bluuebunny/crossref_metadata_2025 huggingface dataset:
Defect in germ cells, not in supporting cells, is the cause of male infertility in the jsd mutant mouse: proliferation of spermatogonial stem cells without differentiation
Authors: Ohta Hiroshi , Yomogida Kentaro , Tadokoro Yuko , Tohda Akira , Dohmae Kayoko , Nishimune Yoshitake
Published: March 2003

C57BL/6 (B6)‐jsd/jsd male mice are sterile because of lack of spermatogenesis. To find the cause of the deficient spermatogenesis, we have examined whether the mutation phenotype is the result of a defect in germ cells or in supporting cells using germ cell transplantation. In the seminiferous tubules of B6‐jsd/jsd mutant mice, donor germ cells derived from the wild type GFP transgenic mouse (B6‐+/+GFP) were able to undergo complete spermatogenesis, indicating that the juvenile spermatogonial depletion (jsd/jsd) mouse possesses normal supporting cell functions. In contrast, undifferentiated spermatogonia derived from B6‐jsd/jsd mice were unable to differentiate in the seminiferous tubules of W/W v mice, even if the mutant germ cells successfully settled in the tubules. These results demonstrate that the deficiency in spermatogenesis of B6‐jsd/jsd mice can be ascribed to a defect in spermatogonia but not in their supporting cell environment. Furthermore, the defect in B6‐jsd/jsd spermatogonia is not in their ability to proliferate, but in their differentiation and may result from their hypersensitivity to high concentrations of androgen in the testis.
Value of the hamster oocyte test and computerised measurements of sperm motility in predicting if four or more viable embryos will be obtained in an IVF cycle
Authors: Ford W. C. L. , Williams K. M. , Harrison S. , Rees J. M. , Ray B. D. , Mclaughlin E. A. , Hull M. G. R.
Published: March 2003

The experimental group consisted of men from 81 couples waiting for in vitro fertilization (IVF), about half of whom had sperm dysfunction defined by a negative post‐coital test. A diagnostic semen sample was subjected to a hamster oocyte penetration test (HOPT) after stimulation of the acrosome reaction with A23187 ± pentoxifylline and to computerized sperm motility measurements (CASA) as well as conventional semen analysis according to the WHO protocol. Logistic regression was used to identify parameters that predicted the probability of achieving four or more viable embryos at IVF among the 65 couples from whom four or more oocytes were collected. The number of oocytes available and whether the woman had previously been pregnant (ever pregnant) were important factors but once these had been taken into account a number of sperm parameters had additional predictive power. The most useful of these were the percentage sperm static (CASA) or the percent sperm progressively motile (conventional semen analysis) in the Percoll preparation. A model incorporating the number of oocytes collected, ever pregnant and percentage sperm static achieved 85% correct prediction of outcome in the experimental dataset but only 62% correct prediction in an independent set of 280 IVF cycles. The percentage of hamster oocytes penetrated was a significant predictor but had no advantage over simple motility measurements. The results illustrate the difficulty of basing a prognosis for achieving satisfactory fertilization in IVF on the properties of spermatozoa.
CMV‐driven expression of green fluorescent protein (GFP) in male germ cells of transgenic mice and its effect on fertility
Authors: Villuendas Gema , Gutiérrez‐Adán Alfonso , Jiménez Adela , Rojo Concepción , Roldán Eduardo R. S. , Pintado Belén
Published: March 2003

To determine if the expression of green fluorescent protein (GFP) during spermatogenesis can compromise the fertility of transgenic animals, we have produced mouse transgenic lines expressing GFP in the testis under the control of the potent immediate early promoter and enhancer region of the human cytomegalovirus (CMV). GFP expression was detected in the germ cells with no apparent effect on the fertility of any of the five transgenic lines studied. We demonstrate that the CMV promoter is transcriptionally active in the testes of mice aged 7 days. However, protein could be visually detected only after day 10. GFP was not found either in mature spermatozoa or in Sertoli cells, but it was evident in round spermatids from seminiferous tubules and in cytoplasmic drops of spermatozoa from the epididymis. We also detected GFP in spermatogonia expressing c‐kit, which indicates that GFP expression driven by the CMV promoter takes place during the proliferative phase of spermatogenesis. The expression of GFP during spermatogenesis did not affect the fertility of transgenic mice.
Are germ cell factors essential in the testicular enlargement after neonatal hypothyroidism recovery? A study using W/Wv mutant mice model
Authors: Saxena D. K. , Yoshinaga K. , Tanii I. , Toshimori K.
Published: March 2003

We examined the issue of whether germ cell factors are required for testicular enlargement that occurs after recovery from neonatal hypothyroidism. Experiments were performed using W/Wv mutant mice (lacking germ cells) and normal mice (ICR). The pups in experimental group (neonatal hypothyroid) received 6 propyl 2‐thio‐uracil (PTU) treatment, administered by adding 0.1% (w/v) to the water provided to the mother from day 1 of birth through day 25 postpartum, while the pups of control group received drinking water only. Mice were sacrificed at the age of day 25, 50 and 90, in the case of ICR mice, or at day 25 and 90 in the case of W/Wv mutant mice. In both groups, early hypothyroidism caused a partial recoverable decrease in body growth and testicular development. Both ICR and W/Wv mutant mice, those recovered from neonatal hypothyroidism showed an increase in testis weights, the number of Sertoli cells, and the diameter of the semniferous tubules. This study demonstrates that neonatal hypothyroidism led recovery caused testicular enlargement not only in ICR mice but also in germ cell depleted W/Wv mutant mice. Hence these findings deny direct involvement of the germ cell factors in the process of testicular enlargement in recovered mice even in vivo, and reaffirm the notion that thyroid hormone directly regulates the dynamics of Sertoli cell maturation.
Application of a 1.48‐μm diode laser for bisecting oocytes into two identical hemizonae for the hemizona assay
Authors: Edenfeld J. , Schöpper B. , Sturm R. , Diedrich K. , Al‐Hasani S.
Published: March 2003

Laser systems are very promising new technical tools in assisted reproduction. It was investigated if laser radiation can replace the mechanical cutting procedure via micromanipulator in the hemizona assay (HZA), a commonly used bioassay to determine the sperm‐zona pellucida binding capacity. An oocyte was bisected precisely into two identical hemizonae with approximately 20 laser pulses (pulse length 30 msec) using a 1.48‐μm diode laser. Compared with the conventional method using microscalpels for zona bisection, laser treated hemizonae showed equivalent sperm‐binding and within the two groups there was no detectable difference between matching hemizonae in their capacity for tight sperm‐binding. To evaluate whether laser radiation affects the outcome of the HZA when effects of certain substances are investigated, the spermatozoa were preincubated with human follicular fluid (hFF), which inhibits the binding of spermatozoa to zona pellucida in vitro. Supplementation with follicular fluid exerted an inhibitory effect in both groups. The hemizona index (HZI) showed no statistical differences between the two methods. Therefore, the 1.48‐μm diode laser is a suitable new instrument for generating equally sized hemizonae. There is no use for holding pipettes and microscalpels, on the contrary, for performing the HZA the laser is a precise, very quick and easy to use new working tool.
Comparison of sibling oocyte outcomes after intracytoplasmic sperm injection and in vitro fertilization in severe teratozoospermic patients in the first cycle
Authors: Kihaile Paul E. , Misumi Junichi , Hirotsuru Keiko , Kumasako Yoko , Kisanga Ramzy E. , Utsunomiya Takafumi
Published: March 2003

To follow up the outcome of sibling oocytes subjected to both conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in the first cycles of severe teratozoospermic patients with normal sperm morphology (NSM)≤4%, a total of 1193 sibling metaphase II oocytes (MII) in 85 cycles were randomly allocated into two groups: 588 underwent IVF and 605 ICSI and the embryo outcomes between the two groups were compared. The fertilization rate was significantly higher in the ICSI groups than in the IVF group (p < 0.05) and fertilization failure rate in the ICSI group (2.3%) was lower than in the IVF group (28.2%). Subsequently, the rates of embryo arrest as well as grade 1 and 2 embryo formation before day 3, ≥6 cell embryos on day 3 and blastocyst formation on days 5 and 6, did not differ significantly between the two groups. There was a trend towards a high pregnancy rate cycle in mixed ICSI/IVF embryo transfer (ET) (49.1%). In conclusion, this study showed that in couples with only severe teratozoospermia, there was a benefit in subjecting sibling oocytes to both IVF and ICSI in the first cycle because 24 (28.2%) cycles of total fertilization failure were avoided. Furthermore, despite initially significant higher fertilization rates in ICSI than IVF oocytes, subsequent rates of development from ≥6 cells up to blastocyst stage were the same suggesting that ICSI should be used with caution, as after day 3, ICSI‐derived embryo development was compromised compared with IVF.
Angiogenesis modulates the tumour immune response
Authors: Griffioen Arjan W. , Tromp Selma C. , P. Hillen Harry F.
Published: March 2003

Outgrowth of solid tumors and metastases is dependent on the process of angiogenesis. Tumors escape from the formation of an effective infiltrate by downregulation of endothelial adhesion molecules. This downregulation of adhesion receptors is governed by the exposure to angiogenic factors. In recent years proof for this has been provided by demonstrating that freshly isolated tumor endothelial cells exhibit a decreased expression of ICAM‐1 and ‐2 as compared to endothelial cells in normal tissue. In addition, adhesion molecules are downregulated on normal tissue endothelial cells when cultured with angiogenesis stimulators such as basic fibroblast growth factor and vascular endothelial cell growth factor, while under these conditions endothelial cells become less responsive to cytokines such as tumor necrosis factor‐α with respect to the upregulation of endothelial adhesion molecules. Very recently it has been demonstrated that this harmful endothelial cell anergy can be counteracted by inhibitors of angiogenesis.
Hepatitis B virus (HBV)‐transgenic mice as an investigative tool to study immunopathology during HBV infection
Authors: AKBAR SK. MD. FAZLE , ONJI MORIKAZU
Published: March 2003

An overview is given regarding the use of hepatitis B virus (HBV) transgenic mice as an animal model of the HBV‐carrier state. Initially, we show how HBV‐transgenic mice have contributed insights into the immunopathobiological processes during HBV infection and later, we show how this new information from the experiments with HBV‐transgenic mice could be used to develop new methods to combat HBV infection.

By microinjecting the full or selected parts of the HBV‐genome into the fertilized eggs of inbred mice, different laboratories have developed different lines of HBV‐transgenic mice, which express products of the HBV genome and also show signs of HBV replication. Studies in HBV‐transgenic mice have provided insights into the process of destruction of hepatocytes, the critical role of cytokines in controlling HBV replication and gene expression, mechanisms underlying the immune response defect in chronic HBV‐carriers and the critical role of antigen presenting cells (APC), especially that of antigen presenting dendritic cells in persistent HBV infection. All this new information has given us a better understanding about HBV immunopathobiology, and has led to the development of new therapeutic approaches to combat HBV infection.
Nitric oxide protects the ultrastructure of pancreatic acinar cells in the course of caerulein‐induced acute pancreatitis
Authors: Andrzejewska Anna , Jurkowska Grazyna
Published: March 2003

Nitric oxide (NO) as a unique biologicalmediator that has been implicated in many physiological and pathophysiological processes may have a significant influence on the course of acute pancreatitis and the recovery process. The aim of the study was to evaluate the effect of a NO synthase inhibitor or a substrate for NO endogenous production on the ultrastructural features of the acinar cells in the course of caerulein‐induced acute pancreatitis. Acute pancreatitis was induced in the rats by a supramaximal dose of caerulein. During acute pancreatitis induction, the rats were treated with l‐arginine (the substrate for NO synthesis), NG‐nitro‐
l‐arginine (L‐NNA, NO synthase inhibitor),
l‐arginine + L‐NNA or saline. Light and electron microscopy examinations were performed in all groups after pancreatitis induction and additionally after 7 and 14 days of recovery. The study demonstrated that the NO synthase inhibitor given during pancreatitis induction in rats enhances the damage to the acinar cells, detected ultrastructurally, and increases the cellular inflammatory infiltration. In the later period, the considerable damage to the mitochondria and the changes in secretory compartment were observed, including dilated cisternae of Golgi apparatus, focal degranulation of rough endoplasmic reticulum, and reduced number of zymogen granules and condensing vacuoles.
l‐arginine reversed to some extent the deleterious effect of L‐NNA, although when administered alone it had no apparent effect on the ultrastructure of pancreatic acinar cells compared with untreated animals. The obtained results indicate that the NO synthase inhibitor enhances the ultrastructural degenerative alterations in the pancreatic acinar cells in the course of caerulein‐induced acute pancreatitis and confirm the protective role of endogenous nitric oxide in this disease.
Cigarette smoking, endothelial injury and cardiovascular disease
Authors: Michael Pittilo
Published: March 2003

Despite the fact that the epidemiological evidence linking cigarette smoking with cardiovascular disease is overwhelming, the precise components of cigarette smoke responsible for this relationship and the mechanisms by which they exert their effect have not yet been elucidated. There are however, some promising pointers as a result of recent developments and this review concentrates on new evidence since earlier reviews of this topic. It is now known that the endothelium has a vastly more important role than was ever thought to be the case a decade ago. Its role in health and disease is increasingly understood, as is the relationship between endothelial injury and the development of atherosclerosis. There is considerable evidence that cigarette smoking can result in both morphological and biochemical disturbances to the endothelium both in vivo and in cell culture systems. Cigarette smoke is a complex mixture and only a few components have been extensively studied. Nicotine and carbon monoxide are much less damaging than is whole smoke. However the free radical components of cigarette smoke have been shown to cause damage in model systems. Further work will be necessary to consolidate the evidence base but the data reported in this review suggest that the free radical components of cigarette smoke may be responsible for the morphological and functional damage to endothelium that has been observed in model systems.
Simultaneous occurrence of unusual odontodysplasia and oligodontia in the permanent dentition: report of a case
Authors: Fujiwara T. , Nakano K. , Sobue S. , Ooshima T.
Published: March 2003

Odontodysplasia is an uncommon clinicopathological condition with a variety of expressions. Although it is generally recognized as a localized disorder of dental tissue, its aetiology has not yet been well explained. In the present case, odontodysplasia with oligodontia in the permanent dentition is reported. The patient was in good health with normal stature and no other physical abnormalities. His parents and siblings were dentally and medically normal. The primary teeth appeared to be normal except for the primary second molars, where the enamel was malformed. However, the permanent incisors that had erupted into the oral cavity showed rough and hypoplastic enamel. An orthopantomogram showed 17 congenitally missing permanent teeth and malformation of the other 11 permanent teeth and tooth‐germs. Because these findings were caused by developmental disturbances of both the mesodermal and ectodermal dental components, we diagnosed the present case as odontodysplasia accompanied by oligodontia in the permanent dentition.
Nasopalatine duct cyst: A case report
Authors: Ely N. , Sheehy E.C. , McDonald F.
Published: March 2003

A case of a nasopalatine duct cyst is reported in an 8‐year‐old. The clinical presentation was of intermittent palatal swelling and the diagnosis was confirmed with radiological and histological examination. This type of cyst is rare in children and should not be excluded from a differential diagnosis in younger age groups.
Pattern of soft tissue injuries to the oro‐facial region in Nigerian children attending a teaching hospital
Authors: Oginni F. O. , Fagade O. O. , Akinwande J. A. , Arole G. F. , Odusanya S. A.
Published: March 2003

Summary. Objective. This study was designed to determine the aetiological factors and pattern of oro‐facial soft tissue injuries among children in a suburban Nigerian population. The problems encountered in the management of the patients are also highlighted.

Setting. Obafemi Awolowo University Teaching Hospitals’ Complex, Ile‐Ife, Osun State Nigeria.

Sample and methods. This prospective study was carried out in children aged ≤ 15 years who presented with oro‐facial soft tissue injuries between July 1996 and December 1997. Data was collected from a clinical examination of the child and a questionnaire completed by the parent or carer.

Results. During the study period, 174 children were managed for oro‐facial soft tissue injuries, an incidence of 1·1%, out of a total of 15 582 child admissions. A male preponderance was found (1 : 0·74). The mean age ± SD was 7·3 ± 4·2 years and the range was 9 months–15 years. Falls were the most common aetiology followed by road traffic accident. The forehead was the most frequently injured site. A mortality of 3·4% was found. Although animal bites and burns accounted for only 13·8% of all injuries, all the deaths were a result of these aetiologies. Road traffic accidents and burn victims had the longest hospital stay.

Conclusion. Although falls and road traffic accidents are frequent causes of oro‐facial soft tissue injuries, less common causes, like burns and dog bites are more likely to result in death.
A therapeutic group for clients with acute mental health problems
Authors: Glenister David A
Published: March 2003

A therapeutic group for clients with acute mental health problems is described using a case study research design The setting of the group is a British community mental health centre Theoretical and research approaches to brief therapeutic work with clients are discussed Results include qualitative descriptions of the group from the perspective of various respondents and quantitative descriptions of client attendance The group was evaluated positively by respondents and high attendance rates indicated that the group met clients’ needs The group was primarily utilized by professionals as an addition to present services rather than as an alternative to in‐patient hospitalization However, m practice many of the clients needed some degree of professional support after ceasing to attend the group In this study, the establishment of a therapeutic group for clients with acute mental health problems improved inter‐professional relations The ability to facilitate therapeutic groups is an important competence for mental health nurses
Career paths revisited: the experiences of graduates in nursing who no longer work full‐time
Authors: Kemp Joan
Published: March 2003

Reports on the progress of British graduates in nursing focus on their early careers, when they are employed full‐time Part‐time and non‐employment is not discussed This paper draws upon a longitudinal study, which began in 1981, to describe the cause and effect of graduates leaving full‐time employment The experiences of 45 female graduates in nursing from the University of Hull show that departure from full‐time employment is associated especially with the establishment of a stable relationship, with child‐rearing and, to a lesser extent, time for personal development
The function of home visits in maternal and child welfare as evaluated by service providers and users
Authors: Vehvilämen‐Julkunen Katri
Published: March 2003

This study looks at how public health nurses and clients of maternal and child welfare clinics evaluate the function and meaning of home visits Another concern is with the options available to the service user The data were collected during November and December 1992 from a total of 203 health centres across Finland, responses were obtained from 263 public health nurses and 323 clients The results are presented in the form of frequencies, percentages and cross tabulations According to the results, the clients felt that the most important function of home visits was to have a competent professional examination of the newborn They also attached much importance to the information function, i e learning about the growth and care of small children The public health nurses, on the other hand, felt that the most important function of home visits was to support and encourage parents and to ensure the continuity of care The advantages of meeting in the client's home environment were equally stressed by both sides By contrast, clients and public health nurses had very different views on the options available to the client Almost all nurses said that the client can freely choose between home visits and visiting the clinic, however, only about half the clients felt they could choose the service they best preferred
The student nurse selection experience: a qualitative study
Authors: Land Lucy M
Published: March 2003

A qualitative study was undertaken to explore the experiences of student nurses recruited to three British colleges of nursing A series of focus groups was initiated to discuss the career decisions surrounding their entry into nursing and their expenences of the selection interview Similar groups were conducted with those who are involved in the selection of candidates for nursing to determine what influenced their decisions to accept or reject people Analysis of the data suggests that nursing is attracting people from careers that are unstable or unsatisfactory Selection procedures are outdated and inconsistent and interviewees quickly learn to provide appropriate responses There is confusion surrounding the skills and qualities required of potential nurses, and more effective recruitment strategies might attract potential undergraduates without losing those with vocational aspirations A more systematic approach to selection, using a range of objective, measurable criteria, may remove the intuitive selection of nurses, increasing the efficiency of the selection process
The process of learning in dementia‐carer support programmes: some preliminary observations
Authors: Coates David
Published: March 2003

Theories of experiential learning, notably the theory of andragogy, can be used to elucidate the process of learning in dementia‐carer support programmes Such theories attach importance to the positive influence of life experience and maturity, and to the salience of personal issues, but their appropriateness needs to be critically analysed Stress is a common manifestation among dementia carers and its presence can significantly affect openness to learning As a result of recent policy changes and of demographic shifts, nurses are likely to be increasingly involved in carer support programmes They need to be aware of the complex issues addressed in this paper
Understanding barriers to basing nursing practice upon research: a communication model approach
Authors: Brown Gary D
Published: March 2003

It is suggested in this paper that the potential barriers to facilitating research‐based practice can be comprehensively understood using a communication model approach Barriers can thus be explored related to the research findings' message, to the ways in which this message is encoded and transmitted by nurse researchers and to the ways in which the message is received, interpreted and accepted by nurse practitioners The role of research‐based practice as a communication feedback mechanism is also described The paper concludes by proposing that strategies for increasing the research base of our profession are more likely to be successful if all of these potential barriers are taken into account
The process of analysis during a grounded theory study of men during their partners' pregnancies
Authors: Donovan Jenny
Published: March 2003

This research builds on the work of Barclay (1993) who studied couples during pregnancy and discovered that there was a mismatch between sexual interest levels of men and women during pregnancy As well, little is known about the social and emotional experiences of men during their partners' pregnancies One antenatal group consisting of six men, whose partners were in the second trimester of pregnancy, attended a series of five meetings and subsequent individual interviews Additional data and insights were gained by the researcher and the research assistant attending other antenatal classes with men and women present The research data consisted of transcripts of tape‐recorded interviews, group discussions, observations and field notes made by the researcher and co‐leader following each of the group sessions The aim was systematically to develop a substantive grounded theory which was drawn from the experiences of the men during this transitional period in their lives This paper discusses the process of analysis which led to the central phenomenon, the core category of the research, around which the grounded theory is built Five theoretical constructs emerged from the data collected (a) ambivalence in the early stages of pregnancy, (b) relationship with baby not real, (c) how should I be as a father?, (d) coping with the changing roles and lifestyle, and (e) disequilibrium in relationship with female partner The last construct emerged as the basic social process The nature of this relationship changed over the duration of the pregnancy Emotional turmoil and anxiety in men contributed to the ‘mismatch’ in male and female expectations of the relationship The findings of the research suggested that current antenatal classes did not meet the needs of the male partner It appears that if men and women were informed early in the pregnancy that ambivalence, anxiety and increased tension were common experiences during pregnancy then they could get on with the business of working out how they might effectively deal with these changes
Nursing faculty practice: challenges for the future
Authors: Martin Linda Moore
Published: March 2003

Just as artists need to create their own art, so nursing instructors need to practise nursing However, traditional educational settings and clinical placements limit the capacity of nursing instructors to practise nursing directly with clients The creation of a nursing faculty practice model in Canada, whereby teaching roles and responsibilities are combined with clinical practice, is discussed within the context of a community college environment A nurse‐managed health centre is suggested as an innovative practice arena which is more in line with the changes in the health care system
Implementation of community care policy in the United Kingdom: will it be achieved?
Authors: Tmobranski Philippa H
Published: March 2003

In the United Kingdom, the provision of health and social care within the community is the subject of major reform This reform is aimed at reducing the dominance of the state as provider of welfare services whilst encouraging the independent sector to provide the bulk of services through competition and market forces The purpose of this paper is to discuss the implementation of government policy with respect to health and social care in the community The policy recommended in the 1989 White Paper Caring for People, which is sanctioned in the National Health Service (NHS) and Community Care Act (1990), is the focus for discussion Implementation theory is used as a framework to explore the modification and reshaping which inevitably accompanies the translation of government policy into reality The nature of any actual or potential deficit between stated policy and community care reform in practice is examined against this theoretical background An historical stance is taken in order to place current policy into the wider context and consider what determinants may have led to the radical proposals for community care, and indeed other sectors of public service A consideration of predominating philosophies is prudent to an analysis of government policy‐making and therefore the values and beliefs of ‘new public management’ are employed as a conceptual framework underpinning current reform The feasibility of a quasi‐market in the delivery of health and social care is considered and some of the main issues which may result in implementation deficit with respect to the implementation of Caring for People are examined
The practice nurse: roles and perceptions
Authors: Mackereth C J
Published: March 2003

In the winter of 1992, a postal survey was conducted on all practice nurses in Gateshead, England The aim of the research was to descnbe the work of practice nurses (nurses working with and employed by general practitioners), with particular reference to health promotion and communication, and to explore the practice nurses’ perceptions of their roles The research found little conformity about what practice nurses do, apart from practical tasks This confirms the essentially practical nature of their work, with poor role definition with regard to screening, health promotion and prevention Training was found to vary, indicating a need for improvement Women's health and surveillance of the health of elderly people were used to illustrate these issues A wide consensus was found about what tasks are appropriate to practice nurses, indicating either that the list of tasks used in the survey accurately describes their potential role or that they are prepared to perform most tasks Practice nurses perceive themselves as the specialists in health promotion although it was not possible to gain an understanding of whether they had a conception of the wider issues involved, which illustrated a limitation of survey methods The information obtained will be relevant in the debate about the future of practice nurses, as well as the future of primary health care services in general
Sociology and the nursing curriculum: a defence
Authors: Porter Sam
Published: March 2003

This paper is a response to Keith Sharp's (1994) argument in the Journal of Advanced Nursing that sociology cannot in principle provide a knowledge base for nursing work The aim here is to reassert the appropriateness of including sociology in the nursing curriculum Three arguments put forward by Sharp are engaged with First, he questions nursing's need for any theoretical basis at all This hypothesis is rejected on the grounds that any occupation that is involved in complex decision‐making requires some sort of theoretical guidance Second, Sharp argues that the multi‐paradigmatic nature of sociology makes it inappropriate for nurses who require more certain knowledge as a basis for their‐actions Two responses to this argument are made first, that the fissures within sociology are not as great as Sharp portrays them and, second, that nurses possess adequate criteria to be able to judge between different sociological propositions Sharp's final argument is that the reflexive approach of sociology is an inappropriate way of thinking for nurses, whose approach is instrumental In reply, it is noted that Sharp's instrumental model of nursing action does not adequately reflect the manner in which nurses interact with patients, and that ‘new nursing’ practices require reflexivity on the part of the nurse
The origins of insane asylums in England during the 19th century: a brief sociological review
Authors: Symonds Bob
Published: March 2003

This paper explores the origins of insane asylums in 19th century England by comparing the official ‘received’ medically dominated perspective with an alternative sociological perspective The major structural changes in provision are addressed as the focus for analysing the differing histories A brief review is presented of the responses to insane people prior to the national asylum programme following the 1845 Lunacy Act, and of the reform logic that underpinned asylum care The alternative sociological perspective presents the origins of psychiatric asylums as part of the social and economic changes occuring generally at that time As such the origins of insane asylums are presented as part of a state‐guided ‘sanitary’movement which included poor, criminal and insane people within its remit The effect of state‐guided correction was the segregation of insane people from both the general population and other deviants who were formerly classed together Insane people are thus presented as a group of deviants who departed most radically from the ‘rational individualist’ qualities of self‐control, predictability and responsibility required in the industrialized world of capital social relations that emerged during the last century
The paediatric oncology community nurse specialist: the influence of employment location and funders on models of practice
Authors: Hunt Jane A
Published: March 2003

A specialist nursing service has evolved in recent years, to care for children with cancer or leukaemia and their families, and co‐ordinate care in the community These paediatric oncology community nurse specialists (POCNS) are mostly based at regional children's cancer treatment centres, although some are based within paediatric units of district general hospitals In addition to the National Health Service (NHS), a major source of funding has been provided from a range of charities This paper examines the impact that the employment location (regional or district) and funding sources have on the process, practice and structure of nursing within the speciality All 43 POCNSs were interviewed from 28 different hospitals across the United Kingdom and Eire Thirty‐one were based at regional treatment centres, whilst 12 were from district general hospitals Funding was provided by the NHS (9), Cancer and Leukaemia in Childhood (CLIC) (10), Cancer Relief Macmillan Fund (5), and other charities (19) Major differences were found according to the location of POGNSs, i e the regional model and the district model, and according to funders, I e the Macmillan model, the CLIC model and the ‘other funders’ model This research suggests that both funding source and location of POCNSs have implications for nursing practice
The politics of nursing: a case study–clinical grading
Authors: Gavin James Noel
Published: March 2003

This paper is a study of the clinical grading policy for nurses in the United Kingdom and the extent to which the participating groups in the policy development process realized then objectives The study is based on the literature available at the time of the research and the results of structured interviews with a range of individuals involved in the policy process The results expose the cleavages between the different representative groups on the staff side They also shed light on the differing power bases of the groups involved In particular, they expose the weakness of nursing as a professional pressure group and the strength of the state and its agents in determining the outcomes of policy in the public arena It is suggested that this weakness vis‐à‐vis the state is responsible for the failure of nurses to achieve a reward system which recognizes the value of clinical nursing expertise, and that the ‘clinical grading’ system, in practice, is having the opposite effect The policy is explored from its origins, its acceptance on to the political agenda, its negotiation and agreement, its contentious implementation, the final outcomes, and its failure to establish a valid‘clinical’pay structure
The cost of registered nurse‐midwifery education in Malawi
Authors: Namate Dorothy E
Published: March 2003

Educational institutions are challenged to produce more graduates with few resources in current sub‐Saharan Africa In such an environment, it is critical that cost information pertaining to nursing education be available to assist nursing education programmes in meeting the challenges of producing more nurse‐midwives with less cost This study explores the cost of registered nurse‐midwifery education and describes factors which influence the cost of such education in Malawi Results demonstrate that nursing education is costly, be it in a developing or developed country The findings on cost of nurse‐midwifery education have implications for policies related to the overall educational planning for the supply of registered nurse‐midwives, the efficiency of nursing education programmes, the organization of nursing education curricula and the sharing of cost of education among the government, students, their families, and other sources
Nurses’ perceptions of the impact of continuing professional education on the quality of nursing care*
Authors: Hogston Richard
Published: March 2003

The purpose of this study was to understand what impact nurses perceived continuing professional education (CPE) to have on the quality of nursing care Given that CPE will become mandatory once the necessary legislation has been implemented, the value and worth of CPE with regard to the quality of nursing care, in both a consumer‐led and financially‐driven NHS, merits serious consideration Little research has been conducted into the real impact that CPE has on the quality of nursing care and this paper begins by providing an overview of the current debate within the profession The method chosen for the study was qualitative and 18 nurses from a large hospital in the South of England were interviewed The data were analysed using the grounded theory method and three categories emerged The categories are descnbed in detail and reveal some of the problems with which the nursing profession is faced The study demonstrates how issues of finance were particularly high, with service managers sometimes negating nurses’ CPE needs However, the study reveals the real importance that nurses attatched to CPE in supporting their professional status and the real impact that CPE and knowledge have on professional competence and the quality of patient care
HIV and homophobia: nurses as advocates
Authors: Mackereth Peter A
Published: March 2003

Nurses are frequently encouraged in colleges of nursing and professional journals to consider themselves as ideally placed to act as advocates for vulnerable patients This paper sets out to challenge this assumption in the light of the stigma and discrimination experienced by people affected by HIV and AIDS Sexuality and in particular homophobia — the fear and aversion of gay and lesbian behaviour — need to be addressed by the nursing profession The paper considers concerns about and evidence of discrimination in the light of nurses’ claim to be best placed to adopt the role of advocate in representing any patient's health care needs It is argued that such an assumption is problematical in the face of homophobia and fears around contagion
The health belief model and use of accident and emergency services by the general public
Authors: Walsh Mike
Published: March 2003

There has been much debate about the use made by the general public of accident and emergency services A strong element of professional dissaproval has been present, as shown by phrases such as ‘inappropriate attender’ This paper examines the reasons why people attend accident and emergency and the factors that delay or accelerate attendance, utilizing a framework espoused in the medical sociology literature, i e the Health Belief Model This predicts that individuals carry out a treatment cost‐benefit analysis when making decisions about seeking medical assistance A sample of 200 adult, ambulatory accident and emergency patients was interviewed whilst waiting to see the casualty officer for this study The data demonstrated that much of the medical, sociological literature concerning patient consultation with doctors is applicable to the accident and emergency situation, in particularthe Health Belief Model A range of factors was shown to make statistically significant differences to the delay times involved in deciding to attend accident and emergency and the time it took to then subsequently attend and register as a patient These factors also fit the cost‐benefit analysis which the Health Benefit Model predicts takes place Accident and emergency attendance therefore needs to be seen as a logical decision‐making process thatrequires hospitals to provide appropriate services, rather than merely labelling the patients as inappropriate
Short or long consultations? Primary care nurses’ considerations in making appointments with general practitioners
Authors: Andersson Sven‐Olof , Hallberg Hans , Norstrom Viveka
Published: March 2003

In Sweden primary care nurses (PCNs) at the health centres (HCs) manage the appointment systems and decide the appointed length of general practice consultation time This study aims at elucidating experienced PCNs’ considerations in booking consultations of different lengths The grounds for giving long or short appointments were searched for Qualitative methods were used and 10 PCNs at eight HCs in Umeå Health District in northern Sweden were interviewed The PCNs take factors from two areas into consideration, one area, often immediately apparent, concerns immediate and straightforward issues such as the patient's reported problem, the patient her/himself, the doctor her/himself and the current situation at the HC and in the catchment area The other area for consideration usually develops through experience over the years and concerns time consumption in a longer perspective The overall quality of the consultations is then in focus and the length of a separate consultation is of minor interest The PCNs do not applicate a straightforward relation between length of time and quality of consultations Experienced PCNs seem to promote accessibility of primary care and their efforts in allocating time in a practical way probably increase the quality of general practice consultation
Addressing barriers: disabled rights and the implications for nursing of the social construct of disability
Authors: Richardson Malcolm
Published: March 2003

Drawing upon the writings of disabled people, this paper explores some of the issues which nurses working with disabled people are trying to address, in particular the barriers model of afflicting the individual, hence the response to disability has been via the charity, health and welfare systems. Disabled people over the past two decades have substantially challenged; this view of disability and the responses it prompts, arguing the disability is created by social barriers and barriers in the built environment. This requires a different response. Nurses working with disabled people, such as learning disability Nurses, have struggled to develop more appropriate responses to disability, for example by developing working alliances with people with learning difficulties in order to both promote health and address disabling barriers. The issues these nurses face and some of the lessons disabled people have taught them are relevant to the nursing profession's wider struggle to shed its medical and dependency image.
A telephone survey of day‐surgery eye patients
Authors: Law Mei‐Lin
Published: March 2003

The objective of this research study was to evaluate the nursing care processes and patient satisfaction with the new day‐surgery services. Forty‐five adult day‐surgery eye Patients were selected at random to take part in a telephone survey. The response rate was 84·4% (38). Patients were contacted 48 hours post‐surgery to obtain their view of the entire surgical experience. The research result found that the majority of the patients were satisfied with the day‐surgery services. The main problems experienced by patients were long waiting times to see the doctor during pre‐operation assessment, unsatisfactory journeys to and from theatre, and difficulty in remembering verbal advice. Twenty‐eight (73·6%) of the day‐surgery patients would prefer day‐surgery again for a similar operation, but 10 (26·3%) would prefer a longer stay in hospital. The main implications for practice are that realistic assessment time should be allocated to reduces waiting time, verbal advice should be accompanied by written leaflets or audio‐tape, and patients should be encouraged to make an informed choice about day or in‐patient surgery. A Regular survey of day‐surgery eye patients should be part of a general audit.
‘Becoming a mother’— developing a new theory of early motherhood
Authors: Rogan Frances , Shimed Virginia , Barclay Lesley , Everitt Louise , Wylli Aileen
Published: March 2003

This paper explains the methods used in a grounded theory analysis of the experience of 55 first‐time mothers in Australia, presented in the first of this series of two papers. The categories identified in the research are realising, readiness, drained, aloneness, loss and working it out, encompassed in the core category becoming a mother. Specifically, this paper extends the analysis and explains the application of a‘paradigm model’ and the identification of a Basic Social Process (BSP). The paper links the analysis to the literature on early motherhood from nusing, midwifery, feminist, and sociological research. A substantive theory is proposed to explain women's experience in becoming mothers that demonstrates how, when responsive to the needs of those researched, a grounded theory analysis can provide a framework for nursing and midwifery care.
HIV and AIDS awareness: an evaluation of a short training programme for midwives
Authors: Bennett Clare , Weale Alan
Published: March 2003

In response to a Department of Health, England, circular encouraging policies of named voluntary antenatal HIV antibody testing, one West Midlands health authority in England introduced a policy of raising the issue proactively at the first antenatal attendance. In order to facilitate this policy a short staff education programme was provided for midwives. This paper reports on part of a study which aimed to evaluate the impact of the HIV awareness training programme. A sample of midwives (n= 65) was randomly selected for inclusion in the study. Thirty‐three had attended training and 32 had not. Data were collected using a self‐administered questionnaire exploring knowledge of aetiology of HIV/AIDS, knowledge of transmission, knowledge of obstetric and paediatric HIV, attitudes to HIV, issues related to antenatal HIV antibody testing and opinions about the HIV awareness training programme. Results indicated no significant difference in levels of knowledge or in attitude between those who had attended the training programme and those who had not. Similarly, no significant difference was found in terms of how midwives would react to women requesting HIV antibody testing. Many of the results contradict the current literature and as a conclusion it is suggested that there is a need to review HIV‐related training for midwives.