bluuebunny/crossref_metadata_2025 huggingface dataset:
Proliferation and apoptosis in the seminiferous epithelium of photoinhibited Syrian hamsters (Mesocricetus auratus)1
Authors: Morales Eva , Pastor Luis M. , Ferrer Concepción , Zuasti Adelina , Pallarés Jacinto , Horn Ramón , Calvo Alfonso , Santamaría Luis , Canteras Manuel
Published: March 2003

In the hamster, male reproductive quiescence is accomplished via testicular atrophy and the germinal epithelium is regressed to spermatogonia and spermatocytes after 8–14 weeks of short photoperiods. However, the cellular mechanisms involved in this process have not been elucidated. As it is suggested that the regulation of seasonal testicular activity is characterized by coordinated shifts in the relationships between mitosis, meiosis and apoptosis, the changes in the proliferative and apoptotic activity in the seminiferous epithelium of photoinhibited Syrian hamster were examined and compared with those maintained in natural photoperiod. The proliferative activity was studied using BrdU immunostaining, and germ cell apoptosis was assessed by in situ TUNEL labelling and transmission electron microscopy. A significant increase in the rate of apoptosis (percentage of TUNEL‐positive spermatogonia + spermatocytes) was observed in photoinhibited animals (2.84 ± 0.16) compared with those exposed to natural photoperiod (0.77 ± 0.03, p < 0.05). The majority of apoptotic germ cells were spermatocytes and in some occasions spermatogonia. Germ cell apoptosis was confirmed by morphological characteristics: condensation of the chromatin and nuclear fragmentation. The rate of proliferation (percentage of BrdU‐positive spermatogonia + preleptotene spermatocytes) was significantly higher in photoinhibited hamsters (42.7 ± 2.6) compared with animals exposed to natural photoperiod (31.1 ± 1.6, p < 0.05). After the exposure to a short photoperiod the apoptotic index positively correlated with the proliferative index (r = 0.8150, p < 0.05). In conclusion, the seminiferous epithelium of photoinhibited Syrian hamsters is characterized by an increased rate of apoptosis associated to an enhanced rate of proliferation.
Effect of cancer therapy on pituitary–testicular axis1
Authors: Howell S. J. , Shalet S. M.
Published: March 2003

Treatment with cytotoxic chemotherapy and radiotherapy is associated with significant gonadal damage in men. Alkylating agents, such as cyclophosphamide and procarbazine, are the most common agents implicated. The vast majority of men receiving procarbazine‐containing regimens for the treatment of lymphomas are rendered permanently infertile. Treatment with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) appears to have a significant advantage in terms of testicular function, with a return to normal fertility in the vast majority of patients. Cisplatin‐based chemotherapy for testicular cancer results in temporary azoospermia in most men with a recovery of spermatogenesis in about 50% after 2 years and 80% after 5 years. There is also evidence of chemotherapy‐induced Leydig cell impairment in a proportion of these men, although this appears to be of no clinical significance in the majority of patients. The germinal epithelium is very sensitive to radiation‐induced damage with changes to spermatogonia following as little as 0.1 Gy, and permanent infertility after fractionated doses of 2 Gy and above, whereas clinically significant Leydig cell impairment occurs rarely with doses of less than 20 Gy.
Multicellular spheroids: a three‐dimensionalin vitroculture system to study tumour biology
Authors: KUNZ‐SCHUGHART LEONI A. , KREUTZ MARINA , KNUECHEL RUTH
Published: March 2003

The growth of tumour cells as three‐dimensional multicellular spheroidsin vitrohas led to important insights in tumour biology, since properties of thein vivo‐tumour such as proliferation or nutrient gradients, can be studied under controlled conditions. While this review starts with an update of recent data on spheroid monocultures, especially concerning tumour microenvironment and therapeutic modalities, the main emphasis is put on the spectrum of heterologous cultures which have evolved in previous years. This type of culture includes tumour cell interaction with endothelial, fibroblast or immunocompetent cells. The relation of the spheroid culture model to other types of three‐dimensional culture and our critical evaluation and presentation of the technical aspects of growing and analysing spheroids are included in the text. These topics are chosed to help the experimental pathologist design experiments with tumour spheroids and to stimulate discussion.
Vascular deprivation‐induced necrosis of the femoral head of the rat. An experimental model of avascular osteonecrosis in the skeletally immature individual or Legg‐Perthes disease
Authors: NORMAN  , REIS  , ZINMAN  , MISSELEVICH  , BOSS
Published: March 2003

The blood supply of rats' femoral heads was severed by cutting the ligamentum teres and stripping the periostium. Histologically, necrosis of the marrow was apparent on the 2nd postoperative day, necrosis of the bone on the 5th postoperative day and fibrous ingrowth on the 7th postoperative day. During the following 5 weeks, progressive resorption of the intertrabecular necrotic debris and necrotic bony trabeculae and subchondral bone plate and, concurrently, appositional and intramembranous new bone formation resulted in remodeling of the femoral heads. In 2 of 7 femoral heads, replacement of the necrotic bone by viable bone was complete at the 42‐day postoperative interval. Also, the articular cartilage of the deformed and flattened femoral heads was undergoing degenerative changes. Reduplicating the pathogenically inferred clinical settings of blood supply deprivation, it is proposed that this model, in a small laboratory animal, satisfies the requirements sought for preclinical studies of treatment modalities of avascular osteonecrosis in man.
The C/EBP family of transcription factors in the liver and other organs
Authors: Takiguchi Masaki
Published: March 2003

Members of the CCAAT/enhancer‐binding protein (C/EBP) family of transcription factors are pivotal regulators of liver functions such as nutrient metabolism and its control by hormones, acute‐phase response and liver regeneration. Recent progress in clarification of regulatory mechanisms for the C/EBP family members gives insight into understanding the liver functions at the molecular level.
Protective effect of pentoxifylline plus thalidomide against septic shock in mice
Authors: ARRIETA OSCAR , ORTIZ‐REYES ARACELI , REMBAO DANIEL , CALVILLO MINERVA , RIVERA ERIKA , SOTELO JULIO
Published: March 2003

Mortality caused by septic shock in experimental animals is reduced by thalidomide, an inhibitor of tumour necrosis factor α. Another drug that could act on the pathopysiological mechanisms of septic shock is pentoxifylline, an inhibitor of platelet aggregation that increases the flexibility of the erythrocyte membrane and has fibrinolytic activity. We studied the effect of pentoxifylline alone and combined with thalidomide in septic shock; 97 NIH mice were injected with lipopolysaccharides of Salmonella abortus equi and D galactosamine. Animals were separated in 4 groups; group A (n = 20) was used as control, group B (n = 15) received thalidomide 50 mg/kg, group C (n = 20) received pentoxifylline 40 mg/kg, and group D (n = 15) received thalidomide plus pentoxifylline. Mortality was recorded every hour. Additionally, 5 animals from each group were sacrificed 8 h after the induction of septic shock for histological analysis of heart, lung, brain, kidney, small intestine, adrenal glands and liver. Microscopic findings were rated as absent, mild, moderate and severe damage. In control animals histological analysis showed intense haemorrhage and necrosis in all organs studied. When compared with controls, treatment with pentoxifylline plus thalidomide reduced mortality (P < 0.03). The tissue damage was less severe in animals from the groups that received pentoxifylline or pentoxifylline plus thalidomide (P < 0.05). Pentoxifylline seems to potentiate the beneficial effects of thalidomide, reducing mortality and attenuating the pathological changes produced by septic shock.
The mechanisms of coronary restenosis: insights from experimental models
Authors: Ferns Gordon A.A. , Avades Tony Y.
Published: March 2003

Since its introduction into clinical practice, more than 20 years ago, percutaneous transluminal coronary angioplasty (PTCA) has proven to be an effective, minimally invasive alternative to coronary artery bypass grafting (CABG). During this time there have been great improvements in the design of balloon catheters, operative procedures and adjuvant drug therapy, and this has resulted in low rates of primary failure and short‐term complications. However, the potential benefits of angioplasty are diminished by the high rate of recurrent disease. Up to 40% of patients undergoing angioplasty develop clinically significant restenosis within a year of the procedure. Although the deployment of endovascular stents at the time of angioplasty improves the short‐term outcome, ‘in‐stent’ stenosis remains an enduring problem. In order to gain an insight into the mechanisms of restenosis, several experimental models of angioplasty have been developed. These have been used together with the tools provided by recent advances in molecular biology and catheter design to investigate restenosis in detail. It is now possible to deliver highly specific molecular antagonists, such as antisense gene sequences, to the site of injury. The knowledge provided by these studies may ultimately lead to novel forms of intervention. The present review is a synopsis of our current understanding of the pathological mechanisms of restenosis.
Inhibition of tumour invasion and angiogenesis by epigallocatechin gallate (EGCG), a major component of green tea
Authors: Jung Young D. , Ellis Lee M.
Published: March 2003

Epidemiological studies have suggested that consumption of green tea may decrease cancer risk. In addition, abundant pre‐clinical data from several laboratories have provided convincing evidence that polyphenols present in green tea afford protection against cancer in both in vivo and in vitro studies. Recently, epigallocatechin gallate (EGCG), a putative chemopreventive agent and a major component of green tea, was reported to inhibit tumour invasion and angiogenesis, processes that are essential for tumour growth and metastasis. Understanding the basic principles by which EGCG inhibits tumour invasion and angiogenesis may lead to the development of new therapeutic strategies, in addition to supporting the role of green tea as a cancer chemopreventive agent.
Angiogenesis in the female reproductive organs: pathological implications
Authors: Reynolds Lawrence P. , Grazul‐Bilska Anna T. , Redmer Dale A.
Published: March 2003

The female reproductive organs (ovary, uterus, and placenta) are some of the few adult tissues that exhibit regular intervals of rapid growth. They also are highly vascular and have high rates of blood flow. Angiogenesis, or vascular growth, is therefore an important component of the growth and function of these tissues. As with many other tissues, vascular endothelial growth factors (VEGFs) and fibroblast growth factors (FGFs) appear to be major angiogenic factors in the female reproductive organs. A variety of pathologies of the female reproductive organs are associated with disturbances of the angiogenic process, including dysfunctional uterine bleeding, endometrial hyperplasia and carcinoma, endometriosis, failed implantation and subnormal foetal growth, myometrial fibroids (uterine leiomyomas) and adenomyosis, ovarian hyperstimulation syndrome, ovarian carcinoma, and polycystic ovary syndrome. These pathologies are also associated with altered expression of VEGFs and/or FGFs. In the near future, angiogenic or antiangiogenic compounds may prove to be effective therapeutic agents for treating these pathologies. In addition, monitoring of angiogenesis or angiogenic factor expression may provide a means of assessing the efficacy of these therapies.
Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement
Authors: Mallow  , Durward  , Klaipo
Published: March 2003

Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment) technique under field conditions in developing countries. The ART technique involves removal of caries using only hand instruments, and placing a glass ionomer cement (GIC) restoration.

Objectives. To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia.

Design. Clinical field trial.

Setting. One high school in rural Cambodia.

Sample and methods. 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate. Subjects were randomly assigned to a dental nurse student for cavity preparation and placement of ART restorations (without cavity conditioning).

Results. 92·1% of the carious lesions required class I or class V restorations, and 85·4% were in the lower molars. 89 teeth were filled. At 1 and 3 years 86·4% and 79·5% of restorations were still present. Restorations were assessed by one dentist according to standard criteria. 76·3% of the restorations were judged to be successful at 1 year, and 57·9% at 3 years.

Conclusions. Factors which may have affected the success rates included: the material used, technical factors, failure to condition the cavity prior to restoration, and inexperience of the operators. The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years. Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements.
Aspiration of an avulsed primary incisor. A case report
Authors: Holan  , Ram
Published: March 2003

A 7‐year‐old girl had injured her maxillary primary incisors in a playground. One of the already‐mobile incisors had been avulsed. The child who had a cough and breathing difficulties during sleep was diagnosed as suffering from upper respiratory infection and was treated with antibiotics. A few days later because her body temperature was elevated a chest radiograph was taken. The radiograph revealed an aspirated tooth in her right bronchus with atelectasis of the lower lobe. The tooth was removed by bronchoscopy. Dentists should suspect any tooth that has been avulsed and not found as possibly aspirated.
Primary failure of eruption in the permanent dentition of siblings
Authors: DiBiase  , Leggat
Published: March 2003

Primary failure of eruption is a condition where there is eruption failure in the permanent dentition with no obvious mechanical cause. It has previously been reported in the literature as a cause of posterior openbite, with a varying degree of familial inheritance. This case report describes two sisters that experienced eruption failure in the permanent dentition, most notably of the first and second molars, with greater severity in the younger sister. Teeth were exposed in both patients and orthodontic traction was applied with little or no success. The report provides further evidence of the genetic contribution to the aetiology of this condition and also highlights the problems in attempting treatment, including exposing to the oral environment teeth that are infra‐occluded and difficult to clean effectively.
Diagnosis of occlusal caries in primary teeth
Authors: Ashley
Published: March 2003

Much research has been published over the last few years looking at alternative diagnostic systems for the diagnosis of occlusal caries in permanent teeth, but there has been little research on primary teeth. The aim of this study was to compare the accuracy of one alternative system (the Electronic Caries Monitor [ECM]) against visual diagnosis for the detection of occlusal dentine caries in primary teeth. Fifty‐eight apparently noncavitated extracted first and second primary molars were selected. They were examined visually and with the ECM for dentine caries. Presence or absence of caries was validated by hemisecting the teeth and examining them under a stereo‐microscope – 37 teeth had occlusal dentine caries, 21 were sound or had enamel caries. Sensitivities and specificities of the ECM diagnoses were 0·81 and 0·90, respectively, and for the visual diagnosis were 0·73 and 1. In conclusion, the ECM did not provide increased accuracy over visual diagnosis when detecting occlusal caries in primary teeth.
Bilateral macrodontia of mandibular second premolars: a case report
Authors: Dugmore C.R.
Published: March 2003

Summary. Macrodontia of single teeth is rare. This has been reported on only six occasions in scientific journals when affecting mandibular second premolars with associated morphological anomalies. The large crown size causes problems with eruption, and disrupts the dentition. There are consequent inherent difficulties for the extraction of these teeth. Once erupted, their anatomy predisposes them to caries. Most cases are seen in children, before interventive surgery has been completed. The morphological anomalies of these premolar Macrodonts appear quite distinct and may justify a separate unique categorization.
A maxillary protracting bow appliance for Class III treatment in the primary dentition
Authors: Murakami T. , Hamano Y. , Hägg U.
Published: March 2003

Summary. The design of a simple facial mask type appliance for the treatment of Class III with anterior crossbite in the primary dentition, is described. Its clinical effect is illustrated in two cases. The appliance is easy to make, cheap, well tolerated and efficient.
Idiopathic noncondylar hemimandibular hyperplasia
Authors: Khorsandian Golnaz , Lapointe Henry J. , Armstrong Jerrold E. A. , Wysocki George
Published: March 2003

A female patient with ‘idiopathic non‐condylar hemimandibular hyperplasia’ was followed from the age of 7·5–11·5 years. This rare disorder was characterised by an increase in volume of the right inferior ramus and mandibular body. It also included accelerated development and eruption of the teeth on the affected side, but no indication of enlargement of the condyle or the condylar neck. To date, review of the literature revealed several cases of hemimandibular hyperplasia and unilateral condylar hyperplasia, both of which present with enlargement of the condyle. However, the patient differed significantly from any previously reported cases, since she had no enlargement of the condyle. The above mentioned patient also differed from patients with hemihypertrophy, since the teeth were accelerated in development, but not hyperplastic. In addition, from histopathologic and radiographic examinations, as well as an angiogram, benign fibro‐osseous and vascular lesions of the mandible were excluded. Although this is a single case report and neither the aetiology nor the pathogenesis is yet understood, it may suggest a new disorder of the mandible. Therefore, future reporting of similar cases should be encouraged.
Paediatric antibiotic prescribing by general dental practitioners in England
Authors: Palmer N.O.A. , Martin M.V. , Pealing R. , Ireland R.S.
Published: March 2003

Objectives. The inappropriate use of antibiotics is known to be a major contributory factor to the problem of antimicrobial resistance. No information is available on how practitioners prescribe antibiotics for children. This study investigated the prescribing of liquid‐based antibiotics for children by general dental practitioners in England.

Design. Analysis of National Health Service liquid‐based prescriptions issued by general dental practitioners in England.

Sample and methods. All prescriptions issued by practitioners in 10 Health Authorities in England for February 1999 were collected. All the liquid‐based antibiotic prescriptions for children were selected and we investigated the type of antibiotic prescribed, whether sugar free, the dose, frequency and duration.

Results. A total of 18614 prescriptions were issued for antibiotics. Of the 1609 liquid‐based paediatric prescriptions 88·3% were for generic and 11·7% for proprietary antibiotics, of which 75·5% were for amoxicillin, 15·2% for phenoxymethylpenicillin, 6·6% for erythromycin, 1·7% for metronidazole. Cephalexin, ampicillin, cephadrine and combinations of two antibiotics were also prescribed. There was a wide variation in dosages for all the antibiotics prescribed. A significant proportion of practitioners prescribed at frequencies inconsistent with manufacturers’ recommendations and for prolonged periods, with some practitioners prescribing for periods up to 10 days. Only 29·1% of all the prescriptions issued were sugar free.

Conclusions. The results of this study show that some practitioners prescribe liquid‐based antibiotics inappropriately for children. This may contribute to the problem of antimicrobial resistance. Clear guidelines on the choice of antibiotic, dose, frequency and duration along with educational initiatives for GDPs might reverse this trend.
Experiences from a school‐based oral health promotion programme in Wuhan city, PR China
Authors: Tai Baojun , Du Minquan , Peng Bin , Fan Mingwen , Bian Zhuan
Published: March 2003

Objectives.To evaluate the effect of a six‐year oral health promotion programme for school children of Wuhan City, PR China.

Methods.The programme group (P‐group) comprised 233 children who had just entered grade 1 (1989). The programme provided an oral health promotion programme, and 215 12‐year‐old children from three schools participated as a control group (C‐group). After the 6‐year period of the programme (1995), all of the children had a clinical examination according to the criteria of the WHO and responded to a structured questionnaire on dental health behaviour.

Results.The results showed that attitudes to dental care, regular tooth brushing habits, use of fluoridated toothpaste, gingival health and dental visits, frequencies of consuming sugary drinks/foods were improved in the p‐group when compared with the C‐group.

Conclusion.The school‐based oral health promotion programme should be expanded.
Administering local anaesthesia to paediatric dental patients – current status and prospects for the future
Authors: Ram D. , Peretz B.
Published: March 2003

Summary. Fear‐related behaviours have long been recognized as the most difficult aspect of patient management and can be a barrier to good care. Anxiety is one of the major issues in the dental treatment of children, and the injection is the most anxiety‐provoking procedure for both children and adults. There is a constant search for ways to avoid the invasive, and often painful, nature of the injection, and to find more comfortable and pleasant means for anaesthesia before dental procedures.

Objective.The purpose of the present review is to summarize relevant data on topics connected with the administration of local anaesthesia.

Methods.The review will survey the current available methods, viz. electronic anaesthesia, lidocaine patch, computerized anaesthesia (the Wand), and the syrijet as well as the conventional injection, used for paediatric patients.

Conclusions.Usually new techniques for locally anaesthetizing dental patients are tested on adults. However, despite recent research in the field, the injection remains the method of choice. It is necessary to continue to conduct studies using new techniques on adults and children, so that a more acceptable technique can be found.
Supernumerary teeth: review of the literature and a survey of 152 cases
Authors: Rajab L. D. , Hamdan M. A. M.
Published: March 2003

Summary. Introduction. A review of the literature relating to supernumerary teeth is presented along with a survey of 152 cases.

Methods. The study population consisted of 152 children who visited the department of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from 5 to 15 years. Supernumeraries were detected by clinical examination and radiographs.

Results. Males were affected more than females with a sex ratio of 2·2 : 1. Seventy‐seven percent of the patients had one supernumerary tooth, 18·4% had double teeth, and 4·6% had three or more supernumeraries. Ninety percent of the supernumerary teeth occurred in the premaxilla, of which 92·8% were in the central incisor region and of these latter 25% were located in the midline. The other 10·4% of the supernumeraries were located in the premolar, canine, molar, and lower central incisor regions. Two cases were of non‐syndrome supernumerary teeth. Seventy‐five percent of the supernumeraries were conical, 83·1% were in the normal vertical position and 26·5% were erupted. Conical‐shaped supernumerary teeth had a significantly higher rate of eruption compared to the tuberculate type.
Knowledge of physicians in hospital emergency rooms in Israel on their role in cases of avulsion of permanent incisors
Authors: Holan G. , Shmueli Y.
Published: March 2003

Summary. Objective. The purpose of this study was to assess the knowledge of physicians in hospital emergency room care on their possible role in cases of traumatic loss of permanent incisors.

Methods. A questionnaire was sent to directors of emergency room facilities in hospitals in Israel regarding the medical team at the emergency room in the hospital, availability of an in‐house dental service and existence of a protocol for management of avulsed teeth. Another questionnaire, completed by physicians in the emergency room, contained demographic questions and questions regarding their knowledge of management of avulsed permanent teeth.

Results. The findings of the study showed that only 4% (12 of 335 physicians) would provide an appropriate initial treatment that, if followed by treatment by a dentist as recommended, could save the avulsed tooth. No correlation was found between knowledge of appropriate treatment of avulsed teeth and type of speciality, years of experience, previous exposure to information on trauma to the teeth and gender. The only significant association was found between physicians’ knowledge and having a dentist spouse. Most of the physicians had never attended any formal seminar or lecture or received printed instructions on the management of avulsed teeth.

Conclusions. Medical students and physicians in hospitals’ emergency rooms should be made aware of their possible role in cases of avulsion of permanent teeth, in order to minimize late complications associated with such injuries. One possible way to achieve this goal is through education during and after training and introduction of a formal protocol for treatment of avulsed permanent teeth and other dental injuries.
An evaluation of comparative strategies for teaching breast self‐examination
Authors: Agars Julia , McMurray Anne
Published: March 2003

This study compared the effects of three alternative methods of breast self‐examination (BSE) instruction (booklet, film and group discussion, individual teaching) on nurses’ personal BSE practice A pre‐test and follow‐up questionnaire were administered to a convenience sample of 166 nurses from Western Australian hospitals The results demonstrated that each method of BSE instruction produced a significant improvement in the technique of BSE (P < 0 0001) However, the nurses involved in the film and discussion had the greatest improvement in BSE proficiency Findings were analysed in terms of the Health Belief Model The variables ‘barriers to action’ and ‘perceived susceptibility’(in this case, to breast cancer) were found to be predictive of BSE practice,‘perceived barriers’ at pre‐test and ‘perceived susceptibility’ at follow‐up The incidence of BSE was significantly higher in the older nurses A reminder to practice BSE was significantly associated with an effective BSE technique Implications for nursing practice are discussed
The conceptual validity of a taxonomy of nursing interventions
Authors: Grobe Susan J , Hughes Linda C
Published: March 2003

The purpose of this paper is to report validity evidence for the nursing intervention taxonomy developed as part of the Nursing Intervention Lexicon and Taxonomy (NILT) Study Using eclectic classification methods of library science, cognitive science, nursing science and computational linguistics, a taxonomy of nursing interventions consisting of seven categories was developed These categories which incorporate care as a central concept are described and denned, and prototypical examples of each category are presented Brinberg & McGrath's validity schema provides the framework within which evidence for validity as value, validity as correspondence and validity as generalizability were examined. Comparison of the NILT categories with previously published categorizations of nursing functions and interventions provides strong support for the validity of this classification Additionally, comparison of the NILT categories with two internationally derived categorizations of nursing functions supports the robustness or generalizability of the NILT classification
A comparison of oral, axillary, rectal and tympanic‐membrane temperatures of intensive care patients with and without an oral endotracheal tube
Authors: Konopad Elsie , Ross Janet , Noseworthy Thomas , Grace Michael
Published: March 2003

Monitoring rectal temperatures (RTs) in orally intubated, critically ill patients is common practice, as they are generally believed to be more accurate than oral temperatures (OTs) This study was designed to compare OTs of critically ill patients, with and without an endotracheal tube, using patients as their own control Axillary (AT), tympanic membrane (TMT) and RTs of patients were also studied Sixty‐five orally mtubated patients ready for extubation, ranging in age from 17 to 96 years (17 female and 48 male), were included in the study OT, AT, RT and TMTs were taken before and after extubation Using a t‐test for paired samples, significant differences were found between both ATs and OTs measured with and without an oral endotracheal tube (P<0.01), the differences (−0 12 and 0 08°C, respectively) were not considered clinically important Further t‐tests for paired samples revealed no significant difference between TMTs and RTs pre and post extubation Respiratory rate, presence or absence of teeth, and mouth position were shown to have no effect on OT (t‐tests, P<0 01) Analysis of variance showed no difference in OT dependent on room temperature or temperature within the endotracheal tube It was concluded that OTs are accurate when taken in patients who are orally mtubated and ready for extubation
Prevalence and characteristics of pain in persons with terminal‐stage AIDS
Authors: Eldridge Ann D. , Severance‐Lossin Liza , Nicholas Patrice Kenneally , Leuner Jean D'Meza
Published: March 2003

A retrospective chart review was undertaken to collect and report data on the prevalence and characteristics of pain in persons with terminal‐stage AIDS A convenience sample consisting of 50 patient charts at a residential AIDS hospice was utilized Data were collected from the McCaffery Initial Pain Assessment Tool (IPAT) (1983) which was completed at the time of each hospice admission The IPAT is composed of 10 sections that collectively describe the patient's pain experience Demographic and AIDS‐related pathology data were also collected Data were analysed using descriptive statistics to examine the incidence and characteristics of pain Pain was experienced by a majority of the subjects in the sample Pain levels for‘present pain,‘worst pain gets,‘best pain gets' and‘acceptable level of pain’are reported Characteristics of pain including location, causal factors and verbal descriptors are reported Implications for nursing practice and suggestions for further research are discussed
Factors influencing nurses' pain assessment and interventions in children
Authors: Hamers JPH , Abu‐Saad H Huijer , Halfens R J G , Schumacher J N M
Published: March 2003

Research is lacking on factors influencing nurses’ decision‐making directed at the diagnosis of pain in children and its related interventions This paper reports on two studies, namely a qualitative study and its replication, in which we explored factors influencing nurses’ pain assessments and interventions in children Those factors found to influence nurses’ decisions were medical diagnosis, child's expressions, age, and parents, and the nurses’ knowledge, experience, attitude and workload Some of these factors seem to have more influence than others For example, the presence of a medical diagnosis seems to legitimate being in pain Furthermore, it is suggested that mainly vocal expressions, especially crying, influence nurses’ decisions to administer analgesics Finally, nurses’ negative views on non‐narcotic analgesics were striking In this paper, the results of both studies and their relationship to information reported in the literature are further elaborated and discussed, and hypotheses on strength and direction of influence of factors on pain assessment and intervention are generated
Nursing: an integration of art and science within the experience of the practitioner
Authors: Rose Pat , Parker David
Published: March 2003

In this paper it is proposed that whilst nursing knowledge is underpinned by the philosophies of art and science they are integrated in such a way that nursing is greater than their sum and is thus a unique discipline It begins with an exploration of the philosophies underpinning art and science, and their relationship to nursing The discussion then moves on to examine critically the nature and development of theory in nursing with reference to art and science, the nursing knowledge thus generated and how that knowledge is learned and expressed The paper concludes with an evaluation of how far the discipline of nursing lies within the paradigms of science and of art, and whether indeed art and science may be, to some extent, false distinctions The authors conclude that nursing may be viewed as an integration of art and science, expressed through the practitioner's unique, yet also shared experience
Collaboration: a concept analysis
Authors: Henneman Elizabeth A , Lee Jan L. , Cohen Joan I
Published: March 2003

Collaboration is a complex phenomenon, yet one that is of significance to nursing This concept analysis presents definitions and defining characteristics of collaboration so that the concept may be used in the creation of operational definitions, or to develop and evaluate tools for measuring collaboration Antecedents, consequences and empirical referents of collaboration are explored Model, contrary and related cases are presented to clarify this concept further
Older women's attitudes to cervical screening and cervical cancer: a New Zealand experience
Authors: White Gillian Eyres
Published: March 2003

An in‐depth series of interviews was undertaken amongst a small group of older, Caucasian women, in Auckland, New Zealand The study was part of the region's cervical screening programme The aim of the study was to determine how the older woman's perceptions of cervical cancer and cervical screening services might be affecting her health‐seeking behaviour Healthy, Caucasian women between 45 and 70 years of age were invited to participate These women had either declined or delayed having regular cervical smears Interviews were recorded and transcribed, then subjected to thematic analysis Although small, the study is important in that it highlights cognitive, emotional, socio‐economic and ego integrity barriers to regular cervical screening Nurse clinicians have a major role in disease prevention and education for healthy older women The findings provide a useful background for developing strategies to increase the uptake of cervical smears amongst older Caucasian women They may also be viewed as a pilot for the development of questionnaires, or for further investigation of perceptions of older women in other ethnic groups
Out of the shadows: a study of the special observation of suicidal psychiatric in‐patients
Authors: Duffy David
Published: March 2003

Special observation is a common nursing activity in psychiatric units, involving intensified observation and assessment of patients deemed at risk of harming themselves or others The activity is problematic because it inevitably violates patient rights, despite the humanistic basis of nursing philosophies and the consumerist ethos of modern health services Nonetheless it is a poorly researched phenomenon and there is little information on which to base training and skill‐mix decisions A grounded theory study was therefore carried out in one in‐patient unit, concentrating on the special observation of suicidal patients Data was gathered from semi‐structured interviews with nursing staff Nine conceptual categories were derived, based on the ambivalent core categories of controlling and helping On the basis of this study it is recommended that policy documents in units with similar problems be reviewed to promote individualized care plans rather than rigid protocols Further, policies should recognize the central role of the nurse in the procedure, and ensure that the patient's named nurse assumes responsibility for implementation, including supervision of the numerous staff usually involved Training programmes should be introduced, taking account of the range of skills and knowledge demanded by the procedure and the need for systematic assessment of suicidal patients
Nurses’ skills in managing ethically difficult care situations: interpretation of nurses’narratives
Authors: Åstrom G , Furåker C , Norberg A
Published: March 2003

A total of 18 good nurses experienced in the care of cancer patients were asked to describe care situations where it had been difficult to know what was ‘the right and good’ thing to do for the patient The purpose of the study was to throw light on how they disclosed themselves in managing ethically difficult care situations, to elucidate the nurse as a part of the concrete care situation A phenomenological henneneutic interpretation disclosed the use of paradigm cases, placing in opposition to each other negative and positive outcomes, limiting and liberating maxims, and reserved and open approaches, on the part of nurses with limited versus extensive skills in managing ethically difficult care situations These patterns were interpreted as revealing psychological defences The study stresses the importance of recurrent education in nursing and nursing ethics, and of individual support
Politics and nursing: an elective experience
Authors: Taylor Georgina
Published: March 2003

The case for enhancing the political awareness of nurses is reviewed, examining the need for the inclusion of political issues in nurse education programmes A brief review of the available literature from North America reveals that some schools of nursing have made progress in including aspects of politics in nursing curricula, either as part of a course on health policy or as a separate elective course Topics addressed in these courses, and experiences offered, aim to raise awareness and equip nurses with the knowledge and skills necessary to engage in politics at a variety of levels An account is offered of the experience of running a 4‐week theoretical elective course entitled ‘Politics and nursing’ as part of the Common Foundation Programme of a Project 2000 course in a college of nursing based in North London, England
A selective review of the literature on nurse‐patient communication: has the patient's contribution been neglected'
Authors: Jarrett Nicola , Payne Sheila
Published: March 2003

The literature on nurse‐patient communication is selectively reviewed Previous research has been critical of the quality and quantity of nurse‐patient communication, describing it as brief and superficial Nurses are depicted as controlling and restricting the course and topics of conversations with patients Communication skills training for nurses has been advocated as a solution for this apparent deficit In this paper it is argued that research has overemphasized nurses’roles in nurse‐patient communication, particularly their communication skills The patients’contribution to the content and organization of nurse‐patient communication has been largely ignored Assumptions have been made about nurses’and patients’intentions and motives during nurse‐patient conversations, but the participants, particularly patients, are rarely asked for their views There has been a tendency to view nurse‐patient communication in terms of isolated excerpts of conversation When environmental and organizational factors are included, it is their effect on nurses’communication capability, not the patients', that are the interest It is suggested that future research consider both patients’and nurses’contributions to nurse‐patient communication
The cognitive component of nursing assessment: an analysis
Authors: Crow Rosemary A , Chase Jonathan , Lamond Dawn
Published: March 2003

This paper presents an analysis of the cognitive component of nursing assessment, complimenting the growth in knowledge of other important aspects of assessment The purpose of the paper is to provide a framework for understanding how nurses structure assessment problems and the types of judgements they make The thrust of the analysis is based on a comparison between nursing assessment and medical diagnosis, since the cognitive component and judgements formed in medical diagnosis have been more fully articulated The results suggest that there may be similarities between the cognitive strategies used in nursing assessment and those used in medical diagnosis, particularly in relation to the gathering and organization of information But the purpose of the information search appears to be different In medical diagnosis the aim is to establish an explanation for the patient's presenting problem In nursing assessment, on the other hand, the aim appears to be to provide an accurate picture of the patient's current condition or situation The assessments formulated fit the definition of a judgement and, in common with medical diagnoses, include some form of prediction Unlike the medical diagnoses, however, which usually remain stable throughout treatment, the assessments need to change as the patient's condition changes The cognitive component of assessment has significant implications for nurse education and clinical practice Further understanding of how nurses structure assessment problems and formulate judgements is therefore needed The findings may also help to clarify the meaning of nursing diagnosis
Framing learning through reflection within Carper's fundamental ways of knowing in nursing
Authors: Johns Christopher
Published: March 2003

Carper's fundamental ways of knowing have been utilized as a framework for the practitioner to consider what he or she has learnt through reflection on experience. The purpose of this paper is to consider, through an interpretation of Carper's writings and through analysing one practitioner's experience shared in a supervision milieu, whether this use of Carper's work can be reasonably justified on a theoretical and practical level
Attributions for illness and treatment interventions by community nurses
Authors: PhD Jane Ogden , Knight Denise
Published: March 2003

The present study evaluated community nurses’attributions for a case patient's heart attack and their recommendations for treatment Eighty‐nine district nurses and health visitors completed a set of rating scales following a case vignette describing a patient who had suffered a heart attack and prior to which had either adopted a healthy lifestyle (n=47) or had maintained unhealthy behaviours (n= 42) The results suggest that subjects in the unhealthy‐behaviour condition rated the case patient as less likely to follow advice, more responsible for his/her condition and rated the heart attack as more preventable In addition, the results suggest that subjects were more likely to offer recommendations for behavioural change to the unhealthy case patient and that these recommendations were significantly related to internal attributions of patient responsibility The results are discussed in terms of theories of health professionals’beliefs and behaviours
The Claybury community psychiatric nurse stress study: is it more stressful to work in hospital or the community?
Authors: Fagin Leonard , Brown Daniel , RMN Heather Bartlett , Leary John , Carson Jerome
Published: March 2003

The Claybury community psychiatric nurse (CPN) stress study collected data on stress levels in 250 CPNs and 323 ward‐based psychiatric nurses (WBPN) in the North East Thames region Four out of 10 CPNs were found to be experiencing high levels of psychological distress on GHQ scores Whilst both CPNs and WBPNs scored highly on scores of occupational burnout, especially on emotional exhaustion scores, WBPNs scored worse on emotional detachment from their patients and were achieving less personal fulfilment from their work Both groups of nurses were more satisfied with direct patient clinical work than with their employment conditions, particularly their working environments and, for CPNs, their relationships with then managers The different patterns of coping skills are explored and discussed for both groups of nurses, especially the use of social support, time management and organization of tasks The study concludes that whilst major changes are occuring in the psychiatric arena for both groups of nurses, stress is reaping its toll on mental health nurses, in terms of higher absence rates, lower self‐esteem and personal unfulfilment This could not only affect the quality of patient care but also future career prospects for nurses The study invites serious consideration of introducing stress‐reducing measures in the work‐place as well as further research into specific stressors for different groups of nurses
The multifaceted role of the nurse in the day hospital
Authors: Booth Joanne , Waters Karen R
Published: March 2003

This paper presents the initial findings from an action research study designed to explore and improve rehabilitation practice in a geriatric day hospital The role of nurses in day hospitals and their contribution to rehabilitation form the focus of the discussion, which emanates from the analysis of semi‐structured interviews with 13 members of the multi‐disciplinary team, and observation of team meetings and patient reviews Factors which influence the therapeutic activity of nurses are identified and tentative interpretations offered The findings indicate that the nurse's role in day hospitals is multifaceted and varied and the conclusion is drawn that, far from being marginalized in rehabilitative and therapeutic terms, the nurse's central co‐ordinating role should be recognized as the lynchpin of day hospital activity
The phenomenological movement: implications for nursing research
Authors: Walters A J
Published: March 2003

This paper presents a comparison of the phenomenologies of Edmund Husserl and Martin Heidegger with the aim of highlighting some of the critical distinctions between these two 'schools’ of phenomenology concerning the methodological implications of each approach for nursing research Specifically, the paper examines the implications of epistemology versus ontology, issues relating to validity, the involvement of the researcher, and aspects relating to interpretation
Finding your way around qualitative methods in nursing research
Authors: Bailey Patricia Hill
Published: March 2003

The intention of this paper is to assist neophyte and traditionally educated nurse‐researchers to navigate the qualitative research literature with understanding. The labeling language describing the central structures of the qualitative paradigm will be discussed as the key element to facilitating insight. The ‘trustworthiness’ of this research perspective will also be addressed within the context of the nursing research literature.