bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre‐admission education in surgical rheumatology nursing: towards greater patient empowerment
Authors: Johansson Kirsi , Katajisto Jouko , Salanterä Sanna 
Published: October 2010

Aims and objectives.  This study compared the pre‐admission education received by two groups of rheumatoid arthritis (RA) patients scheduled for hip arthroplasty. The specific aim was to compare these patients’ knowledge about care‐related issues and sense of certainty about that knowledge, empowering learning experience, length of admission discussion, length of hospital stay and number of health problems.Background.  Previous studies have shown that surgical pre‐admission education is beneficial, but there is no evidence on the relative effectiveness of different methods of education.Design.  We used a pre–post‐test design with two groups of surgical RA patients (Group I pre‐admission education via telephone and standard written educational material, n = 29; Group II standard written educational material, n = 30).Methods.  The data were collected with previously used instruments (OPKQ, MEQ), and demographic and clinical variables were asked.Results.  The mean score for knowledge about care‐related issues and sense of certainty about that knowledge for Group I and for Group II showed no statistically significant differences at baseline and at admission. At discharge, however, a significant difference was seen between the scores – in favour of Group II. On the other hand, patients in Group I were found to be more empowered in all areas than patients in Group II.Conclusions.  Written educational material seems to be a good choice for pre‐admission patient education compared with telephone counselling, particularly when patients are knowledgeable about care‐related issues before admission. However, education via telephone is experienced by patients as more empowering than written educational material.Relevance to clinical practice.  To increase patient’s knowledge written educational material can be recommended for use, but to increase patient’s empowerment telephone education is better.
Let me talk – an advance care planning programme for frail nursing home residents
Authors: Chan Helen YL , Pang Samantha MC 
Published: October 2010

Aims and objectives.  This study attempted to test the plausibility of engaging frail nursing home residents in advance care planning (ACP).Background.  Advance care planning fosters communication among individuals, family and health professionals regarding end‐of‐life care. Yet, such practice seldom takes place in a timely fashion because of its sensitive nature; thus, the concerns of these residents are often left unattended.Design.  This was a one‐year quasi‐experimental study to test the feasibility of the Let Me Talk ACP programme, with its design being inspired by literature and our earlier work, among frail nursing home residents.Method.  Three assessments were conducted at six‐month intervals to monitor the programme effects. The storytelling approach, which allowed participants to thread together their past, present and future, was the key feature of the programme.Results.  Findings showed that the treatment preference stability was significantly higher in the intervention group (κ = 0·53, p ≤ 0·001). Significantly more participants in this group also communicated their treatment preferences to their family or caregivers (p = 0·012), with an odds ratio of 4·52. The programme also had a positive effect on mitigating participants’ existential distress.Conclusions.  The programme was found effective in clarifying participants’ treatment preferences and encouraging them to communicate their preferences to significant others. However, it was also found that involving participants’ family in open discussion remained difficult. Extensive promotion in the community is therefore necessary.Relevance to clinical practice.  It is recommended that such ACP programmes should be integrated into nursing home care practice, as they can be initiated in a relaxed atmosphere and maintained as an ongoing process. The trusting relationship between the nurse in the homes and the residents enables in‐depth discussion. The nurse is also well placed to play the facilitator role in guiding the process, providing information and mediating the family discussion.
Comparing Point of Care International Normalised Ratio testing with laboratory testing methods in a cardiac inpatient population
Authors: Giles Michelle T , Parker Vicki , Bevan Heather , Wright Ian MR 
Published: October 2010

Aims and objective.  To compare agreement between International Normalised Ratio results from Point of Care testing with laboratory testing for cardiac inpatients receiving warfarin sodium.Background.  Availability of point of care technology for International Normalised Ratio testing offers considerable benefits to patients and health care staff across a range of context.Design.  Prospective comparison study.Method.  Setting – Four cardiac wards in a regional referral hospital in New South Wales, Australia. Participants – 50 cardiovascular inpatients receiving warfarin therapy, including those patients being converted from intravenous heparin sodium. Intervention‐Point of Care International Normalised Ratio testing via finger prick using the CoaguChek®XS attended within one hour of laboratory International Normalised Ratio testing. Paired International Normalised Ratio results were compared using spearman rank and Mann–Whitney rank sum. Bland–Altman plots were used to demonstrate agreement.Results.  One hundred and seventeen blinded paired tests were carried out, 44 on patients receiving intravenous heparin. Laboratory and Point of Care International Normalised Ratio testing were highly significantly correlated (r = 0·953, p < 0·0001, n = 117). There was close agreement between Point of Care International Normalised Ratio and laboratory International Normalised Ratio results for patients receiving warfarin regardless of whether they were receiving heparin sodium. There was a mean bias of +0·2 units (95% CI 0·145–0·246). The presence of diabetes significantly reduced the difference between paired tests. Bias significantly increased above an International Normalised Ratio of 4·5 units. Ninety‐seven per cent of all values fell between 20% limits of agreement after accounting for the mean bias of +0·2 units.Conclusion.  Results indicated Point of Care International Normalised Ratio testing can be used for clinical decision making for cardiovascular inpatients receiving warfarin. Clinical guidelines need to be developed and tested in appropriate population groups and across different contexts, because of the potential for significant patient benefit.Relevance to clinical practice.  Point of Care International Normalised Ratio results in time and procedural efficiency, care responsiveness, cost saving, increased patient comfort and reduced handling errors (Pharmacotherapy 22; 2002: 677), as well as the potential for continuity of care.
Subgroups of haemodialysis patients in relation to fluid intake restrictions: a cluster analytical approach
Authors: Lindberg Magnus , Wikström Björn , Lindberg Per 
Published: October 2010

Aims.  To determine whether definable subgroups exist in a sample of haemodialysis patients with regard to self‐efficacy, attentional style and depressive symptomatology and to compare whether interdialytic weight gain varies between patients in groups with different cognitive profiles.Background.  Theory‐based research suggests that cognitive factors (e.g. self‐efficacy and attentional style) and depressive symptomatology undermine adherence to health protective regimens. Preventing negative outcomes of fluid overload is essential for haemodialysis patients but many patients cannot achieve fluid control, and nursing interventions aimed to help the patients reduce fluid intake are ineffective. Understanding the interaction between cognitive factors and how this is related to adherence outcomes might therefore lead to the development of helpful nursing interventions.Design.  Explorative cross‐sectional multicentre survey.Methods.  The sample consisted of 133 haemodialysis patients. Data were collected using structured questionnaires. A brief self‐report form and data on interdialytic weight gain was also used. Two‐step cluster analysis was used to identify subgroups. One‐way analysis of variance (anova) or Pearson’s chi‐square test was used for comparing subgroups.Results.  Three distinct subgroups were found and subsequently labelled: (1) low self‐efficacy, (2) distraction and depressive symptoms and (3) high self‐efficacy. The subgroups differed in fluid intake, but not in age, dialysis vintage, gender, residual urine output or in receiving any fluid intake advice.Conclusions.  Clinically relevant subgroups of haemodialysis patients could be defined by their profiles regarding self‐efficacy, attentional style and depressive symptoms.Relevance to clinical practice.  Based on this study, we would encourage clinical practitioners to take into account cognitive profiles while performing their work. This is especially important when a targeted nursing intervention, which aims to encourage and maintain the patient’s fluid control, is introduced.
Anxiety, depressive symptom and suicidal ideation of outpatients with obsessive compulsive disorders in Taiwan
Authors: Hung Tzu‐Chi , Tang Hwa‐Sheng , Chiu Chen‐Huan , Chen Ying‐Yeh , Chou Kuei‐Ru , Chiou Hsien‐Chih , Chang Hsiu‐Ju 
Published: October 2010

Aims and objectives.  The major aims of this study were to explore the differences in anxiety, depressive symptoms and suicidal ideation between high and low obsessive compulsive symptom groups, as well as predictors for suicidal ideation among outpatients with obsessive compulsive disorder.Background.  Obsessive compulsive disorder is often accompanied by anxiety, depression and even suicidal ideation. However, there have been very few studies exploring the inter‐relationships among anxiety, depressive symptoms and suicidal ideation for patients with obsessive compulsive disorder.Design.  This study employed a cross‐sectional comparative research design.Methods.  A sample of 128 outpatients with obsessive compulsive disorder was recruited from a medical teaching hospital in Northern Taiwan. The major study instruments included the Beck Anxiety Inventory, Beck Depression Inventory II, Yale‐Brown Obsessive Compulsive Scale (Y‐BOCS) and the Beck Scale for Suicide Ideation. We divided outpatients into two groups: outpatients with Y‐BOCS scores higher than 15 were placed in the high obsessive compulsive symptom group, while outpatients with Y‐BOCS score lower than or equal to 15 were placed in the low obsessive compulsive symptom group. Statistical methods included Pearson’s product–moment correlation, independent samples t‐test, chi‐square test and multiple regressions.Results.  Results revealed that obsessive compulsive disorder outpatients with high Y‐BOCS scores also had higher rates of being single and having an earlier onset age, poorer disease control, higher levels of anxiety, depressive symptoms and suicidal ideation. The predictors for suicidal ideation were anxiety and depressive symptoms.Conclusions.  Obsessive compulsive disorder patients with higher obsessive compulsive symptoms are at greater risk of higher levels of anxiety, depressive symptoms and suicidal ideation. In addition to depression, anxiety symptoms contribute significantly to suicidal ideation among patients with obsessive compulsive disorder.Relevance to clinical practice.  Standard nursing care of patients with obsessive compulsive disorder should incorporate assessing levels of obsessive compulsive symptoms to identify the severity of anxiety, depressive symptoms and suicidal ideation more accurately.
Development and implementation of a bereavement follow‐up intervention for grieving fathers: an action research
Authors: Aho Anna L , Åstedt‐Kurki Päivi , Tarkka Marja‐Terttu , Kaunonen Marja 
Published: October 2010

Aims and objectives.  The aim is to present the development and implementation of a bereavement follow‐up intervention for grieving fathers. The development and implementation process and components of the intervention are presented.Background.  There is a lack of research into fathers’ grief and bereavement support for them after the death of a child. Promotion of evidence‐based nursing requires transparent development and implementation of nursing interventions and models to be able to repeat, evaluate their effectiveness and redevelop them.Design.  Phases of action research were used when developing and implementing the intervention.Methods.  Results of the baseline study of father’s grief and social support, the study of current bereavement support and the literature review were combined using triangulation.Results.  In this action research, the development of a bereavement follow‐up intervention for grieving fathers began with the planning phase that included a baseline study about fathers’ grief and social support, a study of current bereavement support systems in Finnish university hospitals and a systematic review of literature on the topic area and collaboration with a panel of experts. The developed bereavement follow‐up intervention included three complementary components: support package, peer supporters’ contact and health care personnel’s contact. Implementation of the intervention included the development of a programme to be used in nursing practice, intervention training for programme implementers and intervention implementation.Conclusions.  Developing and implementing an intervention is a complex, demanding and long‐term process. The planning required theoretical knowledge as well as understanding the experiences of fathers, nursing practice and collaboration with those who implemented the intervention.Relevance to clinical practice.  New information about the fathers’ grief and bereavement follow‐up support is described. The model developed is evidence‐based and can be applied in nursing care where grieving fathers and families are met.
A qualitative study of the perceptions of coronary heart disease among Hong Kong Chinese people
Authors: Chan Choi Wan , Lopez Violeta , Chung Joanne WY 
Published: October 2010

Aims and objectives.  The aim of this study was to investigate the perceptions of coronary heart disease among a sample of Hong Kong Chinese people.Background.  Coronary heart disease is increasing among Chinese populations. Reducing coronary heart disease risk is highly dependant on a person’s evaluation of the risks and lifestyle behaviour. However, Chinese perceptions of coronary heart disease and the risks have been underexplored.Design.  A qualitative study was conducted using focus group interviews.Method.  Focus group interviews were tape recorded and transcribed. The data were analysed using content analysis.Results.  The results show that the Hong Kong Chinese participants underestimated the severity of coronary heart disease. Perceptions of risk of coronary heart disease were influenced by the risk factors, symptoms, age, optimism, levels of suffering from coronary heart disease and reliance on medical professionals. Most of the participants perceived that this is because of inadequate understanding of coronary heart disease and lack of resources for coronary heart disease health education.Conclusion.  Societal readiness is paramount in imparting accurate coronary heart disease knowledge to mediate the perception of coronary heart disease as a major health problem that affects the Chinese population.Relevance to clinical practice.  Understanding the Chinese participants’ perceptions of coronary heart disease is vital in developing illness prevention and health promotion strategies to increase their levels of knowledge of coronary heart disease risk factors reduction.
From continuing education to personal digital assistants: what do physical therapists need to support evidence‐based practice in stroke management?
Authors: Salbach Nancy M. , Veinot Paula , Jaglal Susan B. , Bayley Mark , Rolfe Danielle 
Published: October 2010

AbstractRationale, aims and objectives  Understanding how to structure educational interventions and resources to facilitate physical therapists' application of the research literature is required. The objective of this study was to explore physical therapists' preferences for strategies to facilitate their access to, evaluation and implementation of the stroke research literature in clinical practice.Methods  In‐depth, qualitative telephone interviews were conducted with 23 physical therapists who treat people with stroke in Ontario, Canada and who had participated in a previous survey on evidence‐based practice. Data were analysed using a constant comparative approach to identify emergent themes.Results  Participants preferred online access to research summaries or systematic reviews to save time to filter and critique research articles. To enable access in the workplace, an acceptable computer‐to‐staff ratio, permission to access web sites and protected work time were suggested. Participants considered personal digital assistants as excellent tools for quick access to online resources but were unsure of their advantage over a desktop computer. Therapists favoured use of non‐technical language, glossaries of research terms and quality ratings of studies to ease understanding and appraisal. Teleconferencing or videoconferencing overcame geographical but not scheduling barriers to accessing education. To achieve behaviour change in clinical practice, therapists preferred multiple interactive, face‐to‐face education sessions in a group format, with opportunities for case‐based learning and practice of new skills.Conclusion  Physical therapists prefer technology‐assisted access to resources and education and favour attending multiple interactive, expert‐facilitated education sessions incorporating opportunities for case‐based learning and practice of new skills to change behaviour related to evidence‐based practice.
The impacts of pre‐surgery wait for total knee replacement on pain, function and health‐related quality of life six months after surgery
Authors: Desmeules François , Dionne Clermont E. , Belzile Étienne L. , Bourbonnais Renée , Frémont Pierre 
Published: October 2010

AbstractObjective  The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre‐surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health‐related quality of life (HRQoL) and on contralateral knee pain 6 months after surgery.Method  A total of 141 patients scheduled for TKR were recruited from three hospitals in Quebec City, Canada, and followed up until 6 months after surgery. Pre‐surgery wait, defined as the time between enrolment on the pre‐surgery waiting list and surgery, was considered in four categories (≤3, >3–6, >6–9, >9 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC). HRQoL was measured with the SF‐36.Results  Mean pre‐surgery waiting time was 184 (SD: 120.8) days. Six months after TKR, a significant difference was seen between the four groups of pre‐surgery wait in terms of HRQoL SF‐36 role physical [F(3, 136) = 2.74, P = 0.046] and contralateral knee WOMAC pain [F(3, 136) = 5.78, P = 0.0009] scores. Participants with the longest pre‐surgery wait (>9 months) showed the worst scores 6 months after TKR.Conclusions  Longer pre‐surgery waiting time had a negative clinically important impact on HRQoL and contralateral knee pain 6 months after surgery.
Ketoprofen in piglets: enantioselective pharmacokinetics, pharmacodynamics and PK/PD modelling
Authors: FOSSE T. K. , TOUTAIN P. L. , SPADAVECCHIA C. , HAGA H. A. , HORSBERG T. E. , RANHEIM B. 
Published: October 2010

Fosse, T. K., Toutain, P. L., Spadavecchia, C., Haga, H. A., Horsberg, T. E., Ranheim, B. Ketoprofen in piglets: enantioselective pharmacokinetics, pharmacodynamics and PK/PD modelling.J. vet. Pharmacol. Therap.34, 338–349.The chiral pharmacokinetics and pharmacodynamics of ketoprofen were investigated in a placebo‐controlled study in piglets after intramuscular administration of 6 mg/kg racemic ketoprofen. The absorption half‐lives of both enantiomers were short, and S‐ketoprofen predominated over R‐ketoprofen in plasma. A kaolin‐induced inflammation model was used to evaluate the anti‐inflammatory, antipyretic and analgesic effects of ketoprofen. Skin temperatures increased after the kaolin injection, but the effect of ketoprofen was small. No significant antipyretic effects could be detected, but body temperatures tended to be lower in the ketoprofen‐treated piglets. Mechanical nociceptive threshold testing was used to evaluate the analgesic effects. The piglets in the ketoprofen‐treated group had significantly higher mechanical nociceptive thresholds compared to the piglets in the placebo group for 12–24 h following the treatment. Pharmacokinetic/pharmacodynamic modelling of the results from the mechanical nociceptive threshold testing gave a median IC50for S‐ketoprofen of 26.7 μg/mL and an IC50for R‐ketoprofen of 1.6 μg/mL. This indicates that R‐ketoprofen is a more potent analgesic than S‐ketoprofen in piglets. Estimated ED50for racemic ketoprofen was 2.5 mg/kg.
Sourcing Eurasian beaver Castor fiber stock for reintroductions in Great Britain and Western Europe
Authors: HALLEY Duncan J. 
Published: October 2010

ABSTRACT

Eurasian beavers Castor fiber, formerly threatened with extinction, have been widely reintroduced since the 1920s. Reintroductions and studies of possible reintroductions are continuing.
The International Union for Conservation of Nature (IUCN) guidelines for reintroductions state that ‘the source population should ideally be closely related genetically to the original native stock’.
Palaeoecological studies suggest that the species survived the last Ice Age in two refugia: in the west in Iberia and Southern France and in the east in the Black Sea region. The post‐Ice Age population of Western Europe, including Great Britain, recolonized from the western refugium. Recent mitochondrial deoxyribonucleic acid studies strongly support this view, and extant beaver populations are clearly divided into eastern and western evolutionarily significant units (ESUs).
The western ESU is composed of three stocks which survived the 19th and early 20th century as very small, isolated populations. They are very closely related to each other. Each is genetically depauperate, apparently as a result of genetic drift at low population levels.
There is evidence of inbreeding depression and of phenotypic abnormalities in beaver populations descended from unmixed stocks.
The evidence suggests three coherent management options for sourcing reintroduction stock for Great Britain and for unoccupied areas of western continental Europe. These are (i) use animals from a single western ESU stock; (ii) intentionally mix animals from two or all three of the surviving western ESU stocks; (iii) make an informed exception to the IUCN guidelines and reintroduce animals of mixed eastern and western ESU provenance.
These options are discussed with regard to IUCN guidelines, conservation biology and animal welfare considerations. It would be advantageous if a common policy on the origin of reintroduction stock were agreed by the national agencies responsible.