking differed with regard to the processing of knowledge and to changes or developments in scientific thinking. The teachers' conceptions of the use of scientific nursing knowledge varied as well. The results challenge future teacher education and how it is arranged and developed. Further research, utilising different research methods, is needed into the development of scientific thinking.
Being Female in a Health Care Hierarchy
Authors: Sebrant Ulla
Published: March 2013

The aim of this paper is to illuminate the situation of women working in hierarchical organizations—patriarchal systems where male values and characteristics are normative—especially when the majority of employees in the organization are female. Do organizations where women make up the majority of the work force offer specific opportunities for women? How does the predominance of women affect the social construction of gender and leader identity? These questions are examined from a feminist perspective. Two concepts, gender system and the logic of personal relationships, provide the point of departure. Empirical support is drawn from studies, primarily of health care institutions, one of them an ongoing study by the author. The conclusion is that the hierarchical system seems to be self‐generating among both women and men. A more flexible and anti‐authoritarian work organization gives greater opportunities for women to develop in their work and to accept leading positions. The benefits of certain female characteristics, summarized in the concept of responsible rationality, in organizational life are discussed.
The Effect of Item Observability, Clarity and Wording on Patient/Nurse Ratings when using the ASA Scale
Authors: Halfens Ruud JG , van Alphen Arnold , Hasman Arie , Philipsen Hans
Published: March 2013

Many studies show discrepancies between patients' and professionals' ratings on the same questionnaire regarding the patient's health. A relevant question is whether the differences in ratings reflect real differences between patients and professionals or whether they are caused by characteristics of the instrument. In this study, we address the latter option by examining the effects of 3 item characteristics (item wording, observability and clarity) on the degree of patient/nurse discrepancies in ratings of the items of the Appraisal of Self‐care Agency (ASA) scale. Secondary analysis on 252 patient/nurse ratings showed that item wording (positively and negatively formulated items), and the observability of the items have a significant effect on the mean absolute difference score. No effect was found for clarity. These results were generally confirmed by subgroup analyses.
The Swedish Family: Transition to Parenthood
Authors: White Marjorie A. , Wilson Margaret E. , Elander Gunnel , Persson Berlith
Published: March 2013

Family interaction during pregnancy and the transition to parenthood creates the social environment in which the fetus becomes part of the family, family relationships and roles are reorganized, and the infant's temperament appears. The purpose of this study was to examine the relationships among family dynamics, parental‐fetal attachment, and infant temperament across the transition to parenthood. A sample of 91 families in Helsingborg, Sweden completed the Family Dynamics Measure and the Maternal/Paternal Fetal Attachment Scale during the third trimester of pregnancy. When the infant was 8–9 months old, mothers (n = 62) and fathers (n = 54) again completed the Family Dynamics Measure. The mother completed the Revised Infant Temperament Questionnaire as well. Overall, we found small changes in family dynamics, with an increase in perceived role conflict and mutuality reported by mothers. Fathers reported greater fetal attachment than their partners. Greater paternal‐and maternal‐fetal attachment was related to more positive family dynamics, and maternal‐fetal attachment was positively related to infant mood at 8 months. The stability of family dynamics across the transition to parenthood is a sign that most families negotiate this transition without difficulty.
Continuity, Assessment and Feedback in Orthopaedic Nursing Care Practice is Cost‐effective
Authors: Strömberg Lars , Öhlén Gunnar , Lindgren Urban , Svensson Olle
Published: March 2013

Hip fracture treatment and rehabilitation are often considered as separate issues and generally performed in different locations. The rapidly increasing proportion of patients that is old and very old now calls for a new approach. This is a prospective study of 909 consecutive hip fracture patients, over 64 years old, admitted to hospital from an independent living situation. In a specialized hip fracture unit, 256 patients were given an early and intense rehabilitation program. It focused on continuity, feedback, reorientation and continuous monitoring of cognitive function and activities of daily living (ADL). Eighty‐five percent of the patients could return directly to their own home after the initial treatment period. The mean total utilization of health care resources during the first 4 months after the injury was lower (28 institutional days) than in 286 historical controls given conventional rehabilitation (39 days, p < 0.05). At 4 months, 81% of the patients still lived in their own home vs. 72% of the controls and the 1‐year mortality was 14% (21% in the controls, p < 0.05). After the project had been completed 297 patients formed an additional control group. In this group the proportion discharged to their own home decreased to 44% and the number of bed‐days during the first 4 months returned to the pre‐study level (39 days). It thus appears to be cost‐effective to allocate sufficient rehabilitation resources early in the treatment of elderly patients with hip fractures. Annual savings in the catchment area due to the intervention were calculated to approximately 5000000 SEK. Continuous assessment and adequate continuity gives the staff emotional feedback, which promotes their personal commitment.
Nursing Students' Reasoning about Two Fictitious Elderly Patient Cases
Authors: Fagerberg Ingegerd , Ekman Sirkka‐Liisa , Heyman Ingrid
Published: March 2013

The aim of this study was to examine and describe how nursing students developed their reasoning and knowledge about the state of health of, and their possible actions regarding, two fictitious elderly patient case histories during their three‐year education. The descriptions were audiotaped, transcribed verbatim and analysed by content analysis. The findings show a development in the students' reasoning concerning the more acute case, but no development in reasoning regarding the case of a confused person. This could be due either to a lack of education in gerontology and geriatrics, or to the students receiving limited guidance during their education on how to reason about and reflect upon different ways of approaching emerging problems. The findings could also be understood in the light of traditions and history in nursing education.
Evaluation by Nurses and Students of a New Assessment Form for Clinical Nursing Education
Authors: Löfmark Anna , Thorell‐Ekstrand Ingrid
Published: March 2013

An assessment form was developed, based on Swedish higher education regulations and international guidelines for nursing education, to be used during clinical education regardless of the level of the programme or clinical speciality. Nurses who acted as supervisors for students used the form for continuous and formal assessment, and students used it for self‐assessment. Once developed, the assessment form covered 18 professional and academic areas. After one semester nurses (n = 323) and students (n = 154) from two university colleges evaluated their experiences of using the form by answering a questionnaire. In addition, the completed assessment forms filled in by the nurses were reviewed and analysed. The evaluation showed that the nurses and the students considered the assessment form highly valuable. Both groups believed that the form highlighted the requirements for clinical education and was useful in assessing the students' development. Almost all 18 factors were found to be important to assess. Least important and most difficult to assess were ‘the use of research and developmental work’ and ‘the ability to inform and teach co‐workers and students’. Some areas that were regarded as difficult to assess were also marked by the nurses in the assessment form as ‘not possible or relevant to assess’. The form was found to be useful in assessing students' development towards the goals of nursing education. The study also revealed that essential areas in nursing education have unclear educational demands for those involved.
Professional Assessment of Optimal Nursing Care Intensity Level
Authors: Fagerström Lisbeth , Rainio Anna‐Kaisa , Rauhala Auvo , Nojonen Kaija
Published: March 2013

In the article a new method is presented for allocation of staff resources, ‘Professional Assessment of Optimal Nursing Care Intensity Level’ (PAONCIL). This method is presented as an alternative to classical time study, which has traditionally been considered to belong to systems for patient classification. By means of this method the optimal nursing care intensity level for individual wards can be established. The study comprised 8 wards, and the nurses working in these wards provided a total of 8 458 professional assessments of optimal nursing care intensity levels. The material was analysed by means of simple linear regression analysis. The nursing care intensity scores per nurse in a single ward were used as independent variables and the average PAONCIL score for the same calendar day was used as a dependent variable. The average determination coefficient for different wards was 0.37; the PAONCIL instrument thus explained 37% of the nursing care intensity/nurse variation. This corresponded to a linear correlation of 0.60. In five out of six wards for adults the optimal nursing care intensity/nurse scores were close to each other, ranging from 3.0 to 3.6. The advantage of the PAONCIL method is that it can be easily implemented in a ward, can be used time and again, is advantageous and is based on quality aspects. The PAONCIL method has been developed on the basis of a caring science perspective and can be seen as an administrative method for the nurse manager, with whose help ‘good care’ can become possible.
Discrepancy between Patients' Perspectives, Staff's Documentation and Reflections on Basic Nursing Care
Authors: Adamsen Lis , Tewes Marianne
Published: March 2013

In recent years, Denmark has witnessed an increasing written and oral debate concerning the quality of basic nursing care. The present study is an attempt to characterize basic nursing care in a Danish hospital by collecting data on patient perceptions of their main somatic problems in seven pre‐set categories. These data include documentation of patient problems in corresponding problem categories, and the staffs additional knowledge about patient problems. Triangulation of methods was used. Data were collected on 120 patients and from 22 nurses. The patients had 2.3 problems on average: pain (58%) and sleep (43%) were the problems cited most frequently. Only 31% of patients' experienced problems were documented in the nursing records. The nursing staff had more knowledge than was registered in the nursing records. However, one‐third of the patients' problems was totally unknown to the nursing staff. From the patients' point of view, essential aspects of basic nursing care are overlooked in daily clinical practice. The findings show that the method employed is suitable for integration of the patients' perspective.
The Meaning of Living with Severe Chronic Heart Failure as Narrated by Elderly People
Authors: Ekman Inger , Ehnfors Margareta , Norberg Astrid
Published: March 2013

The meaning of elderly patients' experiences of living with chronic heart failure was studied. Narrative interviews were analysed using a phenomenological hermeneutic approach. ‘Feeling imprisoned in illness’ and ‘feeling free despite illness’ constituted the themes. These themes were interpreted as describing variations in awareness of the relationship between the self and the body. In the theme ‘feeling imprisoned in illness’ the body's illness and disability hindered the subjects from being themselves. In the theme ‘feeling free despite illness’ the disabled body was not experienced as limiting, but rather as a part of the self. The patients' understanding of the illness must be interpreted by the caregiver, who also needs to be aware of different modes of communicating feelings about the illness.
A Reliability and Utility Study of the Care Dependency Scale
Authors: Dijkstra Ate , Buist Girbe , Moorer Peter , Dassen Theo
Published: March 2013

The purpose of this study was to examine the reliability and utility of the Care Dependency Scale (CDS). This 15‐item scale has been developed recently for assessing the care dependency of demented or mentally handicapped inpatients. Data for this study were collected from 153 demented and 139 mentally handicapped inpatients. The sample was measured three times. Internal consistency was determined using Cronbach's alpha and ranged from 0.95 to 0.97. Interrater reliability revealed moderate to substantial weighted Kappa statistics between 0.51 and 0.83. Test‐retest reliability analysis resulted in substantial weighted Kappas between 0.66 and 0.89. Utility tests also revealed satisfactory results. The findings support the reliability and utility of the CDS.
Clinical Pathway of Elderly Persons with Lowered Mood in the Health Care Services
Authors: Arve Seija , Lauri Sirkka , Lehtonen Aapo
Published: March 2013

Elderly persons with mild depression are notable consumers of somatic health services. This study describes the typical clinical pathway including institutional care of two groups, depressed and non‐depressed elderly persons, in different stages of the health care system, and compares possible changes in the use of health care services between the two groups. We also compare differences in morbidity and mortality between depressed and non‐depressed persons. The depressed group of 50 persons in our follow‐up study were selected randomly from among those persons who were diagnosed as having symptoms of depression, as shown in the Zung Self‐Rating Depression Scale (n = 109). Persons (n = 50) who were not diagnosed as suffering from depression and who showed no signs of cognitive impairment (n = 833) were likewise chosen at random as a control group. We found that people suffering from symptoms of depression utilized institutional care, home health care and the outpatient clinics more than non‐depressed people. Depressed people were more likely to suffer cardiovascular (p < 0.023) and pulmonary diseases (p < 0.04) than non‐depressed controls. The mortality among depressed people was significantly higher than that in the control group. The results of our study give reason to believe that home‐care staff are in a key position to identify depressed subjects. They have to understand the relationship between depression and the effect of various diseases on health and functional capacity. It is also important to ensure efficient communication between those responsible for health care.
Impact of Child Health Centre Organization on Parental Satisfaction
Authors: Magnusson Margaretha , Garrett Martha J. , Sundelin Claes
Published: March 2013

The aim of this study is to describe differences in parental satisfaction with child health services under different organizational arrangements. The study had a cross‐sectional design and was based on 3 largely identical surveys, involving 60 questions, performed in 1970, 1988 and 1993. The original questionnaire was developed by one of the authors in 1970. The present study analyses responses to 5 demographic questions and 12 questions regarding the content of child health services, evaluating parental satisfaction with these services. The study population in 1970 consisted of 443 parents (93% of those invited to participate) with children 6–18 months old, 1008 (82%) in 1988 and 1071 (80%) in 1993. Parents expressed more satisfaction with child health services in 1970 and 1993 compared to 1988. This pattern is not attributable to macro‐level societal changes, but corresponds to changes in the organization of child health care services over the study period. The results highlight the vital question of how child health care should be organized in order to satisfy parents. The quality of child health care and parental satisfaction depend in part on the style of organization, including how much nurses with ‘first‐line’ contacts focus on paediatric services.
CONSUMPTION, MONEY, INTRATEMPORAL SUBSTITUTION, AND CROSS‐SECTIONAL ASSET RETURNS
Authors: Gu Li , Huang Dayong
Published: March 2013

When utility is specified recursively as a function of both consumption and money, real money growth becomes a common factor in addition to the market excess return and consumption growth. The risk premium on the money factor is negative because money complements consumption and is positively related to the stochastic discount factor. Growth portfolios, short‐term loser portfolios, and long‐term winner portfolios tend to have higher loadings on the money factor and, thus, earn lower premiums on money.
Migration and Intergenerational Replacement in Europe
Authors: Wilson Chris , Sobotka Tomáš , Williamson Lee , Boyle Paul
Published: March 2013

There are long‐standing concerns over low fertility levels in Europe and an increasingly important debate on the extent to which migration can compensate for below‐replacement fertility. To inform this debate, a wide array of indicators have been developed to assess the joint influence of fertility, mortality, and migration on birth replacement and intergenerational replacement. These indicators are based on various models and assumptions and some are particularly data demanding. In this article we propose a simple method to assess how far migration alters the extent of replacement for a birth cohort as it ages. We term the measure the overall replacement ratio (ORR). It is calculated by taking the size of a female birth cohort at selected ages divided by the average size of the cohorts of mothers in the year of birth. We present estimates of the ORR for a range of European countries representing different replacement regimes. We demonstrate that for many countries net migration has become a key factor in their population trends during the last few decades.
China between Economic Growth and Mass Immigration
Authors: Bruni Michele
Published: March 2013

In order to continue along its path of sustained economic growth, China will need, probably in just a few years, certainly after 2030, an extremely high number of immigrants. This conclusion, which contrasts with a recent World Bank scenario suggesting that the decline in labor supply due to demographic trends can be faced with sustained growth in productivity, is based upon a demand‐driven model of migration. Moreover, according to the same model, the decline in fertility (and the one child policy that has been partially responsible for it) will end up provoking immigration flows above replacement level. The working age population and the total population will continue to increase, and China will remain the most populous country on the planet. The last part of the paper surveys the policies that China could adopt to reduce its structural need for foreign labor.
Useful Ethnographies
Authors: deRoche Constance
Published: March 2013

Books reviewed in this issue.

Strong Hearts, Native Lands: The Culture and Political Landscape of Anishinaabe Anti‐Clearcutting Activism. Anna J. Willow.
Film and Video
Authors: Cool Jennifer
Published: March 2013

Film reviewed in this issue.

In the Wilderness of a Troubled Genre: Conversations with Ethnographic Filmmakers 2000–2012 John Melville Bishop
Neural steroid sensitivity and aggression: comparing individuals of two songbird subspecies
Authors: Bergeon Burns C. M. , Rosvall K. A. , Ketterson E. D.
Published: March 2013

Hormones coordinate the expression of complex phenotypes and thus may play important roles in evolutionary processes. When populations diverge in hormone‐mediated phenotypes, differences may arise via changes in circulating hormones, sensitivity to hormones or both. Determining the relative importance of signal and sensitivity requires consideration of both inter‐ and intrapopulation variation in hormone levels, hormone sensitivity and phenotype, but such studies are rare, particularly among closely related taxa. We compared males of two subspecies of the dark‐eyed junco (Junco hyemalis) for territorial aggression and associations among behaviour, circulating testosterone (T), and gene expression of androgen receptor (AR), aromatase (AROM) and oestrogen receptor α in three behaviourally relevant brain regions. Thus, we examined the degree to which evolution may shape behaviour via changes in plasma T as compared with key sex steroid binding/converting molecules. We found that the white‐winged junco (J. h. aikeni) was more aggressive than the smaller, less ornamented Carolina junco (J. h. carolinensis). The subspecies did not differ in circulating testosterone, but did differ significantly in the abundance of AR and AROM mRNA in key areas of the brain. Within populations, both gene expression and circulating T co‐varied significantly with individual differences in aggression. Notably, the differences identified between populations were opposite to those predicted by the patterns among individuals within populations. These findings suggest that hormone–phenotype relationships may evolve via multiple pathways, and that changes that have occurred over evolutionary time do not necessarily reflect standing physiological variation on which current evolutionary processes may act.
A multicomponent lifestyle intervention produces favourable changes in diet quality and cardiometabolic risk indices in hypercholesterolaemic adults
Authors: Petrogianni M. , Kanellakis S. , Kallianioti K. , Argyropoulou D. , Pitsavos C. , Manios Y.
Published: March 2013

Background

To date, there are no dietary intervention studies available jointly examining the changes produced in cardiometabolic risk indices and diet quality assessed with the Healthy Eating Index 2005 (HEI‐2005). The present study aimed to evaluate the effect of a 3‐month multicomponent lifestyle intervention on several cardiometabolic risk indices, physical activity levels and diet quality.

Methods

A total sample of 108 hypercholesterolaemic adults (40–60 years old) were randomised to two intervention groups provided with and instructed to consume daily: (i) plain milk (n = 37) or (ii) enriched milk (n = 40) respectively; both groups were attending a 3‐month dietary counselling programme. For the needs of the present study both intervention groups were analysed together IG: n = 77) and were compared against a control group following usual diet (CG: n = 31).

Results

Regarding diet quality HEI scores for ‘milk’ (P = 0.021), ‘dark green/orange vegetables and legumes’ (P = 0.050) and ‘total HEI score’ (P = 0.045) were improved in the IG compared to the CG. The IG also improved ‘whole grains’ and ‘calories from solid fats, alcoholic beverages and added sugars’ scores compared to their baseline values. Both groups improved the ‘total vegetable’ HEI score. Regarding physical activity levels and cardiometabolic risk indices, the IG significantly increased the daily number of steps (P = 0.005) and decreased body weight (P = 0.021), body mass index (P = 0.019) and waist circumference (P = 0.027) to a higher extent compared to the changes observed in the CG. Moreover, the IG significantly decreased systolic (P = 0.001) and diastolic blood pressure (P = 0.050) compared to baseline values.

Conclusions

The present study revealed that this 3‐month lifestyle and nutrition counselling intervention programme appears to have favourable effects on diet quality, physical activity levels, anthropometric and certain cardiometabolic risk indices.
Isolation, characterization and the multi‐lineage differentiation potential of rabbit bone marrow‐derived mesenchymal stem cells
Authors: Tan Sik‐Loo , Ahmad Tunku Sara , Selvaratnam Lakshmi , Kamarul Tunku
Published: March 2013

Mesenchymal stem cells (MSCs) are recognized by their plastic adherent ability, fibroblastic‐like appearance, expression of specific surface protein markers, and are defined by their ability to undergo multi‐lineage differentiation. Although rabbit bone marrow‐derived MSCs (rbMSCs) have been used extensively in previous studies especially in translational research, these cells have neither been defined morphologically and ultrastructurally, nor been compared with their counterparts in humans in their multi‐lineage differentiation ability. A study was therefore conducted to define the morphology, surface marker proteins, ultrastructure and multi‐lineage differentiation ability of rbMSCs. Herein, the primary rbMSC cultures of three adult New Zealand white rabbits (at least 4 months old) were used for three independent experiments. rbMSCs were isolated using the gradient‐centrifugation method, an established technique for human MSCs (hMSCs) isolation. Cells were characterized by phase contrast microscopy observation, transmission electron microscopy analysis, reverse transcriptase‐polymerase chain reaction (PCR) analysis, immunocytochemistry staining, flow cytometry, alamarBlue® assay, histological staining and quantitative (q)PCR analysis. The isolated plastic adherent cells were in fibroblastic spindle‐shape and possessed eccentric, irregular‐shaped nuclei as well as rich inner cytoplasmic zones similar to that of hMSCs. The rbMSCs expressed CD29, CD44, CD73, CD81, CD90 and CD166, but were negative (or dim positive) for CD34, CD45, CD117 and HLD‐DR. Despite having similar morphology and phenotypic expression, rbMSCs possessed significantly larger cell size but had a lower proliferation rate as compared with hMSCs. Using established protocols to differentiate hMSCs, rbMSCs underwent osteogenic, adipogenic and chondrogenic differentiation. Interestingly, differentiated rbMSCs demonstrated higher levels of osteogenic (Runx2) and chondrogenic (Sox9) gene expressions than that of hMSCs (P < 0.05). There was, however, no difference in the adipogenic (Pparγ) expressions between these cell types (P > 0.05). rbMSCs possess similar morphological characteristics to hMSCs, but have a higher potential for osteogenic and chondrogenic differentiation, despite having a lower cell proliferation rate than hMSCs. The characteristics reported here may be used as a comprehensive set of criteria to define or characterize rbMSCs.
Do pregnant women with depression have a pro‐inflammatory profile?
Authors: Haeri Sina , Baker Arthur M. , Ruano Rodrigo
Published: March 2013

Aim

We tested the hypothesis that maternal depression is associated with a pro‐inflammatory state in pregnancy.

Material and Methods

In this nested case–control study, pro‐inflammatory cytokine levels were compared between women with depression in pregnancy (n = 100) and a computer‐generated referent group of healthy women known not to be depressed (n = 100). We only included cases with a documented Diagnostic and Statistical Manual of Mental Disorders depression diagnosis in the current pregnancy. Serum samples drawn at 11–14 weeks of gestation were analyzed for levels of tumor necrosis factor‐alpha and interleukin‐6 using high‐sensitivity immunoassays.

Results

Maternal demographics were similar between the groups except for older age (34.1 vs 32.7 years, P = .05), and lower body mass index (27.3 vs 28.9 kg/m2, P = 0.03) among the depressed subjects. Compared to control women, tumor necrosis factor‐alpha (5.8 ± 3.4 vs 3.2 ± 2.8 pg/ml, P < 0.0001) and interleukin‐6 (2.4 ± 3.8 vs 1.5 ± 1.4 pg/ml, P = 0.03) levels were higher among women with depression. The higher rate of inflammatory cytokines remained significant after controlling for potential confounders, including maternal age and body mass index.

Conclusion

Women with depression may have higher levels of inflammatory markers in early pregnancy. Our findings support the hypothesis that inflammation may be a mediator in the association between maternal depression and adverse perinatal outcomes.
Evaluating the risk factors for developing resistance to parenteral therapy for tubo‐ovarian abscess: A case–control study
Authors: Mizushima Taichi , Yoshida Hiroshi , Ohi Yuka , Ishikawa Masahiko , Hirahara Fumiki
Published: March 2013

Aim

The aim of this study was to identify factors that can predict the resistance to parenteral therapy in patients with tubo‐ovarian abscesses (TOA).

Material and Methods

We conducted a case–control study involving 55 admitted patients with TOA. The subjects eligible for this study included 28 patients who failed antibiotic therapy and required surgery (surgical cases) and 27 patients who were conservatively cured (control cases). The clinical characteristics of the patients on admission were reviewed. Logistic regression analysis was performed after univariate analysis to identify potentially important variables and to calculate odds ratios with 95% confidence intervals.

Results

As per the univariate analysis, compared to the control cases, the surgical cases were older (40.4 vs 31.5 years), had higher white blood cell counts (14000 vs 11828 cells/mm3), higher C‐reactive protein levels (16.1 vs 7.6 mg/dL), and a larger abscess diameter (6.6 vs 3.9 cm). There were no significant differences in gravidity, parity, body temperature, rate of endometrial cyst formation, and Chlamydia trachomatis infection rates between the groups. Multiple logistic regression analysis indicated that the only statistically significant risk factor predicting parenteral antibiotic therapy failure was the abscess diameter >5 cm (odds ratio = 69.6; 95% confidence interval = 9.3–527, P < 0.0001).

Conclusion

An abscess diameter >5 cm is an important factor for predicting the failure of antibiotic therapy in patients with TOA. Moreover, it is useful for determining whether patients with TOA should be surgically treated.
From Taken‐for‐Granted to Explicit Commitment: The Rise ofCSRin a Corporatist Country
Authors: Höllerer Markus A.
Published: March 2013

This article contributes to a thriving line of research that examines issue interpretation and social accounts in order to study the adoption and diffusion of organizational concepts and management practices. It employs the empirical example of the rise of corporate social responsibility (CSR) inAustria between 1990 and 2005 to investigate the complex role institutional pressures and social positions of actors play in the local adoption of globally theorized ideas. More specifically, the study reveals distinct patterns in rhetoricalCSRadoption that illustrate the initial hesitation and reluctance of an established elite in theAustrian business community towards theAnglo‐American notion of ‘explicit’CSR, while non‐elite actors who were less favourably positioned in the social order readily embraced the concept. It is in such a sense thatCSRis nevertheless instrumentalized to challenge, reinterpret, or explicitly evoke the autochthonous idea of institutionalized social solidarity. Conceptually, this research takes into account social structure, actors' positions in the social order, and resulting divergent adoption motivations – i.e. the individual, yet socially derived, relevance systems of actors – and relates these to mechanisms and processes of institutional change.