bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractAim  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

Summary

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

Summary

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.
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.