bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of neonatal treatment of rats with potent or weak (environmental) oestrogens, or with a GnRH antagonist, on Leydig cell development and function through puberty into adulthood
Authors: Sharpe Richard M. , Rivas Ana , Walker Marion , Mckinnell Chris , Fisher Jane S.
Published: March 2003

This study addressed whether reduced Sertoli cell number or manipulation of the neonatal hormone environment has an influence on final Leydig cell number per testis in the rat, by applying neonatal treatments known to affect these parameters, namely administration of a GnRH antagonist (GnRHa) or diethylstilboestrol (DES, in doses of 10, 1 or 0.1 μg per injection). The effect of treatment with either of two ‘environmental oestrogens’, bisphenol‐A (Bis‐A) or octylphenol (OP), was also evaluated. Leydig (3β‐hydroxysteroid dehydrogenase immunopositive) cell development and function (plasma testosterone levels) were studied through puberty into adulthood. Treatment with GnRHa impaired testis growth, Leydig cell (nuclear) volume per testis and testosterone levels during puberty, when compared with controls, but final Leydig cell volume/number in adulthood was comparable with controls. As adult testis weight was reduced by 45% in GnRHa‐treated rats, the percentage Leydig cell volume per testis was ∼double (p < 0.01) that in controls, and also at day 35. Testosterone levels in adulthood in GnRHa‐treated rats were lower (p < 0.01) than in controls but were within the lower end of the normal range. Treatment with DES caused largely dose‐dependent suppression of testis growth, Leydig cell (nuclear) volume per testis and testosterone levels up to day 35. Although by adulthood, Leydig cell volume/number per testis was comparable with controls in DES‐treated rats, testosterone levels remained grossly subnormal. Neonatal treatment with either Bis‐A or OP had little consistent effect on any of the parameters studied except that both treatments significantly elevated testosterone levels on day 18, as did treatment with DES‐0.1 μg. The present findings are interpreted in the context of what is known about the hormonal regulation of Leydig cell development. These lead to the conclusion that final Leydig cell number per testis is not determined by the number of Sertoli cells per testis and appears not to be influenced in any major way by gonadotrophins, androgens or oestrogens in the first 2 weeks of postnatal life. This implies that adult Leydig cell number may be determined prior to birth.
Alteration in immunoexpression of glucose transporter 2 in liver of tumour‐bearing rats
Authors: DOI CHIHARU , NOGUCHI YOSHIKAZU , ITO TAKAAKI , YOSHIKAWA TAKAKI , MAKINO TATSUO , MATSUMOTO AKIHIKO
Published: March 2003

To elucidate interactions between the glucose transport system and hepatic glucose production in the tumour‐bearing state, glycogen storage, expression of glucose transporter isoform 2 (Glut 2) and activities of glucose‐6‐phosphatase (G‐6‐Pase) and hexokinase were histochemically examined in hepatocytes of tumour‐bearing rats. Five male F344 rats, subcutaneously inoculated with methylcholanthrene(MCA)‐induced sarcoma cells were compared with five pair‐fed animals and four ad libitum fed controls. Glycogen storage was markedly decreased in liver cells of tumour‐bearing rats compared to in those of control animals. Glut 2 immunoreactivity was uniformly seen in the cellular membrane of hepatocytes from control animals. In rats bearing sarcoma, the staining intensity was significantly decreased, suggesting that Glut 2 with its bi‐directional transport capacity was down‐regulated in the tumour‐bearing state. Positive staining for hexokinase activity was located in the perivenous area in livers from control animals and was more diffusely located and more intense in livers from tumour‐bearing animals. G‐6‐Pase activity, limited to the peripheral area in livers from controls, extended to the intermediate area and had stronger reactivity in livers from tumour‐bearing animals. In the tumour‐bearing cachectic condition, glucose may be partially consumed by a futile cycle, hepatic metabolic zonation was disturbed, and the release of glucose from the liver may not be mediated by a facilitative glucose transporter‐2.
Failure to induce anti‐glomerular basement membrane glomerulonephritis in TNFα/β deficient mice
Authors: Ryffel Bernhard , Eugster Hanspietro , Haas Cordula , Le Hir Michel
Published: March 2003

TNF is a key proinflammatory cytokine playing a central role in the expression of endothelial adhesion molecules required for the recruitment of inflammatory cells. Proliferative glomerulonephritis induced by anti‐GBM antibody is characterized by the recruitment of inflammatory cells into the glomerulus and capillary damage followed by regeneration with crescent formation. The glomerular pathology may be due to TNF induction and we therefore tested this hypothesis in TNFα/β deficient mice. Anti‐GBM antibody administration in sensitised wild‐type mice resulted in deposition of immune complexes and complement factor 3, followed by increased ICAM‐1 and VCAM‐1 expression and influx of polymorphonucelar leucocytes. Distinct proteinuria precedes proliferative glomerulonephritis with glomerular crescent formation, which is fully developed at 10 days. By contrast, no glomerulonephritis developed in TNFα/β deficient mice. Comparable antibody complex deposits are found, but the upregulation of ICAM‐1 and VCAM‐1, the influx of inflammatory cells and the subsequent tissue damage is absent in TNFα/β deficient mice. Therefore, we conclude that TNF plays a key role for the recruitment of inflammatory cells by preventing the upregulation of endothelial adhesion molecule and the subsequent development of proliferative glomerulonephritis.
Interferon‐γ plays a role in pancreatic islet‐cell destruction of reovirus type 2 ‐induced diabetes–like syndrome in DBA/1 suckling mice
Authors: HAYASHI T. , MORIMOTO M. , IWATA H. , ONODERA T.
Published: March 2003

Reovirus type 2 (Reo‐2) infection in DBA/1 suckling mice causes insulitis, which leads to pancreatic islet‐cell destruction,resulting in a diabetes–like syndrome. T‐helper (Th)1 cytokines are thought to play a key role in islet inflammation in insulin‐dependent diabetes mellitus. We examined this hypothesis in the Reo‐2‐induced diabetes–like syndrome. We used reverse transcriptase polymerase chain reaction (PCR) and quantitative PCR techniques to examine mRNA expression of interferon (IFN)‐γ (Th1 type cytokine), and interleukin (IL)‐4 (Th2 type cytokine) in splenic cells. We observed that in Reo‐2 infected mice the level of IFN‐γ expression increases with the development of insulitis, whereas expression of message for IL‐4 is minimal to detectable with the immuno‐inflammatory process 10 days after infection. The treatment of monoclonal antibody (mAb) against mouse IFN‐γ during the expansion phase of insulitis (5–9 days after infection) inhibited the development of insulitis and the elevation of blood glucose concentrations in a dose dependent manner. Furthermore altered CD4+/CD8+ cell ratio compared with uninfected mice in the splenic cells by the infection was recovered to the ratio of uninfected mice by the treatment of mAb against mouse IFN‐γ, suggesting normalization of T cell balance in immune system. These results suggest that Reo‐2‐triggered autoimmune insulitis may be mediated by Th1 lymphocytes and IFN‐γ may play a role in islet inflammation leading to islet cell destruction.
The role of cell cycle‐mediated events in Alzheimer's disease
Authors: Raina Arun K. , Monteiro Mervyn J. , Mcshea Andrew , Smith Mark A.
Published: March 2003

The mechanism(s) underlying selective neuronal death in Alzheimer's disease remain unresolved. However, recently, we and others showed that susceptible hippocampal neurones in Alzheimer's disease express markers common to cells in various phases of the cell cycle. Since neuronal maturation is associated with effective escape from the cell division cycle, emergence out of quiescence may be deleterious. Here, we review a number of current findings indicating that disregulated ectopic re‐activation of cell cycle‐mediated events, akin to neoplasia, represent an important early pathway associated with neuronal death and, more importantly, one that involves virtually the entire spectrum of the pathological events described in Alzheimer's disease.
Root abnormalities, talon cusps, dens invaginati with reduced alveolar bone levels: case report
Authors: Mcnamara  , Garvey  , Winter
Published: March 2003

This is a case report of a Caucasian female who presented with an unusual combination of dental anomalies: short roots on the maxillary central incisors and premolars, talon cusps, dens invaginati, low alveolar bone heights, tubercles of Carabelli on the maxillary first and second permanent molars, with pyramidal root morphology in three of the second permanent molars. None of the anomalies alone are particularly uncommon but they have not previously been reported together. The occurrence of the anomalies is probably incidental as the conditions are aetiologically unrelated.
Malocclusion, dental injuries and dental anomalies in the primary dentition of Belgian children
Authors: Carvalho  , Vinker  , Declerck
Published: March 2003

Aim. To estimate the prevalence of malocclusion, dental injuries and dental anomalies in a sample of 3–5‐year‐old Belgian children.

Design. A cross–sectional study of 3–5‐year‐olds attending kindergartens in the municipality of Leuven, Belgium.

Methods. A total of 750 boys and girls participated in the study. The children were examined at the University School Health Centre in connection with their obligatory medical check‐up. The clinical examination was performed by one examiner using generally accepted criteria for these oral conditions.

Results. 10·1% of the examined children had posterior cross‐bite whereas over‐bite was seen in only 2·0% of the sample. Open‐bite was detected in 32·0% of the studied population. Boys showed a tendency for a higher frequency of malocclusions than girls. Traumatic injuries were identified in 18·0% of children. These were almost entirely restricted to maxillary incisors. Crown fractures were responsible for 42% of all injuries. The following dental anomalies were seen: six cases of supernumerary teeth, three cases of hypodontia, five cases of double teeth and one case of conical maxillary lateral incisor.

Conclusion. Our findings emphasize the importance of early detection of these oral conditions in order to permit effective and long‐term treatment planning, according to the child’s individual requirements
Preventive oral health care and health promotion provided for children and adolescents by the Municipal Dental Health Service in Denmark
Authors: Petersen P.E. , Torres A.M.
Published: March 2003

Summary.
Objective. To describe the current organization of health promoting and preventive activities within the Danish Municipal Dental Health Service and to assess how the service has chosen to comply with the directives as formulated by the National Board of Health.

Design. A cross‐sectional survey of the municipal dental health services was carried out on a national scale. Postal questionnaires were used to collect information on active and passive preventive care activities and community‐orientated health promotion.

Setting. The survey was conducted to aid the reorientation and adjustment of the Municipal Dental Health Services in Denmark.

Subjects. All municipal dental health services in Denmark were considered relevant for the survey and 141 services (71%) responded to the questionnaire.

Outcome measures. Quantitative methods were used to measure recall‐intervals for children and adolescents, passive and active prevention, identification of and care for individuals at risk, and health education. Qualitative methods were applied to record the organization of community health activities.

Results and conclusions. The majority of dental services stated that preschool children are called at regular intervals (every 3, 6 or 8 months); school‐children and adolescents are most often recalled according to individual needs. Chairside assistants, dentists or dental hygienists give oral hygiene instructions systematically to children of grades 0 through to 3. Fluoride is frequently administered through topical application by dentists; fluoride tables are not used. Permanent molars are sealed when this is indicated. Clinical and socio‐behavioural criteria are used to identify children at risk. Half of the services reported school‐based health education, and in one‐quarter of the municipalities community health activities took place. Adjustment of the services should consider population‐directed activities and greater use of ancillary personnel.
Child protection: a survey of experience and knowledge within the dental profession of New South Wales, Australia
Authors: Kilpatrick N.M. , Scott J. , Robinson S.
Published: March 2003

Aim. To establish the experience and knowledge of dental practitioners in New South Wales, Australia in the area of child abuse and protection.

Design. A cross‐sectional telephone questionnaire.

Sample. One hundred and twenty‐two interviews; 67 general dental practitioners randomly selected and 55 members of the Australia and New Zealand Society of Paediatric Dentistry.

Results. All of the dentists interviewed could identify physical abuse and most identified emotional abuse, however, none could describe all five forms of abuse. Significantly more (58%) members of the paediatric dental society had at some time suspected abuse, compared with only 24% of the general practitioners. However, only 20 of the paediatric dentists and seven general practitioners had actually reported any cases. The main reason given for not reporting concerned confidentiality. Seventy‐two per cent of general practitioners did not know their legal obligations or with whom they could discuss any concerns. While paediatric dentists achieved a better percentage, still over half of them were similarly unsure.

Conclusions. Further education and training is required for both the dental profession and the child protection agencies to improve the inter‐agency working relationship and thus provide better protection for children.
Association between early weaning, non‐nutritive sucking habits and occlusal anomalies in 3‐year‐old Finnish children
Authors: Karjalainen S. , Rönning O. , Lapinleimu H. , Simell O.
Published: March 2003

Objectives, design and subjects. Earlier results on the effect of breastfeeding on the one hand, and non‐nutritive sucking habits (pacifier and/or digit sucking) on the other, on the orofacial development of infants are inconclusive. Thus we studied the prevalence of malocclusions and their relationship to the duration of breastfeeding and to non‐nutritive sucking habits in a group of randomly selected 3‐year‐old children (n = 148).

Results. Posterior crossbite was detected in 13%, anterior open bite in 18% and large overjet (> 3 mm) in 26% of the children. The proportion of children with anterior vertical open bite was significantly larger among children with non‐nutritive sucking habits than among the other children (P < 0·001). Neither posterior crossbite nor large overjet were associated with non‐nutritive sucking habits. The duration of exclusive breastfeeding was 5·8 ± 3·6 months while that of total breastfeeding was 7·3 ± 3·8 months on average. The exclusive and total breastfeeding periods of children with posterior crossbite were both significantly shorter than those of the other children (P < 0·01 and P < 0·002, respectively). Children’s height and weight were unrelated to the duration of breastfeeding or occlusal anomalies.

Conclusion. We suggest that an early introduction of bottlefeeding, indicating a pattern of low‐impact muscular activity, may interfere with the normal development of alveolar ridges and hard palate, and hence lead to posterior crossbite.
Dental caries prevalence and dental health behaviour in HIV infected children
Authors: Eldridge K. , Gallagher J.E.
Published: March 2003

Objectives. To determine dental caries prevalence in a group of HIV positive children and their reported dental health behaviour.

Design. Standardized epidemiological dental examination and structured interview.

Setting. Paediatric HIV outpatient department in a South London hospital.

Study population. HIV‐positive children attending the above outpatient clinic over a 6‐month period (30 subjects) and parents (20 informants).

Methods. Epidemiological examination of children was undertaken by one trained and calibrated examiner to determine caries prevalence using dmft/DMFT. Parents were interviewed to obtain information on their children’s dental health behaviour: tooth‐brushing, diet, fluoride; oral medication and dental attendance were explored.

Results. Sixty‐three per cent (n = 19) of children had dental caries experience, much of it untreated. Mean dmft/DMFT was 4·4. Sixty per cent (n = 18) of all children presented with active or untreated caries and the care index for those at/under age 5 years was low (10%). Unfavourable dental health behaviour included: consumption of nonmilk extrinsic sugars at night, use of sugar‐based medications, low fluoride intake, late commencement of toothbrushing and poor dental attendance. Dental health was not considered a priority for many of these children. Parents did not necessarily disclose their child’s HIV status on dental attendance.

Conclusion. Caries prevalence was high, much of the disease untreated, and unfavourable dental health behaviour, including the use of sugar‐based medicines was common. HIV infected children should be considered a high caries risk and receive appropriate dental care, in terms of both treatment and preventive services, following confirmation of seropositivity.
Utilization of day stay general anaesthesia for the provision of dental treatment to children in New South Wales, Australia
Authors: Alcaino E. , Kilpatrick N.M. , Kingsford Smith E.D.
Published: March 2003

Objectives. To assess the demand for paediatric dental general anaesthetic services at a specialist paediatric dental unit in Australia and to evaluate the changing pattern of general anaesthetic use in children at this unit over the past decade.

Methods. A retrospective review of hospital records of a random sample of children receiving dental treatment under general anaesthesia during the years 1984 and 1996. Demographic and clinical data was collated and analysed using SPSS for Windows.

Results. The number of children managed under general anaesthesia increased from 189 in 1984 to 777 in 1996. This was accompanied by an increase in the time the patients waited for treatment. There was little difference in the mean age of the patients with over two‐thirds of the children being under the age of 6 years. Whilst children of Anglo‐Saxon origin accounted for the majority of patients across the 13‐year period there was a significant increase in the number of children from Asian or Middle Eastern backgrounds. A disproportionate number of these children accessed the services as self‐referrals. Caries remained the most common reason for referral, with trauma and dental anomalies accounting for less than 10%.

Conclusions. Despite the general decline in dental caries there remain an important group of young children who have high treatment needs and for whom general anaesthesia provides a useful treatment option. Preventive strategies should be targeted towards these groups of children.
The KBG syndrome, characteristic dental findings: a case report
Authors: Dowling P.A. , Fleming P. , Gorlin R.J. , King M. , Nevin N.C. , McEntagart M.
Published: March 2003

Short stature and developmental delay may be observed in many genetic conditions and well‐defined syndromes. A 7‐year‐old girl presented with the non‐specific findings of subtle dysmorphism, short stature and developmental delay. Although a genetic syndrome was suspected, a definitive diagnosis was not made until the dental findings of KBG syndrome were recognised, namely grossly enlarged maxillary permanent central incisors and hypodontia.
Treatment of intrinsic discoloration in permanent anterior teeth in children and adolescents
Authors: Wray Alyson , Welbury Richard
Published: March 2003

The tenth National Clinical Guideline in Paediatric Dentistry is published here. The process of guideline production began in 1994, resulting in first publication in 1997. Each guideline has a nominated main author but the content is not a personal view; it represents rather a consensus of opinion of current best clinical practice. Each guideline has been circulated to all consultants in Paediatric Dentistry in the UK, to Council of BSPD, and to people of related specialities recognised to have expertise in the subject. The final version of the guideline is produced from a combination of this input and thorough review of published literature. The intention is to encourage improvement in clinical practice and to stimulate research and clinical audit in areas where scientific evidence is inadequate. Evidence underlying recommendations is scored according to the SIGN classification and guidelines should be read in this context. For those wishing for further detail, the process of guideline production in the UK is described in International Journal of Paediatric Dentistry 1997; 7: 267–268.
Inverted eruption of a supplemental lower premolar: report of an unusual case
Authors: Jacobs R. , Willems G.
Published: March 2003

Summary. Eruption of an inverted tooth is a rare condition. This case report describes the inverted eruption of a supplemental lower premolar in a 10‐year‐old Caucasian female. The tooth erupted in a downward direction and reached the lower cortical border of the mandible 2 years later. During an 8‐year follow‐up period, the tooth did not interfere with eruption of permanent teeth and the patient remained symptom‐free. Considering clinical examination, medical and dental history as well as scientific evidence, the inverted eruption was most likely caused by a developmental abnormality with an inverted location of the tooth bud. This reported eruption of an inverted tooth is extremely rare and requires a radiographic follow‐up to evaluate the relative position of this tooth in the jaw bone and its potential interference with neighbouring teeth or anatomic structures.
A deconstruction of caring
Authors: Phillips Pauline
Published: March 2003

This paper presents the argument that much of the current focus on caring in nursing is misdirected in that it is aimed at explaining a complex process with conceptual similarities to teaching, in terms of behavioural categories and structures It is asserted that a pervasive use of the word ‘canng’ as synonymous with nursing has contributed to an erroneous emphasis in general nursing on emotional caring This reflects a dualist notion of physical and emotional care, operationalized as separate nursing activities The growing association of nursing with caring is thought to reinforce a fallacious distinction between caring and curing which has particularly impeded the development of a truly psychotherapeutic role for psychiatric nurses It is concluded that nursing skills will be neither elucidated by further analysis of the concept of care nor promulgated by the connotations of the word
Health promotion in hospitals: the attitudes, beliefs and practices of hospital nurses
Authors: McBnde Anita
Published: March 2003

This research paper explores the attitudes, beliefs and health promotion practices of hospital nurses working on acute adult wards, as demonstrated through the use of semi‐structured postal questionnaires Responses were compared with those from hospital‐based occupational therapists, physiotherapists, dietitians and medical consultants, in order to examine issues of consistency and continuity between professional groups and their interaction with patients in relation to health promotion activity The nurses are considered both as a homogeneous group and also in relation to their seniority within the profession Results demonstrate the lack of a coherent health promotion strategy within acute care settings and highlight the differing educational needs of nurses according to their professional role within the hospital By addressing these issues, a strategy can be developed to enhance health promotion in hospital by building on the concerns and needs identified by the nurses themselves Research literature and analysis of this study demonstrate that whilst the current position of health promotion in hospital is generally poor, nurses are keen to integrate health promotion into their practice
The subjective and psychosocial nature of breathlessness
Authors: West Nancy , Popkess‐Vawter Sue
Published: March 2003

Dyspnoea, also referred to as breathlessness, is a concern of nurses in most clinical settings Nursing interventions are directed toward preventing or treating dyspnoea in a timely manner Even though dyspnoea is a common phenomenon found in clinical settings and discussed in the literature, it has not been added formally to the list of diagnoses developed by the North American Nursing Diagnosis Association, most likely because it is an isolated, observable sign However, breathlessness, the related construct, is a distinctly different phenomenon from dyspnoea The terms dyspnoea and breathlessness are used interchangeably in the literature Traditionally, dyspnoea is defined as difficult or laboured breathing observable to another person Breathlessness is the subjective feeling of laboured breathing with and without dyspnoea and/or abnormal pulmonary functions These authors submit that the nursing diagnosis of breathlessness consists of two essential defining criteria, the subjective feeling of difficulty in breathing and anxiety, in the presence or absence of dyspnoea and/or abnormal pulmonary functions A biopsychosocial model is presented to guide research and nursing care for individuals who experience breathlessness
Evaluation of an information booklet on breastfeeding duration: a clinical trial
Authors: Hauck Yvonne L , Dimmock Joan E
Published: March 2003

Since very few tools used in health education are carefully evaluated, the aim of this study was to examine the effect that a breastfeeding information booklet had on breastfeeding behaviour Feedback about breastfeeding information needs from a preliminary study of 58 Perth mothers at 3 months postpartum provided the basis for the development of an information booklet The sample consisted of 150 mothers of full‐term infants who were breastfeeding for the first time Upon discharge from hospital, a random sample of 75 mothers were sent the booklet These mothers and a control group (n= 75) were surveyed for 52 weeks to compare breastfeeding duration Although the breastfeeding information booklet was found to be useful by 97% of the experimental group, there was no significant difference noted for breastfeeding duration between groups Study findings have implications for clinical practice in highlighting the importance of breastfeeding information in increasing mothers’ confidence, providing suggestions for breastfeeding practice, and helping mothers not to feel alone in their concerns Further research should include investigations into the association between mothers reaching their intended goal for breastfeeding duration and being satisfied with the breastfeeding experience Success with breastfeeding tends to be measured by duration alone, but no research to date has specifically examined the criteria mothers use to determine if their breastfeeding experience was successful
Job satisfaction of community nurses working with people with a mental handicap
Authors: Parahoo Kader , Barr Owen
Published: March 2003

There is a dearth of studies on the job satisfaction of community nurses, especially those working with people with a mental handicap, in the United Kingdom This paper reports on some of the data gathered as part of a survey of community nurses (mental handicap) (CNMH) in Northern Ireland in 1992 A 25‐item questionnaire was sent to all 50 CNMH The response rate was 72% The results showed that most of these CNMH rated then‐ level of satisfaction as high or very high Additionally, they identified a number of factors which contributed to then‐ job satisfaction and/or dissatisfaction These findings have implications for theory building, methodology and nursing practice
Learning to nurse in the clinical setting
Authors: Campbell Iris E , Larrivee Laverna , Field Peggy Anne , Day Rene A , Reutter Linda
Published: March 2003

The findings reported in this paper are part of a larger study examining student socialization into nursing In analysing the data, it became evident that two major factors influenced the students’ learning in the clinical setting the first was the clinical instructor, the second peer support Instructors who were organized, encouraging, outgoing, and who had good relationships with students, patients and nursing staff were seen as‘good’ role models When instructors were unable to establish rapport on a unit, negative feedback from nursing staff could be detrimental to student learning Peer support encompassed three dimensions facilitating learning, providing emotional support, and assisting with physical tasks There was evidence that practising faculty had a stronger influence in shaping students’ attitudes towards nursing than classroom teachers
Violence content in nursing curricula: strategic issues and implementation*
Authors: Hoff Lee Ann , Ross Margaret
Published: March 2003

Many nurse educators today are sensitized to the importance of including content on violence and victim/survivor care in various nursing education programmes While a survey of Ontario's schools of nursing in Canada revealed a considerable number of hours devoted to this topic, the approach is largely incidental, depending heavily on individual faculty interests National and international initiatives to stem the tide of violence against women and children, plus the strategic role of nurses in primary care, call for curricula in which this content is addressed systematically To achieve this goal and avoid pitfalls such as an ‘add‐on’ approach to curriculum revision, nurse educators' needs in Ontario were addressed in a series of workshops involving collaboration between faculty, clinical preceptors and community‐based experts in victim/survivor care
Pain: the views of elderly people living in long‐term residential care settings
Authors: Yates Patsy , Fentunan Belinda , Dewar Anne
Published: March 2003

While an individual's beliefs and attitudes have long been considered important factors in how people respond to pain, few studies have attempted to provide in‐depth descriptions of the nature of such pain beliefs and attitudes The aim of this research was to investigate the views of pain and pain management practices held by elderly people living in long‐term residential care settings Ten 60–90 minute focus group interviews, each involving around five elderly people, were conducted in four large, long‐term residential care settings in Brisbane, Australia Categories of beliefs and attitudes regarding pain were identified following analysis of the verbatim transcripts of these interviews Findings suggest that many elderly people living in long‐term residential care settings may have become resigned to pain, that they are ambivalent about the benefit of any action for their pain and that they may be reluctant to express their pain Implications of these beliefs and attitudes are discussed
Meaning attached to compliance with self‐care, and conditions for compliance among young diabetics
Authors: Kyngas Helvi , Hentinen Maija
Published: March 2003

This paper presents a hypothetical model of the compliance with self‐care of young diabetics, its features, its meaning to them and the preconditions for compliance with self‐care The aim of this research was to develop a model to clarify and expand existing knowledge concerning compliance with self‐care among young diabetics and to produce new ideas for planning and implementing this care Four categories of behavioural pattern were identified Those young people with good compliance experienced a sense of well‐being, health, and freedom They were responsible, active, and well motivated in voluntarily implementing self‐care The second group were those whose actions deviated only slightly from health regimens but who had undergone many negative experiences with self‐care Their actions were guided only by compulsion The third group were consciously non‐compliant Their constant neglect of health regimens was associated with feelings of poor health, fears and indifference They were not motivated to comply, felt that the aims set were too high and the self‐care programme too tightly regimented They felt that they received no encouragement The young people belonging to the fourth group frankly refused to pursue self‐care Their non‐compliance was seen by them as an issue of freedom In effect, their friends controlled their lives, and they felt that their self‐care was all the more unnecessary since nobody encouraged them to keep to it
Professional development and change in a learning organization
Authors: Cowley Sarah
Published: March 2003

There is a growing tendency for learning in the workplace to be seen as a managerial function rather than as the responsibility of educationalists As managers prepare to take a more active role in facilitating professional education, they need to consider the extent to which their organizational arrangements help or hinder the learning of professional skills There is a potential risk that the development of important clinical practice skills may be inadvertently overlooked, because of the kind of organizational arrangements in force This paper outlines alternative approaches to organizational development, explaining the basis for implementing ‘holographic principles’ when planning a system A situational analysis earned out in an inner‐city community provider unit revealed an alternative, more directive and fragmented arrangement The analysis is used to illustrate how a focus on developing the organization as a learning environment during periods of rapid and multiple change can also help to promote clinical nursing skills
The process of empowerment in mothers of chronically ill children
Authors: Gibson Cheryl H
Published: March 2003

As a result of advances in scientific knowledge and technology, the number of children living with chronic illness is ever increasing The burden of responsibility for the care of these children falls increasingly on the involved parents and, particularly, on mothers In spite of the challenges that chronic childhood illness presents, many families are able to adapt to their situation and develop a sense of control over their lives A sense of control has been associated with the notion of empowerment Following a theoretical analysis, empowerment was conceptualized as a social process of recognizing, promoting and enhancing people's abilities to meet their own needs, solve their own problems, and mobilize the necessary resources in order to feel in control of their own lives To understand the concept of empowerment from an empirical perspective, a fieldwork study was undertaken to describe the process of empowerment as it pertains to mothers of chronically ill children This paper presents the process of empowerment that occurred in these mothers Four components of the process of empowerment emerged discovering reality, critical reflection, taking charge, and holding on As a result of the study, empowerment was reconceptualized as largely a personal process in which individuals developed and employed the necessary knowledge, competence and confidence for making their voices heard Participatory competence — the ability to be heard by those in power ‐ was the outcome of this process Although the unique finding in this study suggests that the process of empowerment was largely mtrapersonal, there was a relational element in the process Clearly, the intrapersonal and interpersonal processes of empowerment are intertwined
Theoretical and practical considerations on the use of reassurance in the nursing management of anxious patients
Authors: Teasdale Kevin
Published: March 2003

This paper analyses the concept of reassurance in health care, arguing that it entails giving information predicting a safe outcome, plus the use of personal support to help patients feel secure The literature on anxiety management interventions is reviewed and selected findings are presented from a survey of reassurance in nursing practice based on 351 critical incidents reported by 253 nurses and 51 patients The survey concludes that reassuring strategies are indicated where patients’fears are judged to be unrealistic or excessive Accurate assessment is vital and must take into account coping styles Reassurance may also be indicated as a measure of last resort when working with cognitively impaired patients Personal support interventions are particularly valued by hospitalized patients who appear to observe individual nurses in order to assess their levels of competence and caring before requesting help
The information needs of women newly diagnosed with breast cancer
Authors: Luker Karen A , Beaver Kinta , Leinster Samuel J , Owens R Glynn , Degner Lesley F , Sloan Jeffrey A
Published: March 2003

Nurses can play a key role in patient education, including providing patients with useful and approrate information Rather than focusing on the process of education or information giving by nurses, this study places emphasis on the content of that information by taking the patients’perspective and asking the patients themselves what particular types of information are perceived as important at a specific point in time The aim of the study was to explore what particular types of information were important to women newly diagnosed with breast cancer, to enable nurses and other health care professionals to utilize their time as effectively as possible and provide a high‐quality service to individuals in their care Women with breast cancer (a mean of 2 5 weeks from diagnosis) were interviewed and asked to compare items of information The items of information were presented m pairs and the women stated a preference for one item in that pan‐ Thirty‐six pairs were presented in total The analysis involved the use of a Thurstone scaling model, which allowed rank ordermgs, or profiles of information needs, to be developed, reflecting the perceived importance of each item Information about the likelihood of cure, the spread of the disease and treatment options were perceived as the most important items of information at the tune of diagnosis Other information needs, in order of descending priority, included information about the risk to family, side‐effects
Sleep disturbance in mid‐life women
Authors: Clark Ann J , Flowers Juanzetta , Boots Larry , Shettar Shashidhar
Published: March 2003

A correlational field survey was used to describe sleep disturbance and explore the relationship of that sleep disturbance to the psychological and menopausal status of 23 mid‐life women Subjects were 40–55 years of age and had self‐reported sleep problems Instruments included the sleep disturbance questionnaire (SDQ), Centre for Epidemiologic Studies depression scale (CES‐D), Speilberger state‐trait anxiety scale (STAI), a demographic form, 4 cc blood sample for follicle stimulating hormone analysis, and a 7‐night sleep diary (‘self report of sleep’, or SRS) Ten of the 23 subjects reported periodic limb movement on the SDQ Sleep diaries (SRS) revealed a characteristic sleep disturbance among 13 of the 23 subjects, which paralleled in some respects the changes in sleep efficiency observed with advancing age, but was more pronounced and was present at an earlier age There was no statistically significant relationship between sleep disturbance and menopausal status or symptoms, or anxiety and depression among subjects, as shown by correlational coefficient and chi‐square statistical tests Results suggest that a characteristic sleep disorder accompanied by periodic limb movement may be responsible for sleep disturbance in mid‐life women What remains unclear is whether this sleep disturbance is related to aspects of the perimenopause not addressed in this study or to other aspects of ageing
An analysis of altruism: a concept of caring
Authors: Smith Ann
Published: March 2003

In clinical settings, nurses have observed a conflict within women who are expected to focus on caring for themselves, while their value lies in attending to the needs of others at the sacrifice of self In this concept analysis of altruism, the term is defined and the critical attributes are identified Model, borderline, related and contrary cases illustrate what the concept is and what it is not The meaning of altruism is compared to self‐neglect and co‐dependence, which are two similar concepts The antecedents and consequences of altruism are identified to further refine the critical attributes Implications for research are discussed This is a first step towards developing nursing theory that will give direction for providing more effective care to women within their value system
The art of nursing in a ‘postmodern’ context
Authors: Lister Philip
Published: March 2003

Notion of the ‘postmodern’ pervade various fields of study, but have rarely been applied to the practice and theory of nursing. This paper uses some conceptions of the ‘postmodern’ to remedy this. Though there are many contested usages of the term, here ‘postmodern’ will be used broadly in a periodical sense to trace changes in society and culture from the ‘modernism’ of the 18th and 19th centuries to current concerns about ‘postmodernism’. How these changes have been reflected in nursing practice and nursing theory will be explored. The changing use of the term ‘modern’ to describe up‐to‐date practice will be addressed in the course of this. It is suggested that contextualizing nursing as a social/cultural activity bin this way offers perspectives which will help us untangle the conflicting agendas and issues which form the fabric of the social world in which current nursing takes place, enabling us to act more effectively in promoting our own professional agendas.
Getting sick and getting well: a qualitative study of aetiologic explanations of people with cancer
Authors: Tishelman Carol
Published: March 2003

This paper explores lay explanations of developing a cancer disease and ‘recovering’ from the disease, both phenomena of importance in understanding how information on cancer prevention and recovery is made sense of by non‐professionals. The data derive from interviews conducted with persons diagnosed with a malignant disease during 1987 at one hospital in urban Sweden. Forty‐six patients were interviewed in 1988–1989, and 20 of those surviving were interviewed again in 1992. Explanations most often appear to be negotiated forth because they are able to fulfil a positive function for the patient in the sickness process. Intricate combinations of explanations are found which avoid individual blame, provide the possibility of positive influence and allow for individual successes. The micro‐level explanations are discussed in relation to general discourse about prevention of sickness in our culture.
Willingness to provide care and treatment for patients with HIV/AIDS
Authors: McCann Terence V.
Published: March 2003

This paper is derived from the findings of a larger study which examinies nurses’ and doctors’ attitudes towards mainstreaming of hospital inpatient services for individuals with HIV/AIDS in general hospital wards. The aim of this paper is to discuss the factors which influence nurses’ and doctors’ willingness to provide care and treatment for patients with HIV/AIDS. Two methods of study are used in this researc — a survey questionnaire and semi‐structured interviews. The findings of this study provide several themes abouth the positive attributes associated with caring for and treating patients with HIV/AIDS. These include: that caring for and treating is personally and professionally rewarding; the need to be non‐judgemental and accepting of others; that previous work or social experience is related to willingness to work with patients; the influence of family and colleague support in the work environment; and having a duty of care.
Assessing literacy for patient teaching: perspectives of adults with low literacy skills
Authors: Brez Sharon M. , Taylor Maurice
Published: March 2003

The purpose of this qualitative study was to gain an understanding of the response of English speaking adults with low literacy skills to screening of reading ability in order to facilitate the planning of pateint teaching in a hospital setting. The Rapid Estimate of Literacy in Medicine (REALM) was the screening tool used to provide a screening experience for research subjects. A multiple case study design was employed to gain insight, describe participant experiences and generate an evidence‐based conceptual model. While all participants supported the principle of screening in the context of the hospital, response to the actual experience was varied. Factors found to influence responses to screening included perceived risks of illiteracy exposure, perceived risks of non‐disclosure during hospitalization and the attribution of characteristics to the hospital leading to it's designation as a ‘spaecial’ place. A conceptual model of screening response was developed and compared tof the Health Belief Model and Knox's Proficciency Theory of adult learning. Implications for the health professions are also discussed.
Professional identity: values embedded in meaningful nursing practice
Authors: Fagermoen May Solveig
Published: March 2003

The main research question addressed in this two‐phase descriptive study was ‘What are the values underlying nurses’ professional identity as expressed through what is meaningful in nurses’work?’The first phase was a survey of 767 randomly selected nurses with one, five, and 10 years of experience in nursing, and in the second phase data on work‐meaning were obtained from a convenience sample of six nurses by in‐depth interviews eliciting nurses’stories about providing care to patients. Content analysis of survey‐data revealed that the nurses held both other‐oriented and self‐oriented values, i.e. moral and work values. Human dignity and altruism were the most prominent moral values, whereas the most significant work‐values were intellectual and personal stimulation. The interview‐data, analysed by means of hermeneutic and narrative analysis, revealed a greater diversity in value‐expressions compared to the survey‐data. Altruism, the moral orientation of care, was the overall philosophy, and human dignity appeared as a core value. The nine additional values appeared to be linked to human dignity either by arising from it and/or being aimed at preserving this basic value.