bluuebunny/crossref_metadata_2025_split huggingface dataset:
Some dilemmas of master's level nurse education
Authors: Gerrish Kate , Ashworth Peter D. , McManus Mike 
Published: October 2010

Some dilemmas of master's level nursing education Despite an increase in the growth of master's level provision for qualified nurses in the United Kingdom uncertainty exists regarding the characteristics of master's level performance in respect of professional practice. This paper presents selected findings from a multidisciplinary study that sought to examine the characteristics of master's level performance in health professional courses that had an expressed practice orientation. It focuses specifically on dilemmas nurse educators encountered in relation to British master's level nurse education. Following an initial pilot stage involving focus group interviews with separate groups of nurses, occupational therapists and physiotherapists, an interview agenda was developed to explore participants’ perspectives of the characteristics of master's level performance. Individual in‐depth interviews were undertaken with a purposive sample of 18 nurse educators drawn from eight universities in England. Interview transcripts were coded and thematically analysed. Six kinds of dilemma emerged from the interviews. These were breadth vs. depth in the conceptualization of master's level for nursing, relevance to practice vs. academic detachment, facilitating creative thinking vs. reinforcing rigidity, encouraging or suppressing different modes of critical thinking, postgraduate nurses as loyal change agents vs. the problem of well‐qualified mavericks, and professional experience as facilitating or hindering master's level performance. These dilemmas raise important questions about course design and the role of stakeholders in determining curriculum content. Moreover, a pervasive tension between a utilitarian emphasis on the application and utility of knowledge on one hand, and aspirations to promote creativity and critical thinking which look to alternative possibilities on the other hand, suggests that nurse educators exercise a degree of conservatism in relation to master's level. It is concluded that this apparent quest to maintain a safe variant of the status quo as the best way of promoting the wellbeing of patients should be subject to profound questioning.
Limitations, frustrations and opportunities: a follow‐up study of nursing graduates from the University of Birmingham, England
Authors: Wheeler Herman H. , Cross Vinette , Anthony Denis 
Published: October 2010

Limitations, frustrations and opportunities: a follow‐up study of nursing graduates from the University of Birmingham, England This paper reports an ongoing study of the progress of nursing graduates from the University of Birmingham, England. The aim of the research was to follow‐up early graduates from the programme, to assess their progress and study feedback indicators that could help further the development of this relatively new programme. The study also aims to contribute to the growing body of knowledge about United Kingdom nursing graduates, following the recent shift of nurse education from Schools/Colleges of Nursing into universities. Due to objection from some quarters as to the value of a university education for nurses, even such a small‐scale study is considered to be important. A questionnaire was sent to the first three cohorts of graduates. It revealed interesting findings in relation to work patterns, continuing professional and academic development and perceptions of the value of the degree in practice. The graduates made recommendations regarding changes that might enhance the quality of the Birmingham degree and nursing practice generally.
Communication and information needs of a random sample of community psychiatric nurses in the United Kingdom
Authors: Fakhoury Walid K.H. , Wright Donna 
Published: October 2010

Communication and information needs of a random sample of community psychiatric nurses in the United Kingdom This paper reports on a cross‐sectional survey investigating communication and information needs of community psychiatric nurses attached to community mental health teams in the United Kingdom. Community psychiatric nurses’ access to and communication with other professionals was also assessed. In total, 200 teams were randomly sampled UK‐wide, and postal questionnaires were sent to community psychiatric nurses attached to these teams; 110 questionnaires were completed and returned (55% response rate). Spearman's rho, Pearson's correlation and the chi‐square test were used in bivariate analyses and multiple logistic regression in multivariate analysis. Participants reported to be mainly in contact with psychiatrists (71%) and other community psychiatric nurses (52%). Eighty‐four per cent and 91% reported psychiatrists and community psychiatric nurses, respectively, to be quite/extremely helpful when consulted; the proportions were lower for general practitioners and counsellors/therapists (32% and 31%, respectively). All reported lack of time and 84% reported communication problems with other professionals as barriers to their work. Although 70% reported having the necessary training/skills for managing severe cases, 76% indicated they had information needs. Being a long‐serving community psychiatric nurse (OR=4·51, 95% CI=1·06–19·20), perceiving the discussion of cases with other professionals as less helpful (OR=4·82, 95% CI=1·16–20·01), being mainly in contact with other CPNs (OR=6·72, 95% CI=1·21–37·15), reporting not having the necessary training/skills (OR=7·78, 95% CI=1·37–44·25), and wanting information on mental health law (OR=12·27, 95% CI=1·75–86·36) were significant predictors of having information needs. This survey provided valuable information on problems facing these nurses and highlighted the need for training and for easier access to and increased communication with other professionals.
Hearing the voices of children with chronic illness
Authors: Sartain Samantha A. , Clarke Charlotte L. , Heyman R. 
Published: October 2010

Hearing the voices of children with chronic illness This qualitative study has aimed to explore children’s, parents’ and health professionals’ experience of childhood chronic illness. Seven families and their professional carers participated in semistrucured interviews. The children's interviews were augmented with a ‘drawing’ technique. A grounded theory approach facilitated data collection and analysis. This paper debates the perceived passivity of the voice of children in health care and research and illustrates data collection methods that seek to give children and other disadvantaged groups a voice. The children who participated in this study are described as competent interpreters of their world.
English nursing and medical students’ attitudes towards organ donation
Authors: Cantwell Michelle , Clifford Collette 
Published: October 2010

English nursing and medical students’ attitudes towards organ donation The purpose of the study reported in this paper was to examine nursing and medical students’ attitudes towards organ and corneal donation. A sample of 72 nursing and medical degree students from a British University, completed a 61‐item self‐administered quantitative questionnaire, adapted by Kent and Owens (1995) from an original tool devised by Parisi and Katz (1986). The findings revealed that all but one of the respondents had an overall positive attitude towards organ donation; a significant relationship was found to exist between the extent of this positive attitude held by each student and their personal willingness to donate organs. In total, 74% of the student nurses had already signed a donor card, compared to only 43% of the medical students, and the difference in the two groups’ personal commitment towards donation was significant (P=0·005). However, this disparity between the nursing and medical students was not evident when students were questioned about personally accepting organs, for survival. Most respondents agreed that they would take some form of transplanted organ or tissue into their body, if it was needed to maintain life.Overall, the study revealed that although this group of student nurses seem to be in favour of organ donation, with many willing to sign a donor card, doubts still exist in the medical student group. Further work is required to understand this phenomena.A comparison of the data with an earlier study completed by Kent and Owens (1995) indicate that student nurses may have a more positive orientation to donation than qualified staff.
Attitudes of nursing staff to the autopsy
Authors: Dziobon Mark D. , Roberts Ian S.D. , Benbow Emyr W. 
Published: October 2010

Attitudes of nursing staff to the autopsy We assessed the views of hospital nurses on the autopsy, using a questionnaire which was distributed by hand to all qualified nurses working at Manchester Royal Infirmary during a 48‐h period. We found that many respondents (43%) had had occasion to discuss autopsy with relatives, and the majority (90%) would like to learn more about counselling the bereaved. Few (15%) clearly understood the legal distinction between coroners’ and hospital autopsies. Almost all (97%) thought the main reason for autopsy was determination of the cause of death, and only 12% supported a role in clinical audit. More respondents saw benefits for doctors rather than for nurses, and only 56% perceived a benefit for relatives. In general, nursing staff have a more positive view of the autopsy than we anticipated, and we would advocate making more information about the benefits of autopsy available to nurses.
An accessible analytical approach for investigating what happens between the rounds of a Delphi study
Authors: Greatorex Jackie , Dexter Trevor 
Published: October 2010

An accessible analytical approach for investigating what happens between the rounds of a Delphi study The Delphi method is used to investigate consensus amongst a panel of experts using repeated rounds of a questionnaire, often in healthcare settings. However, many Delphi studies do not report any investigation into what happens to the stability of consensus or the convergence of agreement between the rounds in the study, which may be of importance. In this paper an accessible analytical approach is outlined using graphical presentations of means and standard deviations to identify what happens between rounds. For Delphi studies where the scale upon which experts are expressing their opinions can be considered to be interval, the mean will represent the group opinion whilst the standard deviation will represent the level of agreement. An example Delphi study from a healthcare setting is used to illustrate the methodology.
Classifying clinical decision making: interpreting nursing intuition, heuristics and medical diagnosis
Authors: Buckingham Christopher D. , Adams Ann 
Published: October 2010

Classifying clinical decision making: interpreting nursing intuition, heuristics and medical diagnosisThis is the second of two linked papers exploring decision making in nursing. The first paper, ‘Classifying clinical decision making: a unifying approach’ investigated difficulties with applying a range of decision‐making theories to nursing practice. This is due to the diversity of terminology and theoretical concepts used, which militate against nurses being able to compare the outcomes of decisions analysed within different frameworks. It is therefore problematic for nurses to assess how good their decisions are, and where improvements can be made. However, despite the range of nomenclature, it was argued that there are underlying similarities between all theories of decision processes and that these should be exposed through integration within a single explanatory framework. A proposed solution was to use a general model of psychological classification to clarify and compare terms, concepts and processes identified across the different theories. The unifying framework of classification was described and this paper operationalizes it to demonstrate how different approaches to clinical decision making can be re‐interpreted as classification behaviour. Particular attention is focused on classification in nursing, and on re‐evaluating heuristic reasoning, which has been particularly prone to theoretical and terminological confusion. Demonstrating similarities in how different disciplines make decisions should promote improved multidisciplinary collaboration and a weakening of clinical elitism, thereby enhancing organizational effectiveness in health care and nurses’ professional status. This is particularly important as nurses’ roles continue to expand to embrace elements of managerial, medical and therapeutic work. Analysing nurses’ decisions as classification behaviour will also enhance clinical effectiveness, and assist in making nurses’ expertise more visible. In addition, the classification framework explodes the myth that intuition, traditionally associated with nurses’ decision making, is less rational and scientific than other approaches.
An insulin‐resistant hypertriglyceridaemic normotensive obese dog model: assessment of insulin resistance by the euglycaemic hyperinsulinaemic clamp in combination with the stable isotope technique
Authors: Bailhache E. , Ouguerram K. , Gayet C. , Krempf M. , Siliart B. , Magot T. , Nguyen P. 
Published: October 2010

SummaryMany studies have shown that in humans insulin resistance (IR) is associated with obesity and hypertriglyceridaemia. The aim of our study was to develop slowly dietary‐induced obesity in dogs through long‐term overfeeding of a high‐fat diet, and to characterize this IR, hypertriglyceridaemic and normotensive model. Insulin resistance was assessed by the euglycaemic hyperinsulinaemic clamp technique. The contribution of hepatic glucose production during the clamp was evaluated using a constant stable‐isotope‐labelled glucose infusion.Overfeeding a high‐fat diet for 7 months was associated with a 43 ± 5% body weight increase. Insulin resistance was characterized by hyperinsulinaemia in the unfed state (10 ± 1 vs. 24 ± 1 μU/ml, in healthy and obese dogs, respectively, p < 0.02) and by a reduction of the insulin‐mediated glucose uptake (28 ± 3 vs. 16 ± 1 mg/kg/min, p < 0.02). Hepatic glucose production suppression under insulin infusion allowed to conclude that this reduced glucose uptake resulted from a decrease of insulin sensitivity in obese dogs. Furthermore, animals remained normotensive and exhibited a marked hypertriglyceridaemia (0.26 ± 0.04 vs. 0.76 ± 0.15 mmol/l, in healthy and obese dogs, respectively, p < 0.02). Because hypertriglyceridaemia is the most common lipid abnormality in insulin‐resistant humans, this dog with slowly induced obesity may constitute a good model to study the consequences of IR in lipid metabolism independently of vascular changes.
Malignant melanoma metastatic to the common bile duct
Authors: Garas George , Bramston Brian , Edmunds Simon Ej 
Published: October 2010

AbstractMetastatic melanoma is renowned for its propensity to spread to almost every organ of the body; however, symptomatic metastases within the biliary tree are very rare. We report two cases of bile duct obstruction from metastatic melanoma. The first case was caused by an intraluminal metastatic melanoma to the common bile duct, while the second case was caused by extraluminal involvement. The unique aspects of these cases include clinical presentations masquerading as biliary colic, cholangitis and obstructive jaundice. Management and follow up for 3 years is presented. Aspects of medical and surgical management, as well as a review of the world's literature are discussed.
Helicobacter pylori infection in childhood: Results of management with ranitidine bismuth citrate plus amoxicillin and tinidazole
Authors: Nijevitch Alexander A , Farztdinov Karim M , Sataev Valery U , Khasanov Rinat Sh , Katayev Valery A , Khusnutdinov Shamil M , Akhunov Eduard D , Kazykhanov Nasghat S 
Published: October 2010

AbstractBackground and Aims: To verify whether a triple therapy bismuth citrate plus amoxicillin and tinidazole eradicates H. pylori infection in pediatric patients.Methods: Fifty children (30 females; mean age 12.4 ± 1.1 years, range 10–15 years) suffering from upper abdominal complaints and Helicobacter pylori (H. pylori)‐associated gastroduodenal disease were treated with a 4 week course of ranitidine bismuth citrate (400 mg, twice daily) plus oral tinidazole (20 mg/kg) and amoxicillin (50 mg/kg) for the first 2 weeks.Results: The endoscopic diagnoses were: esophagitis (seven cases), gastritis (six cases), gastroduodenitis (43 cases), duodenitis (one case), gastric ulcer (two cases) and duodenal ulcer (13 cases). Helicobacter pylori was eradicated in 40 (80%) patients and clinical improvement was noticed in 39 (78%) of symptomatic subjects. Duodenal ulcers were healed in all the children, but lymphoid nodular hyperplasia was persistent in all patients, independent of the H. pylori status. The potentially drug‐related adverse events (blackening of the tongue, six patients; diarrhea, one patient; disturbance of taste, two patients) were registered in seven (14%) patients and dark stools were observed in 48 (96%) patients. No children withdrew from the study because of either side‐effects or clinical laboratory changes. No patient had toxic levels of blood bismuth (values ranged between 2.1 and 5.4 μg/L, mean value 3.4 ± 1.04 μg/L).Conclusions: Findings suggest that the present treatment regimen is effective enough in the resolution of H. pylori‐associated peptic ulcer disease of childhood.
Conditionally immortalized mouse hepatocytes for use in liver gene therapy
Authors: Allen Katrina J , Reyes Rosario , Demmler Kirsten , Mercer Julian F , Williamson Robert , Whitehead Robert H 
Published: October 2010

AbstractBackground and aims: The use of hepatocytes for gene therapy is limited by the difficulty of maintaining and altering primary liver cells in culture. A conditionally immortalized mouse hepatocyte cell line has been developed which can be passaged indefinitely at the permissive temperature (33°C), but fails to proliferate and dies at the non‐permissive temperature (39°C) in vitro.Methods: Hepatocytes were harvested from a 6 week‐old male transgenic mouse (‘immortomouse’) carrying a thermolabile SV40 Large T gene, using a modified two‐step collagenase perfusion method, and serially passaged at 33°C for more than 1 year. To assess the ability of immortohepatocytes to engraft and populate mouse liver, cells were infused into partially hepatectomized congenic mice via the portal vein (n = 10) or the spleen with (n = 2) and without (n = 2) partial hepatectomy. The ability to transfect immortohepatocytes was assessed using the reporter gene enhanced green fluorescent protein (EGFP).Results: All immortohepatocytes in culture stained positive by immunohistochemistry for the hepatocyte markers albumin, AFP, CK8 and CK18. In early cultures a proportion of cells also stained strongly for the biliary epithelial markers CK7 and CK19. Late cell cultures were negative for M2PK and CK7 and stained variably with anti‐CK19 antibodies. Cells transferred to the non‐permissive temperature of 39°C ceased proliferation and died within 1 week in vitro. Large T DNA was detected in the liver of all postoperative mice up to 2 weeks post‐hepatocellular transplantation via PCR and Southern blot analysis. The immortohepatocytes were easily transfected with a reporter gene.Conclusions: Immortohepatocytes can survive in vivo after transfer to liver, and will be useful as a model for hepatic gene therapy.
Clinical significance of hepatitis C virus infection to alcoholics with cirrhosis in Korea
Authors: Kwon So Young , Ahn Myoung Soo , Chang Hee Jin 
Published: October 2010

AbstractBackground/Methods: To investigate the prevalence and clinical significance of hepatitis C virus (HCV) infection and its relationship with the development of hepatocellular carcinoma (HCC), 162 consecutive alcoholic patients with cirrhosis were studied. Alcohol intake and parenteral risk factors were investigated by interview using a questionnaire. All patients had consumed at least 80 g alcohol/day for at least the past 5 years. Sera were tested for anti‐HCV using a third‐generation enzyme immunoassay (EIA), hepatitis B s antigen (HBsAg), anti‐HBs, anti‐HBc and anti‐HIV. Serum HCV‐RNA was detected by a one‐tube reverse transcription–polymerase chain reaction (RT‐PCR) method. Patients were classified into three groups accroding to the presence or absence of viral markers: (i) cases without anti‐HCV or HBsAg (group A); (ii) cases with HBsAg only (group B); and (iii) cases with anti‐HCV only (group C). Demographic and clinical findings were compared among the three groups.Results: Anti‐HCV was present in 17 cases (10.5%) and HBsAg was present in 47 cases (29%). No patient had both anti‐HCV and HBsAg. Group C subjects were the oldest, but the duration of drinking in this group was similar to that of group A. There was no significant difference in the daily alcohol intake among the three groups. Previous surgical operations and tattooing were more frequent in group C. Only one patient in group C was an intravenous drug user. The combined rate of HCC was significantly higher in groups B and C than in groups A (34, 23.5 and 6.1%, respectively). Laboratory data showed a higher platelet count, higher albumin level, lower bilirubin level and lower aspartate aminotransferase/alanine aminotransferase ratio in group C patients than in the other two groups. Hepatitis C virus RNA was detected in 14 of 85 cases tested (16.5%), in 11 of 12 cases (91.7%) with anti‐HCV and in three of 73 cases (4.1%) without anti‐HCV.Conclusions: Hepatitis C virus infection is frequent in alcoholic patients with cirrhosis in Korea. Hepatitis C virus, as well as hepatitis B virus, infection may have a synergistic effect on the development of HCC in alcoholic patients.
Interspousal transmission of TT virus: Low efficiency and lack of apparent risk factors
Authors: Liu Chun‐Jen , Kao Jia‐Horng , Chen Wendy , Tsai Ruey‐Jen , Chen Pei‐Jer , Lai Ming‐Yang , Chen Ding‐Shinn 
Published: October 2010

AbstractBackground: The TT virus (TTV) is a newly identified human DNA virus and little is known about its non‐parenteral transmission. The aim of the present study was to explore the prevalence of TTV infection in spouses of index cases and the related risk factors.Methods: Serum TTV‐DNA was studied in spouses of 41 subjects with TT viremia. For couples in which both husband and wife had TT viremia, nucleotide sequences of the open reading frame‐1 region were analyzed by phylogenetic tree constructions.Results: Three (7%) of 41 spouses were positive for TTV‐DNA. No differences were noted between index patients with seropositive spouses and those without seropositive spouses with regard to clinical characteristics, including parenteral risk factors and exposure duration. Nucleotide sequence comparison and phylogenetic tree analysis of the viral genome in three TTV‐infected couples revealed the isolates to be closely related in two, with a homology of 97 and 98%, respectively.Conclusions: These results suggest that interspousal transmission of TTV does occur; however, the efficiency of transmission is low compared with hepatitis C virus and GB virus‐C. There are no apparent risk factors for transmission between spouses and further studies are needed to clarify other modes of non‐parenteral transmission.