bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multi‐scale analysis of fragmentation effects on remnant plant species richness in Phoenix, Arizona
Authors: Stiles Arthur , Scheiner Samuel M. 
Published: June 2010

AbstractAim  Understanding complex ecological phenomena, such as the determinants of species richness, is best achieved by investigating their properties at different spatial scales. Factors significantly affecting the number of species occurring at one scale may not impact on richness at other scales. While this scale dependence has become increasingly recognized, there still remains a need to elucidate exactly how richness is structured across scales, and which mechanisms are influential for determining this important community property. This study explores how woody plant species richness varies in a fragmented system at multiple scales, and which factors are primarily responsible for these patterns.Location  The study area is located in the Sonoran Desert within the bounds of metropolitan Phoenix, Arizona, which is the locus of the Central Arizona–Phoenix Long‐Term Ecological Research (CAP‐LTER) site.Methods  Estimates of local and fragment plant species richness were generated from field data collected from 22 sites. Independent variables describing fragment sites were also calculated, including area, habitat heterogeneity, density of individuals, mean elevation, and extent of isolation. Structural equation modelling, multiple regression, and analysis of covariance were used to assess the contribution of independent variables to richness at the fragment and local scales.Results  Fragment species richness was significantly influenced by area, though not isolation, habitat heterogeneity, mean elevation, or density of individuals. Local richness was not significantly related to fragment area, but was positively related to fragment richness, plant density, and elevation.Main conclusions  The fragment species–area effect resulted from larger remnants supporting higher numbers of individuals at comparable densities, increasing richness through either passive sampling of progressively less common species and/or lower extinction rates among larger populations. Without using multi‐temporal data it is not possible to disentangle these mechanisms. We found that patterns evident at one scale are not necessarily apparent at other scales, as elevation and density of individuals significantly affected richness at the local scale but not at the fragment scale. These results lend support to the concept that mechanisms influencing the species richness of natural communities may be operable only within certain domains and that relevant scales should be specified.
Treatment decision‐making in cancer care: the role of the carer
Authors: Hubbard Gill , Illingworth Nicola , Rowa‐Dewar Neneh , Forbat Liz , Kearney Nora 
Published: June 2010

Aims and objectives.  This study explores the role of the carer in treatment decision‐making in cancer care.Background.  Literature about involvement in treatment decision‐making tends to focus on patients and clinicians, with the carer rarely included. The absence of carers is problematic because the management of illness is often carried out in the context of complex networks of relationships. Although current policy encourages health care practitioners to work in partnership with family members, implementation is troubled by a lack of understanding of the significance of interpersonal relationships and interactions and the role of the relationship throughout the course of the illness experience. Despite awareness, there is little systematic, coherent analysis of the complexity of these interactional dynamics and, in particular, consideration of the implications for involvement and treatment decision‐making.Design.  Qualitative, longitudinal.Methods.  Three serial semi‐structured interviews with 66 patients and 43 carers within the first year following a diagnosis of cancer. A descriptive and thematic approach to data analysis was adopted.Results.  Carers are involved in treatment decision‐making in cancer care and contribute to the involvement of patients through their actions during, before and after consultations with clinicians. Carers can act as conduits for information from patient to clinician and from clinician to patient. They can also act as facilitators during deliberations, helping patients to consider whether to have treatment or not and which treatment.Conclusions.  Our study has highlighted the deficiency of models that fail to acknowledge the role of the carer in the treatment decision‐making process. We propose the adoption of a relational approach by the inclusion of the carer in conceptual frameworks and recommend triadic (patient, carer and professional) models of involvement.Relevance to clinical practice.  Cancer care clinicians should recognise and actively involve the carer as well as the patient in treatment decision‐making.
Parental management of childhood complaints: over‐the‐counter medicine use and advice‐seeking behaviours
Authors: Trajanovska Misel , Manias Elizabeth , Cranswick Noel , Johnston Linda 
Published: June 2010

Aims and objectives. To explore parental management of childhood complaints with respect to factors associated with the purchase of over‐the‐counter medicines and sources of information accessed by parents.Background. The use of over‐the‐counter medicines is extensive, but this practice is not without risks. To ensure safe use, nurses and other healthcare providers need to understand parental reasons for purchase and sources of information they access regarding management practices.Design. A cross‐sectional survey.Method. Three‐hundred and twenty‐five parents of children (aged birth to 24 months) were recruited between September 2006–June 2007 from three recruitment sites across Melbourne, Australia. These included the following: outpatient clinics at a major paediatric hospital, maternal and child health centres and a childcare service of a tertiary education institution. Data were collected using a self‐administered questionnaire.Result. Most parents (82%) purchased over‐the‐counter medicines if suggested by the doctor and if it had been effective in the past. Doctors were the most frequently cited source of advice for management of complaints such as an ear ache (95%), wheeziness (90%) and rash (77%). Advice from maternal and child health nurses was frequently sought for sleep difficulties (60%), while family or friends were sought for advice on irritability or crankiness (47%) and teething pain (44%).Conclusions. The findings revealed the impact of healthcare provider recommendations on parental purchase of over‐the‐counter medicines. Parents mainly sought information and advice from doctors, followed by maternal and child health nurses and family or friends, which appeared to be dependent on the type of childhood complaint.Relevance to clinical practice. The use of over‐the‐counter medicines for symptom management is likely to increase with enhanced focus on self‐care. It is important for all healthcare providers to proactively provide accurate, consistent and evidence‐based information to parents regarding appropriate management of symptomatic and behavioural complaints.
A comprehensive training programme for nurse endoscopist performing flexible sigmoidoscopy in Hong Kong
Authors: Shum Nga F , Lui Yau L , Choi Hok K , Lau So C , Ho Judy WC 
Published: June 2010

Aims.  To describe the process and explore the feasibility of training a colorectal nurse in Hong Kong to perform flexible sigmoidoscopy.Background.  Given the shortage and high turnover rate of medical staff, a pilot programme was designed to train and expand the role of colorectal nurse clinicians. It was hoped that such nurses could share some of the clinical duties of the medical staff. An advanced practice nurse was selected for the programme. One of the training components was the performance of flexible sigmoidoscopy.Design.  This was a descriptive, case review study.Method.  A one‐year‐structured endoscopic training programme was designed for the nurse clinician. Weekly sessions were conducted by one of the trainers. The training process included the following: (1) procedural observation; (2) supervised withdrawal, advancement and manipulation of the sigmoidoscope and (3) a final assessment of the nurse’s competency in performing sigmoidoscopy independently.Results.  In total, 119 outpatients (58 male and 61 female) with a mean age of 57·02 years (SD 14·6 years; range: 18–83 years) underwent flexible sigmoidoscopy by the nurse over 11 months. The mean procedural time was 9·38 minutes (SD 3·5 minutes; range 3–26 minutes). The procedure was terminated prematurely if it could not be tolerated by the patient or if the bowel preparation was inadequate. The mean depth of insertion was 53·5 cm (SD 12·2 cm; range 6–60 cm). In total, 82 patients had a normal exam, 32 patients had abnormalities. There were no procedural complications, and no patient required an unplanned hospital admission after the procedure.Conclusion.  In Queen Mary Hospital, nurses can be trained to perform flexible sigmoidoscopy in a safe and effective manner.Relevance to clinical practice.  Nurse endoscopists could increase the use of flexible sigmoidoscopy in colorectal cancer screening and can also enhance the professional development of colorectal nurses.
Satisfaction with care in oncology outpatient clinics: psychometric characteristics of the Icelandic EORTC IN‐PATSAT32 version
Authors: Hjörleifsdóttir Elísabet , Hallberg Ingalill Rahm , Gunnarsdóttir Elín Díanna 
Published: June 2010

Aim and objectives. To assess the psychometric characteristics of the Icelandic European Organisation for Research and Treatment of Cancer IN‐PATSAT32 (EORTC IN‐PATSAT32) version and to compare satisfaction with care between gender and different age groups.Background. The majority of patients with cancer receive either chemotherapy or radiotherapy on an outpatient basis. There is a need to evaluate satisfaction with care and service for these patients using reliable and valid instruments.Design. Cross‐sectional comparative study.Method. Participants (n = 217) who received treatment for cancer as outpatients answered the EORTC IN‐PATSAT32 questionnaire. Participants were 22–91 years old and 57% of them were female.Results. Overall high satisfaction was found with communication, information and care that patients receive from doctors and nurses. Principal component analysis extracted four factors: ‘satisfaction with nurses’ conduct’, ‘satisfaction with doctors’ conduct’, ‘satisfaction with information’ and ‘satisfaction with service and care organisation’. Patients were most satisfied with nurses’ conduct but least satisfied with service and care organisation. Cronbach’s alpha for the four factors ranged from 0·95–0·67.Conclusion. Although the validity of this instrument including its sensitivity to patients’ level of dissatisfaction as well as satisfaction with care and service was evident, this needs to be further explored in future studies. The psychometric strengths of the EORTC IN‐PATSAT32 are its internal consistency and its construct validity, but there are several issues indicating a need to change and develop the instrument and specifically adopting it to outpatient care.Relevance to clinical practice. Outpatient treatment options offered to cancer patients have increased, and this calls for knowledge of their satisfaction with care and service. Sparse studies are available, and there is a need for further development of reliable instruments. Our study indicates that outpatients with cancer are quite satisfied with the care they receive. Findings may contribute to improvement in outpatients’ clinics that provide treatment to patients with cancer.
Mothers’ experience with 1st–3rd‐grade children with asthma assisting their child’s adaptation of school life in Taiwan
Authors: Cheng Shu‐Chen , Chen Yu‐chih , Liou Yiing Mei , Wang Kai‐Wei Katherine , Mu Pei‐Fan 
Published: June 2010

Aims and objectives.  This study used purposive sampling through semi‐structured interviews to obtain the experiences of mothers of 7–11‐year‐old children with asthma who were assisting their child’s adaptation to school life.Background.  Children with asthma often have problems with social adaptation, including school absenteeism, limits to their activity and bullying by peers. From kindergarten to elementary school, it is a transitional process where the child experiences multiple changes in the body, mind and social situations. It can be difficult for mothers of children with asthma to assist their children with their adaptation to school life.Design.  A qualitative enquiry design was used.Methods.  A total of 15 mothers having elementary school children with asthma in grades 1–3 were interviewed. Participants were contacted at the outpatient department of a medical centre in Taiwan. Verbatim transcriptions of the interviews were examined by the content analysis method. After analysis of the interview data of the 15 informants, no new themes had emerged. Lincoln and Guba’s trustworthiness criteria were employed to evaluate methodological rigour.Results.  There were four themes that formed part of the mothers’ experiences. Those were: (1) being concerned about the child’s adaptation to school life, (2) improving attitudes and relieving symptoms, (3) establishing the child’s self‐management abilities and (4) bearing role strain and normalising the life of the child.Conclusions.  The findings of this study should help health professionals and schoolteachers to understand the needs of families and mothers who have a child with asthma. The findings provide appropriate information and resources to assist the children’s adjustment to school life.Relevance to clinical practice.  The findings indicate that nursing professionals should provide child‐focused and family‐centred care that will assist parents of children with asthma to adjust to school life.
Perceptions of breastfeeding and planned return to work or school among low‐income pregnant women in the USA
Authors: Rojjanasrirat Wilaiporn , Sousa Valmi D 
Published: June 2010

Aims and objectives.  To describe the perceptions of breastfeeding in low‐income pregnant women to understand their needs better as they plan to return to work or school.Background.  Maternal employment has a negative impact on breastfeeding duration. Yet there is insufficient research on challenges and facilitators regarding breastfeeding and employment issue among low‐income women in the USA. Knowing the perceptions of breastfeeding among low‐income pregnant women and their plan to return to work or school may have implications for nurses and midwives in providing quality care.Design.  Qualitative study using focus group interviews.Methods.  The research setting consisted of three Women, Infants and Children clinics (WIC) in a midwestern city of the USA. Seventeen pregnant women (aged 19–35) participated in focus group interviews. Data were coded and analysed for themes and patterns using the QSR software – NVivo 6.Results.  Eleven participants were single. Ten women were primigravida, and seven were multipara. The following five themes were identified: (1) perceived benefits of breastfeeding; (2) general perceptions of breastfeeding; (3) maternal concerns; (4) having the right support; and (5) anticipated challenges of combining breastfeeding and work.Conclusions.  Low‐income women anticipated substantial barriers for breastfeeding when they planned to combine breastfeeding and work or school. The results of this study have many implications for public health practice, research and policy. Educating employers and the public at large about the health and economic benefits derived from long‐term breastfeeding could help promote breastfeeding awareness.Relevance to clinical practice.  Strategies supporting breastfeeding among low‐income working women must be provided at multiple levels to help overcome the barriers they concern. Health care providers should help women gain confidence by minimising their uncertainties and fears about breastfeeding to prepare them to continue breastfeeding successfully after returning to work.
Nurses’ experiences in the relief of postoperative nausea and vomiting
Authors: Sussanne Börjeson , Arweström Carina , Baker Angelica , Berterö Carina 
Published: June 2010

Aim.  The aim of the study was to illuminate the experience of nurses in relieving postoperative nausea and vomiting.Background.  Postoperative nausea and vomiting has been shown to be one of the most common and distressing side effects of surgery. In spite of this, there has been little research on the role of nurses in caring for patients with postoperative nausea and vomiting.Design.  Qualitative approach using narratives.Methods.  Ten female nurses from two general surgical departments were interviewed. The transcribed interviews were analysed using the hermeneutic narrative method inspired by Polkinghorne.Results.  The nurses report that they have what may be described as a set of different tools at their disposal. These tools can be entitled ‘listen and understand’, ‘information’, ‘the clinical eye’ and ‘availability’, all of which can be used in solving several needs. However, some nurses have better skills or more opportunities to use the available tools than do others. By using these tools, the nurses can increase their possibilities for enhancing the patients’ efforts to gain control over their own situation and thereby increase the quality of their care.Conclusion.  Nurses use different types of tools to relieve postoperative nausea and vomiting and it is possible to create a positive nursing care situation if patients are given the opportunity to be in control and handle their own situation.Relevance to clinical practice.  When it comes to relieving postoperative nausea and vomiting, the findings of this study are important as the study highlights the practical actions taken by nurses and their experiences. When nurses have the possibility to use their nursing tools in an optimal way, together with their experience and knowledge and then follow their nursing actions by being able to reflect on them, they can further develop their approach to nursing and thereby increase their competence as nurses.
Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland
Authors: Westergren Albert , Torfadóttir Ólina , Ulander Kerstin , Axelsson Carolina , Lindholm Christina 
Published: June 2010

Aim.  The aim of this study was to explore the point prevalence of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk before and after an intervention.Background.  Malnutrition risk and the precision in targeting nutritional treatment are indicators of quality of care. Knowledge regarding the in‐hospital prevalence of malnutrition and nutritional treatment is meagre for Iceland.Design.  Pre‐ and postintervention study.Methods.  The study was performed during one day in 2006 (March) and one day in 2007 (April). In total, 95 (89%) and 92 (88%) patients agreed to participate. Moderate/high undernutrition risk was defined as the occurrence of at least two of the following: involuntary weight loss, body mass index below limit and eating difficulties according to Minimal Eating Observation Form – Version II. Being overweight was graded based on body mass index. Specific nutritional care actions were recorded. Intervention: A five‐point programme for nutrition and eating was implemented.Results.  Moderate/high risk for undernutrition was found in 25 and 17% in the two years (ns, not significant). A high body mass index was found in 53 and 54% (ns). The number of patients with a documented body mass index significantly increased between the two surveys (1 and 30%, p‐value <0·0005). The use of oral supplements increased from 11–40% (p < 0·0005) and especially among those at no/low undernutrition risk, with ingestion or deglutition difficulties (p < 0·0005 in both cases) but not among those with appetite and energy problems (ns).Conclusion.  Implementing a nutritional programme does not necessarily affect the number of in‐patients with malnutrition, but it is likely to increase the precision of nutritional care to some extent.Relevance to clinical practice.  Greater efforts need to be taken to increase the precision of nutritional care among patients at moderate/high undernutrition risk and among those with appetite and energy problems.
Perception of risk of coronary heart disease among Jordanians
Authors: Ammouri Ali A , Neuberger Geri , Mrayyan Majd T , Hamaideh Shaher H 
Published: June 2010

Aims and objectives.  The purpose of this study was to assess perceptions of risk of coronary heart disease among Jordanians and its association with demographic variables and health behaviours.Background.  Lack of accurate risk perception may prevent adults from considering the need for early preventive behaviours or seeking early life‐saving interventions in the presence of coronary heart disease symptoms.Design.  A descriptive study.Methods.  Using descriptive statistics and regression analysis, a convenience sample of 300 adults was used.Results.  Older Jordanians had higher perception of risk of coronary heart disease (β = 0·237, p < 0·001). Jordanian women (β = −0·121, p < 0·05) perceived coronary heart disease more as unobservable, unknown, new and delayed in manifestation of harm than Jordanian men. Also, adult Jordanians who reported not having family member with coronary heart disease (β = 0·129, p < 0·05) perceived coronary heart disease more as unobservable, unknown, new and delayed in manifestation of harm. Adults with higher level of education indicated higher perception of risk of coronary heart disease. There were no significant associations between perception of risk of coronary heart disease and health behaviours among adult Jordanians.Conclusions.  Our data indicate the need for heart disease education programmes for all adults, including programmes targeted for younger adults, women and persons with low levels of education. It is important to emphasise that adopting healthy lifestyle behaviours can influence their risk for developing long‐term disease.Relevance to clinical practice.  Perception of risk of heart disease can greatly influence the decisions taken by adults in regard to their health care. Lack of accurate risk perception may prevent adults from considering the need for early preventive behaviours or seeking early life‐saving interventions in the presence of coronary heart disease symptoms.
Specificity and trade‐offs in the induced plant defence of common milkweed Asclepias syriaca to two lepidopteran herbivores
Authors: Bingham Robin A. , Agrawal Anurag A. 
Published: June 2010

Summary 1. We studied induced defences in common milkweed (Asclepias syriaca) to two specialist caterpillars (Danaus plexippus and Euchaetes egle) to test several hypotheses about co‐evolution and defence allocation. 2. Latex, a potent defence of milkweed, showed nearly fivefold variation in the amount exuded among genetic families and more than doubled production in response to herbivory by D. plexippus; this induced latex response was fourfold stronger than the latex response to E. egle herbivory. In contrast, D. plexippus and E. egle equivalently induced foliar cardenolide concentration (an average increase of 26%). 3. We found broad‐sense heritable variation for the induced plant responses, and there was a genetic correlation between the responses induced by the two herbivores for cardenolides, but not for latex. We found no genetic correlation between investment in latex and cardenolides in any of the treatments. 4. Using a bias‐corrected Monte Carlo procedure, we found strong evidence for a trade‐off between constitutive and induced cardenolides, but not for latex. 5. Synthesis. As natural selection by specific herbivores varies in space and time, we expect that these defence traits in A. syriaca will evolve independently, with the expression of cardenolides showing less specificity, as well as being constrained by a trade‐off between constitutive and induced defence.