bluuebunny/crossref_metadata_2025 huggingface dataset:
Production of soya milk containing low flatulence‐causing oligosaccharides in a packed bed reactor using immobilised α‐galactosidase
Authors: Rajan Anila , Nair Giridhar R.
Published: August 2010

Peanut α‐galactosidase was immobilised in calcium alginate beads and used to hydrolyse the flatulence‐causing oligosaccharides, raffinose and stachyose, in soya milk in batch and in packed bed reactor with recycle. The immobilised enzyme exhibited a slightly lower activity than the free enzyme. The activity yield of immobilised α‐galactosidase was 75.1% and the immobilisation yield was 82.6%. Batch hydrolysis using immobilised enzyme at 55 °C resulted in 96% reduction in the oligosaccharides after 12 h. For the continuous process, a packed bed reactor with recycle was used. More than 98% of the oligosaccharides were hydrolysed after 6 h of reaction at 55 °C. The immobilised enzyme also proved to be stable up to three repeated hydrolysis reactions.
Fat, wheat bran and salt effects on cooking properties of meat patties studied by response surface methodology
Authors: Tekin Hasibe , Saricoban Cemalettin , Yilmaz Mustafa Tahsin
Published: August 2010

Response surface methodology was used to investigate the main effects and interactions of composition (processing) variables such as fat (10–30%), wheat bran (5–15%) and NaCl (0–2%) on cooking properties of beef patties. In addition, the ridge analysis was conducted to find the values of processing variables that maximise and minimise the cooking parameters (moisture retention, fat retention, reduction in thickness, reduction in diameter, cooking yield, shrinkage and water‐holding capacity). It was found that the moisture and fat retention, reduction in thickness and cooking yield values decreased; however, reduction in diameter and shrinkage values increased, respectively, as the amount of fat increased. However, wheat bran addition increased fat retention, moisture retention, cooking yield and water‐holding capacity values of the patties. Increasing NaCl levels decreased water‐holding capacity value by its quadratic effect and moisture and fat retention value by its interaction effect with wheat bran.
Original article: Apparent thermal diffusivity estimation for the heat transfer modelling of pork loin under air/steam cooking treatments
Authors: Rinaldi Massimiliano , Chiavaro Emma , Massini Roberto
Published: August 2010

Apparent thermal diffusivity linear functions vs. product temperature were estimated for pork cooked under two different treatments (forced convection, FC and forced convection/steam combined, FC/S) at 100, 110, 120 and 140 °C by means of experimental time–temperature data and a developed finite‐difference algorithm. Slope and intercept of each function were employed to calculate apparent thermal diffusivity at 40, 55 and 70 °C. Generally, FC/S treatments gave significantly higher apparent thermal diffusivities in comparison with FC conditions. Apparent thermal diffusivities were used to develop a model for cooking time and final core temperature prediction on the basis of oven setting. The model was validated by means of additional cooking tests performed at different temperatures of those employed for model development. Root mean square error values lower than 3.8 °C were obtained comparing predicted and experimental temperature profiles. Percentage errors lower than 3.1% and 3.5% were, respectively, obtained for cooking times and final core temperatures.
Evolution of volatile compounds in papaya wine fermented with three Williopsis saturnus yeasts
Authors: Lee Pin‐Rou , Ong Yuen‐Ling , Yu Bin , Curran Philip , Liu Shao‐Quan
Published: August 2010

The changes in volatile compounds during papaya juice fermentation with three Williopsis saturnus yeasts were investigated in this study. Time‐course papaya juice fermentations were carried out using three Williopsis saturnus yeasts: W. saturnus var. mrakii NCYC2251, W. saturnus var. saturnus NCYC22 and W. saturnus var. sargentensis NCYC2727. Changes in yeast cell population, Brix and pH were similar among the three yeasts, which preferentially utilised glucose over fructose while partially degrading l‐malic acid. A range of volatile compounds were produced during fermentation including fatty acids, alcohols and esters with esters being the most abundant volatile compounds produced. Benzyl isothiocyanate, butyric acid, 2‐ethylhexanol, benzaldehyde and β‐damascenone present in the papaya juice were metabolised to trace levels during fermentation. There were significant variations among the three yeasts in their ability to produce and metabolise volatile compounds during fermentation. The study suggests that papaya juice fermentation with W. saturnus yeasts is able to result in the formation of a more complex aroma compounds.
A simple and rapid turbidimetric method for determining catechins in beverages
Authors: Nakayama Motokazu , Shigemune Naofumi , Tsugukuni Takashi , Tokuda Hajime , Miyamoto Takahisa
Published: August 2010

We have developed a simple and rapid turbidimetric method to determine catechins based on the fact that many polyphenols produce hydrogen peroxide in an alkaline environment and that hydrogen peroxide oxidises cerium to generate cerium oxide precipitates. Four catechins (epicatechin, epigallocatechin, epicatechin gallate, epigallocatechin gallate) aggregated with these precipitates to form massive precipitates with increased turbidity. The catechins solution (0.18 mL) was mixed with 0.02 mL of 1% CeCl3 solution, and absorbance (650 nm) was measured immediately after agitation for 3 min using a spectrophotometer. Absorbance was strongly correlated (0.99) with the concentration of each catechin compound. For commercially bottled green tea, the estimated catechin content determined using this turbidimetric method showed better correlation with the content determined by high‐performance liquid chromatography than that determined using ferrous tartrate method, which is the official Japanese method for determining the tannin content of green tea.
Mathematical modelling of mass transfer in the concentration polarisation layer of flat‐sheet membranes during clarification of pomegranate juice
Authors: Mirsaeedghazi Hossein , Emam‐Djomeh Zahra , Mousavi Sayed M. , Enjileha Vali , Navidbakhsh Mahdi , Mirhashemi Seyyedeh M.
Published: August 2010

Evaluation of membrane clarification of pomegranate juice showed that a cake layer is created at the beginning of the process. This evaluation was used as the basis for modelling the solute concentration in the concentration polarisation layer to control the fouling of the membrane. The model of changes in concentration as a function of time and distance (in its dimensionless form) was solved numerically using the Forward‐Time/Central‐Space (FTCS) method. Programming was performed using MATLAB software, and the predicted concentration on the membrane surface was compared with experimental data; the prediction fit well with the experimental data. The model showed that the solute concentration increased as distance to the membrane surface decreased, time increased, transmembrane pressure increased and velocity decreased. Also, the model matched the experimental data in that it showed the cake layer to be created in the early stages of the membrane clarification process.
Effect of patient coping preferences on quality of life following renal transplantation
Authors: White Ciara , Gallagher Pamela
Published: August 2010

white c. & gallagher p. (2010) Effect of patient coping preferences on quality of life following renal transplantation. Journal of Advanced Nursing 66(11), 2550–2559.

Aim.  This paper is a report of a study investigating the relationships between quality of life, patient coping preferences, and desire to be actively involved in care following renal transplantation.

Background.  While the general consensus is that quality of life is improved greatly by kidney transplantation, it is apparent that it is not uniformly a positive experience in this regard. There is a need to identify individual difference factors that influence quality of life following renal transplantation.

Method.  A correlational study was conducted in the national referral centre for renal transplantation in the Republic of Ireland in 2006 with a sample of 172 transplant recipients. Data were collected using a questionnaire composed of standardized instruments to measure the key concepts.

Results.  Participants perceived that they had good quality of life, and used more problem‐solving than avoidance coping strategies. Avoidance coping strategies were associated with statistically significantly lower quality of life following transplantation. Being younger, attaining a higher education level, being in employment and being married were associated with higher quality of life following transplantation.

Conclusion.  Assessment of coping strategies among the transplant population should be further explored in clinical practice, and steps employed to promote the use of positive coping strategies in order to maximize quality of life after transplant.
Usability evaluation of a web‐based patient information system for individuals with severe mental health problems
Authors: Kuosmanen Lauri , Jakobsson Tiina , Hyttinen Jari , Koivunen Marita , Välimäki Maritta
Published: August 2010

kuosmanen L., Jakobsson T., hyttinen J., koivunen M. & välimäki M. (2010) Usability evaluation of a web‐based patient information system for individuals with severe mental health problems. Journal of Advanced Nursing. 66(12), 2701–2710.

Aim.  This paper is a report of a study conducted to compare service users’, nursing students’ and Registered Nurses’ evaluations of the usability of a patient education website intended for individuals with severe mental health problems.

Background.  There is an obvious need for reliable mental health information on the Internet. When evaluating the usability of Internet‐based patient education methods, the opinions of all parties need to be ascertained.

Methods.  An explorative descriptive design was used. Twenty‐one service users, 20 nursing students and 35 Registered Nurses were recruited for the study in 2003 and 2004. Data were collected using a self‐developed questionnaire on the content, structure and visual appearance of the website.

Results.  Service users had positive attitudes towards computer and Internet use but they needed support when using the computer and Internet. According to the evaluations, the content, structure and visual appearance of the website were good and it could be adopted for clinical practise after minor revisions. There were some differences in the evaluations between participant groups. Nurses were the most critical group, and the service user group was the most satisfied, although they were less experienced with using both computers and the Internet.

Conclusion.  It is especially important to include service users’ evaluations at the early stages of the development process of Web‐based patient education systems. It is possible to produce an information technology‐based patient education system for individuals with severe mental health problems. Nurses working in psychiatric services need to pay more attention to supporting service users in computer and Internet use.
Smoking among young children in Hong Kong: influence of parental smoking
Authors: Loke Alice Yuen , Wong Yuen Ping Ivy
Published: August 2010

loke a.y. & wong y.p.i. (2010) Smoking among young children in Hong Kong: influence of parental smoking. Journal of Advanced Nursing 66(12), 2659–2670.

Aims.  This paper is a report of a study comparing children with smoking parents and those with non‐smoking parents, in terms of knowledge and attitude towards smoking and the influence of parents and peers on smoking initiation.

Background.  Adolescence is a developmental stage when smoking habits are likely to start. Adolescents are most influenced by the smoking habits of their parents and friends.

Method.  A cross‐section study was conducted with students aged 13–15 years in two schools in 2008, using a questionnaire that collected information on the smoking habits of their parents and peers, knowledge and attitude towards smoking, initiation and inclination towards smoking. Chi‐square tests and binary logistic regression were used to analyse the data.

Results.  A total of 257 of 575 (44·7%) students had smoking parent(s), and 25·4% reported having peers who smoked. Children with non‐smoking parents were more likely than those with smoking parents to consider ‘smoking as disgusting’ (67·3% vs. 45·9%), and to know that ‘smoking is addictive’ (80·5% vs. 70·4%) and ‘harmful to health’ (81·8% vs. 67·7%). More of those with smoking parents had tried smoking than those with non‐smoking parents (13·2% vs. 3·8%).

Conclusion.  Preventive programmes should involve smoking parents to increase their awareness of the impact their smoking has on their children. Interventions should include problem‐solving skills for children to deal with daily stresses and thus eradicate the potential risk of smoking initiation.
Effects of habitat amount and isolation on biodiversity in fragmented traditional orchards
Authors: Bailey Debra , Schmidt‐Entling Martin H. , Eberhart Peter , Herrmann John D. , Hofer Gabriela , Kormann Urs , Herzog Felix
Published: August 2010

1. Habitat fragmentation is a major threat to biodiversity and can lead to the loss of both species and ecosystem services, but fragmentation effects vary greatly between studies and studied organisms. Understanding the distinct effects of habitat amount and isolation at the patch and landscape scale may account for some of this variation.

2. We studied biodiversity in 30 traditional orchards that were selected for independent variation in habitat amount and habitat isolation at the patch and landscape scale. We analysed species richness and abundance of snails, beetles, true bugs, spiders and breeding birds that avoid open farmland but occur in woody vegetation types. Additionally, the abundances of nine single species were analysed using specific habitat definitions.

3. Surprisingly, the effects of habitat isolation were more important than the effects of habitat amount. Effects at the patch scale were more frequent than landscape‐scale effects.

4. Spider species richness decreased with increasing patch‐scale habitat amount. Abundance of the weevilPhyllobius oblongusincreased with landscape‐scale habitat amount. Negative effects of patch isolation were greater for predatory birds and spiders, while the predominately herbivorous beetles, true bugs and snails were less affected. Species richness of birds, spiders and beetles, and abundance of birds,Cyanistes caeruleus,Parus majorandFringilla coelebs, decreased with increasing patch‐scale habitat isolation. In contrast, species richness of spiders and beetles increased with increasing landscape‐scale habitat isolation.

5. Synthesis and applications. The effects of habitat fragmentation differed between taxonomic groups, with stronger and more consistent responses in birds than invertebrates. Our understanding of fragmentation effects may be biased due to the dominance of bird studies in the literature, and further invertebrate studies are encouraged. Landscape management to improve biodiversity or ecosystem services requires a group‐specific approach and coordinated priority setting. High habitat connectivity benefited wood‐preferring birds, spiders and beetles, lending support to national initiatives for increased habitat connectedness. The negative effects of patch isolation were greater for natural pest regulators, birds and spiders than for herbivorous beetles and bugs.
The effectiveness of nursing: a review
Authors: THOMAS LOIS H. , BOND SENGA
Published: August 2010

This paper describes the findings of a literature review of the effectiveness of nursing. Three journals were selected in which this type of study was most likely to be published. A diversity of attempts to measure nursing effectiveness with various types of patient was found. Generally, however, there was a lack of rigour in study design and sample sixes were too small to be able to draw conclusions. No studies were found which undertook a cost‐effectiveness analysis of nursing interventions.

Suggestions for the way forward in measuring nursing effectiveness are given, together with questions to be addressed by nursing research.
A critique of ‘at risk’ pressure sore assessment tools
Authors: SMITH L. N. , BOOTH N. , DOUGLAS D. , ROBERTSON W. R. , WALKER A. , DURIE M. , ERASER A. , HILLAN E. H. , SWAFFIELD J.
Published: August 2010

This paper critiques pressure sore risk assessment tools. No attempt is made to describe individual tools in detail as this literature is available elsewhere.

The economic case for risk assessment is presented along with the criteria for an effective risk assessment instrument.

Reliability and validity studies are reviewed in relation to three risk assessment tools: Norton, Waterlow and Braden.

Finally a number of issues related to threshold scores, research design and the need to view pressure sores as a clinical problem rather than a nursing problem are discussed.
Introduction of the use of structured pain assessment for post‐operative patients in Kenya: implementing change using a research‐based co‐operative approach
Authors: HASTINGS FAYE
Published: August 2010

A research‐based project was conducted to introduce structured pain assessment on a surgical ward at a general hospital in Kenya, East Africa. The aim was to improve pain control, and subsequently patients' recovery and satisfaction with care.

It was agreed that the ultimate aim was to develop and use a common tool for pain assessment throughout the hospital, thereby reducing disparity in various clinical areas, and raising standards of patient care.

The project was seen as a pilot, and planned introduction of the pain assessment took place over 1 month.

This paper describes the findings in relation to the patient sample, and perceptions of nurses taking part. It also contains reflections about action research, and how it may enter the scene as a way of understanding the whole picture retrospectively.
Listening to the voices of older patients: an existential‐phenomenological approach to quality assurance
Authors: KOCH TINA , WEBB CHRISTINE , WILLIAMS ANNE M.
Published: August 2010

The motivation behind this study was a desire to gain access to the experiences of elderly people receiving nursing care in hospital. Previous experience with quantitative approaches to quality assurance had led to dissatisfaction with their neglect of the patient perspective or reliance on patient satisfaction questionnaires.

An existential‐phenomenological approach was used in an attempt to reconstruct patients' experiences as reported in their own words.

Themes which emerged from the data and are reported here focus on ‘routine geriatric care’, ‘care deprivation’, ‘depersonalization’, and ‘geriatric segregation’.

The findings are discussed against the background of literature about nursing care of elderly people. It is suggested that in the setting studied, limitations posed by past management deficiencies, under‐staffing and poor physical environment contributed to the situation reported. Trained nurses felt they worked hard to give the best care they could but, with a high ratio of untrained staff and lack of continuing education, they were aware that their levels of achievement were far from ideal.

The study demonstrates that, with an appropriate methodology, it is possible to gain access to how patients' experience their care and in this sense the attempt to ‘listen to the voices of patients’ was successful and gives pointers to developing more patient‐sensitive quality‐assurance processes.
The management of diabetes in adolescents and young adults: a preliminary case study
Authors: ROBINSON J.J.A. , SOWDEN J. A. , TATTERSALL R.B.
Published: August 2010

This paper describes one part of a first‐stage study concerned with the care received by a group of adolescents and young adults with insulin‐dependent diabetes mellitus (IDDM) in one district health authority.

The paper reports findings from a self‐selected sample of 30 patients aged between 15 and 25. Each of the 30 patients was interviewed during a routine appointment at a diabetes clinic. The patients' doctor at the clinic and one of the diabetes specialist nurses also filled in a short questionnaire for each of the patients interviewed.

The main finding was that although all 30 patients interviewed reported that their diabetes control was at least moderately good, a significant number of patients had blood glucose levels above the recommended norm.

The study lends support to the widely held belief that young adults with diabetes have particular difficulties in maintaining blood glucose levels within a normal range.

It is suggested that processes within the current mode of care may be contributing to this poor level of control. Recommendations for a controlled trial of specialist nurse versus doctor care are made.
Head lice infestation: bug busting vs. traditional treatment
Authors: Plastow Liz , Luthra Manjo , Powell Roy , Wright Judith , Russell David , Marshall Martin N.
Published: August 2010

• The two main methods of managing head lice infestation in the UK are head lice lotions and bug busting; there is no conclusive evidence as to which of these methods is most effective.

• The aim of this study was to compare the effectiveness of the bug busting method with lotion.

• A pilot study in the form of a randomized controlled trial involving two semi‐rural general practices was used. Thirty children aged 4–16 years were randomly assigned to two intervention groups.

• After initial dry combing to detect the presence of head lice, one group was treated with phenothrin lotion. The bug busting group received combing using special combs provided in the bug busting pack and hair conditioner.

• The main outcome measure was the number of adult live lice and nymphs at day 14.

• On day 14 in the bug busting group, total eradication of head lice had occurred in eight children; in the lotion group, total eradication had occurred in two children (P=0.052); number needed to treat 2.5 (95% CI: 2.19–2.81).

• These results suggest that bug busting performed by nurses in a controlled situation is an effective method of managing head lice infestation.
Integration of lucid individuals and agitated individuals with dementia in different care units
Authors: Ragneskog Hans , Gerdner Linda A. , Hellström Lisbeth
Published: August 2010

• The purpose of this study was to illuminate how the integration of lucid individuals and agitated cognitively impaired individuals affects aspects of perceived quality of care.

• A questionnaire was mailed to hospital wards, nursing home wards and residential homes in Sweden. Nursing staff replied to the questionnaire on behalf of each care unit.

• Integration of cognitively impaired and lucid patients/residents was identified as a problem, regardless of whether the care unit was a hospital ward, nursing home or residential home.

• Agitated behaviours in people who were cognitively impaired could result in lucid residents becoming anxious, afraid and irritated. This in turn could lead to an exacerbation of behaviour in residents who were already agitated.

• Sometimes a lucid patient/resident was required to share a room with an agitated individual.

• There is a need for staff training specific to the needs of people with dementia.

• Findings suggest that there is a shortage of units designed specifically for the care of agitated cognitively impaired patients/residents.

• The findings of this study support the need for healthcare providers in long‐term care settings to maintain the rights and well being of all patients/residents.
‘The real stuff’: implications for nursing of assessing and measuring a terminally ill person’s quality of life
Authors: Annells Merilyn , Koch Tina
Published: August 2010

• Two quality of life (QoL) assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL) questionnaires, were trialled within district nursing palliative care to test usefulness and feasibility for holistic intervention selection, individualized palliative care planning, and measurement of the quality of dying.

• The specific focus of this paper is to discuss the less tangible outcomes of the trial, which illuminate the partly ‘hidden’ value and nature of clinical nursing.

• These outcomes include awareness that the use of such tools may: by actual administration of the tool be, in and of itself, a therapeutic nursing action; focus on ‘the real stuff’ from the client’s perspective, that which matters most to the terminally ill client, but may not be classically considered as prompting nursing intervention; and facilitate ‘the real stuff’ of nursing, perhaps known but not usually articulated by nurses, and which usually does not feature on care plans nor in time allocation schedules.
Developing a module for nursing documentation integrated in the electronic patient record
Authors: Hellesø R. , Ruland C. M.
Published: August 2010

• Norway’s regional teaching hospitals are working together on a project to develop an interdisciplinary electronic patient record (EPR).

• This paper presents the results of a project to develop nursing documentation as part of an integrated EPR to improve the quality and continuity of patient care.

• The project used a consensus process as a working norm.

• The most important result is that the five hospitals have agreed on a framework for nursing documentation, and on the main components that need to be implemented in the electronic patient record.
A comparison between EASI system 12‐lead ECGs and standard 12‐lead ECGs for improved clinical nursing practice
Authors: Lancia Loreto , Pisegna Cerone Marina , Vittorini Pierpaolo , Romano Silvio , Penco Maria
Published: August 2010

Aims and objectives.  This study was carried out to verify the accuracy of 12‐Lead ECG, obtained through a continuous ECG monitoring system with five cables positioned in EASI mode, to identify basic ECG alterations.

Background.  This study concerns continuous ECG monitoring systems in Coronary Care Units. Continuous ECG monitoring is an important device for nursing surveillance and is useful in decreasing adverse events.

Design and method.  Thirteen patients admitted consecutively to the Coronary Care Unit for Acute Myocardial Infarction underwent daily and simultaneous recording of a12‐lead ECG using both procedures: EASI ECG and STANDARD ECG. A sample of 1164 ECG leads acquired in EASI mode was compared with a sample of as many ECG leads acquired using the standard procedure with a traditional cardiograph.

Results and conclusions.  In the Coronary Care Unit, Continous ECG monitoring with five cables positioned in EASI mode is a valid alternative to the standard 12‐lead ECG for cardiac rhythm abnormalities detection and for acute myocardial ischemia and old myocardial infarction assessment. Therefore, the EASI system might be advantageous for long‐term patient monitoring.

Relevance to clinical practice.  The EASI system represents a valid device for the nursing surveillance of patients who need continuous ECG monitoring, improves clinical nursing practice in Coronary Care Units, supports the reduction of adverse events such as cardiac arrest and reduces the hospital costs.
A systematic review of empirical studies between 1966 and 2005 of patient outcomes of total hip arthroplasty and related factors
Authors: Montin Liisa , Leino‐Kilpi Helena , Suominen Tarja , Lepistö Jyri
Published: August 2010

Aim.  To determine patient outcomes of total hip arthroplasty and the research methods used to produce knowledge of use to clinical nursing and for purposes of health education. The review consists of three parts. Firstly, it describes the patient outcomes of total hip arthroplasty. Secondly, it addresses the factors related to the patient outcomes and thirdly the research methods used are explored.

Background.  Previous research has identified that total hip arthroplasty is a very common procedure to reduce pain and improve physical function in patients with osteoarthritis. The greatest improvements have been found in reduction in pain.

Methods.  Two databases, Medline and CINAHL were searched from 1966–2005. Studies were eligible for review and included if they met the following criteria: (1) publication in English, (2) empirical research and (3) the indication for total hip arthroplasty was osteoarthritis; 17 studies met the criteria.

Results.  Total hip arthroplasty resulted in pain relief, improved physical function and enhanced health‐related quality of life regardless of patients’ characteristics, type of operation or type of prosthesis. The only factor affecting patient outcomes was patients’ poor pre‐operative function. These patients were more likely to have postoperative pain and low postoperative physical function. Long‐waiting time for surgery may reduce quality‐adjusted life years. Different kinds of questionnaires were used in the studies reviewed leaving out patients’ perceptions concerning the outcomes of total hip arthroplasty.

Conclusions.  Patients’ perceptions should be assessed more closely in further research to gain subjective knowledge about the outcomes of total hip arthroplasty. This could be achieved by using qualitative methods also.

Relevance to clinical practice.  The findings can be seen as a challenge for nurses to plan patients’ education. It is also important that the outcomes of total hip arthroplasty correspond to patients’ expectations. Patients’ preoperative function should be taken into consideration when planning the timing of surgery so that the best possible outcomes were attainable.
Care dependency of children in Egypt
Authors: Tork Hanan , Dassen Theo , Lohrmann Christa
Published: August 2010

Aims.  This study aimed to modify the Care Dependency Scale so that it could be used for children, to apply its Arabic version to Egyptian children to test the reliability and validity of the modified scale and to compare the care dependency of disabled and non‐disabled Egyptian children.

Background.  A higher dependence of children in their daily tasks undoubtedly places a greater burden on their caregivers. To estimate the extent of the problem of care dependency, data from different countries and proper standard instruments are required.

Method.  The Care Dependency Scale was modified for children by Delphi technique. This study assessed the care dependency of non‐disabled children compared with children with physical and mental disabilities using the modified version of the Care Dependency Scale for paediatrics. The total sample included 260 Egyptian school‐age children (50·8% of whom were disabled and 49·2% were non‐disabled).

Results.  Reliability was examined in terms of internal consistency using Cronbach's alpha (0·91). Inter‐rater reliability revealed moderate to very good Kappa statistics between 0·57–0·89. Content validity and criterion validity were evaluated. Differences regarding care dependency were found between disabled and non‐disabled children.

Conclusion.  The psychometric properties of the Care Dependency Scale for paediatrics support its usefulness in measuring the care dependency of children in Egypt. This study provides an Arabic version of the Care Dependency Scale for paediatrics that is easy to administer and may be useful to measure the care dependency in various Arabic countries.

Relevance to clinical practice.  The findings raise concerns regarding the extent to which disabled and also non‐disabled school‐age children are care dependent leading to an increased burden of care on nurses or on caregivers in general. The Care Dependency Scale for Paediatrics can help nurses conduct an appropriate assessment of children's care dependency so that any nursing care can be planned according to the children's needs.
Construction of masculinities among men aged 85 and older in the north of Sweden
Authors: Aléx Lena , Hammarström Anne , Norberg Astrid , Lundman Berit
Published: August 2010

Aim.  The aim was to analyse the construction of masculinities among men aged 85 and older.

Background.  All societies have a gender order, constructed from multiple ideas of what is seen as feminine and masculine. As the group of men aged 85 and older is increasing in size and their demand for care will increase, we must recognize the importance of studying these men and various discourses of masculinities.

Design.  Qualitative explorative.

Methods.  Qualitative content analysis was used to analyse thematic narratives. Masculinity theories provided the point of departure for the analysis.

Results.  The analysis coalesced into three masculinities. ‘Being in the male centre’, developed from subthemes as: taking pride in one's work and economic situation; being in the centre in relation to others; regarding women as sexual objects; and belonging to a select group. ‘Striving to maintain the male facade’ developed from subthemes as: emphasizing ‘important’ connections; having feelings of loss; striving to maintain old norms and rejecting the fact of being old. ‘Being related’ was formulated from subthemes as: feeling at home with domestic duties; being concerned; accepting one's own aging; and reflecting on life.

Conclusions.  Our study indicates the importance of being aware of the existence of multiple masculinities, in contrast to the generally unproblematic and unsubtle particular healthcare approaches which consider men as simply belonging to one masculinity.

Relevance to clinical practice.  Diverse masculinities probably affect encounters between men and healthcare providers and others who work with an older population and therefore our results are of importance in a caring context.
The lived experience of losing a loved one to a sudden death in KwaZulu‐Natal, South Africa
Authors: Brysiewicz Petra
Published: August 2010

Aim.  The aim of this study was to describe the lived experiences of families in KwaZulu‐Natal, South Africa, who had lost a loved one to a sudden death.

Background.  Sudden death implies a natural or unnatural death which is unexpected; occurs without warning; and in some cases, could have been prevented. It usually occurs out of hospital, in the emergency department, or shortly after handing the client over to either critical care or operating theatre personnel. A sudden death has the capacity to leave the bereaved emotionally damaged and may exaggerate the responses to grief.

Method.  An interpretive hermeneutic phenomenological research approach was chosen for this study, as this allows the researcher to describe a phenomenon as experienced and to attempt to provide an understanding of the internal meanings of a person's experiences in the lived world.

Sample.  The sample included five bereaved family members who had lost a loved one to a sudden death and who were all members of a bereavement support group held in Durban, South Africa.

Results.  Bereaved families interviewed described five themes namely: ‘cold reception’ of the hospital staff, lack of closure, acknowledgement of loss, ‘loneliness of grief’ and helping others.

Relevance for clinical practice.  This qualitative study provides rich data regarding what bereaved family members view as important in their care during this time of crisis. The value of simple, small gestures by the health professional is enlightening. This information can be used to ensure that health professionals purposely direct their interventions and interactions with the bereaved family to ensure that they are managed in the most therapeutic way possible.
Service needs of residents in community‐based long‐term care facilities in northern Taiwan
Authors: Huang Jing‐Juin , Lin Kuan‐Chia , Li I‐Chuan
Published: August 2010

Aim.  The purpose of this study was to quantify the service needs of residents in community‐based long‐term care (LTC) facilities and to determine their predictors.

Background.  Disabled older family members in Taiwan are often eventually sent to community‐based LTC facilities. Many service needs of these residents are likely to go unmet.

Methods.  A cross‐sectional survey was used. This involved purposive sampling of 132 residents from 10 LTC facilities in Taipei City. A previously developed LTC service need assessment scale was used to collect information about the residents’ needs in terms of five kinds of LTC services, namely health education, skilled nursing services, referral services, activities of daily living (ADL) assistance and instrumental activities of daily living assistance.

Results.  The mean age of residents was 75·2 years. The average period of institutionalization was 21·93 months. Overall, 70% of the residents had either complete or partial ADL function dependency. Among the specific ADL function dependencies of the residents, inability to take a bath was the most common. The most significant predictors of service needs were health status, age, number of children, number of medical diagnoses and whether the stay is self‐choice. These combined variables explained between 25·5% and 41·6% of the variance of the need for LTC services.

Conclusion.  The findings of this study show that age, health status, number of children, number of medical diagnoses and whether the stay is self‐choice are significant determinants of residents’ needs in terms of LTC. Assessment of the extent to which facilities meet the residents’ needs is the first step in providing the most cost‐effective allocation of scarce resources.

Relevance to clinical practice.  It is suggested that, if reimbursement by the National Health Insurance system of physician visits, including psychiatric visits, to LTC facilities were allowed, this would improve quality of care.
Patients’ attitudes towards, and information needs in relation to, nurse prescribing in rheumatology
Authors: Berry Dianne , Bradlow Anthony , Courtenay Molly
Published: August 2010

Aims and objectives.  To assess the level of confidence that rheumatology patients would have in nurse prescribing, the effects on likely adherence and particular concerns that these patients have. In addition, given that information provision has been cited as a potential benefit of nurse prescribing, the present study assessed the extent to which these patients would want an explanation for the selected medicine, as well as which types of information should be included in such an explanation.

Background.  Nurse prescribing has been successfully implemented in the UK in several healthcare settings. Existing research has not addressed the effects on patients' confidence and likely adherence, nor have patients' information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction.

Methods.  Fifty‐four patients taking disease‐modifying drugs for inflammatory joint disease attending a specialist rheumatology clinic self‐completed a written questionnaire.

Results.  Patients indicated a relatively high level of confidence in nurse prescribing and stated that they would be very likely to take the selected medication. The level of concern was relatively low and the majority of concerns raised did not relate to the nurse's status. Strong support was expressed for the nurse providing an explanation for medicine choice.

Conclusion.  This research provides support for the prescription of medicines by nurses working in the area of rheumatology, the importance of nurses providing a full explanation about the selected medicines they prescribe for these patients and some indication as to which categories of information should be included.

Relevance to clinical practice.  Rheumatology patients who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood.
An observational study on the open‐system endotracheal suctioning practices of critical care nurses
Authors: Kelleher Sean , Andrews Tom
Published: August 2010

Aim and objectives.  The purpose of this study was to investigate open system endotracheal suctioning (ETS) practices of critical care nurses. Specific objectives were to examine nurses’ practices prior to, during and post‐ETS and to compare nurses’ ETS practices with current research recommendations.

Background.  ETS is a potentially harmful procedure that, if performed inappropriately or incorrectly, might result in life‐threatening complications for patients. The literature suggests that critical care nurses vary in their suctioning practices; however, the evidence is predominantly based on retrospective studies that fail to address how ETS is practiced on a daily basis.

Design and method.  In March 2005, a structured observational study was conducted using a piloted 20‐item observational schedule on two adult intensive‐care units to determine how critical care nurses (n = 45) perform ETS in their daily practice and to establish whether the current best practice recommendations for ETS are being adhered to.

Results.  The findings indicate that participants varied in their ETS practices; did not adhere to best practice suctioning recommendations; and consequently provided lower‐quality ETS treatment than expected. Significant discrepancies were observed in the participants' respiratory assessment techniques, hyperoxygenation and infection control practices, patient reassurance and the level of negative pressure used to clear secretions.

Conclusion.  The findings suggest that critical care nurses do not adhere to best practice recommendations when performing ETS. The results of this study offer an Irish/European perspective on critical care nurses’ daily suctioning practices.

Relevance to clinical practice.  As a matter of urgency, institutional policies and guidelines, which are based on current best practice recommendations, need to be developed and/or reviewed and teaching interventions developed to improve nurses’ ETS practices, particularly in regard to auscultation skills, hyperoxygenation practices, suctioning pressures and infection control measures.
Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan
Authors: Wang Tze‐Fang , Lu Chwen‐Hwa , Chen I‐Ju , Yu Shu
Published: August 2010

Aims.  We examined sexual activity and predictive factors among older people in Taipei, Taiwan. We aimed to characterize the older population engaged in sexual activity and determine influencing factors, exploring aspects of sexuality that may influence elders’ health and quality of life (QOL).

Background.  Studies of sexual attitudes and behaviour have found that sexual difficulties are common among mature adults worldwide, influenced in men and women by physical health, ageing, psychosocial and cultural factors.

Design and methods.  We conducted a community‐based retrospective study involving a random sample of 412 men and 204 women over age 65. A questionnaire on demographics and social situations was administered, along with a Sexuality Knowledge and Attitudes Scale; 34 questions evaluated sexual knowledge and 18 evaluated sexual attitudes.

Results.  Two‐hundred and twenty participants were sexually active (35·7%), 185 mainly with spouses (84·1%); frequency was 21·4 (SD 16·9) times per year (range: 1–120). Multiple logistic regressions identified five significant predictors of sexual activity: gender, age, being with spouse, sexual knowledge and sexual attitudes. Sexual activity was significantly associated with higher education levels, lower stress and more self‐reported daily activities.

Conclusions.  Our results agreed with Western studies linking sexual activity with better health and higher QOL in older adults. Older peoples’ stress and daily activity levels are recognized quality‐of‐life measures; lower stress and more daily activities among sexually active older people suggests a connection between sexual activity and higher QOL. Increasing knowledge and improving attitudes about sexuality may help older people build healthier relationships and enhance health and QOL.

Relevance to clinical practice.  If healthcare professionals possess greater understanding of older peoples’ sexuality, healthcare systems may find ways to increase sexual knowledge and foster healthier attitudes and relationships to improve older peoples’ overall health and QOL.
Falls and fall risk among nursing home residents
Authors: Fonad Edit , Wahlin Tarja‐Brita Robins , Winblad Bengt , Emami Azita , Sandmark Helene
Published: August 2010

Aim and objectives.  The aim of this study was to identify risk factors for falls in older people living in nursing homes.

Background.  Impaired cognitive function and a poor sense of orientation could lead to an increase in falls among those with impaired freedom of movement. Many accidents occur while an older person is walking or being moved.

Method.  The study was carried out over four years (2000–2003) and 21 nursing home units in five municipal homes for older people in Stockholm, Sweden, participated. A questionnaire was sent to staff nurses, including questions on fall risk assessments, falls, fractures, medication and freedom‐restricting measures, such as wheelchairs with belts and bed rails. The data were aggregated and not patient‐bound. The study covered 2343 reported incidents.

Results.  There was a significant correlation between falls and fractures (r = 0·365, p = 0·004), fall risk and use of wheelchairs (r = 0·406, p = 0·001, safety belts (r = 0·403, p = 0·001 and bed rails (r = 0·446, p = 0·000) and between the occurrence of fractures and the use of sleeping pills with benzodiazepines (r = 0·352, p = 0·005). Associations were also found between fall risk and the use of anti‐depressants (r = 0·412, p = 0·001).

Conclusion.  In clinical practice, patient safety is very important. Preventative measures should focus on risk factors associated with individuals, including their environment. Wheelchairs with safety belts and bed rails did not eliminate falls but our results support the hypothesis that they might be protective when used selectively with less anti‐depressants and sleeping pills, especially benzodiazepines.
Implementing child‐focused family nursing into routine adult psychiatric practice: hindering factors evaluated by nurses
Authors: Korhonen Teija , Vehviläinen‐Julkunen Katri , Pietilä Anna‐Maija
Published: August 2010

Aims and objectives.  The aim of this study is to describe nurses’ evaluations of factors that are hindering implementation of child‐focused family nursing (CF‐FN) into adult psychiatric practice. In addition, it explains the nurses’ evaluations of the hindering factors related to the hospital organizational structure, the individual nurse, nursing and family.

Background.  There is an increasing amount of families with dependent children in adult psychiatry. Although these families have long‐term benefits from preventive family interventions, implementation of CF‐FN is not routine mental health practice.

Design and methods.  Data were collected via a questionnaire‐survey completed by Registered Psychiatric Nurses (n = 223) and practical Mental Health Nurses (n = 88) from 45 adult psychiatric units in five Finnish university hospitals. The response rate was 51%.

Results.  Family‐related factors, such as families’ fears and lack of time, were considered as ‘most hindering’ to CF‐FN. Nurses who used a family‐centred approach and had further family education considered most of the factors as ‘less hindering’ in comparison to other nurses.

Conclusion.  To meet the needs of the families in mental health services, it is essential to develop nursing intervention methods such as CF‐FN. There is a need for further education and use of family‐centred care to develop this preventive approach.

Relevance to clinical practice.  The results of this study could be considered when developing mental health services and family interventions for families with parental mental illness.