bluuebunny/crossref_metadata_2025 huggingface dataset:
False‐positive Y‐microdeletion result for a fertile male caused by an alteration under a PCR primer
Authors: THORNHILL A. R. , GUENTHER A. J. , BARBAROTTO G. M. , SESSION D. R. , DAMARIO M. A. , DUMESIC D. A. , SNOW K.
Published: March 2003

The pathogenic relationship between the presence of Y chromosomal microdeletions and male infertility is unclear. Nevertheless, a causal relationship is thought to be probable when loci are shown to be deleted in infertile males but are present in fertile males. Polymerase chain reaction (PCR) analysis of the Y chromosome is now routinely performed in the evaluation of the infertile male, although, until recently, there has been no consensus on how the diagnosis should be performed and which loci or markers should be analysed. The European Academy of Andrology (EAA) published guidelines for the molecular diagnosis of Y chromosomal microdeletions in 1999. Following these guidelines, our laboratory developed assays that incorporated the suggested primer pairs for the recommended Sequence Tagged Sites (STS). A number of fertile (n = 117), infertile (n = 17) and unknown samples (n = 20) were tested in our laboratory as part of the validation to provide a clinical assay. Two multiplex PCR assays were optimized, each of which examined STS markers in the centre of the AZFa, b and c regions of the Y chromosome. We correctly identified all but one of the 154 samples (according to the expected result based on fertility or previous testing at another laboratory). A single equivocal result was observed for a sample obtained from a known fertile male who appeared to be deleted for a single marker, sY84, in the AZFa region but not the adjacent marker, sY86. Follow‐up analysis showed that proximal and distal markers within the same region (sY82 and sY98) were also present. Sequencing the region flanking and including the sY84 primer set revealed a single base alteration under the reverse primer, which probably caused the amplification failure. Furthermore, the sY84 sequence itself was present, as was the flanking sequence 50 bp on either side of both primers. This observation underlines the importance of using at least two closely linked STS markers for the reliable diagnosis of Y chromosome microdeletions as proposed by the EAA guidelines.
Kinetics of transforming growth factor‐β1 and extracellular matrix in renal tubulointerstitial lesions of mercuric chloride‐treated Brown Norway rats
Authors: Suzuki Kazuhiko , Uetsuka Koji , Nakayama Hiroyuki , Doi Kunio
Published: March 2003

Renal tubulointerstitial lesions in mercuric chloride(HgCl2)‐treated Brown Norway rats were investigated focusing on the kinetics of transforming growth factor‐β1(TGF‐β1) and extracellular matrix (ECM). Rats were injected with 1 mg/kg b.w. of HgCl2 at days 0, 2, and 4, and 5 rats were killed at days 2, 4, 6, 8, 10, and 20, respectively. TGF‐β1 mRNA expression in the renal cortex measured by competitive RT‐PCR method reached a peak at day 6, mildly decreased at days 8 and 10, and increased again toward day 20. Signals of TGF‐β1 mRNA examined by in situ hybridization method were recognized in the regenerative tubular epithelium at day 6, and in both tubular epithelium and infiltrated mononuclear cells at day 20. After tubular injury, strong immunoreactivity to TGF‐β1 protein was found in desquamated tubular epithelial cells. Then, positive staining was found in the regenerative tubular epithelial cells. Later, infiltrated mononuclear cells also became positive for TGF‐β1 protein. In the ECM, deposition of fibronectin was prominent throughout the experimental period. In conclusion, this strongly suggests that TGF‐β1 derived from tubular epithelial cells and some macrophages might be related to the development of renal interstitial fibrosis in HgCl2‐treated BN rats.
Molecular biology and pathogenesis of the human T‐cell leukaemia/lymphotropic virus Type‐1 (HTLV‐1)
Authors: Johnson Julie M. , Harrod Robert , Franchini Genoveffa
Published: March 2003

Retroviruses are associated with a variety of diseases, including immunological and neurological disorders, and various forms of cancer. In humans, the Human T‐cell Leukaemia/Lymphotropic virus type 1 (HTLV‐1), which belongs to the Oncovirus family, is the aetiological agent of two diverse diseases: Adult T‐cell leukaemia/lymphoma (ATLL) (Poiesz et al. 1980; Hinuma et al. 1981; Yoshida et al. 1982), as well as the neurological disorder tropical spastic paraparesis/HTLV‐1‐associated myelopathy (TSP/HAM) (Gessain et al. 1985; Rodgers‐Johnson et al. 1985; Osame et al. 1986). HTLV‐1 is the only human retrovirus known to be the aetiological agent of cancer.A genetically related virus, HTLV‐2, has been identified and isolated (Kalyanaraman et al. 1982). However, there has been no demonstration of a definitive aetiological role for HTLV‐2 in human disease to date. Simian T‐cell lymphotropic viruses types 1 and 2 (STLV‐1 and ‐2) and bovine leukaemia virus (BLV) have also been classified in same group, Oncoviridae, based upon their similarities in genetic sequence and structure to HTLV‐1 and ‐2 (Burny et al. 1988; Dekaban et al. 1995; Slattery et al. 1999). This article will focus on HTLV‐1, reviewing its discovery, molecular biology, and its role in disease pathogenesis.
Evaluation of dentition status and oral hygiene in Polish children and adolescents with congenital haemorrhagic diatheses
Authors: Mielnik‐Błaszczak M.
Published: March 2003

Summary.
Aim. To investigate the dental status and oral cleanliness of a group of patients with haemorrhagic diatheses and to compare these to values for a group of healthy controls.

Design. Cross‐sectional study of patients and controls.

Methods. The group of patients was made up of 80 children aged 4–18 years. The total included 77 patients with type A or type B haemophilia and three with von Willebrand’s disease. The control group consisted of 80 healthy children of the same age range. A clinical examination was carried out to determine dental status and oral hygiene in the two groups.

Results and conclusions. No significant differences were found between the dental status of sick and healthy children. However, worse dental status was seen in children with severe forms of haemophilia A and von Willebrand’s disease compared to other sick children. Oral hygiene status was worse in the sick children than in healthy children.
Leiomyomatous hamartoma of the anterior tongue: report of a case and review of the literature
Authors: De La Rosa‐GarcÍa E. , Mosqueda‐Taylor A.
Published: March 2003

A case of leiomyomatous hamartoma located on the anterior third of the tongue in an otherwise healthy 6‐year‐old boy is reported. The lesion had been present since birth as an asymptomatic, pedunculated tubular tumour. The lesion was surgically excised and histopathological examination disclosed a non‐neoplastic mass composed of irregularly arranged bundles of smooth muscle embedded in a fibrovascular stroma. No recurrence was observed after 1 year of follow‐up.
An oral health promotion programme for nursing caries
Authors: Hamilton F.A. , Davis K.E. , Blinkhorn A.S.
Published: March 2003

Aim. To evaluate an oral health promotion programme involving health visitors and mothers of 8‐month‐old babies in order to address some of the risk factors associated with nursing caries.

Design. Two cross‐sectional studies using postal questionnaires.

Sample. A random sample of 250 mothers who had not received the oral health promotion programme and 250 mothers who had received the programme.

Setting. The City of Salford.

Results. The oral health promotion programme significantly improved mothers recall of advice given by health visitors encouraging the use of a feeder cup, brushing their babies’ teeth with fluoride toothpaste and restricting sugary foods and drinks. Significant improvements were also found in recall of advice regarding the use of sugar‐free medicine and registering babies with a dentist. The programme encouraged a higher proportion of the mothers to bring their children to clinics for a hearing check.

Conclusion. A simple oral health promotion programme facilitated by health visitors improved recall of advice and clinic visiting behaviour.
A comparison of post‐operative morbidity following outpatient dental care under general anaesthesia in paediatric patients with and without disabilities
Authors: Enever G. R. , Nunn J. H. , Sheehan J. K.
Published: March 2003

An investigation was undertaken of morbidity after outpatient general anaesthesia for comprehensive dental care in a group of paediatric patients over a 1‐year period. Data were collated from the patient’s hospital notes and from the response to a questionnaire sent to parents/carers. Clinical data were obtained for 55 cases (age range 3–17 years) for whom parents/carers had returned questionnaires. There were 27 intellectually and/or physically impaired patients, the other 28 being anxious or phobic. After discharge, 44% of all parents/carers reported symptoms post‐operatively in their child, the prevalence being similar in both groups. The symptoms were nausea/vomiting (20%), unexpected drowsiness (13%) and the need for pain relief at home (13%). Dental procedures were routine restorations (42%), or a combination of restoration, extractions and preventive care for the remainder. Only four patients had extractions only. One teenager had to be admitted for persistent nausea and vomiting, despite prophylactic measures. In conclusion, post‐operative morbidity appears to be low after outpatient general anaesthesia for dental procedures, and is no greater in patients with disabilities.
Dyskeratosis congenita: report of a case
Authors: Brown C.L.
Published: March 2003

Dyskeratosis congenita is a rare multisystem condition involving mainly the ectoderm. It is characterized by a triad of reticular skin pigmentation, nail dystrophy and leukoplakia of mucous membranes. Oral and dental abnormalities may also be present. Complications are a predisposition to malignancy and bone marrow involvement with pancytopenia.

The case of a 14‐year‐old girl is described who presented with several of the characteristic systemic features of this condition, together with the following oral features: hypodontia, diminutive maxillary lateral incisors, delayed dental eruption, crowding in the maxillary premolar region, short roots, poor oral hygiene, gingival inflammation and bleeding, alveolar bone loss, caries and a smooth atrophic tongue with leukoplakia. Although this condition is rare, dental surgeons should be aware of the dental abnormalities that exist and the risk of malignant transformation within the areas of leukoplakia.
A quantitative study of the effect of pumicing and etching on the remineralisation of enamel opacities
Authors: Peariasamy K. , Anderson P. , Brook A.H.
Published: March 2003

Aims. The aim of this study was to investigate the effects of pumicing and acid etching on the remineralisation of enamel opacities using quantitative measure‐ment methods.

Methods. Teeth with diffuse opacities were subjected to a treatment sequence of: (a) pumicing for 30–35 seconds (b) etch with 37·5% phosphoric acid for 2 minutes, (c) pumicing for 30–35 seconds and (d) etch for 1 minute, or served as controls. Both groups were then placed in a remineralising solution containing 1·5 mmol/L Ca2+ for 3 weeks. Mineral content changes were measured using contact microradiography and x‐ray microtomography. In addition, the reflectivity of the opacities was monitored with infrared reflectance.

Result. The treatment sequence removed 34 ± 4 μm of the surface enamel but no mineral loss was observed in the subsurface layer. The treatment sequence enhanced the formation of a new remineralised surface layer with a mean thickness of 22 ± 3 μm. This new surface layer was less reflective.

Conclusion. Pumicing and acid etching can be used as a simple technique for the conservative treatment of enamel opacities.
Cytomegalovirus and cyclosporin‐induced gingival overgrowth in children with liver grafts
Authors: Hosey M.‐T. , Davison S. M. , Gordon G. , Shaw L. , Kelly D. A.
Published: March 2003

Summary.  Objective. To determine whether cytomegalovirus (CMV) is associated with gingival overgrowth in paediatric liver graft recipients treated with cyclosporin.

Study design. Thirty‐four children, 25 of whom were under 5 years of age, who had undergone liver transplantation, were examined. An Index of Severity of Gingival Overgrowth was used to measure the prevalence and severity of the gingival overgrowth. The trough cyclosporin level was recorded and the CMV status of the patient matched to the dental findings. The association between the severity of gingival overgrowth and CMV infection was examined using the contingency coefficient. An anova was used to assess the association between the circulating trough cyclosporin concentration and the severity of gingival overgrowth. Pearson's Product Moment Correlation Coefficient was used to examine the association between the duration of exposure to cyclosporin and the severity of gingival overgrowth.

Results. There was a significant inverse association between the duration of exposure to cyclosporin and the severity of gingival overgrowth. There was no relationship between the trough cyclosporin concentration and the severity of gingival overgrowth. There was no association between CMV and gingival overgrowth.

Conclusion. Gingival overgrowth was related to the duration of cyclosporin therapy but was neither more prevalent nor more severe in subjects who were CMV seropositive.
Congenital epulis of the newborn: a case report
Authors: Merrett S. J. , Crawford P. J. M.
Published: March 2003

Summary. This paper describes the case of a day old baby who was admitted to hospital because of the presence of a large intraoral swelling that was preventing her from breast feeding. Clinical examination showed a firm, pedunculated, lobulated nodule protruding from the mouth and attached to the maxillary alveolus to the left of the midline. The mucosa was normal in appearance. The growth was excised under local anaesthesia and showed a histological appearance consistent with a congenital epulis of the newborn. Healing was complete and no recurrence was seen at review after two weeks. Conservative treatment of congenital epulis is often sufficient but in this case, the nodule prevented feeding. Excision was incomplete but, as in other cases treated in the same way, there has been no obvious tendency to recur.
A victimization assessment tool: instrument development and clinical implications
Authors: Hoff Lee Ann , Rosenbaum Linda
Published: March 2003

Although most health care providers now recognize the importance of crisis intervention, support, and/or treatment for survivors of violence and abuse, such care is compromised unless early detection becomes a routine part of intake and assessment protocols in nursing and other facets of health care This paper describes the development of a tool to assist nurses and other primary care providers with routine assessment for victimization in diverse health and mental health settings It includes outcomes of preliminary validity and reliability studies, and concludes with suggestions for use in clinical work with victims/survivors of abuse in an era of increasing international concern regarding the health implications of violence
Integrating what is taught with what is practised in the nursing curriculum: a multi‐dimensional model
Authors: Ferguson Katharine E , Jinks Annette M
Published: March 2003

The discrepancy between nursing as it is taught in the classroom (theory) and nursing as it is experienced by students in the clinical setting (practice) has long been a source of concern to teachers, practitioners and learners This paper provides an overview of the literature on the theory‐practice gap, exploring some of the many reasons cited for its existence as well as suggested ways of bridging the gap Drawing upon the findings, a comprehensive and multidimensional model designed to integrate theory and practice of nursing is proposed for use by curriculum planners Fundamental to the model is the notion of collaboration between education and service staff at all stages of the curriculum process The model highlights eight key areas for the curriculum team to consider the curriculum model to be used, sequencing of taught content and clinical practice, the content of the course, teaching methods to be used, assessment criteria, the role of tutors in the learning process, the contribution of service staff, and the influence of the hidden curriculum It is argued that only through such a comprehensive model can integration of theory and practice within the curriculum be achieved Adoption of the model, however, will require considerable individual and organizational commitment
A concept analysis of personal knowledge: application to nursing education
Authors: Sweeney Nancy M
Published: March 2003

A concept analysis of personal knowledge is completed using the Walker and Avant method The analysis is based on Polanyi's concept of personal knowledge with a working definition being extrapolated from his writings combined with Belenky and colleagues’ concept of constructed knowledge The goal is to construct a definition of personal knowledge which recognizes the multifaceted processing used by humans in the endeavour to perceive new patterns, and which is free from discrimination based on age, sex, culture, discipline, world view or learning style Knowledge is defined as pattern recognition which may be probabilistically rather than exactly predictive Personal knowledge is defined as recognition of a new pattern through processing by the human being The processing may consist of any combination of human and environmental interaction, ‘rational intuiting’, appraisal, active comprehension and personal judgement, all in a setting of departure from the current conceptual framework The pattern may be new to the person or to humanity Personal knowledge is denoted by perception of the person The antecedents, attributes and consequences are taken from the literature The empirical referents are hypothesized from a review of the nursing, social work and education literature After defining personal knowledge and differentiating it from other phenomena, it is integrated into nursing education An educator accepting personal knowledge as an expectation for students approaches the teaching/learning situation by planning to create an atmosphere in which individual growth and illumination can occur Therein personal knowledge is integrated into nursing education using the most barrier‐free theoretical frameworks in the areas of learning, curriculum and instruction
Power and knowledge in nursing practice: the contribution of Foucault
Authors: Henderson Amanda
Published: March 2003

This paper explores the implications of Michel Foucault's philosophical analyses for understanding nursing practice Foucault describes power within a given society as unfolding not through large‐scale events but rather through a complex‘micro‐physics’ Power operates upon the human body With the increasing use of observation, in understanding both the natural and social world, the body has become the subject of the‘gaze’ The body as object, however, is neither a universal belief nor truth but a product of ways of perceiving and examining it In relation to nursing, the subjection of the body to the‘gaze’ and the practices of the institutional environment of the hospital are important for understanding the knowledge formulated The power of practice is in the generation of knowledge The nature and form of knowledge is instrumental in establishing the quality of nurse‐patient relationships This paper explores, through the particular exemplar of the patient in intensive care, the power of present practices to shape knowledge, and thereby dictate and limit the quality of the nurse‐patient relationship
Geriatric nursing: an idea whose time has gone? A polemic*
Authors: Nolan Mike
Published: March 2003

The future role of the nursing profession in providing health care for older people is considered It is argued that, despite claims to holism, nursing has maintained a narrow focus, concentrating mainly on acute hospital care The concepts of professional protectionism and professional reductiomsm are used to explain the manifest failure of nursing and other professions working with older people and their carers to place the needs of their clients at the top of their agendas A reorientation of nursing practice is advocated in order that the profession fulfils its potential with respect to older people
Are there too many alarms in the intensive care unit? An overview of the problems
Authors: Meredith Christina , Edworthy Judy
Published: March 2003

There are many reported problems with auditory warnings in critical care areas of hospitals such as the intensive care unit (ICU) and operating room There are too many alarms, many of them are unnecessarily loud and continuous, which can be irritating and annoying for staff The problem of excessive alarms is further complicated by the fact that there are no standards agreed between manufacturers on the auditory warnings used for medical equipment Therefore, the same piece of equipment manufactured by different companies will have different alarms that could result in confusion Another possibility as to why confusion could occur is because alarms are often inappropriate in terms of their ‘urgency mapping’ This means there is generally no relationship between the urgency of a medical situation and the perceived urgency of the alarm that signals that condition A further problem involves the number of false alarms that occur, that is, alarms that are not signalling a medical emergency The following paper discusses these problems and suggests attempts to remedy some of them There is also a brief discussion of the amount of monitoring that occurs on the ICU as the more monitors there are the greater the number of alarms there will be
The relationship between health and social support in caregiving wives as perceived by significant others
Authors: Robinson Karen M , Steele Deborah
Published: March 2003

This study explored the relationship between health and social support in wives who care for husbands with dementia In order to understand how significant others begin mobilizing help for caregivers, the significant others' views of the carers' health and social support were analysed Subjects comprised 75 significant others identified as being familiar with the caregiving situation of a like number of caregiving wives Hypotheses, which were rejected, predicted that wife caregivers perceived as ill by the significant other would be seen as needing and receiving more social support as reported by the significant other Findings indicated that healthy caregivers were perceived to have significantly more people in their social network
Critical thinking and intuitive nursing practice
Authors: Paul Richard W , Heaslip Penelope
Published: March 2003

In this paper, we analyse how critical thinking and intuitive practice are related to expertise in nursing We examine how intuitive practice, when performed automatically without care, vigilance, and criticism, can result in prejudice and patterns of practice which are misinformed We will show that the student nurse develops intuitive, skilful performance in nursing by reasoning about nursing knowledge and applying reflective, critical thought m practice situations, thereby gaming increasing expertise in reasoning as a reliable professional ensuring quality client care The elements of thought necessary for sound reasoning in clinical practice will be explored Finally, we suggest educational strategies and tactics which promote the development of the intellectual capacities of student nurses as independent critical thinkers
Findings of a training needs analysis for qualified nurse practitioners
Authors: Sheperd John C
Published: March 2003

Training needs analyses have been identified as an essential part in the development of continuing education programmes and their implementation into practice This study describes the results of a training needs analysis of nurse practitioners across three health authorities in England
Job satisfaction in Japanese nurses
Authors: Yamashita Mineko
Published: March 2003

This study investigated job satisfaction among nurses in Japan The instrument for measuring occupational satisfaction of hospital nurses developed by Stamps and her associates was used Initial items were reviewed by content experts who were familiar with measurement of work satisfaction among health professionals and nursing practice in Japan Based on the item analysis in the cultural context, several items were reworded or eliminated from the original version Twenty‐five items were retained and translated into English by bilingual professionals The questionnaire was administered to 613 nurses Practising in a large, acute‐care hospital in a southern part of Japan The results from testing psychometric properties of the translated version of the instrument were satisfactory It may be concluded that nurses in the study were not satisfied but not dissatisfied either On all items, they showed relatively strong commitment to their work However, extrinsic factors such as having little opportunities for promotion or less favourable working conditions appeared to negatively influence job satisfaction in the study The findings support the dual factor theory of Herzberg and also Maslow's theory Considering the lowest scored item, little opportunities for promotion, which reflects the employment system in Japan, administrators, who are usually male medical practitioners, should be made aware of a need for creating clinical ladder opportunities for nurses who would be promoted based on a merit system, instead of the current practice of a seniority system
The effect of living in a nursing home on socialization in elderly people
Authors: Jacelon Cynthia S
Published: March 2003

The effects of institutionalization on elderly people are of significance both socially and physically Currently, about 5% of elderly people in the United States live in long‐term care institutions, although approximately 33% of all elders will be institutionalized for at least a short period of time The effects on socialization of living in a nursing home have been studied and commented on from several perspectives Several studies directed attention to the elderly person living in an institution Others investigated the institution's response to residents’ needs Some studies have focused on attitudes of health care workers towards elderly people, and still others have examined the interaction between workers and residents This review of the literature will first present studies focused on nursing home residents, then the institutions themselves, followed by studies of nursing home staff, and finally those focusing on the interaction between staff and residents Discussion of possible directions for both practice and research will follow The studies reported here were conducted in the United States, England, Northern Ireland and Finland
Neonatal nursing staff time involved with medication‐related activities
Authors: Ridge Helen E , While Alison E
Published: March 2003

A work sampling study involving 1920 observations derived from 48 2‐hour observation periods is described Approximately one‐tenth of neonatal nurse time was spent on medication‐related activities Just over one‐third of this time involved medication preparation It is suggested that the use of a pharmacy medication preparation service may be more cost‐effective
Gender‐power relations and safer sex negotiation*
Authors: Taylor Bridget M
Published: March 2003

This paper examines the gender‐power relations in heterosexual relationships and discusses the implications for women in attempting to negotiate safer sex Whilst acknowledging the need for examining both male and female perceptions of sexuality, the paucity of research on men's heterosexual experiences has restricted this paper to the consideration of the woman's standpoint Reviewing the literature, the complexities of sexual relationships are explored in terms of the power imbalance which arises from the ideologies of femininity and masculinity The implications for safer sex promotion by practice nurses working in primary health care teams are then discussed within the context of gender divisions of labour and gender role conflict
'Spirituality as integrative energy’: a philosophical analysis as requisite precursor to holistic nursing practice
Authors: Goddard Nancy C
Published: March 2003

Spirituality is a universal human phenomenon, yet conceptual confusion, ambiguity and scientific scepticism have prevented adequate investigation into its potential healing effects A recent resurgence of interest in non‐medical sources of healing and holistic medical practices is causing increased speculation regarding the nature of spirituality The lack of conceptual clarity, and absence of a precise theoretical definition, prevent recognition of spiritual distress and, hence, appropriate nursing intervention In this paper, current usage and definitions of spirituality are discussed and a philosophical definition of 'spirituality as integrative energy’ is proposed The metaphysical nature of this phenomenon makes it the proper concern of philosophy, consequently, a philosophical analysis of the aforestated proposition was completed using the five predicables of logic theory species, genus, differentia, logical property and logical accident Implications of this definition for providing holistic nursing care are also presented
What is philosophy of nursing?
Authors: Edwards Steven D.
Published: March 2003

This paper tries to describe the nature of the subject‐area known as philosophy of nursing. It is suggested that attempts to offer such a description are beset with difficulties surrounding both nurses’ and philosophers’ conceptin of philosophy. Nonetheless, this paper dose seek to offer a description of what philosophy amounts to. Schrock's suggestion that philosophy can be characterised partly by its methods and the distinctive nature of its questions is tentatively endorsed. Her proposal is buttressed with an account of Carnap's distinction between internl and external questions. It is shown that this distinction helps to identify philosophical questions. Further, an attempt is made to show the importance of the distinction between a philosophy of nursing and philosophy of nursing. It is concluded that philosophy involves conceptual analysis and assessment of argument, concern with highly general metaphysical and epitstemological questions, and that such questions can be regarded as‘external’ questions. It is then shown how these three elements of philosophy lso characterise philosophy of nursing.
Caring for a demented elderly person — burden and burnout among caregiving relatives
Authors: Almberg Britt , Grafström Margareta , Winblad Bengt
Published: March 2003

Fifty‐two family caregivers for demented elderly people were investigated for burden and burnout experiences. A structured burden questionnaire and the Burnout Measure were used. Burnout is described in relation to the caregiver's gender, age, family relationship and the demented person's living place. Older wives and daughters‐in‐law also risked developing burnout. Regression analysis showed that limitation in social life, poor health and a lack of positive outlook on caring were the most important independent variables explaining variance in burnout among caregivers having their demented elderly person living at home and those having them in an institution.
Snapshots of experience: vignettes from a nursing home
Authors: Running Alice
Published: March 2003

The specific aim of this research project was to examine and describe the experience of living in a nursing home for six people of 80 years and older. ‘Visit’ is presented as a means of developing nursing knowledge. This research method is founded on the belief that the act of nursing involves the development of a relationship, and was created out of the author's desire for a relational research method. Philosophical support for the method is provided by Maurice Merleau‐Ponty's existentialism, Sally Gadow's existential advocacy, and Jean Watson's Human Caring Theory. Authenticity is proposed as an alternative to the concepts of reliability and validity for judging the scientific merit of the method. Whether the nursing role is researcher, practitioner or educator, each person's unique and inexhaustible story provides the basis for nursing care. Nurse researchers using ‘Visit’ as a method of inquiry can illustrate these unique differences through a story, through the images or pictures each individual creates with his or her own words.
Towards a critical theory of mental health nursing
Authors: Hopton John
Published: March 2003

Towards a critical theory of mental health nursing In this paper, the author argues that, despite the self‐image of the mental health nursing profession as innovative, radical and progressive, this is a‘false consciousness’. Mental health nursing is deeply immersed in a crisis of legitimacy which dates from, at least, the publication of Russell Barton's Institutional Neurosis in 1959. However, although mental health nurses responded positively to the insights of Russell Barton, they failed to respond directly to the dissenting voices of the anti‐psychiatrists or the damning criticisms of various official inquiries into care in various individual psychiatric hospitals during the 1970s. Instead mental health nursing has uncritically embraced humanistic psychology and vaingloriously promoted a false image of mental health nursing which suggests that it has wholeheartedly embraced sensitive user‐centred approaches to care. However, the author suggests that, despite superficial similarities between person‐centred psychology and the theories of the anti‐psychiatrists, mental health nursing can never develop truly liberating approaches to care unless it widens its focus from purely interpersonal relationships and addresses historical, structural and ideological influences on both mental health services and the causation of mental distress.
The role of the nurse in active euthanasia and physician‐assisted suicide
Authors: Muller Martien T. , Pijnenborg Loes , Onwuteaka‐Philipsen Bregje D. , van der Wal Gerrit , van Eijk Jacques Th.M.
Published: March 2003

The researchers wanted to obtain insight into the cooperation between physicians and nurses with regard to active euthanasia and physician‐assisted suicide (EAS). In study I a stratified random sample of 203 clinical specialists, 152 general practitioners (GPs) and 50 nursing home physicians (NHPs) participated. In study II a random sample of 521 GPs was drawn from the province of North Holland and a random sample of 521 GPs was drawn from the rest of the Netherlands. For study III all NHPs were approached. Data were collected by means of an interview in study I. In studies II and III an anonymous, postal questionnaire was used. Approximately half of the GPs did not consult with nurses about a patient's request for EAS, the intention to administer EAS, and the actual administration. In 5% of cases, the NHPs and the specialists did not consult with nurses concerning these aspects. The GPs and NHPs indicated in 4% and 3% of the cases, respectively, that nurses administered the lethal drug(s) to the patients; the corresponding figure for the specialists was 21%. Almost all GPs and NHPs and about three‐quarters of the specialists thought that nurses should never be allowed to administer EAS.
Qualified nurse smokers’ attitudes towards a hospital smoking ban and its influence on their smoking behaviour
Authors: Strobl Judith , Latter Sue
Published: March 2003

This study explored the effects of a complete smoking ban in a large British teaching hospital on nurses’ smoking behaviour and their attitudes and views on the current policy and compliance with it. Questionnaires were distributed to a convenience sample of nurse smokers and ex‐smokers 9 months after the introduction of the smoking ban. A response rate of 64·7% (n=33) was achieved.The reported reduction in work‐time cigarette consumption following the ban was not statistically significant (Wilcoxon test: P = 0·069). No reduction outside work was recorded. Six (21·4%) smokers claimed that the ban had been a reason for them to try to give up smoking. Two of three ex‐smokers reported that the ban had played a role in their giving up. The respondents showed considerable agreement with their health educator and role model function. Support for the policy was, however, very limited and compliance with it was reported to be poor among patients as well as staff. Twenty (76·9%) of current smokers indicated their wish to give up, 11 (39·3%) of them believed their own determination to be an effective way to achieve this. These results would seem to indicate that smoking policies currently have limited impact on smoking behaviour. It is suggested that in future policies should aim at strengthening nurses’ determination to give up as well as secure their support for the restrictions in order to assist them in changing their smoking behaviour.
Postoperative variation in neurocognitive and functional status in elderly hip fracture patients
Authors: Milisen Koen , Abraham Ivo L. , Broos Paul L. O.
Published: March 2003

Regaining independence in the performance of activities of daily living (ADL) is a nursing priority in the postoperative care of hip fracture patients, though often impeded by a temporary yet reversible decrease in cognitive status postoperatively. This study investigated the incidence and evolution of decreased cognitive status in geriatric hip fracture patients from admission through to the fifth postoperative day, and the relationship between cognitive abilities and functional (ADL) status. Twenty‐six elderly hip fracture patients (f: 21, m: 5) with a mean age of 79·5 years ( SD=8·2) admitted to the emergency room of an academic medical centre were monitored longitudinally from admission until the fifth postoperative day regarding neurocognitive status and ADL status, as measured by the mini‐mental state exam (MMSE; including subscales of memory, linguistic ability, concentration and psychomotor executive skills) and an adapted version of the Katz ADL‐scale, respectively. Patients were categorized on the basis of cognitive status as follows: no cognitive impairment (MMSE≥24), moderate (MMSE≤23 but ≥18) and severe impairment (MMSE≤17). Nineteen of the 26 patients (73·1%) showed cognitive impairment (MMSE≤23) at some point in time before and/or after surgery. Some improvement in cognitive status was observed yet only selectively across patient cohorts and neurocognitive dimensions. Cognitive status, especially memorial ability and psychomotor executive skills, seemed to be most vulnerable to becoming impaired after hip fracture surgery. A relationship was found between cognitive and functional status, specifically, strong associations between memory and psychomotor skills relative to ADL and modest associations between linguistic ability and concentration relative to ADL. Further, patients with decreased cognitive status postoperatively remained more ADL‐dependent than non‐impaired patients. This study underscores the importance of a systematic assessment of the cognitive status of elderly hip fracture patients and linking these observations to functional ability in order to enhance the postoperative rehabilitation of this patient group.
Privacy or help? The use of curtain positioning strategies within the maternity ward environment as a means of achieving and maintaining privacy, or as a form of signalling to peers and professionals in an attempt to seek information or support
Authors: Burden Barbara
Published: March 2003

Midwives in the local maternity unit had noted that the interactions between women within the ward environment had started to decline. Women were spending long periods of time behind curtains drawn around their bed space. The staff hypothesized that this was because women desired the privacy of a single room. The literature review revealed a lack of understanding of the concept of privacy within a ward environment from a nursing or midwifery perspective. The review therefore, concentrated on the information offered by the fields of psychology and sociology. This study aimed to observe the methods women use to maintain or preserve their privacy within the ward environment. An ethnographic approach was used incorporating use of documentary evidence, participant observation and discussion, field maps and field notes. The findings of this study centred around the use of curtain positioning, subsequently referred to as ‘signalling’. The strategies employed by women included complete closure for total withdrawal, semi‐closure for seeking information or support, and partial closure of curtains around the individual’s bed space for periods of solitude or rest. The findings have implications for both general and maternity hospital wards but in particular, wards within maternity units that incorporate women with mixed methods of infant feeding, or women in labour mixed with either postnatal or antenatal women.
Familial amyloidotic patients’ experience of the disease and of liver transplantation
Authors: Jonsèn Elisabeth , Athlin Elsy , Suhr Ole
Published: March 2003

Liver transplantation is a new treatment for familial amyloidotic polyneuropathy (FAP). No qualitative study examining these patients’ experiences of the disease and the treatment has been published. The purpose of this study was to explore and describe the experience of the disease and the liver transplantation from the FAP patient’s perspective. In‐depth interviews with 11 liver transplant FAP patients were performed. The process of the FAP disease and a liver transplantation was found to involve the following categories: going downhill, defence and denial, a chance of surviving, the decision — no choice, waiting powerless and uncertain, the first few steps after surgery, freed from the death sentence, still disabled, mastering up strength to recover, and the need for support and help.
The contexts for managing depression and its stigma among black West Indian Canadian women
Authors: Schreiber Rita , Stern Phyllis Noerager , Wilson Charmaine
Published: March 2003

There is a paucity of literature available to assist nurses and other care providers in knowing how to meet the needs of depressed women from non‐dominant cultural backgrounds. To begin to address this need, we conducted a grounded theory study on black West Indian Canadian Women’s strategies for managing depression. We discovered a basic social process, Being Strong, that the women used to manage or ameliorate depression. Being strong occurs within the overlapping areas of three social contexts: the cultural stigma of depression, male–female roles and relationships, and belief in Christian doctrine. These contexts are located against a backdrop of visible minority status within a eurocentric society. This socio‐cultural contextual material provides the setting within which black West Indian Canadian women live and make decisions. In this article, we present findings related to the social and cultural aspects of the women’s situation.
The delivery of quality nursing care: a grounded theory study of the nurse’s perspective
Authors: Williams Anne M.
Published: March 2003

This grounded theory study explored and described the delivery of quality nursing care from the perspective of nurses. Data were gathered by tape recorded interviews, published literature and some participant observation. Ten registered nurses from an acute‐care public hospital located in Perth, Western Australia were interviewed. Twelve additional transcripts from interviews conducted by postgraduate students were also used. Quality nursing care was perceived to relate to the degree to which patients’ physical, psychosocial, and extra care needs were met. The consequences of quality care were interpreted as ‘therapeutic effectiveness’, where the therapy provided by nurses was perceived to positively affect patients’ healing. This was gauged by the patient’s psychosocial and physical response to illness, safety, and satisfaction. Therapeutic effectiveness was facilitated by the development of positive relationships between nurses and patients, nurse’s positive attributes and competent practices, as well as a functional nursing team. The problem of nurses’ inability to consistently provide quality nursing care to all patients was identified. Insufficient time (caused by a lack of human and physical resources) was perceived as the main reason for this. Dissatisfaction and stress in nurses was related to this problem. To deal with this, nurses used a process named ‘selective focusing’. Work was planned to most effectively utilize the time available, within the parameters of safety. Implications for nursing practice, education and management are discussed, and directions for further research are provided.
Adolescents’ perceptions of physicians, nurses, parents and friends: help or hindrance in compliance with diabetes self‐care?
Authors: Kyngäs Helvi , Hentinen Maija , Barlow Julie H.
Published: March 2003

Although compliance with self‐care amongst adolescents with diabetes is known to be problematic, this issue has rarely been examined from the perspective of young diabetics themselves. The purpose of the study was to explore how adolescents with diabetes perceived the actions of physicians, nurses, parents and friends in relation to compliance with self‐care. Fifty‐one young diabetics aged from 13 to 17 responded to a questionnaire concerning compliance and were interviewed on the topic of compliance. Interview data were analysed by content analysis. The categories obtained were quantified and the relationship between compliance and the actions of physicians, nurses, parents and friends analysed by cross‐tabulation. Interviews with 51 adolescents showed that the actions of physicians, nurses and parents described as motivating were associated with better compliance. Good compliance was also more evident when parental actions were perceived as accepting. Young diabetics whose friends offered silent support, or who viewed friends as irrelevant, were more likely to report good compliance. In contrast, physicians’ actions described as routine/negligent, disciplined control by parents, and domination by friends were linked with poor compliance.
Nursing organizational practice and its relationship with other features of ward organization and job satisfaction
Authors: Adams Ann , Bond Senga , Hale Claire A.
Published: March 2003

This paper describes a new classification of ward organizational practice in nursing. Data related to aspects of ward nursing practice were collected by postal survey from a nationally representative sample of 74 acute hospital wards, and subjected to hierarchical cluster analysis. The model which was deemed to best ‘fit’ the data, provided three types of ward practices, which have been named: ‘devolved’, ‘two tier’ and ‘centralized’ nursing. The distinguishing features of the three classifications are similar but not identical to accepted ‘ideal types’ of primary, team and functional systems. The relationships between wards in each of the three identified categories and other ward organizational practice processes of nursing care and job satisfaction are described.