bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual Concerns of Adolescents With Cancer
Authors: Chambas Kristan
Published: June 2007

The sexually related concerns of adolescents with cancer were compared with those of healthy adolescents. Forty-one adolescents age 12 to 19 years participated. A sexual concerns questionnaire was used. The study had three primary objectives: (1) to identify concerns related to physical, emotional, and behavioral aspects of sexuality present among all adolescents in the study; (2) to determine if there were differences between sexual concerns of adolescents with cancer and those of healthy adolescents; and (3) to determine whether a relationship existed between age and the concerns adolescents had about sexuality. Results of the study indicate that although no age-linked trends in sexually related concerns existed for the adolescents studied, adolescents had concerns regarding sexuality. Adolescents with cancer did not seem to be any more concerned about common developmental aspects of sexuality than healthy adolescents. However, adolescents with cancer had numerous sexually related concerns not identified by healthy adolescents. These concerns seem to relate to being treated for cancer. They included worries about hair loss, feeling isolated, ability to have children, and children having genetic or congenital defects. Nurses who care for adolescents with cancer can provide education and support regarding sexual concerns to help adolescents cope with and resolve some of these treatment-related anxieties. Further research that includes in-depth, narrative interviews could give better insight into the concerns that both adolescents with cancer and healthy adolescents have about sexual issues.
Changing Central Venous Catheter Lines: Evaluation of a Modification to Clinical Practice
Authors: Robertson Jeanette
Published: June 2007

As the costs of providing quality nursing care increase, the conservation of both human and material resources becomes increasingly important. This study arose from a need to evaluate the procedure used to change central venous catheter (CVC) lines following the substitution of a time-consuming and costly traditional procedure with a simpler procedure that used less resources. Using a convenience sample of inpatients in the oncology unit who had either fully or partially implanted infusion devices in situ, rates of infection for CVC exit sites were calculated for the 12-month periods preceding and following the introduction of the revised procedure. No significance differences were found between the infection rates at CVC line exit sites; however, the cost of undertaking the procedure decreased following a change of equipment used in the line-change procedure. Data collection methods are discussed, together with results and implications for clinical practice.
Future Life Expectations and Self-Esteem of the Adolescent Survivor of Childhood Cancer
Authors: Overbaugh Kelly A. , Sawin Kathleen
Published: June 2007

The number of adolescent cancer survivors has increased dramatically over the past decade as the result of improved treatment and diagnostic techniques. This population brings with them unique characteristics and concerns. The present study consisted of interviews with 10 adolescent survivors of childhood cancer and their parents. It investigated the adolescent's present self-esteem, the future life expectations held by both the teenagers and parents, and the relationship between the variables. Results indicated that the adolescents felt moderately competent in their lives (measures of self-esteem) and the parents felt more certain than their children that the teenagers would accomplish the tasks deemed appropriate for entry into a healthy adulthood. Pearson correlations showed a strong relationship between parents' future life expectations and adolescents' self-esteem (r = .82; P = .002), but not between parents' and adolescents' future life expectations or between the adolescents' future life expectations and self-esteem. The results are significant in addressing the impact parents can have on their child's self-esteem.
Neuman Systems Model Used as a Guide for the Nursing Care of an 8-Year-Old Child With Leukemia
Authors: Piazza Dianne , Foote Anne , Wright Penelope , Holcombe Judy
Published: June 2007

The Neuman Systems Model (NSM) provides a framework for holistic pediatric oncology nursing practice. In this article, an overview of NSM is given. This model is applied to an 8-year-old child with leukemia for the comprehensive assessment, planning, and evaluation of nursing care. A comprehensive list of nursing diagnoses is categorized by primary and secondary prevention.
Gastrointestinal Manifestations in the Child With Cancer
Authors: Aitken Tamara J.
Published: June 2007

Pediatric oncology nurses provide a major role in the assessment and management of gastrointestinal complications in children resulting from cancer therapies. The clinical problems most frequently seen in this area include stomatitis, nausea, vomiting, constipation, and diarrhea. These areas are reviewed in detail according to various nursing diagnoses including definitions and pathophysiology, recent studies and interventions, special considerations for children, and patient and parent education.
The Role of Stereotactic Radiation Therapy in the Management of Children With Brain Tumors
Authors: Lew Catherine M. , LaVally Beverly
Published: June 2007

Conventional radiation therapy plays an important role in the management of intracranial tumors in children. For certain tumors radiation therapy serves as the primary mode of treatment, and for others it plays an adjuvant role with surgery and/or chrmotherapy. Improvements in long-term survival rates have focused attention on the long-term sequelae of brain tumors and their treatment, and the sequelae, in turn, have become important targets for clinical investigation. Long-term side effects of particular concern in children include cranial nerve damage, memory and intellectual deficits, pituitary-hypothalamic dysfunction, demyelinization of brain tissue, and secondary malignancies. A new form of radiation therapy, sterotactic radiotherapy (SRT), merges the technologies of stereotactic surgery and conventional fractionated radiotherapy. The intent is to deliver maximum tumoricidal doses to the target while limiting the dose to normal surrounding brain tissue. The key feature of SRT is a noninvasive, relocatable immobilization system to assure accurate and reproducible positioning during planning and treatment. The headframes used for children have been modified to address their specific needs. The complexities of this process require careful preparation of patients and their families and the participation of many disciplines. Long-term follow-up will be essential to evaluate the effectiveness of this innovative treatment.
Cognitive Behavioral Pain and Anxiety Interventions in Pediatric Oncology Centers and Bone Marrow Transplant Units
Authors: McCarthy Ann Marie , Cool Valerie A. , Petersen Mary , Bruene Debra A.
Published: June 2007

Although research conducted on the treatment of pain and anxiety in children has found a number of cognitive behavioral interventions to be effective, it is not known to what extent this research has been put into practice. The purpose of this project was to obtain information on the use of cognitive behavioral interventions to help children and families cope with the pain and anxiety experienced during lumbar punctures and bone marrow aspirations. In this descriptive study, 15 Pediatric Bone Marrow Transplant Units and 32 Pediatric Hematology/Oncology Centers from across the country were surveyed using a questionnaire developed to obtain information on the use and effectiveness of cognitive behavioral interventions and the availability of support services. This survey indicates that most centers use a number of cognitive behavioral interventions to help children cope with painful procedures. However, some interventions, such as providing information before procedures and positive reinforcement after procedures, are used more frequently than interventions, such as rhythmic breathing, distraction, and imagery, that require more time and training. A variety of support services were available, although psychological services were primarily available on an as needed basis and support groups were not usually offered on an ongoing basis. In general, nurses are the major providers of these interventions, with other professionals providing interventions specific to their training. Nurses need to continue to study appropriate ways to incorporate use of effective cognitive behavioral interventions into the routine care of children with cancer.
The Power of Humor and Play as Nursing Interventions for a Child With Cancer: A Case Report
Authors: Frankenfield Pamela K.
Published: June 2007

Many benefits of humor and play have been documented in the literature. The purpose of this Case Report was to assess the benefits of humor and play with a 5-year-old retinoblastoma patient in an ambulatory care setting. The use of humor in the forms of tickling, joke-telling, play on words, funny movies, silly stickers, and medical play was found to be helpful in decreasing the anxiety of a pediatric oncology patient during insertion of his Infusaport needle. This article reviews the benefits of humor and play and provides a brief discussion of the developmental aspects of humor and play theory. Implications for further nursing research in the area of humor interventions are also discussed. The promotion of appropriate humor and play use by all health care professionals is encouraged.
Alcohol and Drug Education: Models and Outcomes
Authors: Goodstadt Michael S.
Published: June 2007

Knowledge-attitude-behavior and values-based models are analyzed with regard to their application to development and evaluation of drug education programs; theoretical problems of these models are identified. The experimental evidence regarding the application of these models to drug education is reviewed. Recommendations are made concerning theoretical, programming, and research implications for drug education and for health education in general.
Cutting Back After a Heart Attack: An Overview
Authors: Dolan Mullen Patricia
Published: June 2007

Increasingly, health workers are concerned with the alteration of complex and deeply embedded behaviors; essential to these tasks is an understanding of the other's situation as he or she views it. This study took the perspective of the patient, inductively generating a conceptual formulation to explain and understand life after a heart attack. The basic problem of minimizing losses under conditions of uncertainty and unknown parameters of action is confronted. Resolution is achieved through "cutting back," which has three major stages: (1) immobiliza tion, characterized by explaining and estimating the damage; (2) resumption, in which patients frgure the complex calculus of the new situation to determine what they must cut back, what they should cut back, and what they will and will not cut back; and (3) new normal, when the major work is that of adjusting to the permanent changes wrought by the heart attack experience which affect identity. Exploratory diagnosis of complex health education problems through a "grounded theory" approach is demonstrated by the study.
Successful tourism policies in the European Union
Authors: Akehurst Gary , Bland Nigel , Nevin Michael
Published: June 2007

This paper outlines some of the findings of a recent survey of national tourism policies in each of the Member States of the European Union (EU) undertaken between 1991 and 1993 for the British Department of Employment. This is the first and most comprehensive study of tourism policies ever undertaken within the European Union.

The study has found that policy objectives tend to concentrate on attracting more higher-spending tourists, improvements in product quality and a reduction in seasonality. The most important instrument in the implementation of tourism policy is the national tourist organisation (NTO). Successful tourism policies (measured in terms of visitor arrivals, receipts and trade balance) appear to be linked to there being a clear, coherent central government strategy for developing tourism, where government helps to finance directly or indirectly tourism investment; the central tourism budget is concentrated on a few key areas and tourism policy is clearly co-ordinated with other policies (especially those of transport, environment, culture and regional action).
Customer retention: a strategy for travel agents
Authors: Marsh Peter
Published: June 2007

Marketing campaigns seek to increase a travel agent's client base. Many companies have a clear strategy for doing this, often by discounting. However, new clients, unless they are fresh entrants to the marketplace were once someone else's. A key to success, if not survival, is by retaining as much of an existing client base as possible and in developing a strategy to increase the retained client base. A number of techniques will assist in this. Activity management focuses on effort, not results, to develop ratios of the amount of activity necessary to gain new clients. Relationship management helps build ringfences around clients, protecting them from predators. This includes both existing and newly won clients. Skill levels and attitudes of agency staff are crucial. Decisions should also be made about the quality of products sold, office presentation and the booking process. Finally, constructing a retention plan ensures that an agent is not in danger of losing a high proportion of existing loyal clients and having them replaced with a more fickle, price-sensitive client profile.
Emerging technologies and their impact on travel distribution
Authors: Hoffman Jeffrey D.
Published: June 2007

The briefing starts by considering two major changes resulting from the electronic superhighway: streamlining of the distribution chain; and the emergence in the chain of powerful new players. It goes on to argue that travel agents and those involved in the distribution of travel products must embrace the new technologies if they are to survive and prosper, and to review several types of electronic distribution which are having or will have a major impact on the travel and tourism industry.
Caribbean vacations: a case study of selected marketing factors in Jamaica
Authors: Fish Mary , Gunther William D.
Published: June 2007

Marketing plans must consider the overall effects of macroeconomic variables. Growth in United States income and the relative decrease in island prices ivere significant stimuli to the growth of tourism in Jamaica over the last decade. Changes in US relative prices in relation to Jamaica and other Caribbean destinations affect Jamaican tourist volume and tourist expenditures. Studies adjusting tourist data for the impact of inflation and ofJamaican/US exchange rates on tourism revenue show the effect of these factors.
Positioning the bed and breakfast: how well are we doing?
Authors: Upchurch Randall S. , Boger Carl
Published: June 2007

This paper focuses on measuring consumer needs in terms of amenities and services provided by bed and breakfast operators in the state of Wisconsin. The intent was to provide the operator with consumer ratings of products and services that would assist in positioning the B&B operation.
Should travel companies be selling on-line?
Authors: Richer Paul
Published: June 2007

The Internet has been hyped to such an extent that travel companies are fearful of losing out by not introducing on-line marketing and distribution systems. The paper compares the Internet with established marketing and distribution tools, provides an analytical framework for decidiitg relative level of investment in on-line technology and predicts the effect the Internet will have on the sale of travel products.
Segmenting travellers from the Netherlands by travel arrangements
Authors: Morrison Alastair M. , O'Leary Joseph T. , Yifen Chiang  , Hsieh Sheauhsing , Lang Cheng-Te
Published: June 2007

The European Travel Monitor indicated that Dutch travellers are taking more trips and in particular, long-haul trips of more than four nights. The continued increases in the number of trips by the Dutch are projected to grow from 9 million in 1990 to about 10.5 million in 1995. Additionally, an increase in holiday participation by the Dutch population is anticipated from 69.9 per cent in 1990 to about 74 per cent in 1995 for long holidays.' In this study, the travel arrangements of Dutch long-haul travellers were segmented into three groups — independent trips, escorted tours, and non-escorted packages based on four types of variables, sociodemographics, travel benefits sought, travel trip characteristics, and activity participation. By understanding and satisfying the motivations, needs, and expectations of specific groups of travellers, host countries interested in the Netherlands travel market can improve the effectiveness of their tourism marketing strategies. The results of the study indicated that many variables, particularly travel characteristics, could be useful in differentiating the three travel arrangement groups and represents a viable approach for segmenting the Netherlands travel market. Other factors such as trip and accommodation types and vacation activities, which distinguished the Dutch travellers' choice of travel arrangements, might be considered as other variables with which to segment the travel market in future research studies.
Marketing practice and opportunities in the tour operators' senior travel market: Beyond bowling and ballroom dancing
Authors: Pritchard Annette , Morgan Nigel J.
Published: June 2007

The paper evaluates whether tour operators' current promotional activities are effectively targeting the increasingly important seniors market. It provides an overview of recent research on senior lifestyle and leisure characteristics and uses this research as a basis for evaluating whether current marketing messages and images are reflecting the changing reality of seniors' lives. The empirical data are drawn from the UK and a range of tourism operators' vacation brochures are examined using exploratory, qualitative content analysis techniques. The findings, however, may have some relevance for all marketers interested in targeting this segment. The paper concludes that there is a notable mismatch between the narrow range of consumer images projected by mainstream tourism marketers and the increasingly active and varied consumption experiences of seniors.
The use of technology in hotel marketing
Authors: Palmer John
Published: June 2007

The importance of a well-functioning and well-regulated PMS (Property Management System) is essential for the profitable running of a successful hotel. The author explains in a simple and straightforward way how such a system can be implemented making use of technological advances with the adoption of a suitable software program.
Competitive advantage in the hotel industry — success through differentiation
Authors: Taylor Hugh
Published: June 2007

In an increasingly competitive industry it is essential to produce new and innovative ideas to differentiate a product from others of the same nature. This paper gives practical guidelines from experience as to how hotels can stay one jump ahead of the competition, without necessarily incurring great expense, but by taking creative advantage of every opportunity.
Travel decision pattern segmentation of pleasure travel
Authors: Hsieh Sheauhsing , O'Leary Joseph T. , Morrison Alastair M. , Chiang Dalen
Published: June 2007

The purpose of this research is to identify the different types of travel decisiorr patterns iii the japanese travel market. In contrast to previous studies, a multi-stage segmentation base (travel philosophy — travel benefit sought - travel product preference) ivas used to identify six decision groups of Japanese travellers. The results showed that travel decision pattern segmentation is a viable segmentation approach. Implications of the findings are discussed for this important area.
Marketing of Finnish eco-resorts
Authors: Björk Peter
Published: June 2007

Ecotourism is nature-based and much more exacting than other tourism forms. The four central groups of actors involved in tourism have to cooperate and submit to the principles of stistaittability. The tourism industry has to take advantage of the latest technology and implement a green management policy, the authorities have to support a sustainable development, inhabitants in the host country have to understand their role in the tourism business, and tourists must be willing to follow the rules stipulated. No generally accepted definition of ecotourism has been presented and the Finnish Tourist Board suggests that the concept of ecotourism should not be used in marketing, but instead sustainable tourism. Finland has the possibility of being among the best countries supporting sustainable nature-based tourism, even a potential to develop ecotourism. Development, however, seems to be too Slow from a marketing point of view. The international competition is stiff and it is suggested that special eco-resorts with a distinct image should be developed. To counterbalance the backlash of being small companies with low profit margins, Finnish tourist companies should increase collaboration, create networks and invest in relationship marketing.
The hotel market in the former Eastern Bloc-An overview
Authors: Bartl Henrik
Published: June 2007

This paper looks at the development of the international hotel industry in the former Eastern Bloc countries as they progress in their transition to a free market economy. By looking at occupancy and average rate figures for the main cities and comparing both growth rates in the number of passengers travelling to these cities and gross domestic product (GDP) figures for the countries, it is possible to get a clear picture of the current state of the hotel market and the likely opportunities for future developments.
Hong Kong - a major urban tourism destination in South-East Asia
Authors: Hailin Qu  , Hanqin Qiu Zhang
Published: June 2007

The purpose of this study was to analyse Hong Kong's urban tourism elements and major origin markets, and to explore Hong Kong urban tourism selection factors and tourists' perception and satisfaction towards Hong Kong urban travelling. It addressed issues of marketing strategies which have been used by the Hong Kong Tourist Association to promote Hong Kong successfully as an urban destination in South-East Asia and to estab lish a new image after 1997.
Detection of Rail Wheel Flats using Wavelet Approaches
Authors: Jia S. , Dhanasekar M.
Published: June 2007

Sudden application of heavy traction/braking torque induces flats in rail wagon wheelsets. Flat wheels generate high frequency impact forces sufficient to cause severe damage to the rail head surface. Early detection of flats would facilitate re-profiling the wheels before they cause serious damage to critical rail components, such as switches, crossings, and insulated rail joints. Although there are many sensors available in the market to detect/record wagon accelerations, there are no powerful signal processing tools readily available to detect the presence of wheel flats from the recorded acceleration signatures. This study presents two wavelet approaches to overcome the difficulties in the on-board monitoring and detection systems of rail wheel flats using vibration signals. Signal average techniques, wavelet local energy average concept, and wavelet decomposition are employed in this study. A Matlab-Simulink based dynamic simulation system capable of modeling the wheel flats and track irregularities is also developed for predicting the wheelset/bogie frame acceleration time series. An analysis of the numerical simulation results demonstrates that the methods proposed in this study are effective for the on-board monitoring of wheel flats of sizes smaller than the condemning limits.
The challenges of longitudinal ethnographic research in nursing
Authors: Lathlean Judith
Published: June 2007

The paper describes aspects of the main part of a research project on the implementation and development of lecturer-practitioner roles in nursing, which constituted a detailed exploration of the post over a number of years in one setting. The long-term nature of the study and the challenges it posed for the researcher are discussed, especially those concerning the role of the researcher, and the considerations entailed in using a participant observation approach. Problems encountered and strategies adopted are presented, in order to provide insight into the use of this research methodology in nursing and health care [NT Research 1996; 1: 1, 38-43]
Is there a relationship between feeding difficulty and nursing intervention in elderly people with dementia?
Authors: Watson Roger , Deary Ian
Published: June 2007

The relationship between the level of physical help given by nurses and the level of difficulty with feeding in elderly patients with dementia was investigated by means of structural equation modelling. Data from 49 subjects, obtained at two time points 18 months apart, were correlated by means of a cross-lagged panel analysis and this formed the basis for the models that were tested. Four models were compared and the one that best fitted the data indicated a possible causal relationship over time between the estimated level of physical help given and the measured level of difficulty with feeding according to the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. The method of structural equation modelling is fully described and possible models for testing in future are presented. Limitations of the present study are discussed and possible improvements proposed [ NTResearch 1996; 1: 1, 44-54]
Clinical supervision and Project 2000: The identification of some substantive issues
Authors: White Edmard
Published: June 2007

This exploratory two-stage study, funded for two years by the English National Board for Nursing, Midwifery and Health Visiting, sought to reveal the prevailing circumstance of teaching, support, supervision and role modelling for students in clinical areas, within the context of Project 2000 courses, in three centres in England. Evidential data collection methods were developed which included personal interviews, non-participant observation and the scrutiny of documents. Findings revealed confusion and misunderstanding between students, practitioners and tutors about clinical supervision arrangements and competing explanations were reported. Further controlled research is required to assess and cost the comparative impact clinical supervision may make to student learning experience and to the well-being and skill base of qualified nurses, and the effect of both on the quality of patient care. [NT Research 1996; 1:2, 102-111]
The use of focus group interviews in nursing research: Issues and challenges
Authors: Clark Jill Macleod , Maben Jill , Jones Karen
Published: June 2007

Focus group interviews are becoming more widely used as a data collection technique within nursing research. This paper draws on the experience of the authors in conducting a number of focus group interviews while undertaking a study of perceptions of the philosophy and practice of nursing within the context of Project 2000 1. Some of the main issues and challenges to be considered when utilising this method are examined. These include the practicalities of group size, access and sampling, as well as the fundamental issues associated with group interaction. The role of the moderator in maintaining the flow and focus of the group and in ensuring the participation of all group members is addressed, along with an examination of disclosure and validity. Finally, the issues and challenges posed by the analysis of the focus group data are considered. [ NT Research 1996; 1 :2, 143-153]
Ethical issues for nursing research: A methodological focus
Authors: Lathlean Judith
Published: June 2007

The issues of ethics in research are often portrayed as taken for granted and the same regardless of the research approach adopted. A critique of the considerations within different methodologies shows that while there tends to be a cornmonality of principles, their translation into practice is diverse. In addition, it can be argued that an unquestioning following of the often stated ethical maxims is neither necessarily appropriate nor desirable with different research designs. This paper examines both the shared and distinctive ethical features which are pertinent to different methodologies. If focuses especially on the key facets of the hitherto dominance of the medical model in research and its implications, the challenge to research orientations where there is a need for the researcher to control the research situation, concerns about deception in research and the call for anonymity and confidentiality. Conclusions are drawn which aim to put into perspective the 'received wisdom' of adherence to 'accepted' and universal ethical principles. [ NT Research 1996; 1: 3, 175-183]
What ethical principles should govern the conduct of research?
Authors: Martin Jeannett
Published: June 2007

The Nazi research programmes during the Second World War clearly identified that unethical research results in human suffering. Since then, many professional groups have developed codes of ethics for the conduct of their research. Although the details of these codes vary, they all seem to reflect that humans have rights to autonomy, privacy and freedom from harm. This paper examines these rights, and discusses how they can be applied to govern the conduct of all stages of the research process. Also considered are dilemmas that can be created for nurses by research into patient and nursing care. [NT Research 1996; 1 :3, 193-196]
Community psychiatric nursing
Authors: Burke Jon
Published: June 2007

A literature review of the development of the community psychiatric nursing service in the UK was carried out to locate influences on the emerging role of the CPN, to isolate components of practice, and to identify current issues for service delivery. This assisted in identifying differing models of practice prior to a review of the experience of CPNs with clinical supervision in their practice. Consideration of this will appear in the next issue of NTResearch.
Managed care: Development of an integrated care pathway in neurosciences
Authors: Luther Tony , Crofts Linda
Published: June 2007

The concept of managed care is emerging as a multidisciplinary approach to health care in the United Kingdom. It is implemented through an integrated care pathway (ICP) or care map which is created by the multidisciplinary team around a specific diagnostic group. The ICP consists of key interventions which can be evidence-based, incorporating clinical guidelines where appropriate. The aim of managed care is to improve quality of care while reducing length of stay, thus reducing costs. A pilot project was carried out in the neurosciences unit of a London teaching hospital over a six-month period. Lumbar disc surgery was chosen as the diagnostic group. Outcomes were better coordination of care and less variation in length of stay as well as improved communication and collaboration between the multi-professionals involved. Drawbacks were poor compliance by some clinicians and the time-consuming nature of creating the care map. Recommendations are that where ICPs are used this should be a single record replacing all other documentation.
Lessons from Ontario on the specialist role
Authors: Davis Marie-Roberts
Published: June 2007

Marie Roberts-Davis highlights issues arising from a study she undertook into the roles of 'specialist' and 'adrarrced' practitioners in Canada. The text is based on a paper given at the Florence Nightingale Foundation annual symposium held in London in May this year.
Self-esteem in mental health nurses: Its relationship to stress, coping and burnout
Authors: Carson Jerome , Fagin Leonard , Bromn Daniel , Leary John , Bartlett Heather
Published: June 2007

This paper examines the relationship between self-esteem and stress, coping and burnout in mental health nurses (n=568). Self-esteem is said to be one of the most important moderating variables in determining the effects of stress on individuals. The modified Rosenberg Self-Esteem Scale was administered to nurses in both hospital and community, along with a range of other standardised measures. While there were no significant differences in self- esteem between the two groups of mental health nurses, smokers and drinkers in the sample were found to have significantly lower levels of self- esteem. Equally, nurses who felt happy with their life, were physically fit and who had job security, had higher self-esteem scores. Self-esteem correlated highest with measures of stress. Multiple regression analyses showed that happiness was one of the best predictors of self-esteem. Evidence is also presented on the discriminative validity of the concept of self-esteem. Enhancing nurses' levels of self-esteem may help reduce staff stress levels. Future nursing stress research needs to examine the role of other moderating variables.
'Having your say': Self-advocacy and individuals experiencing mental ill-health
Authors: Mawhinney Sonia , McDaid Catriona
Published: June 2007

Self-advocacy involves individuals speaking out for themselves rather than others speaking for them. Using an action research methodology, the study aimed to explore the views of individuals experiencing mental ill-health regarding self-advocacy. Focus groups were set up as an exploratory method to obtain information for the design of an interview schedule. Interviews were conducted with 35 service-users to determine what encouraged and prevented them from speaking out. Focus groups were also used to obtain the views of mental health workers regarding service-user self-advocacy. Findings from the project emphasised the importance of one-to-one relationships between service-users and staff and underlined the importance of providing service- users with information. The project highlighted training needs both for service-users and mental health workers.
Coming in from the cold? An analysis of research proposals submitted by the Nursing Section at ScHARRI, 1994-1997
Authors: Brooker Charles , Read Susan , Morrell C. Jane , Repper Julie , Jones Roy , Akehurst Ron
Published: June 2007

The Nursing Section at SCHARR was established in 1994 as one of six groups that constituted the Sheffield Centre for Health and Related Research (SCHARR). Based at the University of Sheffield, SCHARR was established as a response to the imperatives outlined in NHS Research and Development Strategy documentation for multidisciplinary health services research (HSR). The Nursing Section at SCHARR has always been fully supportive of such principles and over the past three years has worked with many different health-care researchers to maximise the nursing contribution to health services research. This paper analyses the features of 50 proposals made by the Nursing Section to funding bodies since 1994. Approximately half (52%, n=26) of all bids were successful and led to a total of nurse-related research grants worth 2.7 million pounds. Projects were significantly more likely to be funded if the method proposed was qualitative (or a combination of methods) or the lead researcher was a nurse. However, research was no more likely to be funded if a medical colleague was named as a collaborator, a statistician or health economist was involved in the bid, there were more than three named collaborators on the proposal, or the bid came from more than one university. The implications of these results are discussed in the context of recent critical commentaries on the topic of nurses'supposed relative disadvantage in obtaining funds for multidisciplinary health services research.
Evidence-based practice: A case study
Authors: Simpson Vivienne , Curzio Joan , Gillespie Anice , McCowan Margaret
Published: June 2007

This study describes how one trust addressed the issue of assessing and implementing evidence-based nursing and midwifery practice through the setting up of a Nursing/Midwifery Research and Practice Development (NMR&PD) Group, together with the introduction of evidence-based practice link nurses/midwives. Staffs' awareness of evidence-based practice (EBP) was established and from this an action plan was drawn up to assist with the implementation of EBP The project is in its infancy, although early feedback is encouraging. The authors are optimistic that by establishing a framework for nurses to review care in a professional and sound manner they will feel more confident and comfortable with the concept of EBR.
The provision of family-focused palliative care in hospital using the Delphi technique
Authors: Bridgman Helena , Carr Eloise
Published: June 2007

It has been suggested that an important difference between hospital and hospice care is that the latter is more geared to the attainment of family goals. Nurses are the one group of health-care professionals who work with families during all phases of an illness. Using the Delphi technique, this study aimed to identify some supportive nursing behaviours and some factors which went against effective provision of family care in a hospital. Twenty-two qualified nurses drawn from seven wards participated in the study. Supportive nursing behaviours were identified and priority was given to issues concerning symptom control, privacy, time and honest communication. Factors hindering the effective provision of family care focused mainly on the problems of balancing priorities, issues of disclosure, providing privacy and managing family conflict. The findings identified key areas of family care which warrant further investigation and highlight a potential focus of education and practice initiatives within hospitals.
Reflexivity: A comment on feminist ethnography
Authors: Allan Helen
Published: June 2007

This paper comments on feminist research and in particular the use of reflexivity in feminist ethnography. Reflexivity in ethnography is the use of self as an instrument of the data collection and the researcher's own awareness of reactions to the research data.

Ethnography requires that the researchers immerse themselves in the field and act reflexively while collecting data. I will discuss how using myself reflexively as a researcher during data collection in an assisted-conception unit led me to reconsider an assumption about the methodology underpinning feminist research approaches. It has been argued that feminist research approaches are women-centred and that debates on reproductive technologies are based on the premise that males control assisted conception.

My experience of undertaking a feminist ethnography has challenged these two assumptions. Reflection during and after the data collection has led me to question the aims of women-centred research in a field in which men are participants as doctors and patients. By discussing data from field work, I argue that including men in feminist research offers the potential for the emergence of a new type of research.
Clinical supervision: What is going on? Results of a questionnaire
Authors: Bishop Veronica
Published: June 2007

This paper presents data obtained from a questionnaire sent to trust nurse executives in England and Scotland. White the data indicate a great deal of enthusiasm for clinical supervision, some concern must be shown for the lack of preparation and support for those involved in its implementation, a fact which will undoubtedly reflect badly in any evaluation exercise.
Humanity or bureaucracy? The transition from hospital to long-term continuing institutional care
Authors: Cotter Angela , Meyer Julienne , Roberts Sally
Published: June 2007

This paper is concerned with the transition of older people from acute hospital to continuing institutional long-term care. It aims to highlight issues that can remain hidden in current discussions concerning older people's continuing health and social care needs within a mixed economy of health and social care provision. The focus is on user and carer involvement in the transition. The policy context and the research findings of relevant studies are reviewed. Selected findings from an action research project currently in progress elucidate further the concerns of older users and carers. The conclusion draws together several issues which need to be considered in relation to making the experience of the transition between hospital and long-term care a humane one in the context of the mixed economy of welfare.
The leading edge in nursing research
Authors: Tierney Alison J.
Published: June 2007

The following is the opening address given by Professor Alison Tierney at the Royal College of Nursing's International Nursing Research Conference held at Heriot Watt University, Edinburgh, on April 3, 1998
Highly asymmetric rice genomes
Authors: Ding Jing , Araki Hitoshi , Wang Qiang , Zhang Pengfei , Yang Sihai , Chen Jian-Qun , Tian Dacheng
Published: June 2007

Background

Individuals in the same species are assumed to share the same genomic set. However, it is not unusual to find an orthologous gene only in small subset of the species, and recent genomic studies suggest that structural rearrangements are very frequent between genomes in the same species. Two recently sequenced rice genomes Oryza sativa L. var. Nipponbare and O. sativa L. var. 93-11 provide an opportunity to systematically investigate the extent of the gene repertoire polymorphism, even though the genomic data of 93-11 derived from whole-short-gun sequencing is not yet as complete as that of Nipponbare.

Results

We compared gene contents and the genomic locations between two rice genomes. Our conservative estimates suggest that at least 10% of the genes in the genomes were either under presence/absence polymorphism (5.2%) or asymmetrically located between genomes (4.7%). The proportion of these "asymmetric genes" varied largely among gene groups, in which disease resistance (R) genes and the RLK kinase gene group had 11.6 and 7.8 times higher proportion of asymmetric genes than housekeeping genes (Myb and MADS). The significant difference in the proportion of asymmetric genes among gene groups suggests that natural selection is responsible for maintaining genomic asymmetry. On the other hand, the nucleotide diversity in 17 R genes under presence/absence polymorphism was generally low (average nucleotide diversity = 0.0051).

Conclusion

The genomic symmetry was disrupted by 10% of asymmetric genes, which could cause genetic variation through more unequal crossing over, because these genes had no allelic counterparts to pair and then they were free to pair with homologues at non-allelic loci, during meiosis in heterozygotes. It might be a consequence of diversifying selection that increased the structural divergence among genomes, and of purifying selection that decreased nucleotide divergence in each R gene locus.
Increased standardized incidence ratio of breast cancer in female electronics workers
Authors: Sung Tzu-I , Chen Pau-Chung , Jyuhn-Hsiarn Lee Lukas , Lin Yi-Ping , Hsieh Gong-Yih , Wang Jung-Der
Published: June 2007

Background

In 1994, a hazardous waste site, polluted by the dumping of solvents from a former electronics factory, was discovered in Taoyuan, Taiwan. This subsequently emerged as a serious case of contamination through chlorinated hydrocarbons with suspected occupational cancer. The objective of this study was to determine if there was any increased risk of breast cancer among female workers in a 23-year follow-up period.

Methods

A total of 63,982 female workers were retrospectively recruited from the database of the Bureau of Labor Insurance (BLI) covering the period 1973–1997; the data were then linked with data, up to 2001, from the National Cancer Registry at the Taiwanese Department of Health, from which standardized incidence ratios (SIRs) for different types of cancer were calculated as compared to the general population.

Results

There were a total of 286 cases of breast cancer, and after adjustment for calendar year and age, the SIR was close to 1. When stratified by the year 1974 (the year in which the regulations on solvent use were promulgated), the SIR of the cohort of workers who were first employed prior to 1974 increased to 1.38 (95% confidence interval, 1.11–1.70). No such trend was discernible for workers employed after 1974. When 10 years of employment was considered, there was a further increase in the SIR for breast cancer, to 1.62. Those workers with breast cancer who were first employed prior to 1974 were employed at a younger age and for a longer period. Previous qualitative studies of interviews with the workers, corroborated by inspection records, showed a short-term high exposure to chlorinated alkanes and alkenes, particularly trichloroethylene before 1974. There were no similar findings on other types of cancer.

Conclusion

Female workers with exposure to trichloroethylene and/or mixture of solvents, first employed prior to 1974, may have an excess risk of breast cancer.
Alefacept (anti-CD2) causes a selective reduction in circulating effector memory T cells (Tem) and relative preservation of central memory T cells (Tcm) in psoriasis
Authors: Chamian Francesca , Lin Shao-Lee , Lee Edmund , Kikuchi Toyoko , Gilleaudeau Patricia , Sullivan-Whalen Mary , Cardinale Irma , Khatcherian Artemis , Novitskaya Inna , Wittkowski Knut M , Krueger James G , Lowes Michelle A
Published: June 2007

Background

Alefacept (anti-CD2) biological therapy selectively targets effector memory T cells (Tem) in psoriasis vulgaris, a model Type 1 autoimmune disease.

Methods

Circulating leukocytes were phenotyped in patients receiving alefacept for moderate to severe psoriasis.

Results

In all patients, this treatment caused a preferential decrease in effector memory T cells (CCR7-CD45RA-) (mean 63% reduction) for both CD4+and CD8+Tem, while central memory T cells (Tcm) (CCR7+CD45RA-) were less affected, and naïve T cells (CCR7+CD45RA+) were relatively spared. Circulating CD8+effector T cells and Type 1 T cells (IFN-γ-producing) were also significantly reduced.

Conclusion

Alefacept causes a selective reduction in circulating effector memory T cells (Tem) and relative preservation of central memory T cells (Tcm) in psoriasis.
Utilization of routinely collected administrative data in monitoring the incidence of aging dependent hip fracture
Authors: Sund Reijo
Published: June 2007

Societies are facing challenges as the public health burden increases in tandem with population aging. Local information systems are needed that would allow a continuous monitoring of the incidence and effectiveness of treatments. This study investigates the possibilities of routinely collected administrative data as a data source for hip fracture incidence monitoring in Finland.

The study demonstrates that a straightforward use of register data results in biased estimates for the numbers of hip fractures. An interpretation of hip fractures from the population aging point of view offers an alternative perspective for hip fracture incidence calculation. This enables development of a generalizable method for probabilistic detection of starting points of hip fracture care episodes. Several risk factor and risk population extraction techniques required in register-based data analyses are also demonstrated. Finally, it is shown that empirical evidence suggests that hip fracture incidence is proportional to population level disability prevalence.

In conclusion, Finnish administrative data makes it possible to derive data for rather detailed population level risk factor stratification. Certain limitations of register-based data can be partly avoided by synthesizing data-sensitive methodological solutions during the analysis process.