bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke
Authors: Laird Elizabeth A. , Coates Vivien , Chaney David 
Published: July 2012

AbstractAimThis article presents the results of a systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke.BackgroundHyperglycaemia is common among adults admitted to hospital with stroke.DesignSystematic review.Data sourcesA search for descriptive cohort studies published between January 1996–June 2011, was conducted in MEDLINE, PubMed and Embase electronic databases. The search was performed using the terms ‘stroke’, ‘hyperglycaemia’ and/or ‘glucose’ combined and limited to adults and English language publications. Searching of citations from identified studies supplemented the electronic searches.Review methodsA systematic review was conducted of eight studies, meeting the criteria of: (1) descriptive cohort studies; (2) adults admitted to hospital with acute stroke; and (3) glycaemic status monitored over at least two consecutive days from admission to hospital. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis standards.ResultsThe dynamics of glycaemia after stroke has been investigated in seven prospective cohort studies and one retrospective study. The patterns that emerged were persisting normoglycaemia, transient hyperglycaemia, persisting hyperglycaemia and delayed hyperglycaemia. Surges in glycaemia are likely on days 2 and 3 and some adults will not exhibit hyperglycaemia till day 7.ConclusionFurther large cohort studies are required to explore the dynamic of glycaemia after stroke for at least 1 week duration. The timing of formal screening for diabetes mellitus is important, as early screening may overestimate detection rates.
Practice nurses and general practitioners: perspectives on the role and future development of practice nursing in Ireland
Authors: McCarthy Geraldine , Cornally Nicola , Moran Joe , Courtney Marie 
Published: July 2012

Aims and objectives.  To explore the role dimensions, competence and professional development needs of practice nurses in Ireland from both the general practitioner’s and practice nurse’s perspective and highlight any agreement/disagreement between the professions.Background.  Economic pressure on healthcare delivery is promoting a re‐evaluation of professional roles and boundaries. This coupled with a primary care sector that is evolving prompted an investigation into the role dimensions and competence of the practice nurse. There is a lack of empirical data comparing the general practitioner’s and practice nurse’s perspective on the current role of the nurse, clinical competence (existing and required), strategic direction for the role and continuing professional development.Design.  A descriptive cross‐sectional survey design was used.Methods.  A random sample of general practitioners (n = 414) and a purposeful sample of practice nurses (n = 451) participated. Data from each profession were analysed and comparisons drawn.Results.  General practitioners and practice nurses agree (±5%) that the nursing role is centred on immunisation, direct clinical care and elements of chronic disease management. However, in some areas such as preconceptual advice, family planning, advice on menopause, continence promotion and research, there was a 30% difference between the general practitioners perceptions of the nurse’s involvement and the practice nurse’s actual involvement in the role. Perceived competency differed in a number of areas with nurses more likely to indicate competency in health promotion activities. Both disciplines acknowledged that only a minority of practice nurses were competent in audit, research and dealing with ‘problems with living’ (relationship breakdown, addiction and parenting).Conclusion.  There is some congruence of opinion among practice nurses and general practitioners in Ireland regarding the current role of the practice nurse. Divergent opinions on the nurses’ involvement in a particular aspect of the role may be due to the general practitioners underestimating the nurse’s involvement in the role. Training is required in the areas of audit, research and ‘problems with living’.Relevance to clinical practice.  This research provides data for role clarity and evidence‐based role development for practice nurses within the context of evolving primary care services. It also indicates how general practitioners perceive the nursing role.
Thoughts on death and dying when living with haemodialysis approaching end of life
Authors: Axelsson Lena , Randers Ingrid , Lundh Hagelin Carina , Jacobson Stefan H , Klang Birgitta 
Published: July 2012

Aims and objectives.  To describe inner thoughts and feelings relating to death and dying when living with haemodialysis approaching end of life.Background.  Patients who undergo maintenance haemodialysis suffer a significant symptom burden and an impaired quality of life. The high mortality rate in these patients indicates that about one‐fourth of them are in their last year of life, suggesting the presence of death and dying in the haemodialysis unit.Design.  A qualitative descriptive design was used.Methods.  A total of 31 qualitative interviews were conducted with eight patients (aged 66–87) over a period of 12 months. Qualitative content analysis was used to analyse data.Results. The analysis revealed 10 subthemes that were sorted into three main themes. Being aware that death may be near comprises being reminded of death and dying by the deteriorating body, by the worsening conditions and deaths of fellow patients, and by knowing haemodialysis treatment as a border to death. Adapting to approaching death comprises looking upon death as natural, preparing to face death, hoping for a quick death and repressing thoughts of death and dying. Being alone with existential thoughts comprises a wish to avoid burdening family, lack of communication with healthcare professionals and reflections on haemodialysis withdrawal as an hypothetic option.Conclusions.  Living with haemodialysis approaching, the end of life involves significant and complex existential issues and suffering, and patients are often alone with their existential thoughts.Relevance to clinical practice.  Nurses and other healthcare professionals in haemodialysis settings need to combine technical and medical abilities with committed listening and communication skills and be open to talking about death and dying, with sensitivity to individual and changeable needs.
Ethical issues of incorporating spiritual care into clinical practice
Authors: Polzer Casarez Rebecca L , Engebretson Joan C 
Published: July 2012

Aims and objectives.  The aim of this article was to analyse the scholarly discourse on the ethical issues of incorporating spirituality and religion into clinical practice.Background.  Spirituality is an important aspect of health care, yet the secularisation of health care presents ethical concerns for many health providers. Health providers may have conflicting views regarding if and how to offer spiritual care in the clinical setting.Design.  Discursive paper.Results.  The discourse analysis uncovered four themes: ethical concerns of omission; ethical concerns of commission; conditions under which health providers prefer to offer spiritual care; and strategies to integrate spiritual care. Ethical concerns of omission of spiritual care include lack of beneficence for not offering holistic care. Ethical concerns of commission are coercion and overstepping one’s competence in offering spiritual care. Conditions under which providers are more likely to offer spiritual care are if the patient has a terminal illness, and if the patient requests spiritual care. Strategies for appropriate spiritual care include listening, and remaining neutral and sensitive to spiritual issues.Conclusions.  Health providers must be aware of both the concerns of omission and commission. Aristotle’s golden mean, an element of virtue ethics, supports a more moderate approach that can be achieved by avoiding the imposition of one’s own personal beliefs of a religious persuasion or beliefs of extreme secularisation, and focusing on the beneficence to the patient.Relevance to clinical practice.  Key components for health providers in addressing spiritual concerns are self‐reflection, provision of individualised care, cultural competency and communication.
Emotional intelligence as a moderator in the stress–burnout relationship: a questionnaire study on nurses
Authors: Görgens‐Ekermans Gina , Brand Tamari 
Published: July 2012

Aims and objectives.  To investigate inter‐relationships between emotional intelligence (EI), work stress and burnout in a group of nurses in the Western Cape Province, South Africa. The moderating effect of EI in the stress–burnout relationship and group differences (nurses working in different wards) in burnout were also investigated.Background.  Stress and subsequent burnout commonly threaten the occupational health and well‐being of nurses in South Africa and elsewhere. Developing EI in nurses may increase individual stress resistance and combat burnout.Design.  A cross‐sectional research design with anonymous questionnaires was conducted. Self‐report data were used.Methods.  Survey data were collected from 122 nurses working in different wards at four hospitals from a private hospital group. The Swinburne University Emotional Intelligence Test, Sources of Work Stress Inventory and Maslach Burnout Inventory were used to measure EI, stress and burnout, respectively.Results.  Consistent inverse relationships between emotional control and management as dimensions of EI, and stress and burnout emerged. A differential effect of high vs. low EI on the stress–burnout relationship was evident. Workload and the work/family interface emerged as significant predictors of burnout. Respondents working in maternity, paediatric and ER wards reported more feelings of personal accomplishment than those working in general wards.Conclusions.  Higher EI is significantly related with lower stress and burnout in a sample of South African nurses. The moderator effect of EI in the stress–burnout relationship suggests that enhanced EI may help diminish burnout development when chronic stress is experienced.Relevance to clinical practice.  EI developmental interventions, if introduced in nursing curricula, may increase emotional coping resources and enhanced social skills, which may benefit the long‐term occupational health of nurses. This may be relevant in developing countries, where environmental stressors related to the organisational context (budget constraints) and wider social factors (shortage of qualified nurses) are difficult to address.
Tracking the route to sustainability: a service evaluation tool for an advance care planning model developed for community palliative care services
Authors: Blackford Jeanine , Street Annette 
Published: July 2012

Aims and objectives.  The study aim was to develop a service evaluation tool for an advance care planning model implemented in community palliative care.Background.  Internationally, advance care planning programmes usually measure success by completion rate of advance directives or plans. This outcome measure provides little information to assist nurse managers to embed advance care planning into usual care and measure their performance and quality over time. An evaluation tool was developed to address this need in Australian community palliative care services.Design.  Multisite action research approach.Methods.  Three community palliative care services located in Victoria, Australia, participated. Qualitative and quantitative data collection strategies were used to develop the Advance Care Planning‐Service Evaluation Tool.Results.  The Advance Care Planning‐Service Evaluation Tool identified advance care planning progress over time across three stages of Establishment, Consolidation and Sustainability within previously established Model domains of governance, documentation, practice, education, quality improvement and community engagement. The tool was used by nurses either as a peer‐assessment or self‐assessment tool that assisted services to track their implementation progress as well as plan further change strategies.Conclusion.  The Advance Care Planning‐Service Evaluation Tool was useful to nurse managers in community palliative care. It provided a clear outline of service progress, level of achievement and provided clear direction for planning future changes.Relevance to clinical practice.  The Advance Care Planning‐Service Evaluation Tool enables nurses in community palliative care to monitor, evaluate and plan quality improvement of their advance care planning model to improve end‐of‐life care. As the tool describes generic healthcare processes, there is potential transferability of the tool to other types of services.
Spirituality and spiritual caring: nurses’ perspectives and practice in palliative and acute care environments
Authors: Ronaldson Susan , Hayes Lillian , Aggar Christina , Green Jennifer , Carey Michele 
Published: July 2012

Aims and objectives.  Identify and compare spiritual caring practice by palliative care and acute care registered nurses (RNs), determine any correlation between nurses’ spiritual perspective and their spiritual caring, and to investigate perceived barriers to spiritual caring.Background.  Over the past decade there has been growing interest in spiritual caring in nursing. Professional nursing bodies have proposed spirituality and spiritual caring as an integral component of holistic nursing.Design.  Cross sectional study.Methods.  Palliative care RNs (n = 42) from one community palliative care service and three hospices, and acute care RNs (n = 50) from three major acute care hospitals all in metropolitan Sydney, Australia completed a research questionnaire. Two validated tools and a demographic survey were used to collect data. These tools measured spiritual perspectives including saliency of personal spirituality, spiritual views and engagement in spiritually‐related activities; and spiritual practice including assessment, interventions and barriers to spiritual caring. Data were collected over a six‐month period and interpreted with both descriptive and analytical statistics.Results.  Significant differences were seen between the two RN groups. Palliative care RNs’ spiritual caring practice was more advanced and their spiritual perspective stronger; this relationship was positive. Both RN groups identified ‘insufficient time’ as the most common barrier to spiritual caring practice; ‘patient privacy’ was also common for acute care RNs.Conclusions.  Palliative care RNs’ spiritual perspectives influenced their spiritual caring. These nurses were older and more career‐advanced than the acute care RNs, which may explain the differences observed. Acute care RNs may benefit from additional support for their spiritual caring and to address perceived barriers.Relevance to clinical practice.  The development of nurses’ spiritual perspective early in their preparation for practice, and the articulation and documentation of spiritual caring may enhance their spiritual caring practice. Further research on barriers to spiritual caring in acute care nursing environments is recommended.
‘Struggling to be an insider’: a phenomenological design of new nurses’ transition
Authors: Lee Huei Ying , Hsu Min‐Tao , Li Pei‐Ling , Sloan Rebecca S 
Published: July 2012

Aims and objectives.  To obtain a comprehensive understanding of the transition process of new nurses in Taiwan.Background.  The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised.Design.  We adopted a phenomenological design using focus group interviews.Methods.  Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of ‘being new’. Interview data were analysed according to Sloan’s (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached.Results.  The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of ‘struggling to be an insider’. This phenomenon was characterised by four themes, including (1) ‘being new as being weak’, (2) ‘masking myself’, (3) ‘internalising the unreasonable’ and (4) ‘transforming myself to get a position’.Conclusions.  While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self‐oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently.Relevance to clinical practice.  Recognition of the journey of ‘struggling to be an insider’ helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in‐service training programmes and (4) retain future nurses.
Factors affecting the quality of life of middle‐aged women suffering Hwa‐Byung
Authors: Lim Young Mi , Jung In Chul , Seo Bok Nam 
Published: July 2012

Aims and objectives.  To test a staged theoretical model designed to explain causal relationships affecting the quality of life (QOL) of middle‐aged Korean women suffering from Hwa‐Byung (HB).Background.  The model contains three stages comprised of antecedents (stage 1), perception (stage 2) and outcome variable (stage 3). Stage 1 contains individual characteristic and emotional distress variables. In stage 2, the perception variable is depression (DEP). In stage 3, the outcome factor is QOL.Design.  A cross‐sectional, descriptive design was used.Methods.  A convenience sample of 135 community dwelling middle‐aged women was recruited over a five‐month period in the neuropsychology outpatient clinic at an Oriental hospital in Korea. The instruments were the Korean version of WHO Quality of Life‐BREF (WHOQOL‐BREF), Korean version of State‐Trait Anger Expression Inventory (STAXI‐K), The Korean version of State‐Trait Anxiety Inventory (STAI‐K) and Korean version of Beck Depression Inventory (K‐BDI).Results.  Forty‐five per cent of the variance in the QOL of women with HB was explained by the direct effect of depression (β = −0·356, p = 0·000) and trait anxiety (β = −0·324, p = 0·001). State anger (β = 0·429, p = 0·000) and spouse (β = −0·180, p = 0·021) explained 45·0% of the variance in (of) depression.Conclusion.  The findings showed that depression mediates the relationship between the emotional distress and QOL as a negative outcome.Relevance to clinical practice.  These relationships can guide researchers and psychiatric mental health nurses to understand depression as a mediating factor and to develop nursing interventions to improve QOL of HB women.
Specific interactions between the Candida albicans ABC transporter Cdr1p ectodomain and a d‐octapeptide derivative inhibitor
Authors: Niimi Kyoko , Harding David R. K. , Holmes Ann R. , Lamping Erwin , Niimi Masakazu , Tyndall Joel D. A. , Cannon Richard D. , Monk Brian C. 
Published: July 2012

SummaryOverexpression of the Candida albicans ATP‐binding cassette transporter CaCdr1p causes clinically significant resistance to azole drugs including fluconazole (FLC). Screening of a ∼ 1.89 × 106 member d‐octapeptide combinatorial library that concentrates library members at the yeast cell surface identified RC21v3, a 4‐methoxy‐2,3,6‐trimethylbenzenesulphonyl derivative of the d‐octapeptide d‐NH2‐FFKWQRRR‐CONH2, as a potent and stereospecific inhibitor of CaCdr1p. RC21v3 chemosensitized Saccharomyces cerevisiae strains overexpressing CaCdr1p but not other fungal ABC transporters, the C. albicans MFS transporter CaMdr1p or the azole target enzyme CaErg11p, to FLC. RC21v3 also chemosensitized clinical C. albicans isolates overexpressing CaCDR1 to FLC, even when CaCDR2 was overexpressed. Specific targeting of CaCdr1p by RC21v3 was confirmed by spontaneous RC21v3 chemosensitization‐resistant suppressor mutants of S. cerevisiae expressing CaCdr1p. The suppressor mutations introduced a positive charge beside, or within, extracellular loops 1, 3, 4 and 6 of CaCdr1p or an aromatic residue near the extracytoplasmic end of transmembrane segment 5. The mutations did not affect CaCdr1p localization or CaCdr1p ATPase activity but some increased susceptibility to the CaCdr1p substrates FLC, rhodamine 6G, rhodamine 123 and cycloheximide. The suppressor mutations showed that the drug‐like CaCdr1p inhibitors FK506, enniatin, milbemycin α11 and milbemycin β9 have modes of action similar to RC21v3.
The linker sequence, joining the DNA‐binding domain of the homologous transcription factors, Mlc and NagC, to the rest of the protein, determines the specificity of their DNA target recognition in Escherichia coli
Authors: Bréchemier‐Baey Dominique , Domínguez‐Ramírez Lenin , Plumbridge Jacqueline 
Published: July 2012

SummaryProtein–DNA recognition is fundamental to transcriptional regulation. Transcription factors must be capable of locating their specific sites situated throughout the genome and distinguishing them from related sites. Mlc and NagC control uptake and use of the sugars, glucose and N‐acetylglucosamine. Both their helix–turn–helix motifs and their consensus binding sites on DNA are very similar. One distinguishing feature is that most NagC sites have a C/G bp at positions −11 and +11 from the centre of symmetry of the operator, while all Mlc sites have A/T. By constructing Mlc and NagC chimeras, we show that the helix–turn–helix motif per se is not responsible for specific recognition of Mlc or NagC sites, but that a linker, joining the DNA‐binding domain to the rest of the protein, is the major determinant. We show that a change of just two amino acids in the NagC linker is sufficient to allow NagC to recognize an A/T bp at positions +/−11 and repress Mlc targets. Modelling of the NagC linker suggests that it forms an extended structure containing two arginines and we suggest that these arginines interact differently with the minor groove at positions +/−11 depending upon the presence of a C/G or A/T bp.