bluuebunny/crossref_metadata_2025 huggingface dataset:
Deworming efficacy of Albizia anthelmintica in Uganda: preliminary findings
Authors: Gradé Jeanne T. , Tabuti John R. S. , Van Damme Patrick , Arble Bennett L.
Published: November 2007

This study was conducted to evaluate the anthelmintic effectiveness of Albizia anthelmintica, as a first step in investigating the hypothesis that livestock self‐medicate. In July 2006, an observational study was conducted with 56 young female lambs, to validate A. anthelmintica efficacy. Faecal egg per gram for Coccidia, Strongyle‐type, Monezia, Strongyloides and Dicrocoelia eggs were counted and analysed. Results indicate that A. anthelmintica is effective in controlling infection with a variety of internal parasites in lambs, Monezia was the most sensitive. Furthermore, treatment of Strongyle‐type worms requires a biweekly dose of A. anthelmintica as an effective deworming protocol.
An inventory of medicinal plants used in treating poultry diseases in Jinja district, eastern Uganda
Authors: Bukenya‐Ziraba Remigius , Kamoga Dennis
Published: November 2007

An ethnobotanical study was conducted on medicinal plants used for treating poultry diseases in Busedde, Butagaya, Buwenge and Budondo subcounties in Jinja district, eastern Uganda, between August and September 2003. The study was intended to identify the plants, examine the mode of preparation and dosages administered. Methods used included systematic random selection of farmers, group discussions and semi‐structured questionnaires. A total of 88 plant species representing 47 families were recorded. Fabaceae was the most richly represented family in use with eleven species, followed by Asteraceae, Euphorbiaceae and Solanaceae, each with five species. From the entire collection of 88 species, 37 (42%) were herbs; 24 (27.27%) shrubs; eighteen (20.45%) trees while nine (10.22%) were climbers. Plant materials were collected from a range of habitats, including bush land, cultivated land, roadside, swamps, grazing land and compounds.
Diversity of indigenous fruit trees in the traditional cotton‐millet farming system: the case of Adwari subcounty, Lira district, Uganda
Authors: Agea Jacob G. , Obua Joseph , Kaboggoza John R. S. , Waiswa Daniel
Published: November 2007

A field survey on indigenous fruit tree species (IFTS) was conducted in Adwari subcounty, Lira district between August 2004 and March 2005. The objectives were to: determine IFTS diversity in the traditional farming system; generate a species priority list, characterize and document the values of IFTS as perceived by farmers; and develop criteria for selecting IFTS for on‐farm cultivation. A questionnaire designed to capture socio‐economic data was administered to 120 randomly selected respondents. Farm walks were conducted to identify and assess the proportion of farmland under IFTS. Preference ranking was used to generate a species priority list. On‐farm diversity of IFTS was analyzed using Shannon–Wiener’s diversity index (H′). DAFOR scale was used to rate occurrence of IFTS on‐farm. The diversity of IFTS was relatively high (H′ = 2.164) although the average proportion of farmland under IFTS cover was low (23.3 ± 5%). Vitellaria paradoxa, Vitex doniana, Anona senegalensis and Tamarindus indica were most preferred by local people. The choice of IFTS for on‐farm cultivation varied from their food, medicinal to cash values. There is a need to formulate clear policies and by‐laws to encourage on‐farm cultivation of IFTS.
Agroforestry practices in the buffer zone area of Mt Elgon National Park, eastern Uganda
Authors: Mukadasi Buyinza , Kaboggoza John R. , Nabalegwa M.
Published: November 2007

In this study, we investigated the attitude of local people towards the contribution of agroforestry practices to socio‐economic development in the buffer zone area of Mt Elgon National Park, Uganda. Primary data were collected through formal household survey conducted during June–October 2004 with the use of questionnaires administered to 120 households selected randomly from Mutushet and Kortek Parishes. Data were analysed using chi‐squared test and logistic regression model. The results support the hypothesis that the attitude of people towards agroforestry practices is independent of existence of collaborative forest management, ethnic group, sedentary farming experience and family size but depends on main occupation, education status, distance from park boundary, damage caused by wild animals, landholding size and total livestock units owned. Factors that significantly influenced adoption of agroforestry technologies were age of the household head, education status, extension contact, family labour force and gender. There is need to intensify extension programmes in those areas where the majority of people have negative attitude towards agroforestry practices.
The activity of Mangifera indica L. leaf extracts against the tetanus causing bacterium, Clostridium tetani
Authors: Bbosa Godfrey S. , Lubega Aloysius , Musisi Nathan , Kyegombe David B. , Waako Paul , Ogwal‐Okeng Jasper , Odyek Olwa
Published: November 2007

Mangifera indica L. is a common horticulture and medicinal plant, which is used traditionally to treat various infections. A previous study has shown its leaf extracts to have antibacterial activity against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. This study investigated the activity of the leaf extracts against Clostridium tetani, which causes many deaths around the world. Ether and ethanolic leaf extracts were obtained by sequential extractions. Qualitative studies were carried out to determine the different classes of compounds in the extracts. The chemical tests showed that the ether extract had saponins, steroids and triterpenoids, while the ethanol extract had alkaloids, anthracenosides, coumarins, flavonones, reducing sugars, catechol and gallic tannins, saponins, steroids and triterpenoids. The minimum inhibitory concentration (MIC) of the extracts against the study organism was determined using the gradient serial dilution method. Gentamycin and distilled water were used as controls. Both the ethereal and ethanolic fractions showed anti‐clostridium tetani activity with an MIC of 6.25 and 12.5 mg ml−1, respectively.
The ethnobotany and ecological status of Albizia coriaria Welw. ex Oliv. in Budondo Sub‐county, eastern Uganda
Authors: Tabuti John R. S. , Mugula Ben Belden
Published: November 2007

Useful trees are believed to be threatened. However, most evidence about these concerns is anecdotal. The objectives of this study were to document uses of Albizia coriaria Welw. ex Oliv., local harvesting patterns, perceptions about the species population dynamics, as well as local attitudes to its conservation. A further objective was to determine its availability, distribution and population structure. The study was carried out using ethnobotanical and quantitative ecological methods. The species was found to be multipurpose and produced fourteen different products and services. The most frequently mentioned products were herbal medicines, sawn timber and wood for construction. Individuals of the species were sometimes felled to harvest wood. Community responses indicated that the species was rare and was declining in the area. The quantitative inventory supported this community view: the species had a low density (33 individuals, >5 cm diameter at breast height per ha) and a flat size class distribution with a calculated least‐squares regression slope of −0.0357. The species population appeared to be threatened by clearing of land for crop agriculture, human population growth, logging and a poor attitude to its conservation. Respondents claimed that they were not interested in conserving it because they had a low appreciation of its true value; lacked land, propagation material and skills; or because the species was slow growing.
A critical review of the health belief model in relation to cigarette smoking behaviour
Authors: GALVIN KATHLEEN T.
Published: November 2007

There are a number of health behaviour models and theories available to nurses which have been developed to explain and predict health behaviour. Of particular interest to nurses in recent years is the ‘health belief model’ which has been the most widely used.

Despite a wealth of evidence to support the model's value in predicting health behaviour, often it is evident that there are a substantial number of factors involved in health behaviour which are not health related and are therefore not easily predicted by the model. Cigarette smoking is one interesting example due to the many physiological and psychological factors involved that are not health related.

Another model, the ‘theory of reasoned action’, may be useful in understanding such a complex behaviour as cigarette smoking as it relys not only on health beliefs but also takes into consideration personal factors which are seen as relevant by smokers such as social influence and the individuals positive or negative evaluation of giving up or continuing smoking and it is these factors according to the model, which underlie whether or not a person will intend to give up or continue to smoke.

The theory of reasoned action may be a useful tool to both health educators and nurse researchers.
Maternal–infant attachment following caesarean delivery
Authors: HILLAN EDITH M.
Published: November 2007

A study group of 50 low‐risk primigravidae of normal stature delivered by emergency caesarean section during the course of labour were compared with a closely matched control group of 50 primigravidae delivered vaginally.

Data for the purposes of the study was collected from a number of sources including semi‐structured interviews on the 3rd or 4th postnatal day and 6 months after the birth.

Women delivered by emergency caesarean section took significantly longer than those delivered vaginally to feel close to their infants and these differences persisted for several months.

Contact between women delivered by caesarean section and their babies was found to be restricted in the 24 h following caesarean delivery.

This paper focuses on maternal‐infant attachment following delivery, and discusses some of the implications of the findings for midwifery practice.
A supportive–educative caring rehabilitation programme; improvements of physical health after myocardial infarction
Authors: FRIDLUND BENGT , PIHLGREN CHRISTINA , WANNESTIG LENA‐BRITT
Published: November 2007

The aim of this study was to evaluate the effects of a supportive–educative caring rehabilitation programme involving interdisciplinary efforts to improve the physical health of myocardial infarction patients (MI‐patients).

MI‐patients chosen at random participated either in a 6‐month programme or normal medical follow‐up.

Instruments designed for both subjective and objective measuring of recovery of physical health were used.

Subjective capacity showed significant differences (P 0·05‐0·001) concerning: (i) reported pain and exertion 5 weeks and 6 months after MI during physical exercise, (ii) perceived breathlessness, chest pain, fatigue, physical fitness 6 and 12 months after MI, and (iii) reported callisthenics and coitus 6 and 12 months after MI.

Significant differences (P 0·05‐0·001) in objective capacity were indicated concerning: (i) a symptom‐limited submaximal physical exercise test 5 weeks and 6 months after MI, and (ii) reinfarctions 12 months after MI.

The strength of the study rests on the fact that the improvements of physical health could be statistically verified, regarding both subjective and objective capacity of the MI‐patients. The described caring efforts are simple, easy to carry out and take little time for the MI‐patients and their next‐of‐kin as well as for the health‐care personnel.
An analysis of the literature pertaining to pressure sore risk‐assessment scales
Authors: HAMILTON FIONA
Published: November 2007

The purpose of this analysis was to determine which pressure sore risk‐assessment scale was the most valid and reliable for use outside the elderly setting.

It includes a review of the causes of pressure sores to determine the factors which should be included in a scoring system, an overview of the risk‐assessment scales developed and an analysis of the research performed to test their validity and reliability.

The study has shown that the Gosnell, Knoll, and Douglas scales have had little or no validity studies conducted and should therefore not be used in the clinical setting and the Pressure Sore Prediction Score should be used with caution outside an orthopaedic setting. The Waterlow scale has also not been fully validated and the Norton scale requires further validation to make it applicable to patients outside the elderly setting. The Norton scale has been shown to overpredict the risk of pressure sores, but the Waterlow scale may actually overpredict this risk even more.

The Braden scale appears to be the most appropriate to use because it has been tested on a representative sample of patients with a wide age range (14–102). It also has a sensitivity of 100% and a specificity of 64–90% compared with the Norton scale's sensitivity of 88% and specificity of 36%.

The analysis concludes that more research is required on all of the scales to determine validity and reliability outside of the elderly setting and therefore all scales should be used with caution bearing in mind the limitations of each.
Is ‘sick‐nursing’ an alternative to conversion hysteria?
Authors: HOLDEN ROBYN J.
Published: November 2007

Freud made the interesting observation that many of his patients suffering from conversion hysteria (a psychogenically induced physical dysfunction affecting the special senses) had been engaged in ‘sick‐nursing’ for a prolonged period prior to decompensation.

This paper aims to explore the relationship between ‘sick‐nursing’ and conversion hysteria.

It will be argued that, for a select population group, the unconscious motivation for choosing nursing as a career and decompensation with conversion hysteria rest on the same fundamental factors.

These factors include an unconscious sense of guilt, the need for punishment through suffering, and envy all of which corrupt normal psychosexual development.
The control of pain in labour
Authors: MANDER ROSEMARY
Published: November 2007

This paper examines a selection of the recent literature on the control of pain in labour in terms of the source of that control and its effectiveness.

Emphasis is given to the effect of analgesia on the mother's ability to control her childbirth experience.

Reliable research detailing the effects of more commonly used, less invasive methods of pain control is lacking.

The effects of analgesia are considered in terms of controlling pain, effects on the fetus/baby, effects on the progress of labour and the woman's ability to maintain self control.

There are difficulties inherent in providing the mother with suitably wide‐ranging information.

To have the most benefit, research‐based information would need to be available to the mother when she is both seeking it and able to utilize it.
The contribution of lecturer practitioners to theory and practice in nursing
Authors: LATHLEAN JUDITH
Published: November 2007

Problems surrounding the relationship between the theory and practice of nursing have been pervasive for decades. Whilst, traditionally, concerns have been mainly expressed by nurse educators, and solutions offered from an educational perspective, increasingly the issues are seen as those of practitioners and managers as well, and as broader than the integration of theory and practice in the education of nurses.

Many of the attempts to bring theory and practice together by the development of an educationally driven model, or by the introduction of new roles into an existing system have been problematic, leading to the desire for a more radical proposition.

The development of lecturer practitioners, who aim ‘to identify and maintain the standards of practice and policies in a defined clinical area, and to prepare and contribute to the educational programme of students in relation to the theory and practice of nursing in that unit’ (Vaughan, 1987), offers one such approach.

This article reviews the main empirical literature in relation to issues of theory and practice, as well as reporting on some preliminary findings from a research project aimed at studying the implementation and development of lecturer practitioner roles in one health authority.
Factors influencing staff nurses' decisions for non‐documentation of patient response to analgesia administration
Authors: ALBRECHT MARY NIES , COOK JEANETTE E. , RILEY MARVEL JEAN , ANDREONI VICKI
Published: November 2007

The purpose of this descriptive field study is to determine what factors influence staff nurses' decisions for non‐documentation of patients' response to analgesic administration.

The study, based on Herbert Simon's descriptive model of decision making, has two components: (a) to determine staff nurses' perceptions of the factors that influence their documentation as well as how frequently they document analgesic administration and (b) to determine the actual frequency of nurses' documentation.

Data collected from 67 staff nurses using a questionnaire designed for this study and through an audit of 65 patients' charts allowed comparison of nurses' perceptions with their actual practice.

Analysis involved both quantitative and qualitative approaches.

The results of the study have implications for nurse educators and nurse administrators.
Helping ‘new carers' of the frail elderly patient: the challenge for nurses in acute care settings
Authors: NOLAN MIKE , GRANT GORDON
Published: November 2007

The present policy of community care for frail elderly individuals relies primarily on the provision of support by informal carers. Such carers are usually close family members, most often spouses or children.

Whilst most carers take on their role willingly they often do so at a time of crisis, such as following a period of hospitalization. As a consequence many individuals are ill‐prepared for their new responsibilities. For a minority of others the role of carer is adopted reluctantly.

This paper argues that nurses in acute care settings are in the best position to try and ensure that individuals become carers following an informed decision‐making process.

Suggestions are provided as to how current nursing practice can be improved in order better to achieve this aim.
Post‐surgical hormone replacement therapy: information needs of women
Authors: LACK LESLEY , HOLLOWAY IRMGARD M.
Published: November 2007

This study examines the feelings and thoughts of women who have received hormone replacement therapy (HRT) after a surgically induced menopause.

The paper outlines the patients' need for easily accessible information about HRT from professionals. Sometimes the information is not completely clear because of anxiety or misinterpretation. Women are also concerned about side‐effects.

Women feel that they can cope better if they understand why certain treatments are carried out, and if they have an informed choice about their method of treatment.
Basic care of demented patients living in institutions
Authors: LIUKKONEN ARJA
Published: November 2007

This paper looks at the basic care of demented patients living in institutions and the distinctive characteristics of those patients.

The data included in the study were collected by observing basic care situations and interviewing practising nurses.

The nurses tended to look at demented patients chiefly in terms of the abilities they had lost and the disturbance they caused; less attention was given to their remaining faculties, such as their sense of humour and their ability to enjoy things and to establish contact through gestures and physical touching.

Five models of nursing activity were identified: rejective, routinized, robot‐like, cassette‐like, and skilful.

Nurses concentrated more on obligatory daily activities than on the individual needs of demented patients, the special characteristics of dementia, or encouraging spontaneous activity among demented patients.
Intuition: concept analysis and application to curriculum development. II. Application to curriculum development
Authors: McCORMACK BRENDAN
Published: November 2007

Summary

This is the second of two articles which addresses the subject of intuition and its relevance in practice and to curriculum development.

Ways by which nurse educators can learn to value the concept of intuition and integrate it into the curriculum are discussed.

Following examination of the concept of intuition, some solutions are offered.

Research concerning the measurement of intuition in nursing practice is analysed.

Concepts of intuition and the role of intuitive thinking in nursing practice are presented.
An information booklet for schools to help teachers deal with students with inflammatory bowel disease
Authors: MAYBERRY MARGARET K. , MAYBERRY JOHN F.
Published: November 2007

Summary

A short text for educators entitled Factbook of Inflammatory Bowel Disease: A Primer for Lecturers and Teachers was prepared by a group of doctors and teachers.

As a technical manual it was formally assessed as generally easy to read with a Flesch Kincaid score of 10.1 and a Flesch Reading Ease Score of 47.9.

In a pilot survey of 156 schools in Leicestershire, 78 headmasters or senior teachers completed a questionnaire about its value. Of these 70 (90%) would make use of the booklet.

The results of the survey reflect the lack of professional support for teachers, although if available most educators would prefer nurses to hospital specialists as their point of contact.
A pilot study of the prevalence and psychological sequelae of sexual harassment of nursing staff
Authors: FINNIS SARAH J. , ROBBINS IAN , BENDER MIKE P.
Published: November 2007

Summary

A pilot study of nurses and nursing auxiliaries was carried out to determine the prevalence and psychological sequelae of sexual harassment.

Thirteen nurses and 22 nursing auxiliaries were interviewed.

Sixty per cent reported having experienced sexual harassment on at least one occasion.

The results showed that the predominant experience typically occurred:

to female nursing staff;

by male patients;

on the wards;

often while washing patients.

There was minimal reporting of the incident.

The overriding emotion felt was embarrassment which was perceived as resulting in impaired work performance.
Spirituality and nursing practice
Authors: HARRISON JUDY
Published: November 2007

Summary

Spirituality is often equated or used synonymously with the word religion but it appears this concept can be defined in broader terms.

Nurses do not appear to consider spirituality adequately in clinical practice but if holistic care is to be given to patients it is essential that the spiritual component of individuals is addressed.

This paper explores the concepts of spirituality and clinical practice. Clarification of the term spirituality is given followed by a critical review of the literature in order to establish its relevance to nursing practice and to what extent patients' spiritual needs are met. Aspects of spiritual assessment and spiritual care are also outlined.

It is suggested that nurse education may help nurses incorporate spirituality into clinical practice by increasing their knowledge and understanding of such a concept.
Accountability: a core concept for primary nursing
Authors: EVANS AMANDA
Published: November 2007

Summary

The aim of this paper is to explore how the theoretical definitions of accountability might be put into practice within a structure of primary nursing.

Bergman's preconditions leading to accountability (1981) are discussed with respect to traditional ward organization and contrasted with primary nursing. The size of the case‐load is identified as a significant factor in the way and the depth with which the concept is operationalized.

Adaptations to nursing roles are necessary in order to facilitate accountability in action. The primary nurse is given authority as both case manager and line manager. The ward manager role changes to focus on resource management and developmental need.

Changes of this nature lead to accountability being viewed in a positive light and an abstract concept becoming grounded in reality.
Care or self‐care? Self‐administration of medication in hospital
Authors: BAKER HELEN , PEARSON ALAN
Published: November 2007

Summary

One of the stated objectives of the Professorial Nursing Unit at The Geelong Hospital was to promote self‐care in all patients who were capable. This included self‐administration of medication.

Two years later the implementation of the programme, although approved by the administration of the hospital and actively promoted by the nursing staff, had not occurred.

The barriers to achieving the implementation of self‐medication have largely concerned the need for control by various groups within the hospital community. This case‐study traces the story to date.
Nursing diagnosis in sick children's nursing
Authors: WEBB CHRISTINE , MASON GERALDINE
Published: November 2007

Summary

The North American Nursing Diagnosis Association (NANDA) is receiving increasing attention in the UK, following 40 years of development in the USA.

A study of care plans in children's wards shows that nurses fail to identify comprehensively children's and families' nursing needs.

The potential of using a system of nursing diagnoses to facilitate nursing assessment in children's wards is discussed.
Enhancing students' perspectives of health through non‐traditional community experiences
Authors: SWORD WENDY , MAJUMDAR BASANTI , NOESGAARD CHARLOTTE
Published: November 2007

The shift in emphasis to community‐based health care necessitates that opportunities be provided for nursing students to acquire an understanding of the complex nature of health.

A qualitative study was used to demonstrate the benefits accrued by junior baccalaureate nursing students in non‐traditional community settings.

Key themes that emerged from data analysis included definitions of health and illness as context specific, and environmental factors influencing health.

The study demonstrated that learning experiences with diverse communities can broaden students' perspectives and understanding of health behaviours. Students gained an appreciation of the sociocultural variation in meanings of health and illness as well as of the social and political dimensions of health.
An evaluation of nurse‐led team care within a rehabilitation ward for elderly people
Authors: DAVIES SUSAN M.
Published: November 2007

This small exploratory study evaluated the effects of introducing a system of nurse‐led team care on a ward providing intensive nursing and rehabilitation to elderly people.

A quasi‐experimental design compared three variables between the study ward and two similar wards within the unit. These were:

quality of care,

job satisfaction,

length of patient stay.

Quantitative data were complemented by semi‐structured interviews with team members and by observation of team meetings.

Quality of care scores showed an improvement on the study ward, but no difference on the main comparison ward. There were no differences between nurse job satisfaction between the study and comparison wards or in length of patient stay throughout the period of evaluation.

Observation of team meetings suggested that communication was more structured and focused on the study ward and that patient goals were more clearly specified. Interviews suggested three main factors in successful implementation of the change to nurse‐led team care:

commitment of the team,

open communication about difficulties,

the support of managers and medical staff.

The main effects noted were:

partnership with patients,

equality between team members,

improved decision making and quality of care.

Further studies of nurse‐led team care are required, and the stress and anxiety for staff consequent on developing the nurse's role in this way should be considered.
Knowledge and use of lifting techniques among a group of undergraduate student nurses
Authors: KANE MARION E. , PARAHOO K.
Published: November 2007

As part of a nursing degree course, one of the authors (M.K.) gathered data on the knowledge and use of lifting techniques among a group of undergraduate student nurses. A 17‐itcm questionnaire was administered to one cohort of 19 third‐year students.

The results show that while they were aware of lifts recommended by the RCN and by other researchers, they reported that they frequently used lifts not recommended by the above sources during their medical placement. This behaviour seemed to mirror the practices of ward staff. Possible explanations for the knowledge‐practice gap are offered.
Sexual harassment of nurses: an occupational hazard?
Authors: FINNIS SARAH J. , ROBBINS IAN
Published: November 2007

A questionnaire was administered to qualified and student nurses to assess the prevalence and consequences of sexual harassment.

There was a 56% completion rate. Of these 43 (66%) of the registered nurses and nine (35%) of the student nurses reported having experienced sexual harassment. The incidence of harassment for registered nurses in the year prior to the study was 46%.

Patients were most likely to be the harasser for both student and registered nurses but there was an increased likelihood that other staff were involved in the harassment of registered nurses with doctors and male nursing staff being the predominant perpetrators.

Dimensions of assertiveness and sex role identity did not predict the likelihood of harassment.

Results are discussed in the context of attribution theory and gender power relationships.
The development of research in nursing in the United Kingdom
Authors: HOPPS LINDA C.
Published: November 2007

The last 30 years have seen considerable development in research in nursing.

Nursing is building a repository of research‐based knowledge.

Formal structures around which research can be developed and organized are being established.

Research findings are still not being implemented in practice, but strategies to address this issue are being developed.

Nurses are being educated to utilize research findings in practice.

The Report of the Task‐force on the Strategy for Research in Nursing, Midwifery and Health Visiting was published in May 1993 (DoH, 1993). It advocates that research in nursing should be fully integrated in health‐services research and outlines future strategy in four key areas: priorities, education, practice and careers.
Case management in the community: identifying a role for nursing
Authors: BERGEN ANN
Published: November 2007

This paper describes the findings of” a questionnaire survey designed to create a picture of current case management practices as they relate to community nursing.

Eighty‐three questionnaires were analysed in order to identify client groups, nurse details, functions of case management adopted, other services involved, titles used and advantages and disadvantages of the ways of working adopted.

Findings suggest that interpretation of, and involvement in, case management is variable and that the practice potential for this model of care warrants further research.
A further critical description of the therapeutic community
Authors: CLARKE LIAM
Published: November 2007

A review of the literature pertaining to therapeutic communities in Britain is presented. An outline of the historical origins and development of communities is provided.

Overall, the review is set within a somewhat sceptical context. Mention is made of the inherent confusion of descriptions resulting from the proliferation of competing terminologies in the field. Problems of research are also itemized as are problems of ideological interference with both theory and practice.

A tentative conclusion suggests that outcome measures might assist the process of describing these communities more accurately.
Nursing diagnoses: a Dutch perspective
Authors: LEIH PETER , SALENTIJN CEES
Published: November 2007

In this article, the authors adopt a position with respect to the definition of ‘nursing diagnosis’.

Two central functions of a classification system for nursing diagnoses are distinguished: domain and communication.

Seven issues related to the development of such a classification system are discussed. These issues are of a methodological, philosophical and practical nature.

A proposal is made for further study and development of a Dutch classification system for nursing diagnoses, preferably in collaboration with NANDA.
Automating ward evaluations: a tentative first step
Authors: MOSELEY L. G. , MEAD D. M.
Published: November 2007

Auditing nursing practice is a time‐consuming, error‐prone task.

Feedback to individuals is highly desirable but usually is not offered. This is particularly difficult in large‐scale studies.

In this study of 654 wards a new method was attempted. Structured questionnaires were analysed by a computer program and feedback reports generated automatically.

Informal evaluations by the initial recipients are positive and the method seems worthy of future development.
The hospital health‐promotion facilitator: an evaluation
Authors: McBRIDE ANITA , MOORWOOD ZELDA
Published: November 2007

This 1‐year study tested the transferability of the Primary Care Facilitator model to the hospital setting, and was designed to assess and enhance existing hospital health‐promotion activity.

From work with nurses on three wards in an acute general hospital, the Primary Health Care model was found to be appropriate for the hospital setting.

There were demonstrable changes in attitudes to health promotion and an increase in health‐promotion activity. It now appears appropriate to evaluate the role of the hospital health‐promotion facilitator on a wider basis.

Areas for further research, beyond the scope of this particular project, should be the quality of the health‐promotion activity and exploration of factors that encourage or inhibit utilization of health‐promotion opportunities.
A telephone survey of medical patients 1 week after discharge from hospital
Authors: BOWMAN GERALD S. , HOWDEN JANE , ALLEN SUSAN , WEBSTER ROSEMARY A. , THOMPSON DAVID R.
Published: November 2007

The telephone is an effective means of communication and its use is growing as a means of offering members of the public access to health‐care agencies for advice and support.

Acute hospital beds are at a premium and as lengths of stay in hospital continue to fall there is an increasing need for effective discharge planning and post‐discharge support.

Eighty‐five patients (58 men and 27 women) were interviewed over the telephone 1 week after discharge from a medical ward.

Over half of the patients reported health problems and one‐fifth reported social problems.

Almost half of the patients sought advice.

Telephone follow‐up would appear to be a useful means of monitoring a patient's progress and providing an opportunity for patients seeking, or nurses offering, advice and support.
Preventing heel pressure sores: a comparison of heel pressure relieving devices
Authors: ZERNIKERN WENDY
Published: November 2007

It has been widely recognized that elderly patients with an orthopaedic problem are predisposed to developing heel pressure sores.

In this study four pressure‐reducing devices, commonly used in the prevention of heel ulcers, were objectively compared for their ability to decrease or remove pressure on the heels of patients with fractured necks of femurs and fractured femurs.

Forty‐one patients were randomly allocated a pressure relieving device. The efficacy of the device was evaluated by continuously assessing the skin integrity of both heels on a daily basis over a period of 12 days. Data were collected over a 30 month period.

The four devices were foam splints, eggshell foam, duoderm and heel protector boots. Foam splints and eggshell foam proved to be more effective devices in relieving pressure exerted on the heel.

This study recognizes that meticulous nursing care remains the critical clement in prevention of heel ulcers; however, the use of eggshell foam and foam splints in conjuction with this enhances the maintenance of skin integrity.
Measuring rDNA diversity in eukaryotic microbial systems: how intragenomic variation, pseudogenes, and PCR artifacts confound biodiversity estimates
Authors: THORNHILL DANIEL J. , LAJEUNESSE TODD C. , SANTOS SCOTT R.
Published: November 2007

Molecular approaches have revolutionized our ability to study the ecology and evolution of micro‐organisms. Among the most widely used genetic markers for these studies are genes and spacers of the rDNA operon. However, the presence of intragenomic rDNA variation, especially among eukaryotes, can potentially confound estimates of microbial diversity. To test this hypothesis, bacterially cloned PCR products of the internal transcribed spacer (ITS) region from clonal isolates of Symbiodinium, a large genus of dinoflagellates that live in symbiosis with many marine protists and invertebrate metazoa, were sequenced and analysed. We found widely differing levels of intragenomic sequence variation and divergence in representatives of Symbiodinium clades A to E, with only a small number of variants attributed to Taq polymerase/bacterial cloning error or PCR chimeras. Analyses of 5.8S‐rDNA and ITS2 secondary structure revealed that some variants possessed base substitutions and/or indels that destabilized the folded form of these molecules; given the vital nature of secondary structure to the function of these molecules, these likely represent pseudogenes. When similar controls were applied to bacterially cloned ITS sequences from a recent survey of Symbiodinium diversity in Hawaiian Porites spp., most variants (~87.5%) possessed unstable secondary structures, had unprecedented mutations, and/or were PCR chimeras. Thus, data obtained from sequencing of bacterially cloned rDNA genes can substantially exaggerate the level of eukaryotic microbial diversity inferred from natural samples if appropriate controls are not applied. These considerations must be taken into account when interpreting sequence data generated by bacterial cloning of multicopy genes such as rDNA.
Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross‐sectional study in children
Authors: Kurt Emel , Metintas Selma , Basyigit Ilknur , Bulut Ismet , Coskun Evsen , Dabak Sennur , Deveci Figen , Fidan Fatma , Kaynar Hasan , Uzaslan Esra Kunt , Onbasi Kevser , Ozkurt Sibel , Pasaoglu Gulden , Sahan Sami , Sahin Unal , Oguzulgen Kivilcim , Yildiz Fusun , Mungan Dilsad , Yorgancioglu Arzu , Gemicioglu Bilun , Fuat Kalyoncu A. ,   for the PARFAIT Study of Turkish Thoracic Society Asthma‐Allergy Working Group
Published: November 2007

The Prevalence And Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate prevalence and risk factors of asthma and allergic diseases and also to find out which geographical variables and/or climatic conditions play a role determining the prevalence of allergic diseases in Turkish school children. Study was planned as cross‐sectional questionnaire‐based. About 25,843 questionnaires from 14 centers were appropriate for analysis. Parental history of allergy, having an atopic sibling and other atopic disease in index case was significant risk factors for all allergic diseases. Breast feeding decreased the risk of current asthma (OR: 0.92, CI: 0.86–0.99) and wheezing (OR: 0.93, CI: 0.87–0.99) but not allergic rhinitis and eczema. Respiratory infection in the past was an important risk factor for the occurrence of allergic diseases especially for asthma which was increased 4.53‐fold. Children exposed to household smoke were significantly at higher risk of asthma, wheezing, and allergic rhinitis (OR: 1.20, CI: 1.08–1.33; OR: 1.21, CI: 1.09–1.34; and OR: 1.32, CI: 1.21–1.43, respectively). All allergic diseases were increased in those children living in areas which have altitude of below 1000 m and mean yearly atmospheric pressure above 1000 mb. The study has suggested that household and country‐specific environmental factors are associated with asthma, wheezing, allergic rhinitis, and eczema risk during childhood in Turkey.
The Role of a Mentoring Group for Family Therapy Trainees and Therapists of Color
Authors: WATTS‐JONES DEE , ALI REHANA , ALFARO JOSE , FREDERICK AQUILLA
Published: November 2007

This article discusses the development, process, and impact of a mentoring group for family therapists of color. A within‐group process for trainees of color in a predominantly White institution can provide a valuable resource for support, validation, empowerment, and collective action. The article examines how such mentoring promotes the effectiveness of therapists of color, as well as the practices and goals of social justice and diversity within training institutions and the field in general. Reflections and recommendations for implementing such a group are offered, as well as a personal narrative of a group member's experience of finding her voice in the group.
Couple Communication in Stepfamilies
Authors: HALFORD KIM , NICHOLSON JAN , SANDERS MATTHEW
Published: November 2007

Effective communication is assumed to help sustain couple relationships and is a key focus of most relationship education programs. We assessed couple problem‐solving communication in 65 stepfamily and 52 first‐time‐marrying couples, with each group stratified into high risk and low risk for relationship problems based on family‐of‐origin experiences. Relative to partners in first‐time couples, partners in stepfamily couples were less positive, less negative, and more likely to withdraw from discussion. Risk was associated with communication in first‐time but not stepfamily couples. Stepfamily couples do not exhibit the negative communication evident in high‐risk first‐time‐marrying couples, and available relationship education programs that focus on reducing negative communication are unlikely to meet the needs of stepfamilies.
Anxiety Within Families: Interrelations, Consistency, and Change
Authors: STEVENSON‐HINDE JOAN , CURLEY JAMES PATRICK , CHICOT REBECCA , JÓHANNSSON CESSIE
Published: November 2007

In a community sample of mothers (N=763), each with a focal child aged 4.5 years, anxiety levels were high. Only 54% of mothers had anxiety scores within the “normal” Hospital Anxiety and Depression Scale (HADS) range, compared with 85% for depression. A subsample (N=116) was selected for two‐parent families, one to three children, and mothers spread over low, medium, and high anxiety levels. Mothers' anxiety was not significantly related to age, education, or work status, but rather to mothers' and fathers' independent ratings of marital satisfaction and family functioning, and to fathers' own anxiety and depression. Fathers' anxiety was related not to their own views of marital satisfaction and family functioning, but rather to mothers' views and to maternal anxiety. Assessments 8 years later—of anxiety, depression, and family functioning—showed high consistency over time, particularly maternal anxiety (r=.70) and paternal depression (r=.81). Although means did not change significantly over time for fathers, mothers' anxiety, depression, and perceptions of family functioning all improved (p<.001). For parents who were later to separate (compared with the others), initial family functioning, dyadic adjustment, and maternal anxiety were significantly “worse.” The strongest predictor of later break‐up was fathers' dyadic adjustment.
Assessment of Family Functioning in Caucasian and Hispanic Americans: Reliability, Validity, and Factor Structure of the Family Assessment Device
Authors: AARONS GREGORY A. , MCDONALD ELIZABETH J. , CONNELLY CYNTHIA D. , NEWTON RAE R.
Published: November 2007

The purpose of this study was to examine the factor structure, reliability, and validity of the Family Assessment Device (FAD) among a national sample of Caucasian and Hispanic American families receiving public sector mental health services. A confirmatory factor analysis conducted to test model fit yielded equivocal findings. With few exceptions, indices of model fit, reliability, and validity were poorer for Hispanic Americans compared with Caucasian Americans. Contrary to our expectation, an exploratory factor analysis did not result in a better fitting model of family functioning. Without stronger evidence supporting a reformulation of the FAD, we recommend against such a course of action. Findings highlight the need for additional research on the role of culture in measurement of family functioning.
Eating disorder in women admitted to hospital following deliberate self‐poisoning
Authors: Kent A. , Goddard K. L. , van den Berk P. A. H. , Raphael F. J. , McCluskey S. E. , Lacey J. H.
Published: November 2007

Measures of abnormal eating behaviour in 48 women referred for psychiatric assessment following an act of deliberate self‐poisoning (subjects) were compared with those in 50 women attending an accident and emergency department following minor accidental injury (controls). Disordered eating behaviour was significantly more prevalent in the subject group, even when the effect of depression was removed. Four subjects fulfilled the diagnostic criteria for bulimia nervosa, but none of the subjects met the diagnostic criteria for anorexia nervosa. The prevalence of obesity was the same in both subject and control groups. The degree of abnormal eating was very strongly correlated with a measure of inwardly directed irritability in both subjects and controls, and was strongly associated with measures of impulsiveness, outwardly directed irritability and anxiety in subjects.
Meta‐analysis of randomized, double‐blind, dacebo‐controlled, efficacy and safety studies of mirtazapine versus amitripcyline in major depression
Authors: Stahl S. , Zivkov M. , Reimitz P. E. , Panagides J. , Hoff W.
Published: November 2007

A meta‐analysis was performed on efficacy and safety data from 4 randomized, double‐blind, 6‐week, single‐center studies comparing mirtazapine (n= 194; 5–35 mg/day) with amitriptyline, (n= 193, 40–280 mg/day) and placebo (n= 193) in outpatients with a DSM‐III diagnosis of major depressive episode. On all the main cllicacy variables both active drugs consistently produced significantly greater improvements and significantly greater percentages of responders or remitters than placebo. The meta‐analysis of adverse events shows that mirtazapine was better tolerated than amitriptyline, particularly with respect to anticholinergic and cardiac adverse events. There were no differences between mirtazapine and placebo regarding the incidence of serotonergic adverse events. In conclusion, the results of this meta‐analysis demonstrate that mirtazapine is as effective as amitriptyline but has a better tolerability profile.
Severity of alcohol dependence and its relationship to neurological soft signs, neuropsychological impairment and family history
Authors: Keenan E. , O'Donnell C. , Sinanan K. , O'Callaghan E.
Published: November 2007

We examined the relationship between severity of alcohol dependence, subtle neurological impairment, neuropsychological deficits and genetic vulnerability among 36 day hospital attenders who satisfied the DSM‐III‐R criteria for alcohol dependence. Severity of alcohol dependence was unrelated to the presence of a family history, but was correlated with neurological soft signs and neuropsychological impairment. Neurological soft signs were correlated with neuropsychological impairment on both Trail A and Trail B. Patients with an affected first‐degree relative exhibited more neurological soft signs. These data indicate that severity of alcohol dependence is related not only to neuropsychological impairment, but also to subtle neurological deficits which may not be apparent on conventional neurological examination. Patients with a positive family history of alcohol dependence may be particularly susceptible to the neurological sequelae of alcohol dependence, or may have neurological deficits which antedate their alcohol dependence.