bluuebunny/crossref_metadata_2025 huggingface dataset:
Androgen administration in middle‐aged and ageing men: effects of oral testosterone undecanoate on dihydrotestosterone, oestradiol and prostate volume
Authors: Pechersky A. V. , Mazurov V. I. , Semiglazov V. F. , Karpischenko A. I. , Mikhailichenko V. V. , Udintsev A. V.
Published: March 2003

The gradual reduction of plasma testosterone in middle‐aged and older men from mid‐life onwards coincides paradoxically with the time when there is progressive growth of the prostate, a highly androgen‐dependent organ. The growing interest in androgen therapy for older men makes it essential to understand the effects of exogenous testosterone on the non‐diseased prostate, yet few studies are available. The present study examined prostate volume, prostate‐specific antigen (PSA) and lower urinary tract symptom (IPSS) score in 207 men, aged 40–83 years, presenting with clinical features of age‐related androgen deficiency [sexual and/or urinary dysfunction, elevated lutenizing hormone (LH)] who were treated for 6 months with oral testosterone undecanoate (TU). Men were divided into two groups, group 1 (n=92, plasma testosterone levels > 13 nmol/L) were treated with 80 mg daily; group 2 (n=115, plasma testosterone levels < 13 nmol/L) were treated with given 120 mg daily. Before treatment and after 1, 3 and 6 months of treatment, prostate volume was measured by ultrasound and hormones [testosterone, dihydrotestosterone, oestradiol, LH, follicle‐stimulating hormone (FSH)] and PSA were measured. Within 1 month of treatment, the elevated blood LH levels were markedly decreased in all men in group 1, as well as most men in group 2. Group 2 was subdivided into men whose LH levels were suppressed (n=95, group 2a) and those whose LH levels did not suppress (n=20, group 2b). Men in group 1 and 2a had marked decreases in prostate volume, PSA and lower urinary tract symptom (IPSS) scores whereas no significant changes were observed in group 2b. Groups 1 and 2a also had more striking suppression of LH, FSH, dihydrotestosterone and oestradiol whereas group 2b had no significant increases in blood testosterone concentrations. These findings suggest that exogenous testosterone in middle‐aged and older men with some clinical features of age‐related androgen deficiency can retard or reverse prostate growth and that elevated plasma LH may be a useful index of severity of age‐related androgen deficiency.
Sperm DNA damage and cancer treatment1
Authors: Morris Ian D.
Published: March 2003

Cancer treatments are well known to adversely affect male fertility. Reduction of sperm output arises from the cytotoxic effects of chemo‐ or radiotherapy upon the spermatogenic epithelium. However, if the epithelium survives there is a hazard to reproduction as the treatments are also mutagenic. The presence of DNA damage in the male genome is shown in animal experiments where there is transgenerational expression as a variety of effects ranging from miscarriage to carcinogenesis. The application of DNA damage methodology to sperm provides the opportunity for direct assessment. The Comet and Chromatin structure assays (SCSA) measure DNA damage by different principles, however, conclusions arising from the data are similar. DNA damage is present in sperm from fertile and infertile men and there is some association with infertility. Both assays detect sperm DNA damage after in vivo treatment with genotoxic agents. In a man treated with chemotherapy for cancer there was increased and persistent DNA damage in sperm. This information is consistent with the generation of human genetic diseases after conception with sperm carrying high loads of DNA damage. Whilst studies have not supported any association between paternal cytotoxic cancer therapy and genetic disease in their children, it would be unwise to discount these observations. The institution of better surveillance of genetic disease in the offspring of men surviving cytotoxic therapies may provide more robust risk assessment.
Characterization of the fertility of Kit haplodeficient male mice
Authors: GUERIF F. , CADORET V. , PLAT M. , MAGISTRINI M. , LANSAC J. , HOCHEREAU‐DE REVIERS M. T. , ROYERE D.
Published: March 2003

The role of the proto‐oncogene Kit expression during gonadal development, then in differentiated spermatogonia has been thoroughly established. The present study was designed to investigate the consequences of a partial defect in Kit gene expression on sperm fertilizing ability, using Kit haplodeficient mice (kitW‐lacZ/+). Same inbred mice (kit+/+) were used as controls. Epididymal sperm characteristics and in vivo fertility were assessed, then in vitro‐fertilization experiments were carried out for mice of both genotypes. Epididymal sperm count was drastically reduced, and sperm motility was also decreased in kitW‐lacZ/+ compared with kit+/+ males. Both in vivo or in vitro fertility were greatly reduced in kitW‐lacZ/+ compared with kit+/+ males. By contrast, the fertility of kitW‐lacZ/+ females was apparently unaffected. Additionally, a higher number of spermatozoa with undetected acrosomal contents was revealed by fluorescein isothiocyanate‐labelled Pisum sativum agglutinin acrosomal staining after epididymal sperm retrieval in kitW‐lacZ/+ mice, whereas no difference was observed after induction of acrosomal reaction in mice of either genotype. Ultra‐structural data confirmed the higher frequency of abnormal acrosome in spermatozoa of kitW‐lacZ/+ mice. Thus, sperm production is impaired in Kit haplodeficient mice both on a quantitative and a qualitative basis. Finally, we show that one single copy of Kit gene is not sufficient to maintain genuine fertility in male mice.
Androgen receptor and prostate cancer invasion1
Authors: Bonaccorsi Lorella , Muratori Monica , Carloni Vinicio , Zecchi Sandra , Formigli Lucia , Forti Gianni , Baldi Elisabetta
Published: March 2003

Evidence indicates that androgen‐sensitive prostate cancer cells have a lower malignant potential. We previously demonstrated that expression of androgen receptor (AR) by transfection of the androgen‐independent prostate cancer cell line PC3 decreases invasion and adhesion of these cells through modulation of α6β4 expression. Treatment with the androgen further reduced adhesion and invasion of the cells without, however, modifying α6β4. Here we investigated whether the androgen has a direct effect on α6β4‐EGF receptor (EGFR) interaction and signalling leading to invasion of these cells. Immunoconfocal microscopy demonstrated that in control cells (PC3‐Neo), α6β4 and EGFR colocalize and redistribute in response to epidermal growth factor (EGF). In PC3‐AR cells colocalization and redistribution between the two molecules was reduced and abolished by pre‐treatment with R1881. Co‐immunoprecipitation studies demonstrated that tyrosine phosphorylation of β4 in response to EGF was reduced in PC3‐AR cells compared to PC3‐Neo. Immunoconfocal and co‐immunoprecipitation studies demonstrated colocalization at membrane level and co‐immunoprecipitation of EGFR and AR, indicating an interaction between the two proteins. PI3K activity, a key signalling pathway for invasion of these cells, was decreased in PC3‐AR cells in response to EGF and further reduced by treatment with R1881. EGFR internalization was strongly reduced in PC3‐AR compared with PC3‐Neo cells and was reduced by treatment with R1881. In conclusion, the expression of AR by transfection in PC3 cells confers a less malignant phenotype by interfering with EGFR‐‐α6β4 interaction and signalling leading to invasion through a mechanism involving an interaction between the classic AR and EGFR.
Expression of heat shock protein 47 is increased in remnant kidney and correlates with disease progression
Authors: SUNAMOTO MASAAKI , KUZE KOGO , IEHARA NORIYUKI , TAKEOKA HIROYA , NAGATA KAZUHIRO , KITA TORU , DOI TOSHIO
Published: March 2003

Glomerulosclerosis is characterized by accumulation of the mesangial extracellular matrix, including type I and IV collagen. The processing for the collagens in the glomeruli may play a critical role for development of glomerulosclerosis. We examined the expression of heat shock protein 47 (HSP47), a collagen‐binding molecular chaperone in the progresive glomerulosclerosis model. Subtotally nephrectomized rats, unlike sham‐operated rats, developed focal and segmental glomerulosclerosis. Immunological staining demonstrated an increased expression of HSP47 which paralleled the expression of type I and IV collagen in the glomeruli of the nephrectomized rats as the glomerulosclerosis developed. The mRNA levels encoding type I and type IV collagen and HSP47 were increased 3.4 fold, 3.6 fold and 2.8 fold, respectively, at week 7 after nephrectomy. By in situ hybridization, the expression of HSP47 mRNA was determined to be localized to the glomeruli with segmental sclerosis. These results suggest that HSP47 may play a central role in the process of extracellular matrix accumulation during the development of glomerulosclerosis.
Antibody induced injury to podocytes with proteinuria and foot process swelling in a transgenic (T16) mouse
Authors: Ebrahim  , Evans
Published: March 2003

T16 mice contain a human 3′ untranslated sequence of the Thy 1.1 gene. Unlike normal mice they express Thy 1.1 protein on the podocytes which was immuno‐localized to podocyte apical and basal plasma membranes and filtration slit. When monoclonal anti‐Thy 1.1 antibody (OX7) was injected in nonproteinuric heterozygous mice there was rapid podocyte foot process swelling and proteinuria. Immunofluorescence showed granular glomerular OX7 binding at one hour. Progressive loss of pedicels occurred with 17.9 ± 2.5, 14.4 ± 1.1 and 10.5 ± 3.5 per 10 nm glomerular basement membrane (GBM) remaining 1, 6 and 24 hours, respectively, after 1 mg OX7, vs 32.2 ± 2.0 in T16 mice given saline. Twenty‐four hour proteinuria was OX7 dose‐dependent, peaked at 1–3 days and reduced to near basal levels 9–11 days thereafter. Proteinuria was nonselective except at very low doses (0.1 mg OX7) where microalbuminuria was seen. F(ab′)2 OX7 administration also caused proteinuria in T16 mice. One milligram F(ab′)1 OX7 caused diffuse foot process swelling without manifest proteinuria in T16 mice. Anti‐Thy 1.1 IgM monoclonal antibody did not produce the effects of OX7 in T16 mice. Foot process swelling was not modified by histamine or 5‐hydroxytryptamine antagonists. OX7 did not cause complement activation or leucocyte infiltration, hence glomerular injury appeared to be mediated directly by the antibody.
THE MANAGEMENT OF DROOLING IN CHILDREN AND PATIENTS WITH MENTAL AND PHYSICAL DISABILITIES: A LITERATURE REVIEW
Authors: Hussein  , Kershaw  , Tahmassebi  , Fayle
Published: March 2003

Amongst the duties of the paediatric dentist is the provision of oral care to patients with the problem of drooling. Many, but certainly not all, of these patients have physical and/or learning disabilities. Various methods have been advocated for the management of drooling in the paediatric patient and older patients with disabilities, including behavioural programmes, biofeedback techniques, physiotherapy, biofunctional oral appliances, medication and surgery. It is of paramount importance that the patients and/or carers understand the advantages and disadvantages of any treatment method being considered. The paediatric dentist has an important role to play in explaining the different options to the patients and carers, and in implementing some treatment modalities, particularly non‐surgical approaches. Referral to surgical specialists should be seen as ‘a last resort’ and suggested only if other treatment methods have been exhausted. If pharmacological or surgical treatment is carried out, careful monitoring for the development of dental caries and other problems is essential. The aim of this paper is to provide the paediatric dentist with concise overall knowledge of the causes of drooling and treatment options available.
Cysticercosis of the oral cavity: report of five cases and a review of literature
Authors: Saran R.K. , Rattan V. , Rajwanshi A. , Nijkawan R. , Gupta S.K.
Published: March 2003

This paper reports on five cases of cysticercosis of tongue and buccal mucosa, diagnosed on fine‐needle aspiration cytology (FNAC), affecting child patients who presented between January 1994 and October 1997. Four cases presented with gradually increasing nodular swelling of the dorsum of tongue and in the fifth case the swelling was situated on the buccal mucosa of the left side. A clinical diagnosis of cysticercosis was not entertained in any of these patients, who each presented with a solitary lesion; instead, it was considered to be a benign cyst or benign tumour of salivary gland or mesenchymal tissue, before FNAC diagnosis. These lesions of the oral cavity may present first to a dentist and, in endemic areas, cysticercosis should be included in the differential diagnosis of solitary nodular lesions of the oral cavity, particularly in young individuals.
The chronology and sequence of eruption of human permanent teeth in Northern Ireland
Authors: Kochhar R. , Richardson A.
Published: March 2003

Objectives. To ascertain the average and range of ages and sequence of eruption of human permanent teeth, taking into account the effect of premature loss of primary antecedents.

Design. Longitudinal study.

Setting. Caucasian subjects in Northern Ireland.

Sample and methods. Study casts at 6‐monthly intervals from age 5 to 15 years of 276 children (146 males and 130 females) enrolled in the Belfast Growth Study. The mean and range of ages of eruption of each individual tooth were computed. Comparisons were made between the mean ages of eruption with and without premature loss of primary antecedents, between upper and lower arches, between right and left sides and between males and females. The sequence of eruption was also investigated.

Results. The means and ranges of eruption ages are reported. Premature loss of primary antecedents delayed eruption of permanent successors except for the upper premolars which were accelerated. The differences relating to the upper first premolar and lower canine were not statistically significant. Each lower tooth erupted before its upper counterpart except for the premolars. There was no significant difference in age of eruption between right and left sides. Females tended to erupt teeth before males with the exception of the second molars in both arches; however, the only differences to reach statistical significance related to upper and lower canines and upper lateral incisors. The most frequent orders of eruption were unique to the subject. These occurred in 22% of upper and 33% of lower arches.

 The classic sequences: first molar–central incisor–lateral incisor–first premolar–canine–second premolar–second molar (M1‐I1‐I2‐PM1‐C‐PM2‐M2) in the upper arch and I1‐M1‐I2‐C‐PM1‐PM2‐M2 in the lower arch occurred in only 16% of upper arches and 13% of lower arches. Males adhered to the textbook sequence (20% upper, 17% lower) more than females (12% upper, 8% lower). In the upper arch of females, the order M1‐I1‐I2‐PM1‐PM2‐C‐M2 in 10% of subjects was almost as frequent as the classic sequence.

Conclusion. The ages, ranges and orders of eruption found in this study are more reliable than many which are frequently quoted on account of its longitudinal nature and the fact that the effect of premature loss of primary antecedents is taken into account. The exclusively Caucasian sample makes the data quite precise but limits applicability to patients of this ethnic origin.
Oral health behaviour of 12‐year‐old children in Kuwait
Authors: Vigild M. , Petersen P.E. , Hadi R.
Published: March 2003

Objectives. The objectives of the study were: (1) to describe the pattern of oral health behaviour of 12‐year‐old children in Kuwait, (2) to analyse this in relation to parental education, dental visiting habits and location, and (3) to establish a baseline for planning and evaluation of an oral health care programme for secondary schoolchildren.

Design. Cross‐sectional, interviews with children in 1995.

Sample and methods. The sample included 500 12‐year‐old schoolchildren (250 boys and 250 girls) selected from schools in Kuwait. All the children agreed to take part. Interviews with the children were carried out in the schools by four trained and calibrated Arabic speaking interviewers.

Results. During the previous 12 months, 28% of the children had experienced oral health problems – toothache (10%), or had felt discomfort (18%) either often or occassionally. The children reported that they needed oral hygiene instruction (71%), fillings (32%) and tooth extraction (23%). For 53% of the children the reason for the most recent visit to a dentist was pain or problems with teeth or gums. At their last dental visit 26% of the children had undergone a tooth extraction. The consumption of sugary foods and drinks was extremely high. Children who had visited a dentist within the last 12 months and children whose parents had higher education levels more often claimed frequent toothbrushing than those with no previous dental visiting experience and those whose parents had a low level of education.

Conclusions. Oral health education and oral health care programmes should be established in secondary schools in Kuwait to influence the oral health behaviour of the children and to avoid further deterioration in their oral health.
Orbital infection arising from a primary tooth: a case report
Authors: Rosen D. , Ardekian L. , Abu El‐Naaj I. , Fischer D. , Peled M. , Laufer D.
Published: March 2003

Odontogenic infections may spread to the orbit by one or more of several paths. Such extension is potentially dangerous and may lead to loss of vision. A case of infection from a primary tooth, which extended to the retrobulbar area is presented in this report. Treatment included surgical drainage of the resulting subperiosteal orbital abscess through a Caldwell‐Luc approach as well as aggressive antibiotic therapy. The importance of early suspicion of this entity and its potential sequelae are discussed.
Traditional tooth bud gouging in a Ugandan family: a report involving three sisters
Authors: Dewhurst S.N. , Mason C.
Published: March 2003

It has been reported in the literature that some rural populations of Sub‐Saharan and Eastern Africa and other isolated areas around the world, practise gouging or enucleation of primary tooth buds to cure childhood illnesses. The unerupted primary canine tooth bud is believed to be the cause of febrile illness, diarrhoea, and vomiting; prevalent in infants in these areas of the world.

Tooth bud gouging has implications for the developing dentition, and is a potential risk to the health and life of the child. Reported prevalence ranges from 22%‐90%.

From the information in this case report, the practise of tooth bud gouging is no longer confined to rural areas and may well be performed by communities that have emigrated to the UK. The three sisters described, now resident in the UK, suffered tooth gouging in a city clinic in Uganda. The damage caused to the primary and permanent dentition is described and treatment planning and options are suggested for each case to restore structure and function.

Appropriate provision of healthcare and education could avoid the potential long‐term damage to the health of the child and their developing dentition by the practise of tooth bud gouging, whether it occurs in the developing or developed world.
Riga–Fede disease: association with microcephaly
Authors: Baghdadi Z. D.
Published: March 2003

Summary. A case of microcephaly associated with traumatic ulceration to the ventral surface of the tongue (Riga‐Fede disease) in a 12‐month‐old female is presented. To the best of our knowledge, such association has not been described previously. A conservative treatment regime was used, involving medical management, elimination of the sharp edges of the teeth and use of topical triamcinolone, and the ulceration healed over a period of 4 weeks.
Factitial oral lesions in an autistic paediatric patient
Authors: Medina A. C. , Sogbe R. , Gómez‐Rey A. M. , Mata M.
Published: March 2003

Summary.Self Injurious Behaviour (SIB) is a deliberate harm to the body that may lead to factitial injuries. Its origin may be functional or biological and it has a higher prevalence in females and in psychologically impaired individuals. Seventy per cent of autistic patients have SIB. Seventy‐five per cent of factitial injuries are located in the head and neck region. A paediatric case report concerning a 4‐year‐old autistic female is presented. Detailed medical history, physical examination, clinical intraoral and radiographic examination, incisional biopsy, neuropaediatrical, psychological and speech evaluation were undertaken. Diagnosis included hypochromic macrocytic anaemia, caries, coronal fracture, factitial ulcer, factitial periodontitis, self‐extraction of primary teeth and permanent teeth buds, non‐specific oral ulcer with inflammatory reaction, mild mental retardation, speech impairment, autistic syndrome and self injurious behaviour consisting of putting fingers and foreign objects in the gingiva, fingernail biting and hair pulling. Differential diagnosis included hystiocitosis X, prepuberal periodontitis and leukocyte adhesion deficiency. Dental preventive and restorative treatment was performed. Non‐contingent reinforcement therapy was successfully used to diminish SIB. Treatment of factitial oral injuries must be interdisciplinary and requires cooperation of the patient, the parents, health care providers, and medical team.
Nurses' knowledge of and attitudes towards sexuality and the relationship of these with nursing practice
Authors: Lewis Sarah , Bor Robert
Published: March 2003

Issues concerning sex and sexuality are relevant to nursing practice The objective of this study was to determine the relationship between knowledge of and attitude towards sexuality, and nursing practice Nursing practice in this case was defined as the discussion of sexuality with the patient, with particular reference to taking a sexual history on admission to the ward A multi‐choice questionnaire with sections establishing demographic details and nursing practice, and including the Sex, Knowledge and Attitude Test (SKAT), was administered to 357 registered general nurses (RGNs) Results show a relationship between knowledge and attitude but no relationship between either of these and the nursing practice scale However, a slight but significant correlation between receiving teaching about sexual history taking and questioning patients about sexuality on admission suggests that nursing practice and knowledge are weakly related There is evidence that factors other than those within the scope of this study influence all three independent variables, and these are discussed The implications of the study suggest the need for an improvement in nurse education regarding sexuality at all stages of training
Testicular cancer health education: an integrative review
Authors: Rosella John D
Published: March 2003

Cancer of the testis is the most common malignancy in men between the ages of 15 and 35, yet it is one of the most curable cancers The optimistic prognosis that results from early detection and treatment of testicular cancer underscores the critical need for teaching testicular self‐examination (TSE) However, anintegrative review of the health education literature suggests that the men most susceptible are virtually unaware of the symptoms of testicular cancer and how to detect them Although educational materials have been available, very little intervention research has been published on testicular cancer The literature to date has focused on the psychosocial factors associated with the practice of TSE and increasing knowledge of testicular cancer Although an important beginning step, knowledge of testicular cancer alone as a preventive health behaviour is not sufficient if young men either do not know how to do the examination on their own testicles or do not believe it is important to them Nurses should incorporate health education for testicular cancer and TSE in the delivery of routine primary health care Furthermore, future research should aim to (a) increase knowledge through the educational curricula of high schools and colleges by use of video presentations, (b) examine the efficacy of using silicone models to ensure that men can be trained to detect the symptoms of testicular cancer, and (c) study compliance with recommendations to perform TSE
Student nurses' involvement with death: the image and the experience
Authors: Kiger Alice M
Published: March 2003

A qualitative study of student nurses’ images of nursing revealed that features related to death were prominent in both entry and experience‐mediated images These features appeared in entry images as part of‘the bad’ of nursing and were affirmed in this respect through experience However, mediated through students’ encounters with reality, death‐related experiences also acquired characteristics of‘the good’ The‘involvement’ entailed in caring for the dying represented a poignant but emotionally draining aspect of students’ clinical experiences Regardless of the degree of accuracy of students’ entry images, the‘knowing’ that came through experience made adjusting to death‐related encounters a particular challenge for students A clear implication was the need for effective guidance and support to be provided by the system and by individual members of teaching and clinical staff
Staff attitudes and job satisfaction in the care of demented elderly people: group living compared with long‐term care institutions
Authors: Alfredson Betty Bauer , Annerstedt Lena
Published: March 2003

The present study is one part of a study evaluating group living (GL) care for demented elderly people in comparison with traditional institutional (TI) care The present report concentrates on personal and work‐related effects on staff A staff training programme has been implemented, including relevant gerontological knowledge, principles of the new care concept, support and supervision Effects are evaluated by staff interviews, observation and staff turnover rates Results show increased knowledge and new emotional and social attitudes, resulting in higher competence and professional conduct towards patients as well as increased motivation, job satisfaction and quality of work for GL staff but not for TI staff Group living is now a rapidly developing form of care in Sweden
On the moral nature of nursing practice
Authors: Crowden Andrew
Published: March 2003

Until recent times many nursing authors have relied on rather narrow interpretations of selected aspects from the broader discourse of ethics and moral philosophy in their writing on ethics in nursing As a consequence, discourse in nursing ethics has been limited in its vision and far from comprehensive in its content This can be seen in the large number of texts and journals which discuss issues in nursing ethics Particularly in many of the nursing textbooks up to and including the 1960s, 1970s and, to a lesser extent, the early 1980s, ethics content is commonly framed in terms of the dilemmas of practice Moreover, overall there is a preoccupation with either deontological or teleological positions and the application of corresponding analytical frameworks consistent with the particular view taken In most texts the preferred view is deontological, with a predominating emphasis on principle and duty Recently in nursing ethics there has been a focus towards the deconstruction of the dominant views in ethics encompassed by the more traditional perspectives Consequently, as in other areas of applied and theoretical ethics, there has been a re‐awakening of interest in the ‘virtues’, and in processes which encourage the articulation of ethical dimensions of practice in ways other than applying principles, rules and formulae to situations of clinical dilemma
Casualty nurses' attitudes to attempted suicide*
Authors: Mc Laughlm Columba
Published: March 2003

This study explores the attitudes of casualty nurses to attempted suicide The nurses’ age and length of experience in casualty were the independent variables A total of 142 nurses from 11 hospitals in Northern Ireland had questionnaires circulated to them, with a 66 9% response rate There were significant differences on four of the variables in relation to nurses’ ages, and on two of the variables in relation to the nurses’ length of experience in casualty The older and the more experienced nurses seem to have more positive attitudes than the younger or the less experienced nurses However, further nursing research, in Northern Ireland, is needed to corroborate these findings Other recommendations are made
Struggling to maintain balance: a study of women living with fibromyalgia
Authors: Schaefer Karen Moore
Published: March 2003

Thirty‐six women with fibromyalgia (FM) were asked to describe how they live with their FM Data were analysed using the constant comparative method The goal was understanding the process of living with FM through theory development The women described living with FM as struggling to maintain balance, this involves recalling perceived normality, searching for a diagnosis, finding out and moving on (transcending the illness) Several women relinquished the struggle because of situations that may or may not be under their control (e g depression and feeling imprisoned by treatment) Over time the illness moves from being a primary life focus to being part of the backdrop of the lives of women with FM
The impact of perceived medical dominance on the workplace satisfaction of Australian and British nurses
Authors: Adamson Barbara J , Kenny Dianna T , Wilson‐Barnett Jenifer
Published: March 2003

Current literature on the sociology of health views medical dominance as a structural feature of the health division of labour, and a body of literature has developed exploring the structural components contributing to the subordination of the allied health professions In this paper, nursing literature describing the nature and source of nurses' perceptions, complaints and dissatisfactions with their profession, and sociological analyses of the position of nurses within the structure of the health care delivery system, were employed to provide a framework for assessing the degree to which structural medical dominance of the nursing profession impinges on nurses' perceptions of dominance and how these perceptions affect nurses' workplace satisfaction A 69‐item questionnaire covering aspects of doctor‐nurse, doctor‐patient, nurse‐patient and nurse‐hospital administration relationships was developed One‐hundred and thirty‐three Australian nurses and 108 British nurses completed the questionnaire, in which they ranked their own level of professional satisfaction and the level of satisfaction they perceived doctors to experience Results indicated that Australian and British nurses were not only dissatisfied with many aspects of then‐ work environment, such as their pay and working conditions, but also experienced dissatisfaction with their professional status while perceiving the medical profession to be highly satisfied British nurses were significantly more dissatisfied with their own profession and perceived the medical profession to be more authoritarian than did Australian nurses No difference between Australian and British nurses' perceptions of degree of medical autonomy was found The implications of nurses' perceived discrepancy in workplace satisfaction between nurses and doctors in the delivery of health care are discussed in terms of the structural barriers created by medical dominance Recommendations for the trainmg of nurses and the implications of the findings for nurse practitioners are made, together with suggestions for further research
From paradigm to method in interpretive action research
Authors: Simmons Susan
Published: March 2003

It is generally accepted in many areas of research, including nursing research, that decisions about research methods should be informed by the nature of the research question, that the research question will indicate what approach and methods should be used However, it is arguable that this over‐simplifies the process of decision‐making It is suggested that the axiom that question determines approach and method overlooks the influence of the researcher's personal worldview in such decisions This paper seeks to examine some of the elements of the process of moving from underlying philosophy to research design and strategies, by exploring the concept of paradigm, features of this researcher's worldview, and the principles and processes which influence decisions about the research The process is illustrated by reference to features of a study into the work of community psychiatric nurses in relation to the quality of life and social networks of their clients with enduring mental health problems
Crossing the boundaries — experiences of neophyte nurses
Authors: Seed Ann
Published: March 2003

Boundaries exist that dictate socially acceptable degrees of bodily exposure and touch Certain groups, for example nurses, appear to undertake emotionally charged work where they are called upon to cross these boundaries This paper relates the experience of a student nurse cohort as they ‘crossed the boundaries’ The students' views were collected by participant observation and interview, and analysed by employing grounded theory Since the study was longitudinal the findings reflect how the neophytes’ views changed with the passage of time Early in their course students found giving intimate care stressful, while caring for those of the opposite sex created particular difficulties Both male and female students developed coping strategies, for example ‘ways of seeing’ those they nursed Students maintained that the nature of their work led others to view them in certain ways In some instances female students might be seen as sexually available by men for whom they cared, however, with experience they dealt effectively with sexual advances The cohort considered that wearing a uniform on the one hand protected and legitimized them in crossing boundaries, but on the other it signalled their occupation to others which on occasions was something they might wish to conceal These findings provide insights into the notion of crossing social boundaries, an area which warrants further investigation, since it involves an important aspect of caring (Names of students cited in this paper are pseudonyms)
Care, attention and imaginative identification in nursing practice
Authors: Scott P Anne
Published: March 2003

This paper has relevance for both the major health care professions of medicine and nursing Therefore the author tends to speak of health care practitioners rather than nurses or doctors The author argues that health care practitioners need to be supported and facilitated in analysis of the concept of care both during their initial professional educational preparation and during their professional lives Developing an adequate conceptual base for health care practice enables the practitioner to clarify issues of role, function and responsibilities A conceptual analysis of caring in health care practice highlights the need for practitioners to develop skills of attention and imaginative identification These skills enable the practitioner to provide constructive care for patients Constructive care is care which is patient‐based and patient‐oriented, identification of patient need being the stimulus and the focus of practitioner response
Achieving research‐based nursing practice
Authors: Pearcey Patricia A
Published: March 2003

The literature suggests that nurses may be failing to achieve research‐based practice A range of reasons why nurses fail to use research findings in practice has been highlighted in previous studies The overall aim of this study was to identify the self‐perceived research skills needs of trained nurses with the view to organizing workshops to meet these needs Six hundred trained nurses in six different health authorities were surveyed using self‐administered questionnaires These nurses worked in clinical areas, in hospitals, the community and education The results indicated that 93% (n = 398) of nurses were not satisfied with their research skills Other factors emerging indicated the self‐perceived skills deficit were those of an elementary nature, including locating research reports, reading and evaluating reports and application of results to practice, amongst others This may be an indication of why research‐based practice is still not a reality
Nurses'definitions of and attitudes towards euthanasia
Authors: McInerney Fran , Seibold Carmel
Published: March 2003

A major impetus for this study was recent literature that assumed that nurses’definitions of euthanasia and consequent opinions on decision making are unproblematic The purpose of this study was to identify nurses’definitions of and attitudes towards euthanasia Ten semi‐structured interviews were conducted with nurses working in a variety of clinical practice settings The majority of nurses could distinguish between active and passive euthanasia, but it was only in terms of active euthanasia that the debate was seen as significant It was considered that the term passive euthanasia, particularly in relation to withdrawal of treatment, has served to confuse the real debate centring around active euthanasia Only two participants were in favour of active euthanasia, but emphasized the need for ‘a community of shared responsibility’ in decision making The major finding of the study was the commitment of all participants to caring for and ensuring the comfort of the dying patient The concepts of ordinary and extraordinary forms of treatment and heroic measures were seen as worthy of debate in the context of dying with dignity rather than of euthanasia There was an associated aversion to inappropriate heroic measures, which were perceived as prolonging death and interfering with ‘dying with dignity’ The development of a personal and moral/ethical stance (in relation to euthanasia) was shown to be an evolving process embedded in a caring philosophy and emphasizing the contextual nature of providing appropriate care
An in‐depth study of triangulation
Authors: Dootson Sally
Published: March 2003

Multiple triangulation is an approach to research which is becoming increasingly popular among nurse researchers It is an attempt to improve validity by combining various techniques in one study Provided that the researcher is well informed, the approach can be successful However, the issue becomes clouded because in then‐excitement some nurse researchers seem to have forgotten that the roots of research stem from one of two paradigms, or world views This has led to the suggestion that paradigms may be combined, and has caused the validity of multiple triangulation to be called into question In an attempt to unravel the muddle this paper describes multiple triangulation and goes on to suggest where the confusion has occurred It concludes that multiple triangulation is a valid technique providing that researchers remember that their work will always be influenced by a single paradigm
Young children's behavioural responses to acute pain: strategies for getting better
Authors: Woodgate Roberta , Kristjanson Linda J
Published: March 2003

Behavioural responses of hospitalized young children in acute pain were examined and described Eleven children, aged 24‐79 months, who experienced acute pain in response to surgical intervention, and their parents, participated in the study A qualitative, naturalistic methodology was used Participant observation and child and parent interviews were the primary data collection methods The constant comparative method of data analysis was employed to identify beginning behavioural response categories Findings revealed that the children used the process of‘getting better’in response to pain This process involved three strategies‘hiding away’,‘fighting it’and‘making it good‘ Each of these strategies was characterized by specific behaviours The more pain the children experienced, the more frequently these strategies were employed Recommendations specific to assessing behavioural responses in young children experiencing acute pain are offered
The experience of bereavement in older adults
Authors: Anderson Kathryn L , Dimond Margaret F
Published: March 2003

One of the most profound losses experienced by humans is the death of a spouse The purposes of this report are to describe the grief experiences of older adults over the first 2 years after the death of their spouse, and to compare these experiences with those of younger bereaved spouses Data from interviews with 12 older bereaved spouses were analysed using the universal semantic relationships described by Spradley (1979) The major categories that emerged from the data were‘feelings’,‘physical symptoms’, ‘special hardships’,‘coping’and 'support’This report describes respondent experiences related to the first four categories, the ways in which bereaved spouses received support have been described elsewhere (Rigdon et al 1987) Important similarities and differences between experiences of older and younger bereaved spouses are discussed, and recommendations for how nurses can meet the special needs of bereaved older adults are made
Satisfying solutions? A review of some unresolved issues in the measurement of patient satisfaction
Authors: Avis Mark , Bond Meg , Arthur Antony
Published: March 2003

The measurement of patient satisfaction has been encouraged by a growing consumer orientation in health care, especially since it yields information about consumers’views in a form which can be used for comparison and monitoring However, drawing on literature from a variety of sources, this paper suggests that there remain several unresolved issues relating to the measurement of satisfaction, and some serious questions about the validity of the concept It is argued that current approaches to measuring satisfaction may not be grounded in the values and experiences of patients, therefore satisfaction surveys could be denying patients the opportunity to have their opinions included in the planning and evaluation of health care services
Parents’ perceptions of caring for an infant or toddler with diabetes
Authors: Hatton Doreen L , Canam Connie , Thome Sally , Hughes Anna‐Marie
Published: March 2003

Although the incidence rate of diabetes in children under the age of 3 years is increasing dramatically, no previous studies provide information about the day‐to‐day experience of caring for these infants and toddlers Because a young child with diabetes is dependent on the parent for his/her very existence, the purpose of this phenomenological study was to gain knowledge and understanding of the parents’ experiences so that appropriate interventions could be developed and implemented to support parental care for this unique population Findings revealed three distinct phases in the parents’ experiences the diagnosis and child's hospitahzation, adjusting to care at home, and long‐term adaptation Within these phases, parents descnbed inordinate amounts of stress exacerbated by the child's young age and the complex, intrusive nature of diabetes management On the basis of these findings, implications for practice are discussed
Parallels and contradictions in the theory and practice of action research and nursing*
Authors: Waterman Heather , Webb Christine , Williams Anne
Published: March 2003

This paper draws on the authors’ experiences of nursing in general and of action research projects Parallels will be drawn between, on the one hand, the relationship between the practice and theory of nursing and, on the other hand, the relationship between the practice and theory of action research Difficulties common to nursing and action research will be identified (e g between the implementation of the theory of nursing and of action research) Oversimplification, non‐specificity of issues and gaps in theory are frequent but inevitable problems that hinder theoretical applications Similarly, comparisons will be made between the problems associated with the translation of nursing practice into theory and the difficulties in transposing the experience of research into theory The complexities of practice, whether nursing or research, and the evolutionary nature of experience inescapably give rise to dilemmas when analysing theory and practice The concepts of theory and practice when conceived as a dichotomy present a useful overview of issues We argue that, through a discussion of the core themes of action research, including ‘knowledge in action’ and 'self and group reflection’, consideration should also be given to a symbiotic and complementary analysis of theory and practice We observe that many contradictions exist within the theory and practice of action research and of nursing, and that these need to be addressed to promote theoretical and practical advances Action research offers theoretical and practical insights that contribute to the current debate on the reciprocal relationship between theory and practice
Developing the reflective teacher
Authors: Scanlan Judith M. , Chernomas Wanda M.
Published: March 2003

The conceptual issues and research findings surrounding the meaning and use of reflection are examined in this paper and serve as a foundation for discussing significant assumptions and beliefs regarding the use of reflection in nursing education. The strengths and limitations of reflection are discussed. The paper links current knowledge about reflection to the development of reflective thinking and its use by nurse educators and suggests strategies to enhance this development.
Perceived stressors and coping strategies among individuals with rheumatoid arthritis
Authors: Mahat Ganga
Published: March 2003

The purpose of this study was to identify the stressors perceived by individuals with rheumatoid arthritis (RA) and to describe coping strategies used to cope with illness‐related stressors and their perceived effectiveness. Data were collected from 53 patients attending a rheumatology clinic. Results revealed that pain was the predominantly perceived stressor followed by limitation in mobility, difficulties in carrying out activities of daily living, helplessness, dependency on others, threat to self‐esteem, interference in social activity, interference in family relationships, difficulties performing at work, and discomfort of the treatment. Subjects used optimistic and confrontive coping strategies more frequently than other coping strategies and optimistic coping strategies were perceived to be most effective. Point biserial correlation revealed a number of significant relationships between specific stressors and use of coping strategies: interference in family relationships and use of evasive coping strategies (r=0.27, P<0.05), and threat to self‐esteem and use of both evasive (r=0.45, P<0.01) and emotive (r=0.28, P<0.01) coping strategies. Similarly, a number of significant relationships were found between specific stressors and the effectiveness of the coping strategies: interference in family relationships and the effectiveness of both evasive (r=0.31, P<0.05) and emotive (r=0.38, P<0.01) coping strategies, and threat to self‐esteem and the effectiveness of emotive coping (r=0.29, P<0.05).
Health promotion ideology and nursing education
Authors: Rush Kathy L.
Published: March 2003

Nursing has been concerned primarily with the visible aspects of health promotion and has shown little regard for what is invisible. Yet the hidden ideology powerfully shapes current approaches to health promotion. This paper examines and makes visible the ideology of individual responsibility which is embedded in individualistic health promotion, the primary orientation to health promotion. Ways in which this ideology is perpetuated within nursing curricula are described. Concrete strategies are proposed that may be considered by nurse educators as they seek to prepare students in health promotion, with particular emphasis on strategies that highlight its ideological underpinnings.