bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk management system implemented at the US Army Medical Command
Authors: Kashiwagi Jacob , Sullivan Kenneth , Kashiwagi Dean T.
Published: July 2009

Purpose

To describe the implementation of the Performance Information Risk Management System (PIRMS) to indefinite delivery indefinite quantity (IDIQ) general contractors in the US Army Medical Command (MEDCOM) 26 sites, 150 projects/year, and $250m/year maintenance and repair construction program.

Design/methodology/approach

To test the hypothesis that facility owner management, control, and decision making is a source of risk, and that the transfer of risk and control to the contractors will minimise the risk.

Findings

Include minimising construction management by 33 percent, motivated contractors to regulate their own contracts, minimised unresolved issues by 50 percent, minimised contractor generated change orders by 20 percent, and moving from doing quality control to quality assurance.

Research limitations/implications

The authors see no constraints in the implementation of PIRMS in other organisations. This paper reflects the perceptions of the Arizona State University research team, and publicly available test results, and not the views or policy of the USA Medical Command.

Originality/value

Includes the use of dominant performance/risk information from the contractor's weekly risk reports to create accurate performance and risk information on all ongoing projects, the IDIQ contractors, and on the client's/buyer's personnel. Risk information is being used to streamline a large organisation's organisational structure, minimising decision making and transactions, and transferring risk and control to the party who can minimise the technical risk.
Facilities management: factors influencing the role of Nigerian estate surveyors
Authors: Adewunmi Yewande , Ajayi Cyril , Ogunba Olusegun
Published: July 2009

Purpose

The paper examined the factors influencing the role of estate surveyors in facilities management (FM).

Design/methodology/approach

The study administered questionnaires on 247 practicing estate surveyors within Lagos metropolis, Nigeria in 2006. These were selected through alphabetic systematic sampling of estate surveyors from the list of financial members with designations (2004/2005) of the Lagos state branch of Nigerian Institution of Estate Surveyors and Valuers. The survey achieved a total response rate of 85 percent. Statistical tools employed in analyzing data were relative importance indices and factor analysis.

Findings

The findings suggest that training in FM and type of business of the organisation managed by the estate surveyor were significant factors that influence surveyors' participation in areas of core competence in FM.

Research limitations/implications

Owing to time constraints, authors have only studied one location. No urban area can be representative of all cities in the country. Nevertheless, the results of the study should at least apply to the majority because most of the estate surveyors in Nigeria are based in Lagos.

Originality/value

The paper introduces an empirical approach to the discussion on role of estate surveyors in FM in Nigeria.
The effectiveness of the Dispute Settlement Body of the World Trade Organization
Authors: Varella Marcelo D.
Published: July 2009

Purpose

The purpose of this paper is to analyse the performance of the Dispute Settlement Body (DSB) of World Trade Organization (WTO) performance, between 1995 and 2007, as well as to discuss the main proposals for its improvement.

Design/methodology/approach

First, the paper presents the legal predictability of the system; compliance with its procedural stipulations in regard to its proposed timeframes; and the participation of different groups of States within this system. The timeframes are compared with those that really happened. Thus, there is an analysis of the effectiveness of its decisions and the necessity to induce compliance and retaliation. Finally, the main proposals to change the system are discussed.

Findings

It is concluded that most of legal procedures are accomplished as previewed by DSB, but the system itself is highly dependent of the action of States, who need time to negotiate. It is also possible to conclude that there is a high level of effectiveness and States prefer to respect the decisions of DSB and maintain the legitimacy of the system as a whole than keep advantages in specific matters.

Originality/value

When the WTO was founded, there was an effort to generate a system guided by legal rules. The DSB has made efforts to maintain a high level of legal preciosity. However, it is clear that this system is still very limited by the traditional method of negotiation among States. The implementation of a rule‐oriented system contributes to greater democratization of access to justice and, of course, in a limited way, the principle of sovereign equality of States. Finally, the majority of proposed changes attempt to apply the logic of domestic courts to an international body, assuming a level of organization of the international community as a whole that still does not exist. Others proposals suggest increasing the politicization of the system, which is also not appropriate.
Trade in financial services in developing countries: a case of the Bangladesh financial sector
Authors: Masudur Rahman Mohammad , Arjuman Ara Laila
Published: July 2009

Purpose

The purpose of this paper is to investigate the opportunities and challenging prospects for liberalizing financial services in various ways under the General Agreement on Trade in Services (GATS), in view of Bangladesh's interests and concerns.

Design/methodology/approach

Different tabular and graphical approaches and critical investigation are conducted to analyze the impact of financial liberalization to explore challenges and opportunities of liberalizing financial sector under GATS framework.

Findings

This paper finds that although Bangladesh does not make any commitment under GATS, the rate of liberalization in the financial sector has been quite rapid. As one of the least developed countries (LDCs), Bangladesh should have the flexibility to make commitments as well. From the present status of financial sector liberalization, this paper recommends that Bangladesh should adopt commitments because any non‐commitment sends the wrong signal to the global market and may reduce foreign direct investment.

Practical implications

The recommendation of this paper is very practical for trade policy for liberalizing financial sector in Bangladesh as well as other developing countries which already made great liberalization of this sector but did not make any commitments under GATS.

Originality/value

This paper is the first attempt to analyze the financial sector liberalization under GATS framework in the LDCs particularly in Bangladesh financial sector.
Philosophical basis of the legal theory underlying international commercial arbitration in the Middle East region
Authors: Abu Sadah Muhammad
Published: July 2009

Purpose

The purpose of this paper is to focus on the regional perceptions of the Middle East region in relation to international commercial arbitration and show how these perceptions influence the attempts to harmonise the modern international law in the Middle East region.

Design/methodology/approach

Legal positivism as a general philosophy, mainly influenced by John Austin, is used as an analytical tool in order to identify the general trends from Western and Middle East cultural perspectives that relate to international commercial arbitration.

Findings

The paper shows how the Middle East region has different social and legal values between the West and the Middle East region in respect to the primarily three general and important features of the law – namely, normative, institutionalised, and coercive. Positivism legal theory shows that such success in the context of western European commercial law is inappropriate in the Middle East where different cultural norms make its wholesale and unqualified transferability problematic, notwithstanding its acceptance in highly generalised terms.

Practical implications

The paper generates a proposition that reforms are more likely to succeed if adjustments to the cultural environment are made. Thus, it supports the argument that regional values can add to the global activities of the harmonisation process of international commercial arbitration law.

Originality/value

The paper provides a clear understanding of the guidelines for the reform and development of Middle East international commercial arbitration. Legal culture should be taken into consideration if a successful reform is to be achieved.
Effectiveness of economic cooperation between the EU and the ACP countries
Authors: Evrensel Ayse
Published: July 2009

Purpose

Since the First Yaoundé Convention (1963‐1969), the European Union (EU) has been implementing its development policy in the African, Caribbean, and Pacific (ACP) countries. The purpose of this paper is to focus on the trade and financial flows between the EU and the ACP countries and attempt to empirically evaluate the effectiveness of the EU's development policy during the pre‐Cotonou era (1970‐2000).

Design/methodology/approach

Extensive trade, governance, and external financing data are gathered about 79 ACP countries during the period 1970‐2004. Using the index of standardized trade performance, diversification indices, and regression analysis, the effectiveness of trade preferences and financial assistance in the ACP countries is quantified.

Findings

The results indicate that the preferential trade arrangements between the EU and the ACP countries had neither substantially increased the ACP countries' exports to the EU nor diversified these countries' export structure. Additionally, even though the ACP countries received substantial external financing, these countries continued suffering from the lack of development‐enhancing political and judicial institutions. The empirical results suggest that governance characteristics such as higher corruption and lower democratic accountability have adversely affected the ACP countries' growth rates.

Research limitations/implications

This paper focuses on the effectiveness of the economic cooperation between the EU and the ACP countries during the pre‐Cotonou era. The Cotonou agreement that went into effect in 2000 has changed the EU's approach to the ACP countries significantly. However, the recent nature of this agreement imposes restrictions on data availability, which forces us to exclude the Cotonou era from most of our empirical evaluation.

Practical implications

The empirical results of the paper demonstrate the relevance of governance‐related factors or institutions in developing countries. Neither preferential trade nor financial assistance seems to enhance the growth performance of these countries if they lack political transparency and accountability.

Originality/value

This paper provides empirical evidence that the change in the EU's approach to its economic partnership with the ACP countries is warranted. Because the empirical results suggest that the pre‐Cotonou economic cooperation between the EU and the ACP countries did not contribute to the ACP countries' economic growth, the EU's decision of shifting the focus from trade preferences to governance‐related issues in the ACP countries can be viewed as justified.
Job insecurity and motivation among women in Nigerian consolidated banks
Authors: Chovwen Catherine , Ivensor Emilia
Published: July 2009

Purpose

The purpose of this paper is to examine the predictors of perceived job insecurity and motivation among 286 female participants in merged and acquired banks in two capital cities of South West Nigeria.

Design/methodology/approach

The participants in this survey were accidentally sampled for convenience of participants and ease of administration because of the tight work schedule. Data collected were analysed using regression and t‐test statistics.

Findings

The results of the research indicated joint significant influence of job characteristics and organizational justice in women's perceived threat of job loss and motivation. Specifically, organizational justice (procedural justice) exerted a strong influence on the dependent variables for women in both acquired and merged banks.

Research limitations/implications

Use of accidental sampling is a limitation. Further, studies should adopt other sampling techniques that may capture a significant sample of the population.

Practical implications

These findings implied that unless changes are managed in structured, systematic and constructively in ways perceived by women to be fair, organizations will remain far from realizing the benefits of restructuring and downsizing.

Originality/value

The paper offers insight into job insecurity and motivation among women in the context of Nigerian consolidated banks.
The boardroom gender paradox
Authors: Pesonen Sinikka , Tienari Janne , Vanhala Sinikka
Published: July 2009

Purpose

The purpose of this paper is to contribute to research on gender and corporate boards of directors by focusing on how female board professionals construct particular notions of accessing and succeeding in boards.

Design/methodology/approach

A discursive perspective is offered, based on conceiving gender as something that is “done” in social interaction. In the spirit of critical discourse analysis, the talk of female board professionals, produced in interviews in the Finnish context, is analyzed in‐depth.

Findings

Two discourses are located in the talk of female board professionals: the discourse of competence and the discourse of gender. It is argued that the discourses constitute a boardroom gender paradox, which is characterized by several contradictory elements. By conceptualizing and illustrating this paradox, the study scrutinizes the elusive ideal of women's large‐scale entry into corporate boards.

Research limitations/implications

Future studies should make use of the insights developed, and apply them to cross‐societal comparative research.

Practical implications

For corporate decision‐makers, the findings suggest a rethinking of how “competence” is defined and applied.

Originality/value

Paradox has rarely been addressed in the literature on gender and corporate boards. Understanding how the women interviewed (re)construct a boardroom gender paradox offers a unique contribution to the literature.
Motivational factors in a push‐pull theory of entrepreneurship
Authors: Kirkwood Jodyanne
Published: July 2009

Purpose

Entrepreneurial motivations are often defined as fitting into “push” or “pull” categories. To date, research has focused on the factors motivating men and women separately. What is missing from this research is an analysis of the comparative differences in these motivators of men and women, and an exploration of what this means in terms of push‐pull theory. This paper aims to contribute by applying the existing theory on push and pull factors; and using a gender comparative approach to explore the nature of potential gender differences within entrepreneurial motivations.

Design/methodology/approach

This exploratory study uses a gender comparative approach in semi‐structured, face‐to‐face interviews with 75 entrepreneurs (28 women and 47 men).

Findings

Findings suggest that both women and men appeared similarly motivated by a combination of push and pull factors. Three gender differences were found in the incidence of motivations: women were more influenced by a desire for independence; women considered their children as motivators more so than did men; men were influenced more by job dissatisfaction than were women. The discussion focuses on analysing the nature of gender differences rather than merely their incidence.

Research limitations/implications

A number of further research directions and questions are posed as a way of extending the knowledge in this area. Implications for managers and entrepreneurs are also presented.

Originality/value

Contributes to push‐pull theory by offering a gender comparative approach to advance theory.
Gender diversity in expatriation: evaluating theoretical perspectives
Authors: Shortland Susan
Published: July 2009

Purpose

The purpose of this paper is to examine the range of theoretical underpinning used to explain women's participation as expatriates with a view to identifying the most promising theoretical lenses for future research.

Design/methodology/approach

Drawing upon theoretical explanations in the “women in management” and “women expatriates” literature, four main theoretical domains are identified that are used to understand and explain their continuing low representation as expatriates: women's choices, assignee characteristics, social and societal norms and institutional aspects. Key theories within each domain are evaluated to suggest a future theoretical research framework.

Findings

The most promising theoretical explanation of women's low participation as expatriates is identified as being linked to gender stereotyping reinforced within an isomorphic institutional framework.

Research limitations/implications

Research into women's inroads into management and into expatriation has generated considerable volumes of theorising in the literature. Thus, only representative examples have been selected here. In terms of future research, gender, identity and sex role theories potentially provide the most promising theoretical lenses set within the institutional framework of organisational policy and practice.

Practical implications

Organisational approaches to international assignment policy/practice supporting female corporate expatriation are mediated by how diversity and equal opportunities policies are embedded within policy implementation.

Originality/value

There is little evidence to date of an accepted theoretical framework to test hypotheses relating to women's participation as expatriates. This paper evaluates the options and presents those with the most promise for generating an agreed and accepted framework for future female expatriate research.
Seasonal trophic dynamics affect zooplankton community variability
Authors: BEISNER BEATRIX E. , PERES‐NETO PEDRO R.
Published: July 2009

1. The degree to which communities are variable may be affected by the ecological conditions to which they are exposed and can affect their propensity to form alternative states. We examined the influence of two common ecological factors, predation and seasonal successional stage, on the variability in community composition of herbivorous pond plankton. In a highly replicated, two factor, mesocosm experiment we determined whether beta diversity was affected by seasonal successional stage of the community (two levels), by fish predation (presence/absence) or by their interaction.

2. Several significant changes were found in the composition of the rotifer, cladoceran and copepod assemblages. Most cladoceran abundances showed sharp declines in the presence of fish, while some rotifers, as well as their assemblage species richness, responded favourably to fish. The copepod assemblage was composed of omnivorous and carnivorous species, which added invertebrate predation to the experiment and which intensified as the season progressed. Copepods showed responses to fish predation that depended on seasonal successional stage of the initial community, because of changes in their stage structure and edibility as they grew from nauplii to adults.

3. Community variability was consistently high at the end of each month‐long experimental period for both cladoceran and rotifer assemblages, except under two conditions. In the early season treatments, the rotifer assemblages were more consistent (lower beta diversity) in the presence of fish. This was attributed to high population growth rates for rotifers under these ecological conditions because of reduced copepod predation on them through a trophic cascade from fish. Low community variability was also observed in the late season for rotifers when fish were excluded and, as a result, they were exposed to high invertebrate predation from cyclopoid copepods.

4. Results from the early season support theoretical predictions that when community size increases, variability in composition should decline because of an increase in competitive processes over stochastic ones. Late season results suggest that a second mechanism, specialist predation, can also reduce prey community variability. Our study demonstrates that plankton communities may be more predictable under certain trophic web configurations and challenges ecologists to find ways to incorporate such inherent variability into experiments and community theory.
Sperm DNA integrity in cancer patients: the effect of disease and treatment
Authors: Ståhl O. , Eberhard J. , Cavallin‐Ståhl E. , Jepson K. , Friberg B. , Tingsmark C. , Spanò M. , Giwercman A.
Published: July 2009

As oncological treatment might impair the patients’ fertility, male cancer patients are offered to cryopreserve semen prior to treatment. Impaired sperm DNA quality is associated with reduced fertility, and in case of assisted reproduction, sperm DNA integrity may have an impact on choice of method. Therefore, we have assessed sperm DNA integrity in cancer patients, comparing pre‐ and post‐treatment quality. Sperm DNA integrity was investigated in cryopreserved semen from 121 cancer patients, the predominating diagnoses were germ cell cancer (GCC) and Hodgkin’s lymphoma (HL). Post‐treatment samples, with a median follow‐up of 3 years, were analysed for 58 of the men, allowing a pre‐ and post‐treatment analysis on an individual basis. Sperm DNA integrity was assessed using the Sperm Chromatin Structure Assay and expressed here as the DNA Fragmentation Index (DFI%). One hundred and thirty‐seven fertile men served as controls. Before treatment, GCC (n = 84) and HL (n = 18) patients had higher DFI% than controls (n = 143) with a mean difference of 7.7 (95% CI 3.2–8.8) and 7.0 (95% CI 2–12), respectively. The same trend was observed for other cancer diagnoses, but without reaching statistical significance (mean difference 3.6, 95% CI −1.2 to 8.4). No increase was seen in DFI% comparing pre‐ and post‐treatment semen, regardless of treatment modality. A moderate elevation of DFI% was observed in cryopreserved semen from cancer patients. Oncological treatment, generally, did not induce any increase in DFI. These findings should be considered when discussing the utilization of pre‐treatment cryopreserved semen vs. post‐treatment fresh sperm in cancer patients undergoing assisted reproduction.
Creating context for critical thinking in practice: the role of the preceptor
Authors: Forneris Susan Gross , Peden‐McAlpine Cynthia
Published: July 2009

Title.  Creating context for critical thinking in practice: the role of the preceptor.

Aim.  This paper is a report of a study to determine the impact of the preceptor coaching component of a reflective contextual learning intervention on novice nurses’ critical thinking skills during the first 6 months of their practice.

Background.  The use of preceptors to develop novice nurses’ clinical skills has been well documented in the literature. However, there is little literature focused on preceptor involvement to develop novice nurses’ critical thinking.

Method.  This small case study was conducted in the United States of America in 2004 with six nurse/preceptor dyads. Stake’s qualitative instrumental case study design was used to evaluate the preceptor component of the contextual learning intervention. Stories of preceptor experiences were analyzed using Stake’s phases of data analysis (i.e. description, categorical aggregation, establishing patterns, naturalistic generalizations). Specific questions (e.g. nature of coaching used by the preceptor) guided the analysis. Repeating patterns were coded and isolated and later collapsed as the analysis moved forward.

Findings.  Preceptors use of the contextual learning intervention created a context that stimulated novice nurses’ critical thinking. Two main themes describe the novice nurses’ critical thinking skills relative to the preceptor coaching: 1) critical thinking as organizing and carrying out tasks; and 2) critical thinking as intentional, reflective thinking.

Conclusion.  Preceptor education should incorporate the following components: understanding the impact of power and anxiety on critical thinking of novice nurses transitioning into practice; creating dialogue that invites questions in a reflective and critical manner; and challenging thinking through sharing of perspectives.
Patients and families experiences with video telehealth in rural/remote communities in Northern Canada
Authors: Sevean Pat , Dampier Sally , Spadoni Michelle , Strickland Shane , Pilatzke Susan
Published: July 2009

Aim.  To explore patients’ and families’ experiences with video telehealth consultations as a method of health care delivery in rural/ remote communities in Northern Canada.

Background.  Accessing health services in isolated populations where human resources and infrastructure are constrained by vast geographical landmasses poses challenges and opportunities for nurses, health care providers, patients and families.

Design.  A qualitative approach was adopted with a purposeful sample of 10 patients and four family members representative of nine communities.

Method.  Selection criteria included patients receiving telehealth visits for a minimum of a year and willing to share their experiences. Data were collected during the winter of 2006 using semi‐structured video taped interviews and analysed using a qualitative thematic content analysis.

Results.  Patients and families experiences of their telehealth visits centered on three key themes: lessening the burden (costs of travel, accommodations, lost wages, lost time and physical limitations), maximising supports (access to family, friends, familiar home environment, nurses and other care providers), tailoring specific e‐health systems to enhance patient and family needs.

Conclusion.  The benefits of telehealth extend not only to patients and families but are linked to benefits for providers as well as the health care system.

Relevance to clinical practice.  This study indicates that video telehealth is an effective mechanism for delivering nursing and other health services to rural/remote communities and can impact positively on the quality of health care. The integration of telehealth practice can enhance the coordination, organisation and implementation of health care services.
The validity and reliability of an instrument to assess nursing competencies in spiritual care
Authors: Van Leeuwen René , Tiesinga Lucas J , Middel Berrie , Post Doeke , Jochemsen Henk
Published: July 2009

Aim. This study contributes to the development of a valid and reliable instrument, the spiritual care competence scale, as an instrument to assess nurses’ competencies in providing spiritual care.

Background. Measuring these competencies and their development is important and the construction of a reliable and valid instrument is recommended in the literature.

Design. Survey.

Method. The participants were students from Bachelor‐level nursing schools in the Netherlands (n = 197) participating in a cross‐sectional study. The items in the instrument were hypothesised from a competency profile regarding spiritual care. Construct validity was evaluated by factor analysis and internal consistency was estimated with Cronbach’s alpha and the average inter‐item correlation. In addition, the test–retest reliability of the instrument was determined at a two‐week interval between baseline and follow‐up (n = 109).

Results. The spiritual care competence scale comprises six spiritual‐care‐related nursing competencies. These domains were labelled: 1 assessment and implementation of spiritual care (Cronbach’s α 0·82) 2 professionalisation and improving the quality of spiritual care (Cronbach’s α 0·82) 3 personal support and patient counseling (Cronbach’s α 0·81) 4 referral to professionals (Cronbach’s α 0·79) 5 attitude towards the patient’s spirituality (Cronbach’s α 0·56) 6 communication (Cronbach’s α 0·71). These subscales showed good homogeneity with average inter‐item correlations >0·25 and a good test–retest reliability.

Conclusion. This study conducted in a nursing‐student population demonstrated valid and reliable scales for measuring spiritual care competencies. The psychometric quality of the instrument proved satisfactory. This study does have some methodological limitations that should be taken into account in any further development of the spiritual care competence scale.

Relevance to clinical practice. The spiritual care competence scale can be used to assess the areas in which nurses need to receive training in spiritual care and can be used to assess whether nurses have developed competencies in providing spiritual care.
Student engagement in interprofessional working in practice placement settings
Authors: Pollard Katherine
Published: July 2009

Aim.  To investigate the nature of student engagement in interprofessional interaction while on placement.

Background.  Due to continuing emphasis on improving interprofessional collaboration, UK educational establishments are required to offer prequalifying health and social care students interprofessional education in order that they acquire relevant competencies. However, few formal interprofessional education initiatives occur in practice settings and little is known about prequalifying students’ non‐formal learning about interprofessional issues while on placement.

Design.  From 2003–2005 an English Faculty of Health and Social Care conducted a qualitative study to explore opportunities for interprofessional learning and working available to students in practice placement settings.

Methods.  Case studies were conducted in a coronary care ward, a medical ward for older patients, a maternity unit, a paediatric unit, an integrated community learning disabilities team and a residential facility for adults with challenging behaviour. Gaining access was complex, due to variable student timetables and UK research governance requirements. Sites were therefore selected according to geographical area and timing of student placements. Details of interprofessional interaction (formal and informal) were observed and recorded. Interviews were conducted with a convenience sample of 20 practitioners and 15 students. Data were analysed thematically.

Results.  Student experience varied considerably. Contributing factors included the influence of doctors and differing professional cultures; mentors’ support for student engagement in interprofessional working; and individual students’ confidence levels. Most sites were managed by nurses and some senior nurses were proactive in involving students interprofessionally. However, many students lacked systematic support for interprofessional engagement.

Conclusions.  Students lack parity of experience concerning interprofessional activity on placement. Where they do not have systematic support, their engagement depends mainly on their own confidence.

Relevance to clinical practice.  Senior nurses are ideally placed to promote environments where students can develop interprofessional competencies through systematic interprofessional engagement.
The first experiences of clinical practice of psychiatric nursing students in Taiwan: a phenomenological study
Authors: Hung Bai‐Jin , Huang Xuan‐Yi , Lin Mei‐Jue
Published: July 2009

Aims and objectives.  The purpose of this study is to understand the experiences of psychiatric nursing students during their first encounters with psychiatric patients in a clinical setting. The objective is to assist educational professionals in mental health to improve teaching strategies.

Background.  In clinical settings, student psychiatric nurses have to face complex problems and situations that can result in distress. Sometimes the student nurse will be uncertain of their own ability and this is reflected in a sense of fear on the part of some nurses. However, little research has been conducted into the first clinical experiences of such nursing students in Taiwan.

Design.  A qualitative phenomenological study was devised to explore what psychiatric nursing students perceived during their first experiences of clinical practice and narratives were analysed using Colaizzi’s seven‐step method.

Method.  A phenomenological approach and purposive sampling were used in the study. Face‐to‐face interviews were conducted to collect the data and during the process of data analysis we established epochs (bracketing) and focused on the reality of the student nurses’ experience to keep the data objective.

Results.  Four themes were identified: breaking the stigma of mental illness, developing a trusting relationship with the patient, gaining professional knowledge and skills and the process of student growth.

Conclusion.  The findings from this study demonstrate that it is important to understand the perceptions of students during their first experiences of psychiatric nursing in a clinical setting and highlight the importance of educational programs.

Relevance to clinical practice.  By understanding the emotional process that psychiatric nursing students may go through during their clinical practice, educators can be better able to design suitable training courses in the future.
A randomised controlled trial of the effects of cryotherapy on pain, eyelid oedema and facial ecchymosis after craniotomy
Authors: Shin Yong Soon , Lim Nan Young , Yun Sung‐Cheol , Park Kwang Ok
Published: July 2009

Aim.  To identify the effects of cryotherapy on patient discomfort following craniotomy.

Background.  Following craniotomy, many patients suffer from unexpected discomfort, including pain, eyelid oedema and ecchymosis. Cryotherapy is regarded as a safe method for managing these postcraniotomy problems.

Design.  Randomised controlled trial.

Methods.  A total of 97 Korean patients who underwent elective supratentorial craniotomy were randomly assigned to a cryotherapy or a control group. In the cryotherapy group, ice bags were applied to surgical wounds, and cold gel packs were applied to periorbital areas, for 20 minutes per hour, beginning three hours postoperatively and for three days thereafter. The level of patient pain was measured using the visual analogue scale while the eyelid oedema was measured using the Kara & Gokalan’s scale. Ecchymosis was also classified according to its extent.

Results.  The level of pain three hours after craniotomy was similar in the cryotherapy and control groups (57·9 vs. 58·7). Three days after surgery, pain had significantly decreased in the cryotherapy group (p = 0·021). After adjusting diagnosis by analysis of covariance (ancova), pain score did not differ significantly between the two groups. The mean eyelid oedema scores were lower in the cryotherapy group than in the control group (0·59 vs. 2·29, p < 0·001), with ancova showing that cryotherapy had a significant effect on eyelid oedema (p < 0·001). Pain (p = 0·047) and eyelid oedema (p < 0·001) in the cryotherapy group were significantly decreased over time. Ecchymosis were significantly less frequent in the cryotherapy (11/48, 22·9%) than in the control (26/49, 53·1%) group (p = 0·003). Logistic regression analysis showed that cryotherapy affected ecchymosis (p = 0·001).

Conclusion.  These results indicate that cryotherapy can control pain, eyelid oedema and facial ecchymosis after craniotomy.

Relevance to clinical practice.  Cryotherapy, which is both convenient and cost‐effective, can be used to prevent postoperative discomforts in a clinical setting.
Managing capacity issues in clinical placements for pre‐registration nurses
Authors: Murray Sonya C , Williamson Graham R
Published: July 2009

Aims and objectives. To explore influences on decision‐making concerning placement capacity planning for supporting nursing students in clinical placements. The research questions were:

How are decisions relating to capacity planning and management of the learning environment made within the practice areas?

What factors were or are perceived as important to take into consideration when making these decisions?

Background. It is already known that clinical placements are pivotal to pre‐registration nurse education. The recent large expansion of nurse education places means that more students require clinical placements than previously. This study explored decision‐making about placement capacity amongst mentors in one central English county.

Design. A qualitative design using focus groups.

Study and methods. Collecting data allowed researchers to engage mentors in discussions concerning their decisions about how many students they could support in practice and the learning environment they could provide. Twenty‐nine active nursing student mentors participated, representing three branches (Adult, Mental Health and Child Health Nursing) from various acute and community settings and professional roles.

Results. Three themes emerged relating to capacity management issues in clinical placements:

Capacity issues: how decisions are made in relation to capacity planning, by whom they are made and what influences them?

Supporting learners and enhancing support in practice.

Issues impacting on learning in practice.

Conclusions. This study adds further understanding of the need for robust information to support allocation decisions, coupled with greater clinical staff and mentors’ involvement in decisions about student support. The forthcoming Skills for Health Ensuring Quality in Partnership requirements may add authority and structure to student support activities.

Relevance to clinical practice. Strategic practice and placement development links and joint appointments between UK NHS trusts and higher education institutions should be considered if placement capacity issues are to be addressed successfully and the quality of students’ placements are to be safeguarded.
Do pressure ulcers influence length of hospital stay in surgical cardiothoracic patients? A prospective evaluation
Authors: Schuurman Jaap‐Peter , Schoonhoven Lisette , Keller B Paul JA , Van Ramshorst Bert
Published: July 2009

Aim and objective.  The aim and objective of this study was to determine whether the occurrence of pressure ulcers following cardiothoracic surgery increases the length of hospitalisation.

Background.  Literature suggests that a pressure ulcer extends the length of hospital stay. The impact of pressure ulcers on length of hospital stay after cardiothoracic surgery is yet undetermined.

Design.  Prospective follow‐up study.

Methods.  Two hundred and four patients admitted for elective cardiothoracic surgery and with an intensive care unit stay of >48 hours were included in a prospective cohort study. The course of the skin condition in relation to pressure ulcers was monitored during their stay in a teaching hospital. Length of hospital stay was compared between the group with and without pressure ulcers.

Results.  Hospital stay for cardiothoracic patients with and without pressure ulcers did not differ significantly (p = 0·23). Patients that developed pressure ulcers had a median hospital stay of 13 days (interquartile range: 9–19) vs. 12 days (interquartile range: 7–15) for patients without pressure ulcers. However, we observed that length of stay in the intensive care unit was significantly (p = 0·005) longer for patients with pressure ulcers. This was not associated with the occurrence of complications. However, the occurrence of pressure ulcers was significantly correlated with length of intensive care support in postoperative care.

Conclusion.  Non‐complicated pressure ulcers in postsurgery patients do not significantly increase the length of total hospital stay.

Relevance to clinical practice.  Health professionals need to recognise that patients who have undergone major surgery (such as cardiothoracic surgery) are prone to develop pressure ulcers. Despite the fact that pressure ulcers do not necessarily extend hospital stay, monitoring the skin condition remains of crucial importance for prevention and early detection as well as treatment of pressure ulcers and to minimise patient discomfort. Moreover, as pressure ulcers often originate in the operating room, prevention in the operating room should receive more attention.
Efficient Recovery of HLA Class I Expression in Human Tumor Cells After Beta2‐Microglobulin Gene Transfer Using Adenoviral Vector: Implications for Cancer Immunotherapy
Authors: Del Campo A. B. , Aptsiauri N. , Méndez R. , Zinchenko S. , Vales Á. , Paschen A. , Ward S. , Ruiz‐Cabello F. , González‐Aseguinolaza G. , Garrido F.
Published: July 2009

Here we report a successful use of a non‐replicating adenovirus expressing the wild‐type human β2m gene in recovery of normal human leucocyte antigen (HLA) class I expression in β2m‐null cancer cells. Total loss of HLA class I expression in these cell lines is caused by a mutation in β2m gene and a loss of heterozygosity in chromosome 15 carrying another copy of that gene. Normal HLA class I expression on the tumour cell surface is critical for the successful outcome of cancer immunotherapy as T cells can only recognize tumour‐derived peptides in a complex with self‐HLA class I molecules. In this report we characterize the newly generated adenoviral vector AdCMVβ2m and demonstrate an efficient β2m gene transfer in tumour cell lines of different histological origin, including melanoma, prostate and colorectal carcinoma. The β2m re‐expression lasted for an extended period of time both in vitro and in vivo in human tumour xenograft transplants. We propose that in a subset of cancer patients with structural defect in β2m gene or chromosome 15, the adenoviral‐mediated recovery (or even increase) of HLA class I expression on tumour cells in combination with vaccination or adoptive T‐cell therapy can provide a complementary approach to improve the clinical efficacy of cancer immunotherapy.
Modelling of Bet v 1 Binding to Lipids
Authors: Mattila K. , Renkonen R.
Published: July 2009

As birch pollen allergen enters epithelium of allergic patients via lipid rafts and caveola we began to analyse its putative amphiphilic and lipid ligands on atomic level using molecular modelling and computational ligand docking. We carry out 3D modelling docking with both experimentally verified Bet v 1 ligands as well as larger lipid molecules for which experimental affinity studies were not available. The results suggest that the hydrophobic cavity of Bet v 1 has different binding sites for different ligands and groups of ligand type‐specific amino acids can be defined. Bet v 1 proteins may also be able to bind and transport more complex amphiphilic molecules like ceramides and sphingomyelins known to be enriched on caveolae/lipid rafts. Furthermore, the suggested binding mode, where the hydrophobic tail groups of lipids locate inside Bet v 1, while the polar head group may remain solvent accessible, would allow Bet v 1 to bind glycolipids, e.g. gangliosides, also rich on caveolae/lipid rafts. Taken together, this in silico work suggests that Bet v 1 bind to amphiphilic and lipid ligands present on the caveolae/lipid rafts and thus could provide a molecular mechanism for the pollen entry to epithelial tissue of allergic patients.
The Role of Granulocyte Macrophage‐Colony Stimulating Factor in Gastrointestinal Immunity to Salmonellosis
Authors: Coon C. , Beagley K. W. , Bao S.
Published: July 2009

Human Salmonella infection, in particular, typhoid fever is a highly infectious disease that remains a major public health problem causing significant morbidity and mortality. The outcome of these infections depends on the host’s immune response, particularly the actions of granulocytes and macrophages. Using a mouse model of human typhoid fever, with Salmonella typhimurium infection of wild type and granulocyte macrophage‐colony stimulating factor (GM‐CSF) knock out mice we show a delay in the onset of immune‐mediated tissue damage in the spleens and livers of GM‐CSF−/− mice. Furthermore, GM‐CSF−/− mice have a prolonged sequestration of S. typhimurium in affected tissues despite an increased production of F4/80+ effector cells. Moreover in the absence of GM‐CSF, a decrease in pro‐inflammatory cytokine expression of tumor necrosis factor‐α, interleukin‐12 (IL‐12) and IL‐18 was found, which may alter the host’s immune response to infection. GM‐CSF appears to play an important role in the pathogenesis of Salmonellosis, and may contribute significantly to the development of protective gastrointestinal mucosal immune responses against oral pathogens.
Cell‐mediated immunity and multi‐locus heterozygosity in bluethroat nestlings
Authors: FOSSØY F. , JOHNSEN A. , LIFJELD J. T.
Published: July 2009

Recent evidence suggests that marker‐based heterozygosity‐fitness correlations may be driven by only one or a few markers, indicating local heterozygosity effects caused by linkage disequilibrium with functional genes. In this study, we investigated the relationship between microsatellite heterozygosity and a measure of cell‐mediated immunity (phytohaemagglutinin; PHA) in bluethroat (Luscinia s. svecica) nestlings using a full‐sibling design. We found significant positive associations between PHA response and two different indices of microsatellite heterozygosity, i.e. multi‐locus heterozygosity and mean d2. However, model comparisons disclosed that both associations were more likely caused by local effects rather than general effects and that the two local effects appeared to be realized through two different genetic mechanisms. Our results indicate that both the random assortment of parental chromosomes during meiosis as well as inbreeding can drive heterozygosity‐fitness correlations.
Condition dependence varies with mating success in male Drosophila bunnanda
Authors: McGUIGAN K.
Published: July 2009

Although key to sexual selection theories, condition dependence has proven a challenging area of empirical research. It is expected that availability of resources will affect both mean and variation of sexual trait expression, with lower mean and greater variation in harsher environments. Here, I manipulated the environment in a laboratory population of Drosophila bunnanda to test for condition dependence of sexually selected traits. Sexually successful and unsuccessful males differed in how the environment affected sexual trait expression. Specifically, sexual trait attractiveness declined more rapidly with declining resources in sexually unsuccessful males, consistent with the expectation that low quality males were less able to meet the greater signalling costs associated with harsher environments. This study illustrates the potential insights into condition dependence that might be gained through considering sexual trait expression and mating success within the same manipulative experimental design.
How is sexual conflict over parental care resolved? A meta‐analysis
Authors: HARRISON F. , BARTA Z. , CUTHILL I. , SZÉKELY T.
Published: July 2009

Biparental care of offspring is both a form of cooperation and a source of conflict. Parents face a trade‐off between current and future reproduction: caring less for the current brood allows individuals to maintain energy reserves and increase their chances of remating. How can selection maintain biparental care, given this temptation to defect? The answer lies in how parents respond to changes in each other’s effort. Game‐theoretical models predict that biparental care is evolutionarily stable when reduced care by one parent leads its partner to increase care, but not so much that it completely compensates for the lost input. Experiments designed to reveal responses to reduced partner effort have mainly focused on birds. We present a meta‐analysis of 54 such studies, and conclude that the mean response was indeed partial compensation. Males and females responded differently and this was in part mediated by the type of manipulation used.