bluuebunny/crossref_metadata_2025 huggingface dataset:
Marine biogeography of southern Australia: phylogeographical structure in a temperate sea‐star
Authors: Waters Jonathan M. , Roy Michael S.
Published: December 2004

Aim  To test whether marine biogeographical patterns observed at the community level are also important within species. It is postulated that historical hydrogeographic barriers have driven in situ diversification.

Location  The intertidal and shallow subtidal zones of southern Australia, New Zealand and nearby islands. Australia's temperate marine communities are characterized by a high degree of endemism and show strong biogeographical structure along an east–west axis.

Methods  Phylogeographical analysis of the widespread asteriid sea‐star Coscinasterias muricata Verrill across southern Australia and New Zealand. Forty‐two samples from 27 locations were included in phylogenetic analyses of mitochondrial (CO1; control region) and nuclear (ITS2) DNA sequences.

Results  Analysis of mtDNA revealed a deep phylogenetic split within Australian C. muricata, strongly correlated with latitude. ‘Northern’ haplotypes (latitude ≤ 37.6° S, nine sites, 15 samples) were 7.3–9.4% divergent from ‘southern’ haplotypes (latitude ≥ 37.6° S, 19 sites, 27 samples), consistent with late Pliocene separation. Eastern and western representatives of the ‘northern’ clade were 0.5–1.0% divergent, probably reflecting Pleistocene isolation. The ‘southern’ clade of Australia is also represented in New Zealand, indicating Pleistocene oceanic dispersal. Nuclear DNA (ITS2) sequences yielded relatively little phylogenetic resolution, but were generally congruent with mtDNA‐based groupings.

Main conclusions  The phylogeographical pattern detected within Australian C. muricata closely resembles marine biogeographical groupings proposed on the basis of community and species distributions. Recurring evolutionary patterns may have been driven by the hydrographic history of southern Australia. Specifically, we suggest that Plio‐Pleistocene temperature change and the repeated opening and closure of Bass Strait promoted allopatric divergence and perhaps cryptic speciation in C. muricata.
Central venous catheter dressings: a systematic review
Authors: Gillies Donna , O'Riordan Elizabeth , Carr Debbie , O'Brien Ida , Frost Judy , Gunning Robbie
Published: December 2004

Background.  Gauze and tape or transparent polyurethane film dressings such as Tegaderm®, Opsite® or Opsite IV3000® are the most common types of dressing used to secure central venous catheters (CVCs). Currently, there are no clear guidelines as to which type of dressing is the most appropriate.

Aims.  To identify whether there are any differences between gauze and tape and/or transparent polyurethane film dressings in the incidence of CVC‐related infection, catheter‐related sepsis, catheter security, tolerance to dressing material, dressing condition and ease of application in hospitalized patients.

Methods.  The Cochrane Controlled Trials Register and Medline, Embase and CancerLit databases were searched to identify any controlled trials comparing the effects of gauze and tape and/or transparent polyurethane dressings on CVCs. Additional references were sought from published and non‐published literature. Twenty‐three studies were reviewed. Data were extracted independently from each paper by two members of the review team and results compared. Differences were resolved either by consensus or referral to a third person. Authors were contacted for missing information.

Results.  Of the 23 studies reviewed, 15 were excluded. Of the remaining eight, data were available for meta‐analysis from six studies. Of the six included studies, two compared gauze and tape with Opsite IV3000, two compared Opsite with Opsite IV3000, one compared Tegaderm with Opsite IV3000, and one compared Tegaderm with Opsite.

Conclusions.  There was no evidence of any difference in the incidence of infectious complications between any of the dressing types compared in this review. Each of these comparisons was based on no more than two studies and all of these studies reported data from a small patient sample. Therefore it is unlikely that any of these comparisons would have had sufficient power to detect any differences between groups.
Workplace stress in nursing: a literature review
Authors: McVicar Andrew
Published: December 2004

Background.  Stress perception is highly subjective, and so the complexity of nursing practice may result in variation between nurses in their identification of sources of stress, especially when the workplace and roles of nurses are changing, as is currently occurring in the United Kingdom health service. This could have implications for measures being introduced to address problems of stress in nursing.

Aims.  To identify nurses’ perceptions of workplace stress, consider the potential effectiveness of initiatives to reduce distress, and identify directions for future research.

Method.  A literature search from January 1985 to April 2003 was conducted using the key words nursing, stress, distress, stress management, job satisfaction, staff turnover and coping to identify research on sources of stress in adult and child care nursing. Recent (post‐1997) United Kingdom Department of Health documents and literature about the views of practitioners was also consulted.

Findings.  Workload, leadership/management style, professional conflict and emotional cost of caring have been the main sources of distress for nurses for many years, but there is disagreement as to the magnitude of their impact. Lack of reward and shiftworking may also now be displacing some of the other issues in order of ranking. Organizational interventions are targeted at most but not all of these sources, and their effectiveness is likely to be limited, at least in the short to medium term. Individuals must be supported better, but this is hindered by lack of understanding of how sources of stress vary between different practice areas, lack of predictive power of assessment tools, and a lack of understanding of how personal and workplace factors interact.

Conclusions.  Stress intervention measures should focus on stress prevention for individuals as well as tackling organizational issues. Achieving this will require further comparative studies, and new tools to evaluate the intensity of individual distress.
Prostate mucinous adenocarcinoma with signet ring cell
Authors: GUMUS EYUP , YILMAZ BANU , MIROGLU CENGIZ
Published: December 2004

Prostate mucinous adenocarcinoma with signet ring cell is a rare neoplasm with only 11 cases reported to date. We present the 12th case of prostate mucinous adenocarcinoma with signet ring cell. The case was detected incidentally as a result of a biopsy taken from a lesion in the prostatic urethra during a urethrocystoscopy of a 47‐year‐old male patient who underwent an internal urethrotomy operation due to urethrostenosis. Endoscopic examination showed a loose, spongy, gray–white structure covering the prostatic urethra, especially the right lobe of the prostate. The diagnosis resulting from the pathological examination of the biopsy was prostate mucinous adenocarcinoma with signet ring cell. A total of 50 Gy radiotherapy was applied to the patient. In the 27th month of follow‐up after treatment, thoracoabdominal computed tomography, bone scintigraphy, and tumor markers (PSA, CEA and CA19‐9) were found to be normal.
Combined effect of clarithromycin and imipenem/cilastatin against urinary biofilm infection after pyeloplasty
Authors: FURUHATA MASAYUKI , IWAMURA MASATSUGU , BABA SHIRO , INOUE MATSUHISA
Published: December 2004

The present report concerns a 38‐year‐old man, who had been treated with pyeloplasty and lithotomy for the improvement of urinary excretion and resolution of a kidney stone. The patient developed a biofilm infection involving Pseudomonas aeruginosa and Staphylococcus epidermidis, and had been suffering from recurrent acute pyelonephritis for one year. Combination therapy with clarithromycin (CAM) and imipenem/cilastatin (IMP/CS) consisted of administration of CAM at a dose of 400 mg/day for 1 week, followed by 500 mg/day of IMP by intravenous infusion combined with CAM (400 mg/day) for 5 days. This therapy produced an immediate antimicrobial effect and no further signs of pyuria have been seen during one year of follow‐up in this patient.
Unusual case of post‐cesarean vesicouterine fistula (Youssef's syndrome)
Authors: KILINC FERHAT , BAGIS TAYFUN , GUVEL SEZGIN , EGILMEZ TULGA , OZKARDES HAKAN
Published: December 2004

Vesicouterine fistula without vaginal leakage of urine, cyclic hematuria and amenorrhea is a rare condition, referred to as Youssef's syndrome. The most common cause of this syndrome is trauma during a cesarean section. Herein a new case is reported.
Delayed recovery of urinary continence after laparoscopic radical prostatectomy
Authors: EGAWA SHIN , KURUMA HIDETOSHI , SUYAMA KAZUHO , IWAMURA MASATSUGU , BABA SHIRO
Published: December 2004

Aim: To study the rate at which patients regained urinary continence during our institution's early experience with laparoscopic radical prostatectomy.

Methods: The urinary continence of 34 patients was recorded at various intervals following laparoscopic radical prostatectomy. These data were compared with those from 49 patients who had undergone radical retropubic prostatectomy.

Results: For laparoscopic prostatectomy patients, 2.9% had regained urinary continence at 1 month, 29.4% at 3 months, 46.9% at 6 months, 56.0% at 9 months and 60.0% at 12 months. For retropubic prostatectomy patients, the corresponding rates were 22.4% at 1 month, 63.3% at 3 months, 84.1% at 6 months, 92.9% at 9 months and 92.9% at 12 months. Backward stepwise logistic regression analysis indicated that laparoscopic surgery itself significantly predicted urinary incontinence at every interval from 1 to 9 months following surgery (P < 0.05).

Conclusion: Patients’ postoperative recovery of urinary continence was not satisfactory in our early experience with laparoscopic radical prostatectomy. Further efforts to elucidate the reason for this poor functional outcome are mandatory before the procedure is accepted as part of standard practice.
Transitional cell carcinoma in an ectopic ureter
Authors: NARITA SHINTARO , AKAO TOSHIYA , TSUCHIYA NORIHIKO , KUMAZAWA TERUAKI , KAKINUMA HIDEAKI , SATOH SHIGERU , SATO KAZUNARI , HABUCHI TOMONORI , KATO TETSURO
Published: December 2004

We experienced an 82‐year‐old man with transitional cell carcinoma in an ectopic ureter draining into the prostatic urethra. Carcinoma arising from an ectopic ureter is very rare and a differential diagnosis is difficult. To our knowledge, our case is the third male case reported in the literature.
Soil Organic Carbon Build‐up and Dynamics in Rice–Rice Cropping Systems
Authors: Ramesh K. , Chandrasekaran B.
Published: December 2004

Intensive irrigated rice system is the most important food production system in the world. Continued population growth necessitates increased rice production to meet the increased need of food production through increased rice productivity to ensure food security. In contrast, the recent slowdown in yield growth in intensive irrigated rice‐based cropping systems as a result of deterioration of soil health and decline in productivity level is a serious cause for concern. The objective of this research was to investigate the soil organic carbon (SOC) build‐up and its dynamics in rice–rice cropping system by including a green manure (GM) crop Sesbania rostrata Berm. either during fallow and/or intercrop at 4 : 1 ratio as additive series without changing rice geometry. The results revealed that there is a gradual build‐up of SOC when S. rostrata included and in situ incorporated at flowering stage as a basic means of improving soil quality in rice–rice cropping system. Further, the soil organic matter fractions viz. humic acid and fulvic acid were also improved in all GM‐incorporated systems. In general, the proportion of fulvic acid was higher than humic acid. Cropping system involving three GMs viz. S. rostrata‐rice/S. rostrata‐rice/S. rostrata registered significantly higher SOC and was 10.63 percent higher than traditional rice–rice cropping system (A1). This was followed by S. rostrata‐rice/S. rostrata‐rice system. Although the traditional rice–rice cropping system (A1) also conserved SOC (0.29 and 1.69 % higher than initial during first and second annual cropping cycle, respectively), the magnitude was very low. Repeated application of S. rostrata as GM improved SOC, which formed the basis for sustainable management of soil resources. It can be concluded that S. rostrata would affect the rate of loss of SOC in cropping systems and its ultimate level in soils.
Pressure ulcer prevention and treatment: transforming research findings into consensus based clinical guidelines
Authors: Lewis Matthew , Pearson Alan , Ward Cathy
Published: December 2004

The translation of research findings into practice guidelines is an important aspect in maintaining the currency of practice and adding value to research. While there has been a large amount of published literature regarding the treatment and prevention of pressure ulcers, very few studies have attempted to provide clear clinical guidelines. The present study proposes a model to transform research into clinical guidelines whilst developing a series of guidelines that can be applied to a variety of clinical settings.
Ensuring excellence: an investigation of the issues that impact on the registered nurse providing residential care to older Australians
Authors: Cheek Julianne , Ballantyne Alison , Jones Jacqueline , Roder‐Allen Gerda , Kitto Simon
Published: December 2004

The aim of this paper is to provide a comprehensive picture of the issues that impact upon the registered nurse providing residential aged care, in order to contribute to best practice initiatives to enhance both the health and well‐being of older Australians and the professional working life of registered nurses working in this sector. The impact of an ageing population is being felt in Australia as in other western countries. In Australia, there is an estimated 12% of the population aged 65 and over, with a projected increase to 18% by 2021. Paradoxically, there is an emerging crisis in attracting and retaining skilled registered nurses to provide residential aged care. Little research evidence exists that provides a comprehensive picture of the issues impacting on this group of nurses. This exploratory qualitative study comprised three stages involving the use of interviews, focus groups, nominal groups and a series of workshops. Ongoing iterative analysis of the multiple data sources identified five key issues impacting on registered nurses providing residential aged care, as well as a range of strategies designed to address those issues. The final recommendations were developed with key stakeholders in terms of language, intention and ranked order, and are included in full.
Job stress, coping and health perceptions of Hong Kong primary care nurses
Authors: Lee Joseph KL
Published: December 2004

Few empirical studies have investigated job stress, coping and health perceptions of nurses working in primary care settings. One thousand self‐report questionnaires, which consisted of the modified Nursing Stress Scale, Coping with Work Stress Checklist and Health Perceptions Questionnaire, were distributed randomly to a group of Hong Kong nurses working in primary care settings, to examine issues related to job stress. Three hundred and sixty‐two nurses responded. Findings indicated that nurses in these settings experienced low‐to‐moderate frequency of stress, adopted direct coping strategies, and perceived themselves as rather healthy. There were also statistically significant links between job stress, coping and perceived health status. The findings of this study suggest that job stress, coping and health perception of nurses working in primary care settings were distinct from their colleagues working in acute care settings.
Different meanings of quality of life: a comparison between what elderly persons and geriatric staff believe is of importance
Authors: Berglund Anna‐Lena , Ericsson Kjerstin
Published: December 2004

The principle aim of this study was to obtain a more complete understanding of quality of life (QoL) through exploring different factors affecting that concept among elderly persons and staff members, combining mixed methods for validation of QoL categories and themes, and enlightening the meanings through some quotes. Elderly persons (n = 207) as well as members of geriatric staff (n = 48) answered the open‐ended question ‘what does quality of life mean to you?’. The elderly persons also answered questions on health, loneliness and social contacts. Descriptive statistics, Spearman rank correlation coefficient, content analysis and triangulation were used to evaluate the data. The findings revealed differences in the answers regarding what was considered most important for QoL. Staff members overestimated two of the categories, namely health and social network, while the elderly persons themselves emphasised being appreciated and living a good life. Staff members believed that elderly persons want to be seen, listened to and feel useful. The only category where staff members and elderly persons differed was ‘how to be treated’, where the elderly group did not find it as important as the staff members. Furthermore, elderly persons did not wish to be a burden to their family or society. In conclusion, elderly persons’s own viewpoint is highly significant in care planning.
The use of moist wound‐healing dressings in the management of split‐thickness skin graft donor sites: a systematic review
Authors: Wiechula Rick
Published: December 2004

The aim of this systematic review was to determine the best available evidence related to the post‐harvest management of split‐thickness skin graft (STSG) donor sites. Studies included in the review were those involving patients of any age examining interventions relating to the post‐harvest management of STSG donors and were intra‐individual or randomized controlled trials. All studies were checked for methodological quality, and data were extracted using a data extraction tool. Many studies were combined in meta‐analysis. The present report concerns studies examining moist and non‐moist wound‐healing dressings. Broad comparisons of moist wound‐healing dressings against traditional non‐moist dressings favoured moist wound‐healing approaches in terms of healing rates, pain and infection. In comparing dressings within and between moist wound‐healing dressing groups, the lack of studies of sufficient quality prevented determining a ‘best dressing’ for STSG donors. Moist wound‐healing products have distinct clinical advantages over non‐moist products in the management of STSG donors. There is a strong case for further head‐to‐head studies comparing products within the moist wound‐healing group.
Targeted prodrug treatment of HER‐2‐positive breast tumor cells using trastuzumab and paclitaxel linked by A‐Z‐CINNTM Linker
Authors: Gilbert Carl W. , McGowan Eleanor B. , Seery Gerald B. , Black Kirby S. , Pegram Mark D.
Published: December 2004

Targeting drugs for delivery and release has the potential to increase the efficacy of treatment. A bifunctional linker, A‐Z‐CINNTM Linker was used to create a targeted prodrug, A‐Z‐CINN 310. A‐Z‐CINN Linker links to a potent chemotherapeutic agent, paclitaxel, via an energy‐reversible ester bond and also binds a targeting agent, the monoclonal antibody trastuzumab (Herceptin®). This study demonstrates the effectiveness of a single‐treatment use of A‐Z‐CINN 310 in decreasing tumor volume and tumor cell density of human HER‐2‐positive BT‐474 mammary tumor cells implanted in scid mice, compared to treatment with simultaneously administered trastuzumab and paclitaxel and with saline control. After treatment with A‐Z‐CINN 310, some mice received light exposure at 6 h for 5 min adjacent to the tumor to cause light‐accelerated release of paclitaxel. Changes in tumor volume were measured for 28 days following treatment; changes in histology were measured at 31 days. Animals treated with A‐Z‐CINN 310, then light, showed dose‐dependent decreases in tumor volume and tumor cell density which were more rapid and extensive than those seen with A‐Z‐CINN 310 without light or a 10‐fold higher concentration of co‐administered trastuzumab plus paclitaxel. This suggests that targeted delivery of paclitaxel using A‐Z‐CINN 310 kills tumor cells by localized release of paclitaxel at the tumor site, which can be accelerated by light treatment. These results indicate that a targeted prodrug therapy containing trastuzumab as the targeting agent and A‐Z‐CINN–paclitaxel as the prodrug results in a conjugate that is more effective in killing tumor cells than equivalent concentrations of co‐administered trastuzumab and paclitaxel. Targeting of a drug can reduce the dose needed for effective therapy and can increase local bioavailability. This makes targeted therapy using an A‐Z‐CINN prodrug delivery system feasible for treating both primary and metastatic tumors.
Managing empowerment and control in an intranet environment
Authors: Duane Aidan , Finnegan Pat
Published: December 2004

Abstract.An intranet increases in sophistication and complexity as it evolves. This evolution leads to an increasing need for control over the intranet. However, this is a contentious issue, as an intranet is deemed to be an empowering technology. Consequently, intranet control systems must balance empowerment and control so as not to negate each other. This paper investigates intranet control activities and their effect on users’ perceptions of empowerment throughout the evolution of an intranet in Hewlett Packard (Ireland). The growth of the intranet is charted as a six‐stage model that illustrates an evolution of purpose, control and empowerment. The control strategies for managing the intranet implemented at each stage are investigated, and their resultant effects on empowerment are evaluated. The study reveals the importance of balancing control strategies with empowerment initiatives in managing intranet environments. Based on the evidence available, the study recommends the implementation of specific controls at particular stages in the evolution of an intranet in order to achieve control systems that balance empowerment and control.
Chemosensory proteins of Locusta migratoria
Authors: Ban L. , Scaloni A. , Brandazza A. , Angeli S. , Zhang L. , Yan Y. , Pelosi Paolo
Published: December 2004

Two different classes of chemosensory proteins (CSPs) in Locusta migratoria have been identified on the basis of the molecular cloning of a series of different cDNAs from the antennae of this insect. Several CSP isoforms have been purified and biochemically characterized from antennal and wing extracts, some of them corresponding to expression products predicted for the identified cDNAs. In wings, the nature of the main endogenous ligand binding to these proteins was determined as oleoamide by a gas chromatography–mass spectrometric approach. One of these isoforms has been expressed in a bacterial system with high yield and used in a fluorescent binding assay. Competitive binding experiments have indicated the presence of long‐chain compounds among the best ligands.
Molecular cloning and expression of the dihydrofolate reductase (DHFR) gene from adult buffalo fly (Haematobia irritans exigua): effects of antifolates
Authors: Elvin C. M. , Liyou N. E. , Pearson R. , Kemp D. H. , Dixon N. E.
Published: December 2004

The folate analogues methotrexate, aminopterin and pyrimethamine were toxic when fed in a blood meal to adult buffalo flies (Haematobia irritans exigua), but aminopterin caused greater mortality than methotrexate, while trimethoprim was not toxic to adult flies. This is the first recorded instance of mortality in adult insects caused by ingestion of folate analogues. In order to investigate the mechanism of this toxicity, the dihydrofolate reductase (DHFR) gene was cloned from adult buffalo fly cDNA using a PCR‐based approach. The full‐length DHFR coding sequence (BF‐DHFR) was 887 bp and contained an open reading frame encoding a protein of 188 amino acids. The deduced protein sequence identities between BF‐DHFR and the other known insect DHFR sequences were: Drosophila melanogaster, 75%; Aedes albopictus, 54%; Heliothis virescens, 43%. The BF‐DHFR gene has a single 52 bp intron, an organization more similar to Dipteran species (Drosophila and Aedes). The cDNA encoding BF‐DHFR was inserted into an Escherichia coli expression vector and the recombinant protein was expressed to levels representing about 25% of total cell protein. The active enzyme was purified by affinity chromatography on methotrexate‐agarose and displayed a relatively low affinity (IC50 = 30 nm) for methotrexate.
The conservative approach to managing unerupted lower premolars – two case reports
Authors: Murray P. , Brown N. L.
Published: December 2004

Summary.General dental practitioners frequently refer patients with unerupted premolars for specialist management. The frequency of unerupted lower second premolars in 15‐year‐old children has been cited as high as 9·7%. Two cases are discussed involving unilateral unerupted premolars, which initially appear to be in unfavourable positions. The first patient was referred at 16 years of age and presented with an unerupted lower left first premolar positioned along the lower border of the mandible. The second patient presented with an unerupted distally inclined, horizontally positioned second premolar impacting on the roots of the first permanent molar. Both cases were reviewed without any treatment, and both premolars erupted into excellent positions. This raises important questions concerning the possible treatment options for such teeth as well as the timing of any interceptive treatment. In cases where premolars are unerupted or impacted, a multidisciplinary approach is indicated involving orthodontics, paedodontics and oral surgery to establish the optimal treatment plan.
Dental care of a child in pain – a comparison of treatment planning options offered by GDPs in California and the North‐west of England
Authors: Blinkhorn A. , Zadeh‐Kabir R.
Published: December 2004

Summary. Objective. To compare the treatment plans offered by general dental practitioners (GDPs) in the North‐west of England (UK) and California (USA) in dealing with a child in pain.

Methods. A cross‐sectional postal survey of a convenience sample of 135 UK and 170 USA GDP. These GDPs were asked to consider a case scenario of a 5‐year‐old child with pain from a lower first primary molar and to offer a treatment plan. The plan was to have three phases: immediate care, follow‐up care and longer term preventive strategy. The influence of cost on treatment plans was also recorded.

Results. Response rates for the GDPs were 117 (86·6%) from the UK and 139 (81·8%) from the USA. The major differences in immediate care were as follows: 98% of Americans would take a radiograph, 41% would consider extraction, 37% would place a space maintainer and 4% would use general anaesthesia to extract a tooth. Comparable proportions for the English dentists were 20%, 21%, 2% and 40%. Later clinical options also showed differences: 39% of UK dentists would extract all first primary molars compared to only 1% of Americans. Eighty‐eight per cent of USA dentists would place a nickel chrome crown compared to 4% of UK respondents. There were also differences in the longer term preventive measures. Greater proportions of American dentists would offer fluoride varnish (30%) and fluoride mouthrinse (37%). Comparable UK responses were 13% and 28%. Cost of care was only mentioned by 3% of UK dentists, whereas 70% of USA dentists mentioned cost as a factor in treatment planning.

Conclusion. There were marked differences in the treatment of a child in pain between general practitioners in the UK and the USA. Further investigations are required to elucidate the reasons for these differences.
The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic
Authors: Honkala E. , Behbehani J. , Ibricevic H. , Kerosuo E. , Al‐Jame G.
Published: December 2004

Summary. Objectives. The aims of this study are to assess the feasibility of the Atraumatic Restorative Treatment (ART) approach in primary teeth and to compare the ART approach with traditional amalgam restorations in primary molars.

Methods. This study was conducted in a paediatric dentistry clinic in Kuwait between April 1999 and December 2001. The ART and amalgam restorations were placed randomly on comparable pairs of primary molars, if available. In addition, the ART approach was used for other primary teeth that had no pulpal involvement and no perceived pain before treatment. The restorations were assessed by both the ART evaluation criteria and USPHS criteria in August–September 2000 and in August–December 2001. The mean follow‐up period for the restorations was 8·3 months in the first assessment (2000) and 22 months in the second assessment (2001). The assessment was possible for 35 children (mean age = 5·7 years), 18 of whom had comparable pairs (n = 35 pairs) of restorations in their primary molars. In addition, 48 other ART restorations were assessed in 2000 and 42 in 2001.

Results.

In a 2‐year follow‐up, 89·6% of all ART restorations were considered successful. The failure rate of the comparable pairs of ART and amalgam restorations was 5·7%. There was no significant difference in success rate between ART and amalgam techniques.

Conclusions. Based on a 2‐year follow‐up evaluation, the class I ART restorations seemed to have a high success rate, indicating the appropriateness of the ART approach in primary teeth.
Abstracts from other journals
Authors: Fleming Paddy
Published: December 2004

Abstracts are presented as originally published or with only minor modifications
Occlusion and tooth/arch dimensions in the primary dentition of preschool Jordanian children
Authors: Abu Alhaija E. S. J. , Qudeimat M. A.
Published: December 2004

Summary. Objectives. To assess tooth and arch dimensions, occlusal relationships and the presence of spacing or crowding in primary dentition of Jordanian children.

Study design. A list of 10 kindergartens was randomly selected in the governate of Irbid, Jordan. A total of 1048 children (2·5–6 years old) with complete primary dentitions were examined for occlusal relationships in three planes, and the presence of spacing or crowding. Of those, study casts were taken for 87 randomly selected 4–5‐year‐old children (39 girls, 48 boys). Measurements of tooth and arch dimensions were made using electronic digital sliding callipers.

Results. In general, males had larger mesiodistal tooth width and larger arch dimensions. Bilateral mesial step molar relationship was found in 47·7% of children followed by bilateral flush terminal molar relationship in 37% and bilateral distal step in 3·7%. Asymmetric right/left molar relationship was found in 11·6% of children examined. Class I canine relationship was found in 57% of children, followed by Class II canines in 29% and Class III canines in 3·7%. Fifty per cent of children examined had Class I incisors, 24·7% had Class II Division 1, 13·5% had Class II Division 2 and 11·8% showed reversed overjet. Ideal overbite was seen in 44·3% of children, reduced overbite in 21·8%, increased overbite in 28·2% and 5·7% had anterior openbite. Buccal crossbite was seen in 7% of the sample. Generalized spacing was found in 61·8% and 61·1% of children in the upper and lower arches, respectively. Anthropoid spaces were found in 70% of the upper arches and in 51% of the lower arches.

Conclusions. Males had larger tooth/arch dimension than that of females in the primary dentition stage. Mesial step molar relationship was found in 47·7% of the subjects followed by flush terminal molar relationship in 37%. The majority of children examined had spaced primary dentition.
Increased primary tooth size in a 47,XXY male: a first case report
Authors: Hunter M. L. , Collard M. M. , Razavi T. , Hunter B.
Published: December 2004

Summary.Increased tooth size has previously been reported in association with Klinefelter syndrome. However, until now, this observation has been restricted to the permanent dentition. In this paper, we report increased mesio‐distal width in the primary incisor and molar teeth of a 47,XXY male.
Assessment of quality of life with the Nottingham Health Profile among patients with coronary heart disease
Authors: Lukkarinen Hannele , Hentinen Maija
Published: December 2004

The aim was to describe the quality of life of people suffering from coronary artery disease. The patients had been treated with medication (n=80), percutaneous transluminal coronary angioplasty (n=100) and coronary artery bypass surgery (n=100). Of the 280 patients, 189 were men and 91 women. The patients who participated in this study were seriously ill, as nearly half of them had three or more stenosed coronary arteries. Male patients were most numerous in the bypass surgery group and female patients in the angioplasty group. The quality of life was evaluated using the Nottingham Health Profile (NHP) instrument relation to an age‐and sex‐matched general population, the background factors and the severity of the coronary disease. The NHP questionnaire consists of 38 statements on health problems, making up six dimensions of subjective health: physical mobility, pain, sleep, energy, emotional reactions and social isolation. The health‐related quality of life of coronary patients before the invasive procedures was significantly poorer on all the six dimensions than the quality of life in an age‐and sex‐matched general population. The most obvious differences were seen on the following dimensions: energy, pain, emotional reactions, sleep and physical mobility. The smallest differences occurred in social isolation. Both males and females had the lowest value for energy and social isolation in the youngest age group (35–54 years). The index values of emotional reactions in the two youngest groups were significantly higher among females than males, which reflects poor quality of life. The women in the age group of 35–54 years found the manifestation of a serious disease extremely hard to face. Our findings clearly suggest that while choosing the mode of treatment, the patient's quality of life should be considered along with the clinical severity of the disease, especially in the case of young women. From the societal and social points of view, the patient's symptoms and quality of life are even more important than the objective medical outcome. In clinical decision‐making, the goal is to integrate the results of health‐related quality of life assessments with clinical decisions, and this underlines the need to evaluate whether the treatment given is congruent with the patient's quality of life. On the basis of the present findings, the NHP instrument seems to be applicable to quality of life measurements among coronary patients. It does not, however, necessarily give an accurate and profound view of an individual's overall quality of life.
The problem of arriving at a phenomenological description of memory loss
Authors: Moyle Wendy , Clinton Michael
Published: December 2004

This paper discusses a methodological difficulty that arose when uncovering the conscious experience of being nurtured as an in‐patient with depression on a psychiatric ward. It considers the problem of arriving at a phenomenological description of memory loss in a patient who had undergone electroconvulsive therapy (ECT). The paper begins by describing the prevalence of depression and its significance for nurses working in in‐patient settings. Examples of empirical research into memory loss in depression are used to show what researchers must set aside if they are to arrive at a phenomenological description of memory loss. The choice of a phenomenological approach to the wider study from which the methodological problem discussed here arose is then justified. The phenomena of memory is introduced to show the methodological significance of attempting to arrive at a phenomenological description of the statement made by one of the participants, a woman being treated as an in‐patient for major depression. A possible description of the phenomena of memory loss based on the existential phenomenology of Sartre is offered to call into question the ability of researchers to bracket their assumptions. The significance for nurses of the wider study from which our example is taken is then described. Finally it is argued that despite the methodological difficulty described, a phenomenological perspective based on the philosophy of Husserl can point nurses in the direction of meeting the human needs of their patients.
Adherence: a matter of self‐efficacy and power
Authors: Buchmann Werner F.
Published: December 2004

This paper examines the relationship between self‐efficacy and social power (expert and referent) and how the application of this relationship, leads to client adherence and compliance. Referent power is defined, including methods that health care professionals may use to develop and apply referent power. Expert power is defined and addressed in the context of referent power, self‐esteem and self‐efficacy as a means of promoting adherence. Self‐efficacy as a concept is defined and explored in the context of social power. The relationships between self‐efficacy and social power (expert and referent) are shown as important determinants of adherence and compliance. The theory of the application of referent and expert power in relationship with self‐efficacy has been compared with an effective programme, yielding high compliance, at Western Psychiatric Institute and Clinic, showing the theory's relevance and applicability in determining compliance. Explored are the reasons for non‐compliance in the elderly population and how the theory model can remedy these detriments for compliance. The empowerment of elderly patients through the application of this theory to medication compliance is examined. The determination of adherence and compliance is shown by the application of the relationship between self‐efficacy and both expert and referent power.
What should nurse teachers be doing? A preliminary study
Authors: Cahill Heather A.
Published: December 2004

There is little doubt that the role of the nurse teacher is complex and multifaceted in nature. The apparently conflicting demands of NHS trusts and education in the United Kingdom, at the time of integration of nurse education into the higher education sector, further complicates the role. This recognition underlines the need to capture and measure key aspects of nurse teacher function in order to maximize educational gain. Using a comprehensive literature review, focus group discussions and a small number of individual semi‐structured interviews, this preliminary study explored the issue of teacher workload, from the perspective of the principal stakeholders in nurse and higher education. Competing research and clinical practice objectives for nurse teachers are identified against a background of changing health care provision, reduced availability of placements and an increased need for evidence‐based practice.
Defining quality student feedback in distance learning
Authors: Price Bob
Published: December 2004

The quality of student feedback is of critical importance in distance learning. Students studying such courses may be geographically far removed from tutors, and limited contact opportunities necessitate a sharp and accurate focus upon aspects of study which link theory, research, clinical practice and written assessment closely together. An understanding of quality feedback begins with an appreciation of the role of distance learning course tutors and the education models which can usefully guide them. Quality also relies upon a close evaluation of support to students as courses are planned, launched and then monitored through course boards or their equivalent.
Heuristics, servants to intuition, in clinical decision‐making
Authors: Cioffi Jane
Published: December 2004

This paper explores intuitive judgements of nurses in clinical decision‐making situations. The qualities of intuition are presented from both theoretical and practical perspectives and attitudes towards intuition from both nurses themselves and other health professionals are identified. An heuristic framework from cognitive psychology is applied to intuitive aspects of the clinical judgements that nurses have made. This interpretation is proposed as a partial explanation of intuition, and its use in advancing the understanding of intuition is recommended.
The salience of the body: transition in sexual self‐identity for women living with multiple sclerosis
Authors: Kralik Debbie , Koch Tina , Eastwood Sue
Published: December 2004

Aim. The purpose of this paper is to outline understandings about the construction of sexuality and the impact of a changing body for women living with multiple sclerosis (MS). We suggest that the process of transition towards incorporating the experience of chronic illness into one's life is influenced by the (re)construction of self‐identity.

Design and methods. A participatory action process guided the research. The women joined the authors for five group sessions that totalled 15 hours of contact time. In addition, we offered women the opportunity for one‐to‐one interviews at home. Nine women volunteered to participate. This allowed us to gain additional in‐depth data about individual experiences. The interpretive framework was guided by the self‐identity literature. When reading the transcripts we questioned: What is going on here? What does this say about the construction of self? What does this say about the construction of identity? What influence does the body have in the construction of self‐identity? Analysis was collaborative (with the women) and the resultant emerging construction of sexuality is shared in this paper. Data generated during one‐to‐one interviews are privileged and we include two accounts from women who live with MS. The women's stories focus on sexuality, however, within this sexual context, we observed shifts in self‐identity which we contend may shape the illness transition experience.

Findings. The rationale for privileging only two accounts is to expand understanding of Ordinariness and Extraordinariness with particular focus on the salience of the body in the ‘sexual’ lives of the women. Self‐identity was shaped by how they felt about themselves as sexual beings, how they experienced their body, how they felt about sexual activities and by the way others reacted to them. Importantly, we view the women's sense of self, identity and the relationship to the body and find that shifts in self identity shape the woman's transition towards Ordinariness.

Conclusions. This exploration of illness experiences is a reminder that our bodies are vehicles for our sense of self and identity. Cultural, educational, social, religious and family contexts all impact on women's capacity to shape the consequences of illness and the choices available to them. Facilitating women towards an awareness of the choices available in order to sustain or reclaim self may in turn expedite transition towards Ordinariness so that illness may become a part of their life.
A training programme for prevention of occupational exposure to bloodborne pathogens: impact on knowledge, behaviour and incidence of needle stick injuries among student nurses in Changsha, People's Republic of China
Authors: Wang Honghong , Fennie Kristopher , He Guoping , Burgess Jane , Williams Ann B.
Published: December 2004

Background.  Although the human immunodeficiency virus (HIV) epidemic in China is expanding rapidly, the principles of universal precautions (UP) are not widely disseminated in Chinese hospitals. Lack of training about occupational prevention of bloodborne pathogens (BBP) may place student nurses at risk when they are in clinical practice.

Aim.  To examine the impact of structured training on prevention of occupational exposure to BBP on knowledge, behaviour, and incidence of medical sharp injuries among student nurses in Changsha, China.

Methods.  A quasi‐experimental study evaluated changes in knowledge, self‐reported UP behaviours, observed adherence to UP, and needle stick/sharp injuries during a 4‐month follow‐up period. The study population consisted of 106 student nurses in two classes. One class served as the experimental group, while the other served as a control group. Students in the experimental group participated in a structured training intervention consisting of lectures and demonstrations.

Results.
 At 4 months, the group that received the BBP training scored significantly higher than the standard education group on both knowledge (
P
 < 0·001) and behaviour (
P
 = 0·002). Although students in the experimental group were not observed to practise UP significantly more frequently than those in the control group, they were less likely to experience needle stick/sharp injuries (OR = 0·29; 95% CI 0·11, 0·74;
P  = 0·004).

Conclusion.  Structured training in prevention of occupational exposure to BBP improved knowledge and behaviour and reduced the number of needle stick/sharp injuries among Chinese student nurses, compared with students who did not receive the training. Training in the techniques of UP could play a role in reducing the risk for occupational exposure to BBP among Chinese future nurses. In view of the accelerating HIV epidemic, implementation and evaluation of such training programmes are urgently needed.
Cognitive interviewing: verbal data in the design and pretesting of questionnaires
Authors: Drennan Jonathan
Published: December 2004

Purpose. The purpose of this paper is to discuss problems that occur in questionnaire responses and how cognitive interviewing can be used to identify problematic questions prior to using the questionnaire in the field.

Background. Questionnaire design involves developing wording that is clear, unambiguous and permits respondents successfully to answer the question that is asked. However, a number of problems in relation to respondents' understanding and successfully completing questionnaires have been identified. Cognitive interviewing, an amalgamation of cognitive psychology and survey methodology, has been developed to identify problematic questions that may elicit response error. The overall aim is to use cognitive theory to understand how respondents perceive and interpret questions and to identify potential problems that may arise in prospective survey questionnaires.

Methods. A literature review is used to examine the process of questionnaire design and how cognitive interviewing can be used to reduce sampling error and increase questionnaire response rates.

Findings. Cognitive interviewing involves interviewers asking survey respondents to think out loud as they go through a survey questionnaire and tell them everything they are thinking. This allows understanding of the questionnaire from the respondents' perspective rather than that of the researchers. Cognitive interviews have been used in a number of areas in health care research to pretest and validate questionnaires and to ensure high response rates. Interviewing has been found to be highly effective in developing questionnaires for age specific groups (children and adolescents) and in ascertaining respondents' understanding in health surveys prior to distribution. However, cognitive interviews have been criticized for being overly subjective and artificial.

Conclusion: Cognitive interviews are a positive addition to current methods of pretesting questionnaires prior to distribution to the sample. They are most valuable in pretesting questions that are complex, where questions are sensitive and intrusive and for specific groups for whom questionnaire completion may pose particular difficulties.