bluuebunny/crossref_metadata_2025 huggingface dataset:
Titration of non‐replicating adenovirus as a vector for transducing active TGF‐β1 gene expression causing inflammation and fibrogenesis in the lungs of C57BL/6 mice
Authors: Warshamana G. Sakuntala , Pociask Derek A. , Fisher Krishna J. , Liu Jing‐Yao , Sime Patricia J. , Brody Arnold R.
Published: March 2003

Investigators have shown that interstitial pulmonary fibrosis (IPF) can be induced in rats by overexpressing transforming growth factor beta1 (TGF‐β1) through a replication‐deficient recombinant adenovirus vector instilled into the lungs (Sime et al. 1997). We have shown that this vector induces IPF in fibrogenic‐resistant tumour necrosis factor alpha‐receptor knockout (TNF‐αRKO) mice (Liu et al. 2001). The object of our studies is to understand how peptide growth factors, such as TGF‐β1, mediate interstitial lung disease (ILD). To do so, we must be able to manipulate the dose of the factor and sort out its effects on multiple other mediators in the lung parenchyma. As a step in this complex process, in the studies reported here, we have determined the concentrations of the recombinant adenovirus vector carrying the gene for porcine active TGF‐β1 (AVTGFβ1) that have little apparent effect, cause clear induction of disease, or severe disease. The disease largely resolves by 28 days in all cases, thus providing a valuable model to understand the mechanisms of the IPF that is mediated, at least in part, by TGF‐β1. The findings here show that 106 plaque‐forming units (pfu) of AVTGFβ1, provide essentially a ‘no‐effect’ dose, but even this amount of TGF‐β1 causes a significant increase in whole‐lung collagen by day 28 after treatment. In contrast, 108 and 109 pfu cause severe IPF in 4 days, whereas 107 and 5 × 107 are intermediate for all parameters studied, i.e. TGF‐β protein, inflammatory cells, cell proliferation, pro‐α 1(I) collagen gene expression and whole‐lung collagen accumulation, and expression of growth factors such as TGF‐β1, TNF‐α and PDGF‐A and ‐B. Interestingly enough, TGF‐β1, as a potent blocker of epithelial cell proliferation, appears to suppress airway epithelial cell growth that would be expected during the inflammatory phase of IPF. Thus, this model system helps us to understand some quantitative aspects of TGF‐β1 biological activity and allows us to manipulate this potent factor as a mediator of interstitial fibrogenesis.
ORAL HEALTH ADVICE: REPORTED EXPERIENCE OF MOTHERS OF CHILDREN AGED 5 YEARS AND UNDER REFERRED FOR EXTRACTION OF TEETH UNDER GENERAL ANAESTHESIA
Authors: Hunter  , Hood  , Hunter  , Kingdon
Published: March 2003

Aims. To examine the reported receipt of oral health education among mothers of children who required the extraction of teeth under general anaesthesia.

Design. Cross‐sectional study using questionnaires completed at interview.

Sample. 150 mothers of children aged 5 or younger who had been referred for extraction of teeth under general anaesthesia.

Setting. Dental School, University of Wales College of Medicine.

Results. 27% of mothers recalled receiving advice from their dentist about dental care during their pregnancy. With regard to their child’s oral health, 48% had received dietary advice and 31% oral hygiene advice from the same source. All children lived in areas with suboptimal water fluoride levels; 27% of mothers had been advised by their dentist to give their child fluoride supplements. Few of the mothers recalled receiving advice about oral health from their health visitor.
Dental problems associated with hypophosphataemic vitamin D resistant rickets
Authors: Goodman  , Gelbier  , Bennett  , Winter
Published: March 2003

Objective. To review a series of cases of hypophosphataemic vitamin D resistant rickets.

Subjects included: Seventeen cases, aged between 2 years 1 month and 15 years 9 months at first referral, and with an established diagnosis of vitamin D resistant rickets from twelve families were included in the review. Information was drawn from patient records for follow‐up periods between 9 months and 20 years 4 months.

Setting. All subjects had been referred to the Eastman Dental Hospital between 1973 and 1997.

Findings. Abscessed non‐carious primary and/or permanent teeth were a presenting feature in eleven of the seventeen cases. Although attrition and exposure of the abnormally formed dentine accounted for the route of infection in primary teeth, the route for microbial invasion of pulpal tissues in permanent teeth remained unexplained in a number of patients. The possible part played by infractures of the enamel as a portal of entry for infection is discussed. Enamel defects were observed in only six patients, in three of whom these changes were limited to the primary dentition. Taurodontism of permanent molar teeth was confirmed as a feature of the condition in the more severely affected male subjects.
Multiple salivary mucoceles in a young boy
Authors: Porter  , Scully  , Kainth  , Ward‐Booth
Published: March 2003

A rare case of multiple mucoceles in a 4‐year‐old boy is reported. The patient presented with multiple sessile swellings on his lower lip, with no obvious local aetiology. The patient was otherwise well. The lesions were excised surgically and histopathological examination confirmed the lesions to be extravasation‐type mucoceles. The article includes a brief review of mucoceles.
Autotransplantation as a treatment option after loss of a maxillary permanent incisor tooth. A case report
Authors: Waterhouse P.J. , Hobson R.S. , Meechan J.G.
Published: March 2003

A case is described of the management of a maxillary left permanent incisor, damaged by several traumatic injuries, in a 13‐year‐old girl. The traumatized incisor tooth required extraction and as part of an orthodontic treatment plan, a mandibular left second premolar was surgically transplanted to the prepared extraction socket at the maxillary anterior alveolus. After splinting, the transplanted tooth underwent endodontic treatment, because of pulpal necrosis. Orthodontic treatment commenced 3 months post‐transplantation. Permanent root obturation was provided after orthodontic treatment and a porcelain veneer was placed to restore aesthetic appearance. The case emphasizes the importance of correct case selection, a multidisciplinary approach to treatment planning, and regular follow‐up for transplanted teeth.
Desmoplastic fibroma of the mandible: report of a case
Authors: Bakaeen G. , Rajab L.D.
Published: March 2003

This paper describes a case of desmoplastic fibroma in a 4‐year‐old patient with a history of a small slowly growing swelling at the right angle of the mandible over a 3‐month period. Desmoplastic fibroma was diagnosed on histological and immunohistochemical bases. The lesion responded well to thorough curettage and has not shown signs of recurrence 3 years after the surgical intervention. The clinical picture, the pathology and the management of the case are described, and the differential diagnosis and treatment are discussed.
Primary double teeth. A retrospective clinical study of their morphological characteristics and associated anomalies
Authors: Aguiló L. , Gandia J.L. , Cibrian R. , Catala M.
Published: March 2003

Aim. To investigate the relationship between morphology and position of double teeth, and the occurrence of other dental anomalies in the same subjects and in their siblings.

Sample of children and methods. Fifty‐three double teeth in a group of 50 Spanish children were included in the study. All of these children were examined clinically and had radiographs and photographs taken at the time of examination. Twenty‐two of the children had a total of 30 siblings who were also examined for the presence of anomalies.

Results. Of the 50 subjects, 47 had one and three subjects had two double teeth. Statistically there were no significant differences in occurrence between boys and girls, left and right sides or between maxilla and mandible. Four morphological types were identified: type I, bifid crown–single root; type II, large crown–large root; type III, two fused crowns–single root; type IV, two fused crowns–two fused roots. Type I was seen only in the maxilla and types II and III only in the mandible. Type IV was seen mostly in the maxilla. More than half of the cases showed associated anomalies in the permanent dentition and anomalies of number or shape were also present in six of the siblings.

Conclusion. It is suggested that both double teeth and other anomalies in the same children or in their siblings may be manifestations of a primary abnormality in the distribution of dental material.
Multiple dental anomalies in a young patient: a case report
Authors: O’Sullivan E.A.
Published: March 2003

This case illustrates the management of multiple dental anomalies in a young patient, which included anomalies of number and morphology. Although individually these anomalies are not uncommon, the combination is unusual and highlights the importance of careful clinical and radiographic examination of patients with dental anomalies.
The effect of wavelength, bandwidth, and probe design and position on assessing the vitality of anterior teeth with laser Doppler flowmetry
Authors: Roebuck E.M. , Evans D.J.P. , Stirrups D. , Strang R.
Published: March 2003

Objectives. To investigate the effect of four variables: wavelength (633 nm and 780 nm), bandwidth filter (3 kHz, 15 kHz, 22 kHz), probe fibre separation (250 μm and 500 μm) and distance of the probe from the gingival margin (2–3 mm and 4–5 mm) when assessing the vitality of anterior teeth with a laser Doppler flowmetry system.

Design. Split‐mouth cohort clinical trial.

Setting. Childrens dental clinic, Glasgow Dental Hospital and School.

Sample and methods. Sample included 11 non‐vital maxillary incisors with necrotic pulps in 10 patients (mean age 12·25 years old). Recordings were taken from the non‐vital tooth and from a vital maxillary incisor from the same patient, using all 24 combinations of the recording variables listed above. The vital/non‐vital ratios of the signals from the 11 pairs of teeth were calculated and discriminant analysis applied to the data.

Results. Of the variables investigated, the combination of a 633 nm laser source with a 3 kHz bandwidth filter using a probe with a 500 μm fibre separation placed 2–3 mm from the gingival margin was the most reliable, with 10 out of a possible 11 true positives for pulpal necrosis, no false positives and one equivocal diagnosis, and was the only combination that recorded a smaller blood flow from the non‐vital tooth compared with the vital control tooth for all 11 pairs of teeth investigated.

Conclusions. It was concluded, therefore, that laser Doppler flowmetry can be of use in assessing the vitality of anterior teeth and that this is the preferred combination of recording variables for further investigations.
The management of severe dental phobia in an adolescent boy: a case report
Authors: Levitt J. , McGoldrick P. , Evans D.
Published: March 2003

Dental fear is a widespread problem that represents one of the major barriers to dental care. This report describes a case study of a 12‐year‐old boy who presented with dental phobia characterized as ‘fear of catastrophe’, ‘generalized dental fear’ and ‘fear of specific stimuli’. The referral came from his general dental practitioner who had been unable to carry out even the simplest dental procedure on him. The patient required prevention, conservation and root canal therapy. The case illustrates the use of physical strategies, including muscle relaxation and relaxation breathing; practice strategies, including graded exposure and cognitive strategies, combined with individual control methods and inhalation sedation to successfully complete the dental treatment plan.
Late forming supernumerary tooth in the premaxilla: a case report
Authors: Cho S.Y. , So F.H.C. , Lee C.K. , Chan J.C.Y.
Published: March 2003

A case of late forming supernumerary tooth in the premaxilla is presented in this report. The patient has been followed‐up radiographically from the age of 9 years but the supernumerary tooth could only be detected radiographically when the patient was 11 years old. This emphasises the importance of thorough clinical and radiographic examination of the developing dentition in children.
Intranasal tooth as a complication of cleft lip and alveolus in a four year old child: case report and literature review
Authors: Gupta Y.K. , Shah N.
Published: March 2003

Ectopic position of teeth is not rare. The presence of teeth have been reported in ovaries, testes, anterior mediastinum, and pre‐sacral regions. In the maxillo‐facial region, teeth have been found in maxillary sinus, mandibular condyle, coronoid process, chin, nose, and even orbit. Approximately 50 cases of a tooth in the nasal cavity have been reported in literature. However, an intranasal tooth in cases of cleft lip and palate is comparatively rare.

Intranasal teeth can cause problems such as nasal obstruction, chronic rhinorrhea and speech problems. Sometimes however, they are totally symptom‐free.

We present here an interesting case of an intranasal tooth in a four year‐old‐boy, who was operated on for cleft lip and alveolus at 6 months of age. The intranasal tooth did not cause any symptoms. The tooth was extracted under general anaesthesia when it was found to be very loosely attached to the nasal mucosa. The case is discussed in the light of relevant literature on intranasal teeth in cases of cleft lip and palate.
Caries prevalence in Belgian children: a review
Authors: Vanobbergen J. , Martens L. , Declerk D.
Published: March 2003

A review of epidemiological surveys on dental caries prevalence, published between 1980 and 1999 in Belgian children, was compiled through a literature search. The number of studies performed in Belgium to date is limited. Methodological differences and confounding factors, especially socio‐demographic influences, limit national comparisons of caries prevalence data.

Although exact comparisons are difficult, data suggests a decline in caries prevalence in 5, 7 and 12 year‐old Belgian schoolchildren in the last 20 years. In the primary dentition dmft values have decreased from 2·66 (1981) to 1·38 (1994) in 5‐year‐olds and from 4·1 (1983) to 2·24 (1996) in 7‐year‐olds. In 12‐year‐olds DMFT values in the permanent dentition have decreased from 3·9 (1983) to 1·93 (1994). WHO goals for the year 2000 appear to have been already reached in Flanders, with a recent estimate of 1·93 for DMFT in 12‐year‐olds and 56% of children being recorded as caries free at the age of 5.

Continuing efforts are needed to screen the oral health of different age groups but standardised criteria and sampling procedures should be used if benefits are to be gained from national and international comparison. Data has often been limited to small selected areas and information representing the entire community of Flanders or Wallonia would be of particular value.
Moebius syndrome with oral involvement
Authors: De Serpa Pinto M. V. X. , De Magalhães M. H. C. G. , Nunes F. D.
Published: March 2003

Summary. The oral findings of 12 patients with Moebius syndrome are described. Facial weakness, hypoplastic upper lip, microstomia, mouth‐angle drooping, hypoplasia of mandible, gothic palate, tongue weakness, fissured tongue, tongue atrophy and open bite were found. In addition to describing the oral findings, this report discusses some implications for dental treatment of patients with this syndrome.
Hypoplasia of primary and permanent teeth following osteitis and the implications of delayed diagnosis of a neonatal maxillary primary molar
Authors: Kimoto S. , Suga H. , Yamaguchi M. , Uchimura N. , Ikeda M. , Kakizawa T.
Published: March 2003

Summary. A 2‐year‐and‐6‐month‐old Japanese girl with delayed eruption of a maxillary right primary canine and disturbance in the development of maxillary right primary molars was examined. The crown of the maxillary right first primary molar was severely decayed and hypoplastic. The periodontal tissues on the maxillary right posterior region were swollen and slight erythrogenic change was observed. Radiographic examination revealed a disturbance in the development of the permanent successor and the primary teeth in the maxillary right quadrant. According to the history, the maxillary right first primary molar had erupted on day seven after birth. It is suggested that the disturbance in development of the permanent successor and the primary teeth was secondary to osteitis caused by infection of the neonatal tooth. Appropriate dental treatment had not been administered for more than two years because the neonatal molar had not been diagnosed.
The prevalence and severity of dental fluorosis among 12‐year‐old schoolchildren in Jordan
Authors: Hamdan M. A. M.
Published: March 2003

Summary. Objectives. To assess dental fluorosis, provide base‐line data among Jordanian children and to compare fluorosis in incisor teeth between areas with different fluoride levels.

Design. Cross‐sectional study among school children.

Sample and methods. A sample of 1878 subjects aged 12 years, 940 boys and 938 girls, were randomly selected from 128 schools in urban (69 schools) and rural (59 schools) areas. The Thylstrup & Fejerskov (TF) index was used to record the dental fluorosis on the labial surfaces of incisors.

Results. A total of 18·5% of the children examined showed dental fluorosis. The difference in fluorosis between males (17%) and females (20%) was not statistically significant (P > 0·05). Children in rural areas had a higher prevalence of fluorosis (31·8%) than their counterparts in urban areas (11·3%), a difference that was statistically significant (P < 0·01).

Conclusions and recommendations. Findings suggest that there is a need for continued monitoring of mottling and further investigation into the fluoride intake from all sources in Jordan. However, there is a need to change the drinking water supplies in the southern region of Jordan. Active steps should also be taken to suppress emissions of vapours high in fluoride from phosphate plants to within acceptable limits.
A critical analysis of Neuman's systems model in relation to public health nursing
Authors: Haggart Monica
Published: March 2003

The public health movement is an old discipline being given new life and meaning based on a recognition of continuing health problems associated with social inequalities The ‘new public health’ movement has goals which are closely aligned to those of the World Health Organization in their Health for All by 2000 initiative which represent a collective approach to health in contrast to the current political emphasis on individual responsibility for health Public health nursing is a relatively new concept in Britain but posts are beginning to be established in many areas where nurses are working in partnership with communities in a public health capacity At a time when this area of nursing is in its relative infancy it is appropriate to develop a clear philosophy and framework and to examine potential strategies This paper sets out to contribute to the development of this discipline by critically analysing the work of Betty Neuman to determine its utility for public health nursing
Water intoxication: one nursing staff's response and intervention
Authors: Davidhizar Ruth , Kriesl Richard
Published: March 2003

Water intoxication is a significant problem for psychiatric nurses, especially those in long‐term care settings Water intoxication can cause psychological and physiological symptoms which can lead to death The programme described in the paper can significantly modify and change patient behaviour and assist patients in controlling their own impulses to participate in self‐limiting fluid and their own self‐care satisfactorily
Catharsis: an investigation of its meaning and nature
Authors: Kettles Alyson McGregor
Published: March 2003

Nurses commonly use catharsis and cathartic techniques as part of their clinical practice to enable clients and themselves to release emotion, to feel better and to facilitate coping However, the literature does not provide clinical nursing evidence for its use The main purpose of the investigation is to examine the beliefs about and understanding of catharsis which two groups of nurses hold one group of nurse teachers and one group of nursing students One hundred and forty‐two respondents completed self‐administered questionnaires asking about their understanding of and beliefs about catharsis as being beneficial, social, negative or psychotherapeutic in nature The possible relationship of their answers to age, sex, philosophical orientation and qualifications was deemed to be important The results suggest nurses understand that catharsis is related to emotion and has a psychotherapeutic purpose However, there appear to be gaps in their understanding Nurses also seem to believe that the release and expression of emotions is more acceptable for women than for men There is also evidence that the more experienced nurses think differently from less expenenced nurses, placing more emphasis on behaviour rather than emotion as they grow older The problems associated with catharsis are discussed along with the implications for research and practice
Philosophy, biology and mental disorder
Authors: Dawson Paul J
Published: March 2003

The biological model has become the touchstone for our thinking on mental disorder The success of this model has relegated opposing views to the sidelines Philosophers have been considering the nature of mind for well over 2500 years, and then‐ speculations may provide a useful antidote to the creeping reductionism and materialism inherent in simple biology The emphasis in philosophical theories is on the nature of the mental and the structuring role of the mind in our construction of reality This paper focuses on three philosophers, Kant, Heidegger and Husserl, and their contribution to our understanding of the nature of psychopathology The biological theory is re‐examined from the differing perspectives offered, and some of the assumptions on which it is based are subjected to criticism The emphasis, found in the philosophical theories, on the mental as opposed to the physiological aspects of the mind, is considered to be more germane to the practical and therapeutic concerns of those who must deal with the dis‐ease of mental disorder
The concept of vulnerability in relation to child protection: health visitors' perceptions
Authors: Appleton Jane V
Published: March 2003

The aim of this paper is to describe part of the findings of a study which explored the health visitor's role in identifying and working with vulnerable families in relation to child protection The study was conducted using a broadly qualitative approach A two‐stage approach was undertaken to explore the concept of vulnerability and to assess health visitors’ work in this area of practice In stage one a postal survey of 102 health visitors was conducted with a response rate of 58 (57%) In stage two 12 m‐depth interviews were completed with health visitors This paper outlines one major aspect of the findings and focuses specifically on health visitors’ perceptions about the concept of vulnerability and its relevance to child protection work The analysis suggests that vulnerability is a nebulous, transient and complex concept influenced by multiple interacting factors The existence of a continuum of vulnerability is clearly evident It appears that families move in and out of vulnerability at various stages of the life cycle and this is largely dependent on‘internal’ and‘external’ stress factors and coping ability This paper contributes to the knowledge base of vulnerability and raises a number of issues for health visiting practice
Preceptors' perceptions of benefits, rewards, supports and commitment to the preceptor role
Authors: Dibert Cathy , Goldenberg Dolly
Published: March 2003

The purpose of this descriptive correlational study was to examine the relationships among preceptors' perceptions of benefits, rewards, supports and commitment to the preceptor role A convenience sample of 59 nurse preceptors in a 400‐bed urban teaching hospital participated by completing a four‐part questionnaire the Preceptor's Perception of Benefits and Rewards Scale, the Preceptor's Perception of Support Scale, the Commitment to the Preceptor Role Scale, and a demographic questionnaire Kanter's (1977) model 'Structural Determinants of Behaviour in Organizations' provided the conceptual framework for the study Three study correlations reached statistical significance, suggesting that commitment to the preceptor role is positively associated with (a) preceptors' perception of benefits and rewards, (b) preceptors' perception of support, and (c) the number of preceptor experiences The results have implications for nursing administrators and nursing educators to ensure that adequate benefits, rewards and supports are available to preceptors Recommendations for developing more effective preceptor programmes are proposed
Assessment of anxiety in hospital patients
Authors: Shuldham C M , Cunningham G , Hiscock M , Luscombe P
Published: March 2003

There has been research in North America to validate the nursing diagnosis of anxiety As part of this work, Young used the defining characteristics and developed a tool to measure anxiety The present research sought to extend that study in the United Kingdom, assess the anxiety‐defining characteristics tool and identify key indicators of anxiety that might be useful in clinical practice Four anxiety measurement tools, drawn from the literature, were used These were the state trait anxiety inventory, the graphic anxiety scale, the hospital anxiety and depression scale, and the anxiety‐defining characteristics tool A random sample of 79 hospitalized patients were interviewed and their anxiety rated using all four measures Calculation of Spearman's correlation co‐efficients revealed convergent validity between the anxiety‐defining characteristics tool and the state trait anxiety inventory and the anxiety score on the hospital anxiety and depression scale Anxiety levels were found not to be affected by the age or sex of the respondent, or the length of stay or number of previous admissions Discriminant analysis suggested that six characteristics adequately discriminated anxious subjects sweating, faintness, tendency to blame others, continual review of things in then‐ mind, focus on self and a lack of self‐confidence The study concluded that there is a scope for further research into these characteristics and then‐ use in clinical practice
A study of the attitudes of nurses to parental involvement in the initial child‐protection conference, and their preparation for it
Authors: Bell Margaret
Published: March 2003

Fifty‐four nurses and 205 other professionals provided data on their attitudes to the involvement of parents in initial child‐protection conferences in a northern English city, and on the preparation and training they had received for it Data were collected before the local authority involved parents and again 1 year later, after parents had been invited to the conferences in four neighbourhood teams This paper describes the attitudes and training of the nurse respondents at the two points in time, before the authority involved parents and after, and the degree and nature of the training they received in preparation Overall, attitudes became more favourable over time There were, however, some abiding concerns, for example, that discussion might be inhibited, and the interests of the child become less central There were also differences in attitude by agency which reflected an agency orientation and its commitment to the child‐protection task Social workers were initially the most positive and then‐attitudes the least likely to change Teachers and police began with the most negative attitudes, but their attitudes changed the most The nurse professionals occupied the middle ground There were also differences by agency and over time in the amount of training and preparation received Nurses were the most likely to be offered training and teachers the least Inter‐agency training, including input from experienced practitioners, was valued
Student nurse wastage: a case study of the profile and perceptions of students of an institution
Authors: Mashaba Grace , Mhlongo Thokozani
Published: March 2003

A case study was undertaken at a university school of nursing in South Africa in order to establish to what extent student nurse wastage at this school conformed to trends in schools offering the same 4‐year basic nursing course Further, the views of students were solicited about factors that precipitated student nurse attrition at this school, as well as means which, in their opinion, could curb wastage and retain students on this course A total of 147 students who were currently pursuing the course, and all previous students of this school who answered the description of actually or potentially dropping out of the course, were the target population A questionnaire was returned by 84% of this group Findings showed that this institution was amongst those whose attrition rate was low, but it conformed to the trend of student attrition in other universities Respondents’perceptions of this issue were divergent, and so were their recommendations
Are nurses aware of the differing health care needs of Vietnamese patients?
Authors: Shanahan Mary , Brayshaw D Lynette
Published: March 2003

This study examined the knowledge a small group of community nurses have of the Vietnamese culture In our multi‐cultural society nurses are being challenged to offer culturally appropriate care Provision of care depends on an accurate assessment of health care needs which may differ from those of the dominant culture The results indicated a lack of knowledge of the Vietnamese culture and the specific health care practices of the Vietnamese This lack of knowledge is being rectified by in‐service education
The conflict between ‘new nursing’ and ‘scientific management’ as perceived by surgical nurses
Authors: Wigens Lynne
Published: March 2003

Nursing on surgical wards is a major area of employment for nurses, but the literature is sparse in relation to this group. Dramatic alterations in surgical care have occurred over the past few years, including the introduction of day surgery on a major scale, increased technical equipment and faster ‘throughput’ of patients. This has led to Nicholas Fox describing ‘a conveyor belt of surgery’. These changes are occurring alongside major evolution within the nursing profession. Nurses are encouraged to give holistic, individualized care in what has been termed the ‘new nursing’ movement. This study addresses the problem of how nurses resolve these two conflicting discourses. Following an initial phase of participant observation, 10 registered surgical nurses were interviewed using the techniques of career biography, critical incident analysis and informal interviews. Different interpretations by the key members of the ‘new nursing’, discourse have been identified. These have been termed the professional project discourse, the modernist discourse, and the traditionalist discourse. Various strategies are adopted by nurses to reduce cognitive dissonance caused by the two conflicting discourses. The most commonly used being rationalization about the need for emotional labour.
A concept analysis of consent
Authors: Brennan Maureen
Published: March 2003

This paper considers the meaning of consent for nursing. Consent had traditionally been looked at in relation to the medical profession. The paper argues for patient advocacy and discusses issues of competency and advocacy and implications for practice. The paper then goes on to critique the process of concept analysis and suggests ways of proceeding with this vital development for nursing.
Policy matters: critical policy analysis and nursing
Authors: Cheek Julianne , Gibson Terri
Published: March 2003

Policy is an integral part of nursing. At the organisational level, policies are constantly developed in a seemingly endless quest to provide more effective and efficient nursing services and outcomes. Such an increasing generation of policy appears to rest on the taken‐for‐granted assumption by nurses that policy is essential for good nursing practice. However, is it necessarily the case that the generation of policy documents advances the practice of nursing? Rather, does the apparent uncritical adoption of the role of policy by nurses actually serve to further regulate, control, and even limit the practice of nursing? This paper uses a critical perspective to explore nursing policy. In so doing it exposes the effect of policy on the construction and maintenance of everyday understandings of nursing practice.
A study of the educational and research priorities of registered nurses in rural Australia
Authors: Bell Pamela F. , Daly John , Chang Esther M.L.
Published: March 2003

This study set out to identify the educational and research priorities of registered nurses practising in rural and remote areas of Australia. It included two groups of participants, one which identified as rural and another which identified as remote. The findings for the rural cohort in the study are presented in this article. Research participants represented a national sample. The Delphi method was used to obtain the most reliable consensus of the nurse participants. In the final phase of the study, 13 high priorities were identified. Study findings highlight perceived needs for clinical nursing research and continuing education for nurses practising in rural Australia.
Florence Nightingale, feminism and nursing
Authors: Holliday Mary E. , Parker David L.
Published: March 2003

Three key aspects of Florence Nightingale's remarkable life are examined. First, the influences during her formative years: the education and guidance provided by her father, the resistance by her family when she decided to become a nurse; and the rejection by Nightingale of the societal expectations of a woman in the Victorian era. Secondly, her professional life is examined, in particular how she appears to have been viewed by certain members of society, and how in turn she viewed them. It is anticipated that her position as an early feminist will be postulated and illuminated. Thirdly, an analysis of her personal and professional life indicates a way forward for the nursing profession.
The knowledge and attitudes of mental health nurses to electro‐convulsive therapy
Authors: Gass John P.
Published: March 2003

Three hundred and forty‐five questionnaires containing the knowledge and attitude scale for ECT devised by Janicak et al. (1985
) were distributed to mental health nurses working in Wales, the data were collected from the 167 returned. Limitations in the reliability of the instrument with respect to the degree of internal consistency were found, this suggested that the knowledge statements used were inconsistent in providing a reliable measure of respondents knowledge of ECT. Findings suggested that a higher level of knowledge appeared to be associated with the length of experience of the nurse and their area of clinical practice. In addition, there were substantial variations in actual knowledge, particularly with regard to cognitive side‐effects with ECT. Attitudes to ECT in this study were significantly related to the place in which the nurse was practising and the degree of contact the nurse had with patients receiving the treatment. Greater knowledge scores were obtained by those nurses who indicated a more positive response towards ECT. The conclusions suggest that knowledge of ECT required improvement in many cases, and this has implications for nurse education. A relationship between knowledge and attitudes appears to exist in this study, however, such a relationship would need to be tested further in future research.
Educational intervention with international nurses and changes in knowledge, attitudes and willingness to provide care to patients with HIV/AIDS
Authors: McCann Terence V. , Sharkey Ron J.
Published: March 2003

This paper reports the findings of a study which examines the relationship between the use of an educational intervention with nurses from several Asian countries and changes in knowledge, attitudes and willingness to care for patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). A pre‐test and post‐test questionnaire was used to collect the data. The results indicate, that whilst there was an improvement in knowledge following the educational intervention, there is a need for further improvement in the knowledge levels of the nurses. The method of contracting the virus is less influential in shaping students’ attitudes towards people with HIV/AIDS. Fear of contagion is evident; this increases when more invasive clinical procedures are being carried out. What is also evident is that multiple levels of infection control protocols are used with patients. Fear of contagion is also apparent in the participants’ willingness to work with colleagues and patients with HIV/AIDS. While the participants stated that they were more willing to work with colleagues and patients with HIV/AIDS following the educational intervention, they said that they would continue to take additional precautions for fear of contracting HIV in the workplace. The conclusion emphasizes that it is important for education about HIV/AIDS to be incorporated within current undergraduate and in‐service programmes.
The use of professional nursing practice standards in nursing labour arbitrations in British Columbia, 1987–1994
Authors: Leipert Beverly
Published: March 2003

This study examined the use of nursing practice standards in British Columbia in labour arbitrations related to patient care for the years 1987–1994. Retrospective secondary content analysis was the method used to analyse the cases. Although practice standards were referred to in some of the cases, the nature and clarity of these standards were not always evident. In addition, corporate and industrial precedents, rather than health care precedents, formed the basis for much of the arbitration deliberations. The perspectives of nurses, patients, and families were not significantly represented. Many of the arbitration hearings did not get beyond procedural matters, and so did not address substantive patient care situations. Clearly, the visibility and importance of nursing standards need to be raised among nurses and non‐nurses alike. Implications and recommendations for nursing practice, administration, education and research, as well as for nursing professional associations and unions are discussed. Research questions for the future are suggested.
Schizophrenia: all in the mind or locked in the brain?
Authors: Clarke Liam
Published: March 2003

This paper questions whether a natural science language can be transposed either into the care of individuals affected by mental illness or the educational curricula of those preparing to care for them. The importance of biological research into schizophrenia is not denied. However, it is suggested that paradigms which depend upon ownership (of knowledge) may be less worthwhile to schizophrenic people than an approach which rests upon a philosophy of being. In this sense, a consideration of the place of consciousness in investigations into brain function is stated to be relevant: issues of mind and brain are central to discussions about schizophrenia. It is not denied that the laboratory‐bench may ultimately unravel genetic susceptibility to schizophrenia. However, a biology of persons — however persuasive its language — can lead, in the case of schizophrenia, to formulations of human defect. Forms of care which proceed from determinism can lead, as they did in the past, to the curtailment of individual aspirations for both carers and patients.
Collecting patients’ views and perceptions of continence services: the development of research instruments
Authors: Clayton Jane , Smith Kirsteen , Qureshi Hazel , Ferguson Brian
Published: March 2003

This paper describes one part of a feasibility study carried out in England which examined the costs, quality and effectiveness of continence services in areas with different approaches to provision. It involved the design of instruments to collect the views and perceptions of patients and an investigation of ways to develop a methodology to implement comparative studies. It is the design and piloting of the questionnaires and the way patients responded that forms the focus of this paper. The main sample group recruited for the study were women who had recently sought formal help with urinary incontinence and were likely to receive conservative treatment or management in the community. They were interviewed and asked to complete four questionnaires at two points in time. A smaller sub‐group of disabled women, interviewed only once, were included to compare cost profiles for different client groups. The questionnaires which were developed address the impact of urinary incontinence (using a standard scale), the effectiveness of service provision in terms of patients’ clinical history, expectations and hoped‐for outcomes, service receipt and its cost, and patients’ satisfaction with several aspects of service provision. In total 118 women were interviewed, including 28 disabled women. The study generated a set of survey instruments which might be used for a variety of purposes including audit and future research and which could inform purchaser and provider decisions by using patients’ perspectives of quality of life outcomes to enhance service development.
Experiences and consequences of pain in persons with post‐polio syndrome
Authors: Widar Marita , Ahlström Gerd
Published: March 2003

This study describes the meaning of pain and its implications for everyday life in 35 persons with symptoms of post‐polio syndrome. The mean age of the study group is 65 years and the sex ratio of men to women is 1·5:1. The study persons were interviewed on two occasions in their homes and answered a pain questionnaire. The result shows that everyday vocabulary is used to express pain experiences. The study persons normally answered that it hurt, although the interviewers used pain in their questions. The results show that the lower back is the most common location of pain. Joint pains are most common in the upper extremities. The pain is worst in the evening and at night, and tangibly affects the daily rhythm. Physical strain and climatic factors commonly provoke pain, whereas rest and heat give relief. The study show that interviews and pain questionnaire should be supplemented with questions on activities so as to gain a comprehensive view of the difficulties experienced in everyday life.
Critical thinking as an outcome of nursing education. What is it? Why is it important to nursing practice?
Authors: Daly William M.
Published: March 2003

Critical thinking is currently a highly valued educational outcome throughout the educational spectrum, but particularly so in relation to higher and professional education. International concerns have focused upon citizen’s thinking abilities and thus the nations’ abilities to function and compete in complex societies and economies. Educationalists are questioning the wisdom of teaching content as opposed to teaching how to think as a means of dealing with relentless information development and change. Nursing education is also embracing the construct critical thinking as a desirable educational outcome. Some commentators refer to the importance of critical thinking in nursing practice as a central component or in some cases a given. This paper intends to examine the background to the construct and address in detail some of the important questions surrounding critical thinking, and its association with competent nursing practice.
Who cares? Who cures? The ongoing debate in the provision of health care
Authors: Baumann Andrea O. , Deber Raisa B. , Silverman Barbara E. , Mallette Claire M.
Published: March 2003

Who cares? Who cures? The ongoing debate in the provision of health care¶In the debate about the role of health professionals, two normative models have been placed in opposition —‘care vs. cure’. To many, the cure model has been associated with physicians, and the care model with nursing and the other allied health professions. As the shortcomings of a cure‐orientated model have been recognized, particularly in dealing with chronic disease, more attention has been focused on care, with many writing as though the two were mutually exclusive. In this paper, we suggest that these models are instead end‐points on a continuum which ideally should be used by all health providers, rather than being characteristic of different clinical professionals. This conceptualization places less concern on what should be done by doctors as opposed to nurses, and more on the needs of the particular situation. The resulting convergence among roles should not imply that nursing and the allied health professions will adopt the medical model, but that medicine, nursing and others will work together with patients for all members’ mutual benefit. In this expanded continuum, the focus for decision making becomes the patient and family in partnership and collaboration with health professionals.
Atypical neuroleptics: autonomy and compliance?
Authors: Marland Glenn R.
Published: March 2003

Atypical neuroleptics: autonomy and compliance?¶Non‐compliance is a major stumbling block to the effectiveness of drug therapy. The nurse, both in hospital and community, has a crucial role to play in overcoming this problem to the benefit of the patient. Recent treatment advances, `new‐generation' anti‐depressants and atypical neuroleptics, make this issue highly topical in mental health nursing. The atypical neuroleptics are a pharmacological breakthrough in the treatment of schizophrenia, which could herald a new era in psychiatry. These medicines give the benefits of the older (typical) neuroleptics but with fewer side‐effects. Neuroleptics are sometimes called antipsychotics, antischizophrenics or major tranquillisers. Currently the atypical neuroleptics are not available in depot form. This critical review considers literature on interventions to promote compliance with neuroleptics generally and reflects on nursing implications relevant to the atypical neuroleptics. Three main forms of interventions emerge from the review; these are labelled as: imposed compliance, chosen compliance and active compliance. Historically the literature shows a gradual trend towards a realization by professionals that increased patient autonomy and involvement relates to improved compliance. This change in thinking is reflected in the new name `adherence', which has begun to replace the term `compliance'. It is concluded that mental health nurses have a key role to play in enabling this reconceptualization to change practice.
Evaluating the impact of primary nursing practice on the quality of nursing care: a Nigerian study
Authors: Archibong Uduak E.
Published: March 2003

Evaluating the impact of primary nursing practice on the quality of nursing care: a Nigerian study¶This paper is abstracted from an action research project on promoting family‐centred care in Nigeria through the practice of Nigerian Primary Nursing (NMPN). This article will present results of comparative evaluation of the impact of primary nursing on the quality of care received by patients in a 37‐bedded acute medical‐surgical, mixed sex ward in a specialist hospital in eastern Nigeria. A total of 44 nurses' interactions with 10 patients in the pre‐NMPN period and 58 nurses' interactions with eight patients in the post‐NMPN period were assessed using QUALPACS (Quality Patient Care Scale.). Results showed a significant improvement in the quality of nursing care with primary nursing practice. The greatest improvement in quality of nursing appeared to be in the elements that address the individual needs of the patient, while the smallest improvements were in the area of physical care — elements of routine, technical nursing care. Implications of the study and recommendations for further studies are made.