bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of the temperature increase rate on the accuracy of diffusion parameters estimated under non‐isothermal conditions
Authors: Brandão Teresa R. S. , Oliveira Fernanda A. R.
Published: November 2003

The accuracy of the diffusion parameters estimated under non‐isothermal conditions was studied using computer‐generated pseudo‐experimental points. The data sets were obtained from Fick's 2nd law and an Arrhenius‐type temperature dependence of the diffusivity. A normally distributed error was randomly attributed to the model data. The pseudo‐experimental points thus obtained were then fitted to the model equation, with non‐linear regression using the Simplex algorithm, yielding the estimates of the pre‐exponential factor and activation energy. Several linear temperature profiles were studied, from 0.014 to 16°C min−1. It was concluded that the accuracy of the parameters estimation depends on the temperature increase rate. The effects of the pre‐exponential factor, the activation energy, the range of temperature and the magnitude of the experimental error on the value of the temperature increase rate that led to maximum accuracy of the parameters estimates were also studied.
The influence of mash pre‐aging on the development of the flavour‐active compound, 4‐hydroxy‐2(or5)‐ethyl‐5(or2)‐methyl‐3(2H)‐furanone (HEMF), during soy sauce fermentation
Authors: Hayashida Yasuo , Nishimura Kenryo , Slaughter J. Colin
Published: November 2003

Inoculation of Zygosaccharomyces rouxii into a soy sauce mash free from lactic acid bacteria at 106 cells mL−1 resulted in the formation of the flavour‐active compound HEMF over a number of days at 30°C. Delays in inoculation up to 14 days after production of the mash greatly increased the amount of HEMF formed and under some conditions concentrations in the commercial range were achieved without addition of any other microorganisms.
Scaling approach to water sorption isotherms of hydrogels and foods
Authors: Mizrahi Shimon , Ramon Ory , Silberberg‐Bouhnik Miriam , Eichler Sigal , Cohen Yachin
Published: November 2003

Mechanisms affecting water sorption isotherms of foods, at high water activities, were evaluated by the processes of swelling and shrinking of model systems of uncharged and charged hydrogels. Their water activity was found to be determined by the combined effect of their osmotic pressure and the network pressure of the polymeric network. The scaling approach in polymer science indicates that in an uncharged network the osmotic pressure is affected by the mobility of the polymer segments and thus by the degree of cross‐linking. However, in charged gels, which behave in a similar manner to many food systems, the counterions play the dominant role in determining the osmotic pressure. The network pressure may shift from a positive to a negative value during shrinking (dehydration), thus counteracting or co‐operating with the osmotic pressure in decreasing the water activity. A scaling sorption isotherm, at high water activity, is formulated for a food system with physically significant parameters.
Analysis of operating strategies in the production of special foods in vials by freeze drying
Authors: Lombraña José I. , De Elvira Carlos , Villaran María C.
Published: November 2003

A finite element model (FEM) with axial symmetry conditions and isoparametric elements was applied to the freeze drying of special foods in vials. The model was verified by experiments using a methyl cellulose test material. The model was used to simulate and evaluate various heating strategies in freeze drying in order to reduce drying cycles and increase process efficiency. The effect of sublimation front temperature and freeze drying periods on the process duration was analysed.
Effect of frozen storage on deep‐fat fried breaded onion rings
Authors: Gennadios Aristippos , Hanna Milford A. , Ling Du
Published: November 2003

Freshly fried and frozen breaded onion rings with and without in‐pack dessicant were compared with freshly fried similar rings for moisture content of onion and for moisture content, colour and shear force/toughness of the coating. Moisture migration from onion to coating during freezing/storage/thawing increased significantly without dessicant, but did not remain in the coating with dessicant. Significant moisture loss/juiciness occurred from the onion in both frozen packs, and neither procedure was satisfactory.
Effect of fermentation and drying conditions on the quality of rooibos tea
Authors: Joubert Elizabeth , De Villiers Ockert T.
Published: November 2003

The effect of fermentation (30°, 34°, 38° and 42°C) and drying temperatures (40°, 50°, 60° and 70°C), as well as the effect of controlled drying as opposed to sun‐drying on rooibos tea quality were investigated. The quality of rooibos tea improved with increasing fermentation temperature whereas quality decreased with increasing drying temperature (P < 0.05). No significant subjective quality difference between the two drying methods was obtained. Tea dried under controlled conditions was lighter in colour than sun‐dried rooibos tea (P= 0.003) as indicated by higher L* values. The chromaticity parameters (a* and b*) were not significantly affected by drying under controlled conditions. Less chlorophyll was present in sun‐dried tea than in tea dried under controlled conditions. The colour of tea prepared under experimental conditions was comparable with the colour of commercially‐produced rooibos tea samples.
Effect of ‘ropy’ strains of Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus on rheology of stirred yogurt
Authors: Rawson Helen L. , Marshall Valerie M.
Published: November 2003

The TA‐TX2 Texture Analyser and the Brookfield RVT Viscometer have been used to investigate the contribution of ropiness to the texture of stirred yogurts made using ropy strains of bacteria. Back extrusion and texture profile analysis, not commonly used to quantify rheological properties of semi‐solid foods, have been found useful in distinguishing the contribution of exopolysaccharides to different texture attributes (Toba et al., 1990). Thus ropiness, a characteristic which is imparted to the product as a result of fermentation with particular polysaccharide‐producing strains, contributes to ‘adhesiveness’, while ‘firmness’ and ‘elasticity’ are likely to be influenced more by the protein matrix of the yogurt than by secretion of the polysaccharide by the ropy strains. Effects on viscosity and ability to recover viscosity after disruption were apparent, although the contribution of ropiness was not always positive. Ropy strains increased viscosity of stirred yogurts when compared to yogurt made with non‐ropy cultures. But, whilst a ropy Lactobacillus delbrueckii ssp. bulgaricus (Lb r+) combined with a non‐ropy Streptococcus thermophilus (St r−) produced a viscous product which recovered its viscosity well, a yogurt made by combining both ropy strains did not recover its viscosity as well as yogurt made by combining two non‐ropy cultures and lost its structure more rapidly during the destructive testing. These results show therefore that inclusion of a ropy strain will not always lead to improved texture attributes, that while ropy strains may increase viscosity they may not influence ‘firmness’ and lend support to the view that this latter attribute is more influenced by protein–protein interactions.
Seasonal changes and preliminary characterization of cathepsin D‐like activity in sardine (Sardina pilchardus) muscle
Authors: Gómez‐Guillén M. Carmen , Batista Irineu
Published: November 2003

The seasonal changes of cathepsin D‐like activity in white and dark muscle of sardine were followed and maximum activity was found in April and October, which could be related to the spawning period of this species. Higher catheptic activity was measured in dark muscle and females. The crude extract of this muscle enzyme had an optimum pH and temperature of 3.2 and 55 °C, respectively, and the activity was strongly inhibited by low levels of NaCl (6%). The thermal stability was lower at pH 3.2 than at pH 6.5 and the enzyme was stable in the pH range 3–4.5. The activity of this protease was detected during the ripening process of salted sardine which suggests its participation in this process.
Velocity field in a twin‐screw extruder
Authors: Bakalis Serafim , Karwe Mukund V.
Published: November 2003

Velocity measurements inside the screw channels of a co‐rotating, self‐wiping, twin‐screw extruder were carried out. A laser Doppler anemometer (LDA) system was used to measure tangential and axial velocity components in the translational region of one of the screws of a twin‐screw extruder. The velocity measurements were carried out using heavy corn syrup at different screw speeds and for two forwards conveying elements differing in their pitch. It was found that velocity profiles in the translational region were substantially affected by the pitch of the screw element, however, screw speed (30–90 r.p.m.) did not have a significant effect on the shape of the velocity profiles. The range of velocity values in a 14 mm pitch screw element was wider than that in a 28 mm pitch screw element. Experimentally measured velocity profiles were compared with predictions of a one‐dimensional model, which showed that the model underpredicted the velocity values, for the 14 mm pitch element.
Paddy husk support and rice bran for the production of glucoamylase by Aspergillus niger
Authors: Arasaratnam Vasanthy , Mylvaganam Ketheeswary , Balasubramaniam Kandiah
Published: November 2003

Aspergillus niger CFTRI 1105 was cultivated on solid medium for glucoamylase production. Glucoamylase activity obtained was 83.7 U g−1 DFR (Dry Fermentation Residue) in a medium containing rice bran (100 g), corn flour (2 g), stock mineral solution (10 mL) and tap water (90 mL). When corn flour (2 g) in the medium was substituted with soya flour (2 g) no significant increase in glucoamylase was observed. The effects of soya flour, urea and peptone at the same elemental nitrogen concentration as with corn flour as carbon source on glucoamylase production were investigated. Supplementation with soya flour gave the highest glucoamylase activity (121 U g−1 DFR) at 72 h and addition of paddy husk to a medium containing corn and soya flour altered the enzyme production from 121 U g−1 DFR to 71.3 U g−1 DFR. Addition of gingili oil and coconut oil to the medium caused no improvement in glucoamylase production.
Influence of processing on the extension of shelf‐life of Nagli‐fish (Sillago sihama) by gamma radiation
Authors: Ahmed Ismail O. , Alur Madhavesh D. , Kamat Annapurna S. , Bandekar Jayant R. , Thomas Paul
Published: November 2003

Studies were carried out to evaluate the microbiological profile, shelf‐life and quality of Nagli fish (Sillago sihama) subjected to gamma irradiation. Non‐irradiated samples were unacceptable organoleptically after 7–8 days of storage at 1–2°C while irradiated samples (2 and 3 kGy) were acceptable up to 19 days. Dressing prior to irradiation had no additional advantage to shelf‐life over whole fish. Total bacterial count (TBC), total volatile basic nitrogen (TVBN), trimethylamine (TMA) and sensory evaluation data revealed no significant differences between whole and dressed fish. Salmonella sp. were not detected in 3 kGy‐irradiated samples whereas 2 kGy destroyed Vibrio parahaemolyticus and Staphylococcus aureus. Listeria monocytogenes and Yersinia enterocolitica were not detected but non‐pathogenic species such as L. grayi, L. murrayi, and Y. tuberculosis were present in the fish prior to irradiation. Irradiation doses of 2 and 3 kGy destroyed Yersinia sp. and Listeria sp., respectively. These organisms were not detected during storage of the treated fish.
Clinical guidelines: an introduction to their development and implementation
Authors: Duff L A , Kitson A L , Seers K , Humphris D
Published: November 2003

There is a great deal of interest in the United Kingdom in clinical guidelines as a means of assisting practitioner and patient decision making about care options and in improving the quality of the care provided Confusion remains, however, over what is meant by a clinical guideline and how it differs from and relates to protocols and standards This paper was written under the auspices of the Royal College of Nursing Steering Group for the college's work on clinical guidelines, with the aim of clarifying some of the terminology used in the field and introducing ways in which clinical guidelines might be used by practitioners and patients to readers At the moment just how effective the use of clinical guidelines can be on care is poorly established What is known, however, is that crucial to their success are the strategies and methods used for their implementation Such strategies and methods raise questions about how a sense of ownership can be engendered in those using the clinical guidelines and how they may be best operationalized These questions are considered in this paper
Entry age, entry mode and academic performance on a Project 2000 common foundation programme
Authors: Houltram Brian
Published: November 2003

With the increasing academic expectations in the United Kingdom arising from the demands of the recently‐introduced Diploma in Higher Education/ Registration course (Project 2000) and with fairly substantial proportions of both unqualified (DC test) and mature entrants being admitted onto the course, a study was carried out into the relationship between entry age, entry qualifications and academic performance on the common foundation programme, which lasts for the first 18 months of the course The entry data and common foundation programme results of each student from the first three intakes, 258 in total, were reviewed A different subject design was used for the study m which students were placed into one of four groups, according to entry age and entry qualifications, which were (a) 17‐21 conventional entry requirements met, (b) 22 + conventional entry requirements met, (c) 17‐21 unqualified (DC test entrant), and (d) 22 + unqualified (DC test entrant) Results indicated that the performance of most mature students, whether qualified or not, was above average, with the qualified group securing the best results of any of the four groups Among the 17‐21 age group, while the qualified performed as expected, the unqualified performed the worst of any of the four groups, registering both a high discontinuation rate and low overall mean scores for the programme No improvement in the relative performance of the 17‐21 unqualified group was noted over the three cohorts and there were indications that under‐performance among the unqualified group extended beyond the 17‐21 age range In terms of recruitment, results could indicate a need for a change m policy, with evidence of proven academic ability being required from all younger applicants If continued recruitment of unqualified younger students is planned, then a more vigorously targeted policy of academic support and guidance for these students will be required Without this, it seems likely that poor performance and high wastage among this group will continue
The clinical role of the nurse teacher: a review of the dispute
Authors: Lee Diana TF
Published: November 2003

Although clinical education has been acknowledged as being the ‘heart’ of all nursing education programmes, the role of the nurse teacher in relation to the clinical learning experience of the student nurse is an area of long‐standing confusion and dispute This unresolved problem has led to the lack of a concerted effort in the provision of educational input in the clinical area and the quality of patient care is indirectly being affected This paper presents a comprehensive review of this dispute, with an attempt to unravel how the debate could be moved forward It is found that the clinical role of the nurse teacher appears to be implicit and ‘hidden’, resulting in a wide difference in the interpretation of the extent, purpose and nature of that role The controversies surrounding these issues were then traced and possible directions for future research are outlined
Teacher‐induced counter‐transference in clinical teaching
Authors: Paterson Barbara , Groening Marlee
Published: November 2003

Although it is acknowledged that clinical teaching is an interpersonal process that is relational in nature, little has been written regarding the conflicts and feelings that can exist within the student‐teacher relationship The article is a discussion of the concept of countertransference in psychotherapy, specifically as to how it may be applied to understanding clinical teachers'subjective responses to students The authors present arguments to support the fit between the concept of countertransference and clinical teaching, focusing on the negative effects of a teacher's countertransference in clinical teaching The implications of the concept of countertransference in clinical nursing education is explored
Teaching metaphors of student nurses
Authors: McAllister Margaret , DipTeach Denis McLaughlin
Published: November 2003

This research focused on exploring the metaphors nursing students use to express their experience of university teachers'practice A social constructivist approach to meaning underlies the process of interpreting student language in this study The following evolved as major research questions What are the metaphors students use to describe teaching? How do these metaphors operate? The research concluded that students readily use metaphors to describe then‐experiences of teaching within the nursing degree programme, there is a pattern to the choice of metaphors, some of these images function as incremental or constructive metaphors, extending understanding of what it means to teach, others support current understandings and reflect taken‐for‐granted notions of teaching Specific metaphors used by students to describe teaching were contextually analysed A number of them may offer teachers of nursing insight into their craft Metaphors such as teacher as umpire, teacher as student, teaching with distance and teaching the big picture may be useful images for teachers to think about to guide their practice
A Dutch study of the effects of primary nursing on job characteristics and organizational processes
Authors: Boumans N P G , Landeweerd J A
Published: November 2003

In an 850‐bed Dutch hospital a study was earned out to evaluate the effects of the implementation of a Dutch form of primary nursing on five job characteristics (viz autonomy, responsibility, feedback/clarity, complexity/difficulty and Job demands) and on the communication and power processes in the organization of the nursing unit The study consisted of three measuring moments one preintervention (t1, March 1992) and two post‐intervention moments (t2, November 1992 & t3, May 1993) Primary nursing was introduced in the two experimental units (the experimental group) after t1 No changes were made to the control group After t2, this quasi‐experimental design changed, because primary nursing was also implemented in the three original control units (the control group) after this moment The research variables were measured by means of questionnaires No significant effects were found for the five job characteristics Only the improvement in the communication with the team head and the decrease in the influence of physicians on patient care in the experimental group and the improved communication with physicians in the control group were in line with expectations Changes in the amount of influence of different groups on patient care were inconsistent with what had been expected according to the nurses the influence of the nursing management increased, whereas the influence of the nurses decreased and the influence of the patients did not change In other words, the shift of power was not in the expected direction
An epidemiological study of rheumatoid arthritis in a northern Ontario clinical practice: the role of ethnicity
Authors: Jacono John , Jacono Brenda , Cano Pablo , Segami Maria , Rubin Laurence
Published: November 2003

This study was designed to investigate differences between cultural groupings in rheumatoid arthritis (RA) The sample was made up of 235 individuals suffering from RA from four groupings Canadian aboriginals, Finnish Canadians, Italian Canadians and other Caucasian Canadians The study was a retrospective chart analysis (non‐randomly selected) designed to compare ethnic groupings on the following dimensions demographic factors, clinical manifestations of RA, laboratory results, and drug therapy response Results of the study support to some extent findings from previous research Specifically, the following was found The study showed a female to male predominance in sufferers of RA in all but one ethnic group Canadian aboriginals tended to contract the disease much earlier in life than other ethnic groups More Canadian aboriginals reported a family history of RA than other groupings Only Canadian aboriginals and Caucasian Canadians showed involvement of the C1‐C2 joint with subluxation Italian Canadians tended to have a higher mean haemoglobin than other groupings, while Canadian aboriginals tended to have a higher mean platelet count than other groupings, and an elevated anti‐nuclear antibody count While most of the drugs used to treat RA produced no significantly distinct reactions, the Italian and Canadian Caucasian groups had the highest percentage of subjects with reactive dermatitis
Undergraduate nursing students' health promotion counselling self‐efficacy
Authors: Spence Heather K
Published: November 2003

In this study, undergraduate nursing students' self‐efficacy for carrying out health promotion activities with clients in nursing settings was examined Students in the first, second and fourth year of a baccalaureate programme felt moderately efficacious about their knowledge and abilities for health promotion counselling in the three content domains measured (smoking cessation, nutrition and exercise) Senior nursing students had the highest self‐efficacy scores, suggesting a positive impact on health promotion skills over the educational experience In all areas of health promotion, regardless of year in then: educational programme, students reported significantly lower efficacy for their ability to engage clients in an educational programme for behavioural change Educational directions from Bandura's theory are described
Using factor analysis to explore nurses' fear of AIDS in the United States of America
Authors: Wang Janet F , Paterson John
Published: November 2003

The purpose of this study was to create a reliable research instrument to test the fear of AIDS (FOA) and to explore the dimension of FOA among nurses We hypothesized that certain factors, such as physical closeness to AIDS patients or HIV‐positive blood and nontolerance of homosexuals, increase fear of AIDS among nurses A sample of 365 nurses in a mid‐Atlantic state of the United States was surveyed with an 82‐item Knowledge, Attitudes, and Practice (KAP) questionnaire to examine the fear of AIDS among nurses in the United States Using correlation, item and factorial analysis, a 23‐item FOA Scale II (alpha = 0 826) was created and seven FOA factors were identified Factor analysis was used to help understand the dimensions of FOA as measured by FOA Scale II Principal components analysis was used to analyse the correlation matrix because some items were on a five‐point scale and some were on a three‐point scale The varimax rotation was used, because if one were to define dimensions then these dimensions should be as independent of each other as possible The coefficient alpha of 0 826 obtained from using FOA Scale II indicated that FOA could be considered to be a general factor, but the general factor could be exhibited through several avenues It was determined that FOA could be represented by four or by seven dimensions, and if one uses the eigenvalue of 1 for a cut‐off point then one would argue that there were seven factors If one used the screen test, then one could assume that there were four factors of interest Our decision for the analysis of this paper was to attempt the interpretation of the seven factors We used both the factor loadings — the correlation of the item score with the linear combination — and the factor score coefficients (the weights of the items to form the linear combinations) to interpret the factor The factor analysis thus seems to give insight into the dimensions of FOA as measured by FOA Scale II Fear of AIDS seems to be exhibited in the following seven ways (a) support for policies which would protect me from AIDS, (b) fear of contact with blood and bodily fluids of AIDS
Comfort and nurses' moral choices
Authors: Wurzbach Mary Ellen
Published: November 2003

Caring has been advocated as integral to nursing ethics, and much theorizing has suggested that it may be a partial or the entire foundation for nursing's ethic Yet few research studies have examined the practical expression of caring in the clinical setting The author describes the concept of comfort as an aspect of care experienced by long‐term care nurses in their daily practice related to moral choices The design of the study was descriptive and qualitative The sample consisted of 15 registered nurses who were participants in the author's previous study of moral certainty and uncertainty Their responses to interview questions during the previous study suggested the topic for the present study A semi‐structured interview consisting of eight neutral open‐ended questions was conducted with each participant The findings suggest that long‐term‐care nurses function in the roles of mediator and communicator In these roles, they try to meet a mental ideal of ‘good nursing practice’ They use multiple criteria on which to base their moral choices including comfort, their own and their residents The author examines the providing and feeling of comfort as related to the nurses' moral choices
Expressed emotion on long‐stay wards
Authors: Finnema Evelyn J , Louwerens Jan Willem , Slooff Cees J , van den Bosch R J
Published: November 2003

We examined the influence of an educational programme on nurses' level of expressed emotion (EE), on ward climate and on social functioning and psychopathology of hospitalized schizophrenic patients Nurses and patients were from long‐stay wards of six Dutch psychiatric hospitals Despite an increase of nurses' knowledge about schizophrenia we did not find measurable effects on nurses' levels of EE According to the five minute speech sample method, a third of the nurses participating in this study had a high level of expressed emotion, mainly consisting of criticism This was a rather stable pattern Patients, however, were reluctant to give their nurses high EE ratings on the level of expressed emotion scale Psychopathology was not influenced by the educational programme, but social functioning of patients was related to EE in nurses Moreover, we found a significant decline in the number of restrictive ward rules at follow‐up We conclude that, while it may be difficult to detect changes in EE level after an educational programme for nurses, there nevertheless appear to be measurable benefits for patients
Is caring the ethical ideal?
Authors: Warelow Philip J
Published: November 2003

This paper will examine the claim that caring is an appropriate ethical ideal for nursing. Initially it will examine nursing's philosophy of care and caring, highlighting some areas of difficulty and dissatisfaction articulated by many of its contemporary theorists Evaluation of the notion of caring as an appropriate ethical ideal for nursing will be balanced against those in opposition, and in this process their critique will be discussed This discussion will focus on areas such as virtue, virtue ethics, moral responsibility, feminine values, mothering and the debate between male and female caring Different forms of caring will be evaluated and balanced against different forms of nursing The paper will then suggest that current views which hold aloft nursing as a bedmate of caring may be detrimental to both the cared‐for and the carer, advocating in the process a move toward change
Measuring the quality and quantity of information‐giving to in‐patients
Authors: Cortis Joseph D , Lacey Ann E
Published: November 2003

Community health councils (CHCs) were set up in the United Kingdom in 1974 as part of the reorganization of health care delivery They were intended to have a ‘watch dog’ function, monitoring the quality of health care in their own district and acting as a link between the providers of care and the public, who are the health care consumers This paper describes a year‐long survey undertaken by one CHC to monitor the quality of information‐giving in acute hospital care A large sample of 1500 discharged patients were sent questionnaires relating to satisfaction with information‐giving, and a good response rate was achieved Results indicate a generally high level of satisfaction, particularly relating to information about surgical and other technical procedures Information was less satisfactory about non‐technical aspects of care and about administrative procedures
Participation in continuing professional education in nursing: findings of an interview study
Authors: Barriball K Louise , While Alison E
Published: November 2003

The evidence suggests that enrolled nurses and those working part‐time and on night duty consistently attend less continuing professional education than their more senior, full‐time and day duty colleagues This was substantiated in the findings of this study which also highlighted the paucity of opportunities for continuing education among unqualified practitioners In the light of recent developments within the health services, this inequitable provision of continuing professional education to all nursing practitioners will need to be addressed and resolved Continuing professional education provided on an arbitrary and random basis will not afford maximum positive outcomes for clients, the service and practitioners and has the potential to increase the levels of frustration among disadvantaged groups of nursing staff
The use of the Nominal Group Technique in research with community nurses
Authors: Carney Orla , McIntosh Jean , Worth Allison
Published: November 2003

The use of group‐based techniques to generate ideas and offer solutions to problems is commonplace in many disciplines and for many purposes What were originally useful adjuncts to market research have become valuable and illuminating tools in education, policy and research This paper will describe the use of one such technique, the Nominal Group Technique, and its practical application in bridging the gap between researchers and practitioners in one particular study of community nursing
Caring, curing, coping: towards an integrated model
Authors: Webb Christine
Published: November 2003

There is an extensive literature discussing the ‘care cure dilemma’ This usually puts forward the position that it is doctors who do the curing and nurses who do the caring Patients are rarely included in the discussion This paper considers some of this literature and examines whether this separation of functions is a valid one, the part of lay carers in the process, and the perspective of patients It focuses particularly on cancer because this is an area where the issues seem particularly pertinent The paper concludes by proposing an alternative and integrated conception which includes patients, nurses and doctors in a cognitive‐phenomenological model of coping It is suggested that this model moves forward from the previous limitations of the care cure approach and enables more fruitful research and education of practitioners to be undertaken
The diagnosis of foetal distress: a challenge to midwives
Authors: Mead Marianne
Published: November 2003

The diagnosis of foetal distress is complex it is influenced by a number of factors which range from the physical examination of the mother and foetus to the psychological and social world in which the mother, the midwife and other health care professionals work The consequences of an incorrect diagnosis of normality or foetal distress are potentially serious for both mother and baby Recent changes in the practice and delivery of midwifery care have placed more responsibility on midwives It is therefore imperative that midwives become more aware of the complexity of the diagnosis as well as of some of the factors which can improve the quality of their diagnosis This paper reviews the literature associated with the diagnosis of foetal distress, physiological and pathological changes during pregnancy and labour, and the usefulness and limitation of the tools readily available to midwives for the diagnosis It also examines the limits of the relationship that exists between intra‐uterine and neonatal markers The purpose of this paper is to provide background information that would support midwives in the diagnosis of foetal distress in the hope that the false positive diagnoses can be reduced for the benefit of mothers and babies Ultimately an improvement in outcome should be reflected in the more efficient and effective use of resources available to maternity services
Patient's perspectives and experiences of day case surgery
Authors: Otte Debra L
Published: November 2003

This qualitative study aimed to examine patients'experiences and views of day case surgery to improve health professionals'knowledge and understanding, in order to make recommendations for improving the quality of this service and to provide information which may be considered when further developing services in the future The grounded theory methodology was adopted using informal conversational style interviews with eight participants The constant comparative method was employed to identify coherent patterns and themes in the data Patients expressed dissatisfaction with the scheduling of their operations and emphasized the importance of planning before admission, during their period of hospitalization and in preparation for discharge Patients unanimously recognized that they were inadequately prepared for day case surgery in terms of informational and educational support and from a perceived knowledge gap within the multi‐disciplinary health care team They also believed that there was a lack of continuity of care during their day case experience, and were unprepared for the increased level of patient empowerment but were interested in developing a collaborative relationship with staff Patients claimed that they like day case surgery because it resulted in minimal disruption to their personal lives Patients are consumers of the National Health Service (NHS) and have first‐hand experience and knowledge of the services provided in order to improve satisfaction further, patients'perspectives must be used to reshape and make better use of the limited resources to benefit the service, patients and ultimately the NHS
Breast self‐care practices in women with primary relatives with breast cancer
Authors: Chalmers Karen I , Luker Karen A
Published: November 2003

Breast cancer is a major threat to the health of women, two‐thirds of women diagnosed with breast cancer are likely to die from the disease hi North America one woman in nine will experience breast cancer at some point in her lifetime In the United Kingdom, the figure is somewhat lower, one in 12, and increasing Increasing age and a family history of breast cancer are considered major risk factors With no known primary prevention, early detection measures remain the main hope of decreasing mortality Despite controversy surrounding the effectiveness of breast self‐examination in reducing mortality, breast self‐examination or breast self ‘awareness’ are advocated by health departments and voluntary cancer organizations In this paper, breast self‐care practices of women with a family history of breast cancer are reported A descriptive study using in‐depth semi‐structured interviews as the prime data collection procedure was conducted with 55 women who had mothers, sister(s) or mothers and another primary relative with breast cancer All interviews were tape recorded, transcribed and analysed using latent content analysis and constant comparison techniques The findings revealed that women constructed their own personal meanings about the benefits and limitations of breast self‐examination and their use of this self‐care behaviour within their daily lives Women used breast self‐examination as a means of gaming control over their feelings of the threat of breast cancer Women's earlier involvement with their relative during the cancer experience and their own processing of their personal risk for breast cancer influenced their breast self‐care practices
A computer‐aided comparative study of progressive alertness changes in nurses working two different night‐shift rotas
Authors: Dingley Jane
Published: November 2003

Two groups of nurses were investigated during the course of two different types of night‐shift rota The purpose was to define, if possible, the optimum shift pattern for hospital night staff The mental alertness of two groups of nurses was assessed, both subjectively and objectively, at the beginning and end of each night‐shift of a set of nights being worked Alertness was assessed subjectively by means of a visual analogue scale, and objectively by means of a computer generated test, the unprepared simple reaction time task One group worked permanent nights and the other rapidly rotating nights Subjectively the nurses felt they were more alert at the beginning than at the end of a night‐shift, and also at the beginning of a span of nights than at the end With computer testing, performance was broadly worse at the beginning of a shift than at the end It was worse at the beginning of a span of nights, improving to a peak at around the fourth day, and then in the case of permanent nights, remaining about the same or deteriorating slightly towards the end of the span The improvement by day 4 could be a practice effect or it may be that it takes this long to adjust to the new pattern of working as some authors have described Debate centres around whether nurses should cease working nights just as they have become accustomed to them as in the rapid rotation, or continue for longer to gain benefit from this acclimatization as in permanent nights
A focus group inquiry into the perceptions of primary health care teams and the provision of health care for adults with a learning disability living in the community
Authors: Thornton Cynthia
Published: November 2003

This study addresses the primary health needs of adults with learning disabilities living in the community Policies specific to this client group and incorporating the ideology of normalization are noted and evidence of their implementation is sought Previous research suggests that the adoption of a social rehabilitative model of care may have resulted in the neglect of health care needs The recent closure of a local, subnormality hospital provided a critical situation and context for the study The research question is, how do primary health care teams perceive the needs of adults with learning disabilities living in the community, and are they meeting their needs' Three primary health care teams formed the sample and data were obtained through semi‐structured, focus group interviews A conceptual framework developed early in the study influenced both the interview guide and the data analysis The study suggests that practitioners working within primary health care teams have a limited awareness of the health care needs of adults with learning disabilities Contributing factors were identified and include negative attitudes towards the concept of normalization, inadequate education, a shortfall in financial and human resources, and poor collaboration with the specialist team
Meaning of illness for women with breast cancer
Authors: Luker Karen A , Beaver Kinta , Leinster Samuel J , Owens R Glynn
Published: November 2003

The meaning that women with breast cancer ascribe to their disease may well have an impact on the effectiveness of coping strategies used to come to terms with breast cancer Health rare professionals need to know what meanings women with breast cancer are ascribing to their disease if they are to identify maladaptive coping strategies and ensure that women receive the support that they need in order to promote physical and psychological recovery This study involved assessing meaning of illness for a group of women with breast cancer at two points in time, the time of diagnosis and a mean of 21 months from diagnosis The eight meanings of illness devised by Lipowski were depicted by the following words challenge, enemy, punishment, loss, strategy, relief, weakness and value The most popular choice of meaning for the women was challenge, although some women's choices indicated that maladaptive coping strategies were being used The implications of the study for nurses and other health care professionals are discussed
Changing nursing practice through reflection on the Roper, Logan and Tierney model: the enhancement approach to action research
Authors: Bellman Loretta M
Published: November 2003

To the clinical practitioner both nursing models and nursing research may currently be viewed as distant and élitist In the current political climate neither may be highly valued by practitioners or managers Yet, by facilitating group reflection on the nursing model identified in the ward philosophy and adopting the enhancement approach to action research, surgical nurses were empowered to effect change and, consequently, to enhance the quality of patient care in their ward The study was undertaken in two phases over a 15‐month period and utilized a multi‐method approach In phase 1 triangulation of the data enabled the practitioners/co‐researchers to identify and reflect on patients ‘psychological needs within the independence/dependence continuum of the Roper et al (1990) model Phase 2 involved a collaborative approach to the planning, implementation and evaluation of innovations which resulted from reflection on practice Nurse‐doctor relationships including anaesthetist non‐compliance were, though, a controversial issue Collaborative practice was undermined by the co‐researchers' ambivalence concerning feedback from the medical staff Overall, however, the individual contribution of each co‐researcher was recognized and valued They had both choice and control which enabled them to develop personally and professionally Group reflection was seen as an essential feedback strategy during the change process
Preceptorship: a review of the literature
Authors: Bain Louise
Published: November 2003

Preceptorship is an important part of the United Kingdom Central Council for Nursing's (UKCC) post‐registration and practice recommendations Therefore, there is a great need for educationalists and clinical practitioners to explore the issues surrounding preceptorship and come to informed decisions on how they intend to implement preceptor programmes There is a need to identify existing knowledge and its application to practice based on the commonly occuring themes within the theoretical and empirical literature This paper reviews the current literature addressing these themes of role definition, preceptor selection, preceptorship programmes, the preceptorship experience and the limitations of preceptorship in clinical practice
Constructing meaning in the learning experience: the role of alternative theoretical frameworks
Authors: Lauder William
Published: November 2003

Student nurses actively interact with their experiences and construct theories about nursing in an attempt to make sense of their experiences These alternative theoretical frameworks (ATFs), it will be suggested, do not conform to the types of structures that are thought to be the hallmark of formal theories but instead the knowledge of students can be understood as a series of narratives The relationship between ATFs and the formal theories presented by educators may create difficulties for both students and teachers
A re‐examination of the experimental design for nursing research
Authors: Poole Karen , Jones Adrian
Published: November 2003

This paper will present a case for the re‐examination of the experimental design for contemporary nursing research It is an attempt to re‐dress the academic ‘romance’ with the new found orientation towards exploratory descriptive research To make the case, there is a need to make explicit some of the erroneous assumptions regarding the philosophical origins of the experimental design By ignoring the contribution of the experimental design, there is the risk of overlooking certain areas of potential nursing knowledge This is particularly pertinent in the current political climate, where the need to provide cost‐effective outcomes is reliant upon the principles of causality and certainty inherent in experimental designs
A concept analysis of trust
Authors: Johns Jeamne L
Published: November 2003

Trust is an important and pervasive concept In nursing, it has been considered primarily from two perspectives Clinically, it is an important aspect of the nurse‐patient relationship Organizationally, trust is associated with various outcomes and levels of effectiveness Much of the nursing literature that discusses trust relies upon vague conceptualizations or borrows from other disciplines The absence of a clear conceptualization of trust has been cited A core concept of trust is presented which is applicable to nursing in both clinical and organizational settings Established methods for concept analysis are supplemented by a sequential step model developed by the author The concept is developed as both process and outcome, and the relationships of the two states to measurement of the concept are identified The utilization of the core concept in context‐specific instances is discussed, and suggestions are made for further research
Implementation of a hermeneutic inquiry in nursing: philosophy, rigour and representation
Authors: Koch Tina
Published: November 2003

The thesis of this paper is that researchers working in interpretive traditions need to address three central issues philosophy, rigour and representation This paper discusses the process of an hermeneutic inquiry as a research methodology used in seeking to understand the experiences of older patients admitted to an acute hospital The methodology includes the philosophical framework and assumptions underpinning the research Philosophical hermeneutics guides the inquiry as a reflection of the research process Three issues concerning legitimation of the hermeneutic research process arise the philosophical underpinnings of the methodology, representation, or the participation of the researcher in making data, and rigour, or the way in which trustworthiness of hermeneutic research can be established I recommend that Gadamer's primacy of application to the understanding of texts can also be applied to understanding of health environments I conclude that Gadamer's post‐modern sensibility regarding text and the framework of Guba & Lincoln's fourth generation evaluation are compatible within a hermeneutic inquiry
Reforming the practice of nurses: decolonization or getting out from under
Authors: Huntington Annette , Gilmour Jean , O'Connell Anne
Published: November 2003

The practice of nurses has been formed and informed by many disciplinary discourses We argue that this leads to the subjugation and colonization of nurses' practices and the discipline By debating and challenging current developments in knowledge the opportunity is created for nurses to reform representations of our practices in a way that can privilege diversity, complexity and ambiguity In particular, modernism and postmodernism are critiqued to highlight the impact of particular philosophical traditions on the practices of nurses