bluuebunny/crossref_metadata_2025 huggingface dataset:
Histogenesis of congenital and acquired melanocytic nevi based on histological study of lesion size and thickness
Authors: TOKUDA Yasutaka , SAIDA Toshiaki , MURATA Hiroshi , MURASE Sumio , OOHARA Kuniaki
Published: August 2010

The histogenesis of melanocytic nevi is poorly understood. It is important to determine the differences and similarities in histogenesis between congenital and acquired nevi. To clarify the histogenic differences between acquired melanocytic nevi (AMN) and congenital melanocytic nevi (CMN), diameter and depth of nevus cells (tumor thickness) were examined in histological specimens from 80 cases of CMN and 71 cases of AMN, and these nevi were classified according to Mark’s pathological CMN criteria. In all cases, giant CMN nevus cells were found in the lower marginal portion of excised specimens. The mean diameter and lesional thickness were significantly higher in CMN than in AMN. AMN diameter showed a significant correlation (r = 0.567, P < 0.05) with lesional thickness, while no such relation was observed in CMN. In addition, a significant correlation between lesion diameter and thickness was observed in small (<10 mm) non‐Mark’s type CMN (r = 0.626, P < 0.05). CMN may be classified into three subtypes: (i) caused by increased proliferation of melanoblasts during the course of migration from the neural crest to the epidermis; (ii) proliferation of nevus cells after arrival at the epidermis, and nevus cell distribution affected by adnexa and dermal differentiation; and (iii) arising after completion of skin development before birth.
Anticipatory nausea among ambulatory cancer patients undergoing chemotherapy: Prevalence, associated factors, and impact on quality of life
Authors: Akechi Tatsuo , Okuyama Toru , Endo Chiharu , Sagawa Ryuichi , Uchida Megumi , Nakaguchi Tomohiro , Sakamoto Masaki , Komatsu Hirokazu , Ueda Ryuzo , Wada Makoto , Furukawa Toshiaki A.
Published: August 2010

The purposes of this study were to investigate the prevalence of anticipatory nausea (AN), its associated factors, and its impact on quality of life (QOL) among ambulatory cancer patients receiving chemotherapy. Patients were randomly selected to participate in this study, and were asked to complete the Morrow Assessment of Nausea and Emesis scale, the Hospital Anxiety and Depression Scale, the Short‐form Supportive Care Needs Survey questionnaire, and the European Organization for Research and Treatment of Cancer QLQ‐C30 questionnaire. Complete data were available for 214 patients. A total of 10.3% of the patients experienced very mild to severe AN. The presence of AN was significantly associated with most domains of the investigated patients’ outcome, including psychological distress and perceived needs, with the exception of the health system and information domain of patients’ needs, and the physical functioning domain of QOL. Anticipatory nausea was also associated with QOL even after adjustments for age, sex, performance status, and psychological distress. The prevalence of AN in ambulatory cancer patients who receive chemotherapy may not be as high as previously reported. However, given its potentially significant impact on relevant outcome, including QOL, AN should not be neglected in current clinical oncology practice. (Cancer Sci 2010; 101: 2596–2660)
Changes in smoking prevalence in 16–17‐year‐old versus older adults following a rise in legal age of sale: findings from an English population study
Authors: Fidler Jennifer A. , West Robert
Published: August 2010

Aim  To assess smoking prevalence before and after the rise in legal age of sale of cigarettes in England and Wales from age 16 to age 18 in October 2007.

Design  A series of monthly cross‐sectional household surveys: the ‘Smoking Toolkit Study’.

Setting  England.

Participants  A total of 53 322 adults aged 16 and over interviewed between October 2006 and May 2009, 1136 of whom were aged 16 or 17 years.

Measurements  Change in smoking prevalence from pre‐ to post‐legislation, assessed by self‐reported smoking status, among the 16–17‐year‐old group and older adults.

Findings  The prevalence change following the legislation among those aged 16 and 17 was 7.1 percentage points (denominator = 1136) compared with 2.4 percentage points (denominator = 52 186) for older adults (odds ratio 1.36, P = 0.024, 95% confidence interval = 1.04–1.77 for the interaction). There was no difference within older age categories.

Conclusions  There was a greater fall in prevalence in 16–17‐year‐olds following an increase in age of sale than in older age groups. This provides some support to the view that raising the age of sale can, at least in some circumstances, reduce smoking prevalence in younger age groups.
Meta‐analysis: ribavirin plus interferon vs. interferon monotherapy for chronic hepatitic C – an updated Cochrane review
Authors: Brok J. , Gluud L.‐L. , Gluud C.
Published: August 2010

Aliment Pharmacol Ther 2010; 32: 840–850

Background  Multiple randomized trials have been published on antiviral treatment for chronic hepatitis C.

Aim  To meta‐analyse the effect of adding ribavirin to interferon for chronic hepatitis C.

Methods  The results of randomized trials were combined in cumulative meta‐analyses. Trial sequential analyses were used to adjust for spurious results because of random errors and multiplicity. The outcome measures were undetectable hepatitis C virus RNA in serum (sustained virological response) and liver‐related morbidity plus all‐cause mortality.

Results  We included 82 randomized trials with 12 615 patients. Trial sequential analysis established clear beneficial effect of interferon plus ribavirin vs. interferon on the sustained virological response in 1998 after nine trials (RR: 0.74; 95% CI: 0.64–0.85, P < 0.0001, 1734 patients). Subsequently, additional 73 trials were published just narrowing the confidence interval and decreasing the P‐value. By contrast, trial sequential analysis found that additional evidence is needed to convincingly detect a beneficial effect of interferon plus ribavirin vs. interferon monotherapy on clinical outcomes.

Conclusions  The rationale behind several recent trials on adding ribavirin to interferon for chronic hepatitis C is debatable as the effect on virological response is established. More evidence is needed to assess if adding ribavirin to interferon improves clinical outcomes.
Cells with hematopoietic activity in the mouse placenta reside in side population
Authors: Ramadan Ahmed , Nobuhisa Ikuo , Yamasaki Shoutarou , Nakagata Naomi , Taga Tetsuya
Published: August 2010

The discovery of a major hematopoietic stem cell pool in midgestation mouse embryo has defined the placenta as an important hematopoietic anatomical site. In this study, we examined the flow cytometric pattern of mouse placenta cells on embryonic days (E) 10.5 to E15.5, in view of CD45 and c‐Kit expression. We also determined which population of these cells shows differentiation potential toward multiple hematopoietic lineages by performing coculture with OP9 stromal cells and colony‐forming assay in methylcellulose. Only CD45+c‐Kit+ population showed the ability to form hematopoietic colonies including multiple lineages. To distinguish which fraction of placenta cells have the hematopoietic activity, we used GFP transgenic mice in which the fetal part of the placenta is GFP positive and the maternal part is GFP negative. E11.5 and E13.5 CD45+c‐Kit+ placental cells that have ability to form hematopoietic colonies are the fetal GFP positive placental cells. E11.5 and E13.5 CD45+c‐Kit+ placental cells that have an ability to form hematopoietic colonies mainly reside in Hoechst dye‐effluxing side population area (SP). Taken together, in the placenta of mouse embryo, we conclude that SP cells in the CD45+c‐Kit+ fetal placental cells have the ability to form hematopoietic colonies.
Thomsen's parameters from p‐wave measurements in a spherical sample‡
Authors: Bóna Andrej , Nadri Dariush , Brajanovski Miroslav
Published: August 2010

The aim of this paper is to understand the seismic anisotropy of the overburden shale in an oilfield in the North West Shelf of Western Australia. To this end, we first find the orientation of the symmetry axis of a spherical shale sample from measurements of ultrasonic P‐wave velocities in 132 directions at the reservoir pressure. After transforming the data to the symmetry axis coordinates, we find Thomsen's anisotropy parameters δ and ɛ using these measurements and measurements of the shear‐wave velocity along the symmetry axis from a well log. To find these anisotropy parameters, we use a very fast simulated re‐annealing algorithm with an objective function that contains only the measured ray velocities, their numerical derivatives and the unknown elasticity parameters. The results show strong elliptical anisotropy in the overburden shale. This approach produces smaller uncertainty of Thomsen parameter δ than more direct approaches.
Brining kinetics of different cuts of anchovy (Engraulis anchoita)
Authors: Czerner Marina , Yeannes María I.
Published: August 2010

Brining is a preliminary operation in the process of salting–ripening anchovy in which, conventionally, whole fish is immersed in saturated brine (osmotic solution) until equilibrium. The aim of this work was to study the mass transfer kinetics in three different cuts of anchovy (whole fish, gutted fish and fillet) and to model it using the Zugarramurdi and Lupín and the Peleg equations. Fillet reached equilibrium after 5 h, gutted fish after 10.42 h and whole fish after 19.75 h. Equilibrium constants were 1.054, 0.706 and 0.603 for fillet, gutted fish and whole anchovy, respectively. These results indicate that the presence of skin affects both the initial rate of mass transfer and the equilibrium water and salt content. The Peleg model was more suitable to describe the salt gain kinetics, and the Zugarramurdi and Lupín model results in a more accurate prediction of water loss and equilibrium conditions.
‘Mutual intacting’: a grounded theory study of clinical judgement practice issues
Authors: Elliott Naomi
Published: August 2010

elliott n. (2010) ‘Mutual intacting’: a grounded theory study of clinical judgement practice issues. Journal of Advanced Nursing 66(12), 2711–2721.

Aim.  This paper reports a study conducted to explore how nurses working at advanced practice level in chronic and acute care outpatient contexts responded to decision‐making concerns in clinical practice.

Background.  Current theoretical explanations of clinical judgement offer insight into how healthcare professionals process information; however, they are incomplete as they do not consider psychosocial issues. Research evidence informing clinical judgement practice is based largely on acute care hospital settings. Consequently, little is known about how practitioners make clinical judgements in outpatient contexts where patients can participate in their own care.

Method.  A grounded theory approach was used to analyse interview data about clinical judgements made in actual clinical practice. Twenty‐one nurses working at advanced practice level in mental healthcare clinics and accident and emergency in the Republic of Ireland were recruited. Concurrent data collection and analysis, constant comparative analysis and theoretical sampling were conducted in 2002–2005.

Findings.  The core category to emerge from the data was ‘mutual intacting’. This refers to the main strategies that practitioners used to resolve concerns about eliciting patient information and selecting treatments that were acceptable to patients. It highlights the clinical judgement practices that practitioners find useful to engage patients to facilitate effective decision‐making.

Conclusion.  Practitioners could draw from the various strategies identified in this research to develop their clinical judgement practice further in ways that include the development of an effective relationship with their patients. Negotiation and compromise are particularly useful strategies that should be used to facilitate effective treatment delivery that takes account of patients’ circumstances.
Family caregivers’ needs predict functional recovery of older care recipients after hip fracture
Authors: Shyu Yea‐Ing Lotus , Chen Min‐Chi , Wu Chi‐Chuan , Cheng Huey‐Shinn
Published: August 2010

shyu y.‐i.l., chen m.‐c., wu c.‐c. & cheng h.‐s. (2010) Family caregivers’ needs predict functional recovery of older care recipients after hip fracture. Journal of Advanced Nursing 66(11), 2450–2459.

Aim.  This paper is a report of a study of the effect of family caregivers’ needs on the functional recovery of elders with a hip fracture during the first 6 months after discharge.

Background.  Family members are closely involved in the postdischarge care of older Chinese patients. However, the influence of family caregiving‐related variables, such as caregiver’s needs, on recovery after hip fracture has not been explored.

Methods.  Data were collected between 2002 and 2005 with elders with hip fracture and their family caregivers at a medical centre in Taiwan. Data were collected at 1, 3 and 6 months after discharge, and 120 people completed all follow‐ups. The effect of caregiver needs on elders’ recovery was analysed using the generalized estimating equations approach.

Findings.  Elders whose caregivers reported a need for information on caregiving and related health care were more likely (odds ratio = 1·93, confidence interval = 1·08–3·46) to recover their walking ability than those whose caregivers did not report such need. However, elders whose caregivers reported a need for social services were less likely to recover their walking ability (odds ratio = 0·38, confidence interval = 0·18–0·78), and activities of daily living (odds ratio = 0·40, confidence interval = 0·17–0·94) than those whose caregivers did not report such need.

Conclusion.  Healthcare providers should include caregivers’ needs in their clinical assessment of Chinese elders after surgery for hip fracture. Given the rapidly increasing population of Asian elders in Western countries, the results of this study may be applicable to other countries with Chinese populations.
The novice objective structured clinical evaluation tool: psychometric testing
Authors: Walsh Mireille , Bailey Patricia Hill , Mossey Sharolyn , Koren Irene
Published: August 2010

walsh m., bailey p.h., mossey s. & koren i. (2010) The novice objective structured clinical evaluation tool: psychometric testing. Journal of Advanced Nursing 66(12), 2807–2818.

Aim.  This paper is a report of a study of the psychometric properties of the Novice Objective Structured Clinical Evaluation Tool.

Background.  A collaborative undergraduate nursing programme is currently using an objective structured clinical evaluation at the conclusion of the first nursing clinical course to determine student competence as a component of quality and safety education. However, the reliability and validity of the assessment tool has not been established.

Methods.  Psychometric testing was conducted with a convenience sample of 565 nursing students. Data were collected during three consecutive years from 2002 to 2004. Exploratory factor analysis and reliability testing were conducted on this 25‐item tool.

Results.  Principal axis factoring method identified two factors through the orthogonal, oblimin and promax rotations: Factor 1 Safety and Factor 2, Anticipation. Spearman‐Brown’s result for Factor 1 was 0·93 and for Factor 2 was 0·77. Cronbach’s alpha was.94 for Factor 1 and 0·71 for Factor 2.

Conclusion.  The tool was found to have adequate construct validity and reliability. Its stability should be tested by conducting test–retest analysis. Equivalency dimensions of reliability should be evaluated by looking at interrater reliability. This tool shows merit for assessing elements of quality and safety education.
Combining ground count, telemetry, and mark–resight data to infer population dynamics in an endangered species
Authors: Johnson Heather E. , Scott Mills L. , Wehausen John D. , Stephenson Thomas R.
Published: August 2010

1. To successfully manipulate populations for management and conservation purposes, managers must be able to track changes in demographic rates and determine the factors driving spatial and temporal variation in those rates. For populations of management concern, however, data deficiencies frequently limit the use of traditional statistical methods for such analyses. Long‐term demographic data are often piecemeal, having small sample sizes, inconsistent methodologies, intermittent data, and information on only a subset of important parameters and covariates.

2. We evaluated the effectiveness of Bayesian state‐space models for meeting these data limitations in elucidating dynamics of federally endangered Sierra Nevada bighorn sheepOvis canadensis sierrae. We combined ground count, telemetry, and mark–resight data to: (1) estimate demographic parameters in three populations (including stage‐specific abundances and vital rates); and (2) determine whether density, summer precipitation, or winter severity were driving variation in key demographic rates.

3. Models combining all existing data types increased the precision and accuracy in parameter estimates and fit covariates to vital rates driving population performance. They also provided estimates for all years of interest (including years in which field data were not collected) and standardized the error structure across data types.

4. Demographic rates indicated that recovery efforts should focus on increasing adult and yearling survival in the smallest bighorn sheep population. In evaluating covariates we found evidence of negative density dependence in the larger herds, but a trend of positive density dependence in the smallest herd suggesting that an augmentation may be needed to boost performance. We also found that vital rates in all populations were positively associated with summer precipitation, but that winter severity only had a negative effect on the smallest herd, the herd most strongly impacted by environmental stochasticity.

5. Synthesis and applications. For populations with piecemeal data, a problem common to both endangered and harvested species, obtaining precise demographic parameter estimates is one of the greatest challenges in detecting population trends, diagnosing the causes of decline, and directing management. Data on Sierra Nevada bighorn sheep provide an example of the application of Bayesian state‐space models for combining all existing data to meet these objectives and better inform important management and conservation decisions.
Post‐glacial patterns in vegetation dynamics in Romania: homogenization or differentiation?
Authors: Feurdean Angelica , Willis Katherine J. , Parr Catherine L. , Tanţău Ioan , Fărcaş Sorina
Published: August 2010

Aim  This paper examines eight fossil pollen datasets from Romania with the aim of exploring regional and elevational patterns in site similarity throughout the Holocene. In particular, we aim to determine whether there are clear intervals of homogenization/differentiation and to ascertain the potential driving factors.

Location  Romania.

Methods  Qualitative (pollen diagrams) and numerical methods including principal components analysis and Bray–Curtis similarity analyses were used.

Results  We found strong variability in the past vegetation dynamics during the Holocene. Bray–Curtis similarity analyses show large fluctuations in vegetation similarity and distinct periods of homogenization and differentiation throughout the Holocene. The magnitude and length of these periods appear quite variable in time, but the significant ones can be delimited as follows: (1) differentiation between 11,250 and 11,000 cal. yr bp, 10,000 and 9750 cal. yr bp, 6000 and 5750 cal. yr bp, 2500 and 2250 cal. yr bp, and especially over the last 200 years; and (2) homogenization between 9750 and 9500 cal. yr bp, and 2750 and 2500 cal. yr bp, with more stable periods between 9000 and 7750 cal. yr bp, 4750 and 3500 cal. yr bp, and 2000 and 1000 cal. yr bp.

Main conclusions  First, periods of biotic homogenization that occurred before significant anthropogenic impact on vegetation demonstrate that not all homogenization is a product of anthropogenic change: it can also be driven by natural causes. In fact, recent human impact (over the last 200 years) appears to have resulted in increased regional differentiation and not in homogenization – a result that contradicts most studies based on more modern, short‐term records. Second, both abiotic (climate and disturbance) and biotic factors are likely drivers of intervals of differentiation and homogenization. We suggest that differentiation may be triggered primarily by climate changes and disturbances (mostly natural pre‐2500 cal. yr bp and human‐induced thereafter), whereas homogenization may be driven predominantly by biotic interactions (e.g. immigration and interspecific competition). Third, this long‐term study raises awareness that assessments of pattern in vegetation homogenization/differentiation may depend on the specific time period and length of investigation. Long‐term investigations through multiple generations are likely to yield particularly useful information on the mechanisms and effects of biotic homogenization.
The development of clinical leadership through supported reflective practice
Authors: McCORMACK BRENDAN , HOPKINS EILEEN
Published: August 2010

The notion of clinical leadership is significant in current nursing practice, particularly since recommendations made by the Department of Health in ‘The Strategy for Nursing’. However, while it is a concept that many nurses aspire to implement, in reality the operationalizing of such a concept is fraught with difficulty.

This paper aims to explore the issue of clinical leadership through a collegiate model developed in a particular practice area.

The development of this collegiate relationship is articulated through the mediums of reflective practice and clinical supervision.

A model of collegiality is offered as an approach to the integration of the spheres of clinical leadership.

If reflective practice is to be a reality then it is essential that both clinical leaders and practitioners engage in such processes within a supportive culture.
Gynopia in nursing practice: the case of urethral catheterization
Authors: MACKENZIE JENNIFER , WEBB CHRISTINE
Published: August 2010

A pilot study of catheterized women was designed to investigate their perceptions of pain and discomfort during the procedure.

The study aimed to test the feasibility of conducting a larger randomized controlled trial.

Problems were encountered during the execution of the study, due to the need to conform to established principles in clinical research.

Restrictions on access to patients impinged upon the opportunity to ‘cast the net wide’ in order to generate meaningful data.
A model for research‐based practice
Authors: BURROWS DEE E. , MCLEISH KERRY
Published: August 2010

Nursing practice is based on experience, tradition, intuition, common sense, untested theory and sometimes research.

There are a number of reasons why nurses may see research as irrelevant to their practice.

This paper provides a model identifying possible strategies to help nurses develop research‐based practice.
The effect of a clinical nurse specialist in gynaecological oncology on quality of life and sexuality
Authors: Maughan K. , Clarke C.
Published: August 2010

• Gynaecological malignancy has an immense impact on the well‐being of women. For many women, however, treatment such as surgery is curative and healthcare intervention focuses on the physiological status of the women.

• The psychological, social and sexual consequences of the malignancy and its treatment have received little attention in research or in practice.

• The present study used a mixed quantitative and qualitative design to analyse a specialist nurse intervention (including psychosexual intervention), and to explain the impact of the illness on women's lives.

• The qualitative arm of the study collected interview data from 20 women and six partners. The randomized controlled trial sample consisted of 36 women, with data collected using a quality of life measure (the EORTC QLQ‐C30) and the Lasry Sexual Functioning scale.

• This paper focuses on the randomized controlled trial data, which identified that sexual functioning and quality of life were improved in the active group who received specialist psychosexual counselling.

• However, the validity of the sexual functioning scale is challenged by the qualitative results of the study, which emphasize the social meaning of sexuality.
Patients’ and practice nurses’ perceptions of secondary preventive care for established ischaemic heart disease: a qualitative study
Authors: Wright F. L. , Wiles R. A. , Moher M.
Published: August 2010

• A significant proportion of patients with established ischaemic heart disease remain unrecognized in general practice and those who are receiving treatment are experiencing sub‐optimal care.

• The provision of coronary prevention by practice nurses may be an important strategy to improve the quality of this care, and this is feasible and effective.

• This study explored what occurred during patients’ initial assessment for secondary prevention of ischaemic heart disease with a practice nurse and investigated patients’ and practice nurses’ views of nurse‐led clinics in primary care.

• Nurses were effective in history taking and offering reassurance and dietary advice, yet were less confident in discussing patients’ understandings of heart disease and related medication.

• Practice nurse‐led coronary preventive care is acceptable to both nurses and patients.

• Further practice nurse education is required in heart disease, cardiac medications and skills necessary for exploring and challenging patients’ understandings of these issues.
Family involvement in perioperative nursing of adult patients undergoing emergency surgery
Authors: Paavilainen Eija , Seppänen Sinikka , Åstedt‐Kurki Päivi
Published: August 2010

• The purpose of this study was to describe how adult patients undergoing emergency surgery experience family centredness in perioperative nursing practice. The central aim was to generate knowledge to be used while developing the practice, education and management of perioperative nursing.

• Data were collected using a questionnaire with emergency surgical patients in five regional hospitals in Southern Finland. The number of distributed questionnaires was 132. The response rate was 85% (n=112).

• The results were mainly described as frequencies and percentages. The open‐ended sections of the answers were analysed using qualitative content analysis. The findings from the open‐ended questions were used for deepening and complementing the quantitative description of the results.

• In the preoperative phase, ascertaining the family situation and informing the family member chosen by the patient were not achieved systematically. Family situation was also rarely examined in the intraoperative and postoperative phases, although it is central to coping after surgery, especially in home care.

• The results support the view of earlier research about the importance of individuality of patients and their families during the perioperative care process and hence enhance the endeavour to develop nursing based on families’ real needs.
Supporting students in practice
Authors: Williamson Graham R. , Webb Christine
Published: August 2010

• This article reports a project aiming to assess the effectiveness of clinical nurses employed in support roles for students in clinical practice in one UK higher education institution and its linked NHS Trusts.

• Focus groups and telephone interviews were used to collect data from the clinical support nurses themselves, senior nurse managers and pre‐ and post‐registration students.

• Findings show that personal commitment to the role was high and that these support staff made a valuable contribution to up‐to‐date clinical input into classroom teaching.

• Managers also valued the university–clinical link role fulfilled by these staff.

• Students had mixed opinions, pre‐registration students having had little exposure to this kind of support and post‐registration students often not regarding clinical support as necessary because of their own existing clinical experience and expertise.

• For clinical support staff themselves, the role was a busy one and they often experienced conflict and role overload in balancing the education and clinical sides of their work.

• Necessary improvements for functioning of the roles were identified, including having regular meetings between university and NHS managers and support teachers for liaison purposes, joint appraisal, and formal support mechanisms for role occupants.

• The overall conclusion drawn is that the roles were successful in bridging the theory–practice gap for the University and NHS Trust managers, but less so for students, and that they did this at some personal cost for role holders.
Post‐operative epidural analgesia: introducing evidence‐based guidelines through an education and assessment process
Authors: Richardson Janet
Published: August 2010

• The aim of this project was to re‐introduce post‐operative epidural analgesia on to two orthopaedic wards using an evidence‐based practice approach. This was achieved through the provision of appropriate staff education and information, assessment of staff competence, and provision of relevant and appropriate staff support.

• An education programme was developed which included study days, ward‐based teaching and the assessment of competence.

• The introduction of guidelines followed an audit cycle in order to measure the success of the education programme.

• All nursing staff involved in the project were asked to complete a questionnaire which assessed their knowledge of caring for patients with postoperative epidural analgesia. This was completed before and following the education programme.

• The outcome measures were: (i) successful completion of competence‐based assessment; (ii) levels of knowledge as assessed by the knowledge questionnaire; and (iii) participant perceptions of the project.

• The results of the questionnaire demonstrated significant improvements in knowledge following the education programme. Participants commented on the importance of the ward‐based teaching. They also felt that pain was controlled more effectively using this method of analgesia.
Blood pressure measurement – an observational study of 21 public health nurses
Authors: Drevenhorn Eva , Håkansson Anders , Petersson Kerstin
Published: August 2010

• The purpose of this study was to observe how public health nurses perform blood pressure measurement.

• Structured observations were made of 21 randomly selected public health nurses while they performed three blood pressure measurements.

• The public health nurses used an overall correct method for blood pressure measurement.

• Five nurses out of 21 used the Tri‐cuff but the soft cuff was most frequently used. When choosing the breadth of the cuff, 10 nurses decided by eye and not by the marks on the cuff.

• To ensure a completely correct method additional information is needed by nurses.
Reflective practice and clinical outcomes: practitioners’ views on how reflective practice has influenced their clinical practice
Authors: Paget Tony
Published: August 2010

• There has been a recent increasing interest in reflective practice in nursing. There is a wealth of literature about its apparent advantages and benefits, but very little empirical research into clinical outcomes consequent to reflective practice.

• This study attempts an initial exploration into this area. A retrospective, three‐phase, multi‐method study in a single department of nursing was conducted. The research sample comprised students and former students of the department who had previously participated in an assessed reflective practice course or module.

• Years of experience, speciality or academic level did not have a significant influence, but the effectiveness of the facilitator was an important factor.

• The results suggest that reflective practice is regarded highly and that most respondents could identify significant, long‐term changes to clinical practice resulting from it.
The effect of a 3‐year pre‐registration training course on students’ self‐esteem
Authors: Randle Jacqueline
Published: August 2010

• Self‐esteem is an acquired set of beliefs about the ‘self’ and is the largest determinant of behaviour.

• This study was carried out to identify changes in the self‐esteem of students in order to assess the major influencing factors during their transition to becoming a nurse and to explore the interpretations and constructions which students ascribed to their experiences during this transition.

• Data were collected by the use of unstructured interviews.

• Analysis of data was qualitative, using a grounded theory method.

• Students’ self‐esteem became fragmented during the transition to becoming a nurse.

• The findings indicate a need to implement strategies to increase nurses’ self‐esteem.
The development of nurse‐led clinics in cancer care
Authors: Loftus Linda Ann , Weston Val
Published: August 2010

• This paper provides a review of current literature which focuses on issues relating to the care of cancer patients in the 21st century and the evolving role of the advanced practitioner in nurse‐led clinics in cancer care.

• The review, in particular, identifies more specifically the skills used and the patient needs which can be met by innovative nurses working in nurse‐led clinics.

• An in‐depth discussion of a specific nurse practitioner's experience allows some of the skills of advanced nursing practice to appear more visible, for example, the assessment and investigation of patients experiencing symptoms associated with colorectal cancer.

• The implications for clinicians and educationalists in cancer care is highlighted within the conclusions.
Support as a crucial predictor of good compliance of adolescents with a chronic disease
Authors: Kyngäs Helvi , Rissanen Marianne
Published: August 2010

• The purpose of this study was to describe the factors that predict compliance among adolescents with a chronic illness.

• The data were collected by questionnaires from adolescents with asthma, epilepsy, juvenile rheumatoid arthritis (JRA) and insulin‐dependent diabetes mellitus (IDDM). Groups of 300 adolescents with these illnesses were selected from the Finnish Social Insurance Institution’s register, giving a total study series of 1200 individuals. The final response percentage was 88% (n=1061).

• The data were analysed with the SPSS software. Logistic regression was used to indicate the predictors of good compliance.

• The compliance of adolescents with a chronic disease was predicted on the basis of support from parents, nurses, physicians and friends, as well as motivation, energy and willpower.

• The most powerful predictor was support from nurses. The likelihood of adolescents supported by nurses complying with health regimens was 7.28‐fold compared to the adolescents who did not receive support from nurses.

• The next powerful predictor was energy and willpower. Adolescents who had the energy and willpower to take care of themselves complied with health regimens with a 6.69‐fold likelihood compared to the adolescents who did not have energy and willpower.

• Adolescents who had good motivation were 5.28 times more likely to comply than the adolescents who did not have motivation.

• Support from parents, physicians and friends similarly predicted good compliance with health regimens.
‘The everlasting trial of strength and patience’: transitions in home care nursing as narrated by patients and family members
Authors: Efraimsson Eva , Höglund Ingela , Sandman Po
Published: August 2010

• The aim of this study was to describe and interpret patients’ and their family members’ lived experiences of caring at home. Twelve tape‐recorded narratives, with seven patients and five family members, were interpreted in accordance with a phenomenological–hermeneutic method inspired by Ricoeur.

• The findings revealed life situations where natural caring was changed into patient–care‐giver relations and the home became a public room. The patients had to deal with decreased abilities and the family members with adjusting to caring needs.

• The changes in the life situations were interpreted as long lasting and trying transitions.

• Implications for nursing and further research are proposed.
Promoting a tobacco‐free generation: who is responsible for what?
Authors: Von Bothmer Margareta , Fridlund Bengt
Published: August 2010

• The aim of the study was to investigate how adolescents, parents and school staff look upon different agents’ responsibilities in relation to the goal ‘a tobacco‐free generation’.

• This study was part of a larger study and used a descriptive, cross‐sectional three‐group design with questionnaires as the means of data collection. The sample comprised 216 pupils in grade five (11 years old) and 225 pupils in grade eight (14 years old) in a south‐western county in Sweden, 293 of their parents and 119 school staff (headteachers, teachers, school nurses).

• All respondents agreed that adults should take a clear stand against adolescent tobacco use. The adolescents ranked their parents as the number one source of tobacco information, while pupils, parents, teachers and headmasters ranked school nurses at the bottom rank. The teaching at school focused on risks from tobacco use. The non‐smoking norm at school was viewed differently by pupils, parents and school staff. The actions of family, school and society reflect the norms and these do influence adolescent smoking.

• The conclusion was that the responsibility to promote a tobacco‐free generation was viewed differently by the categories involved in this study. The adolescents put the responsibility mainly on parents, while parents put it on the school, and the school staff on special health educators. Both parents and school staff need to recognize their importance in creating a non‐smoking culture. To contribute to the creation of a non‐smoking generation, school nurses should abandon their passive role in health promotion, as shown in this study, and instead engage in encouraging pupils, parents and teachers to remain or become tobacco‐free.
Integrating complementary therapies into health care education: a cautious approach
Authors: Richardson Janet
Published: August 2010

• The movement of complementary therapy training and education into higher education in the United Kingdom (UK) and the interest in alternative therapeutic approaches within the health professions presents an ideal opportunity for multidisciplinary teaching and shared learning. The diversity and similarities of complementary therapies and areas of convergence with conventional healthcare practice can be explored.

• The recent publication of the House of Lords Select Committee on Science and Technology report on complementary and alternative medicine (HL Paper 123) provides a broader context for discussion and makes specific recommendations about regulation, education and research in the UK.

• This paper considers the appropriateness of integrating complementary therapies into education for conventional healthcare practitioners, what we should integrate, and when might be the most appropriate time in the education of healthcare practitioners to introduce different therapeutic modalities and their respective philosophical languages.

• Rather than present a range of solutions, the paper raises some fundamental issues that are central to the integration of complementary therapeutic approaches. If these issues are neglected as we hurry to incorporate different ‘techniques’ into our conventional practice, we may simply be left with additional tools that we are ill equipped to use.
Carers’ reflections about their video‐recorded interactions with patients suffering from severe dementia
Authors: Hansebo Görel , Kihlgren Mona
Published: August 2010

• Stimulated recall interviews were used in connection with carers’ video‐recorded interactions with patients suffering from severe dementia before, during and after a 1‐year intervention involving supervision for individualized nursing care.

• The aim was to illuminate carers’ reflections on their everyday life with the patients, and to find out if any changes took place across the intervention.

• A phenomenological‐hermeneutic approach was used in the analysis, which revealed that carers’ reflections were focused on the carers themselves, on the patients, on context and on the work itself in the shared everyday life.

• After repeated stimulated recall interviews, together with supervision every month, an improvement in carers’ ability to verbalize their reflections and an awareness and knowledge about their own influence on care quality were seen.

• The interdependence between carers and patients made it necessary for the carers to cope with many complicated here‐and‐now situations, and in their reflections the carers kept coming back to their efforts to maintain a sense of dignity for the patients as well as for themselves.

• Reflection through stimulated recall seems to be an important tool for carers in dementia care to facilitate understanding and to help them learn through lived experience, thus developing their skills in nursing care.
Discharge training and counselling increase self‐care ability and reduce postdischarge problems in CABG patients
Authors: Cebeci Fatma , Çelik Sevilay Şenol
Published: August 2010

Aims and objectives.  The aim of this study was to determine how discharge training and counselling provided to patients, who had undergone coronary artery bypass graft (CABG) surgery, had effects on patients‘ self‐care ability and on the problems encountered after discharge. The objectives were to help patients develop self‐care behaviour to deal more comfortably with the problems caused by the disease and, hopefully, to reduce the number of problems they may encounter.

Background.  CABG surgery patients needing to manage various aspects of their self‐care at home often find these tasks very difficult to carry out effectively. Discharge training and counselling services help patients undergoing CABG to develop self‐care behaviours.

Design.  The study was prospective and quasi‐experimental.

Methods.  The intervention and control groups consisted of 57 patients who were given discharge training and counselling by a researcher and 52 patients who were given routines by a nurse, respectively. The intervention group began receiving discharge training and counselling on the day of hospitalization. These were provided according to their individual knowledge needs and patients were given a booklet developed for training purposes. Data were collected by researcher using the Personal Information Form, the Self‐Care Agency Scale.

Results.  It was found that the intervention group had a higher mean self‐care score than the control group and experienced fewer problems following discharge compared with patients in the control group.

Conclusion.  The discharge training and counselling services given to patients in the intervention group had a positive impact on the self‐care ability of these patients and on alleviating the problems they encountered.

Relevance to clinical practice.  As discharge training and counselling services had a positive impact on the self‐care and alleviation of the problems that patients encounter after being discharged, we recommend application of these services and the usage of the training booklet for CABG patients.
Institutionalized elders with dementia: collaboration between family caregivers and nursing home staff in Taiwan
Authors: Alice Lau Wai‐Yin , Lotus Shyu Yea‐Ing , Lin Li‐Chan , Yang Pei‐Shan
Published: August 2010

Aims and objectives.  To explore the process of development of collaborative relationship between family caregivers of institutionalized elders with dementia and nursing home staff in Taiwan.

Background.  Evidence suggests that family members are continuously involved in the lives of loved ones and have not given up their roles as caregivers after the institutionalization of a family member. Little is known, however, about how family caregivers develop a collaborative relationship with nursing home staff, particularly in Asian countries.

Design and methods.  Grounded theory methodology was used. Data were collected via interviews and observations from 11 family caregivers of patients who were suffering from dementia and living in an institution for persons with dementia in northern Taiwan. Data were analysed by constant comparative analysis.

Results.  Findings revealed that ‘institutional social penetration’ was the process most used by family caregivers to achieve an harmonious collaborative relationship with the nursing home staff. Institutional social penetration is a dynamic process, which includes three components: self‐disclosure, evaluation of care and penetration strategies. Family caregivers, who had developed a ‘socially penetrating’ relationship with the nursing home staff, were more likely to disclose information in more breadth and depth, to receive positive care evaluations and to adopt multiple effective penetration strategies.

Conclusions.  Institutional social penetration between family caregivers and nursing home staff can sensitize healthcare providers to meet the family's needs during the placement of their loved one and provide a basis for developing intervention strategies.

Relevance to clinical practice.  Findings of this study may help healthcare providers to understand the ways in which collaborative relationships develop between the families of elders with dementia and nursing home staff. Interventions can be developed to facilitate self‐disclosure of both the family members and nursing home staff through timely feedback and familiarising family caregivers with different penetration strategies.