bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender diversity in expatriation: evaluating theoretical perspectives
Authors: Shortland Susan 
Published: July 2009

PurposeThe purpose of this paper is to examine the range of theoretical underpinning used to explain women's participation as expatriates with a view to identifying the most promising theoretical lenses for future research.Design/methodology/approachDrawing upon theoretical explanations in the “women in management” and “women expatriates” literature, four main theoretical domains are identified that are used to understand and explain their continuing low representation as expatriates: women's choices, assignee characteristics, social and societal norms and institutional aspects. Key theories within each domain are evaluated to suggest a future theoretical research framework.FindingsThe most promising theoretical explanation of women's low participation as expatriates is identified as being linked to gender stereotyping reinforced within an isomorphic institutional framework.Research limitations/implicationsResearch into women's inroads into management and into expatriation has generated considerable volumes of theorising in the literature. Thus, only representative examples have been selected here. In terms of future research, gender, identity and sex role theories potentially provide the most promising theoretical lenses set within the institutional framework of organisational policy and practice.Practical implicationsOrganisational approaches to international assignment policy/practice supporting female corporate expatriation are mediated by how diversity and equal opportunities policies are embedded within policy implementation.Originality/valueThere is little evidence to date of an accepted theoretical framework to test hypotheses relating to women's participation as expatriates. This paper evaluates the options and presents those with the most promise for generating an agreed and accepted framework for future female expatriate research.
Seasonal trophic dynamics affect zooplankton community variability
Authors: BEISNER BEATRIX E. , PERES‐NETO PEDRO R. 
Published: July 2009

Summary1. The degree to which communities are variable may be affected by the ecological conditions to which they are exposed and can affect their propensity to form alternative states. We examined the influence of two common ecological factors, predation and seasonal successional stage, on the variability in community composition of herbivorous pond plankton. In a highly replicated, two factor, mesocosm experiment we determined whether beta diversity was affected by seasonal successional stage of the community (two levels), by fish predation (presence/absence) or by their interaction.2. Several significant changes were found in the composition of the rotifer, cladoceran and copepod assemblages. Most cladoceran abundances showed sharp declines in the presence of fish, while some rotifers, as well as their assemblage species richness, responded favourably to fish. The copepod assemblage was composed of omnivorous and carnivorous species, which added invertebrate predation to the experiment and which intensified as the season progressed. Copepods showed responses to fish predation that depended on seasonal successional stage of the initial community, because of changes in their stage structure and edibility as they grew from nauplii to adults.3. Community variability was consistently high at the end of each month‐long experimental period for both cladoceran and rotifer assemblages, except under two conditions. In the early season treatments, the rotifer assemblages were more consistent (lower beta diversity) in the presence of fish. This was attributed to high population growth rates for rotifers under these ecological conditions because of reduced copepod predation on them through a trophic cascade from fish. Low community variability was also observed in the late season for rotifers when fish were excluded and, as a result, they were exposed to high invertebrate predation from cyclopoid copepods.4. Results from the early season support theoretical predictions that when community size increases, variability in composition should decline because of an increase in competitive processes over stochastic ones. Late season results suggest that a second mechanism, specialist predation, can also reduce prey community variability. Our study demonstrates that plankton communities may be more predictable under certain trophic web configurations and challenges ecologists to find ways to incorporate such inherent variability into experiments and community theory.
Sperm DNA integrity in cancer patients: the effect of disease and treatment
Authors: Ståhl O. , Eberhard J. , Cavallin‐Ståhl E. , Jepson K. , Friberg B. , Tingsmark C. , Spanò M. , Giwercman A. 
Published: July 2009

SummaryAs oncological treatment might impair the patients’ fertility, male cancer patients are offered to cryopreserve semen prior to treatment. Impaired sperm DNA quality is associated with reduced fertility, and in case of assisted reproduction, sperm DNA integrity may have an impact on choice of method. Therefore, we have assessed sperm DNA integrity in cancer patients, comparing pre‐ and post‐treatment quality. Sperm DNA integrity was investigated in cryopreserved semen from 121 cancer patients, the predominating diagnoses were germ cell cancer (GCC) and Hodgkin’s lymphoma (HL). Post‐treatment samples, with a median follow‐up of 3 years, were analysed for 58 of the men, allowing a pre‐ and post‐treatment analysis on an individual basis. Sperm DNA integrity was assessed using the Sperm Chromatin Structure Assay and expressed here as the DNA Fragmentation Index (DFI%). One hundred and thirty‐seven fertile men served as controls. Before treatment, GCC (n = 84) and HL (n = 18) patients had higher DFI% than controls (n = 143) with a mean difference of 7.7 (95% CI 3.2–8.8) and 7.0 (95% CI 2–12), respectively. The same trend was observed for other cancer diagnoses, but without reaching statistical significance (mean difference 3.6, 95% CI −1.2 to 8.4). No increase was seen in DFI% comparing pre‐ and post‐treatment semen, regardless of treatment modality. A moderate elevation of DFI% was observed in cryopreserved semen from cancer patients. Oncological treatment, generally, did not induce any increase in DFI. These findings should be considered when discussing the utilization of pre‐treatment cryopreserved semen vs. post‐treatment fresh sperm in cancer patients undergoing assisted reproduction.
Creating context for critical thinking in practice: the role of the preceptor
Authors: Forneris Susan Gross , Peden‐McAlpine Cynthia 
Published: July 2009

AbstractTitle.  Creating context for critical thinking in practice: the role of the preceptor. Aim.  This paper is a report of a study to determine the impact of the preceptor coaching component of a reflective contextual learning intervention on novice nurses’ critical thinking skills during the first 6 months of their practice.Background.  The use of preceptors to develop novice nurses’ clinical skills has been well documented in the literature. However, there is little literature focused on preceptor involvement to develop novice nurses’ critical thinking.Method.  This small case study was conducted in the United States of America in 2004 with six nurse/preceptor dyads. Stake’s qualitative instrumental case study design was used to evaluate the preceptor component of the contextual learning intervention. Stories of preceptor experiences were analyzed using Stake’s phases of data analysis (i.e. description, categorical aggregation, establishing patterns, naturalistic generalizations). Specific questions (e.g. nature of coaching used by the preceptor) guided the analysis. Repeating patterns were coded and isolated and later collapsed as the analysis moved forward.Findings.  Preceptors use of the contextual learning intervention created a context that stimulated novice nurses’ critical thinking. Two main themes describe the novice nurses’ critical thinking skills relative to the preceptor coaching: 1) critical thinking as organizing and carrying out tasks; and 2) critical thinking as intentional, reflective thinking.Conclusion.  Preceptor education should incorporate the following components: understanding the impact of power and anxiety on critical thinking of novice nurses transitioning into practice; creating dialogue that invites questions in a reflective and critical manner; and challenging thinking through sharing of perspectives.
Patients and families experiences with video telehealth in rural/remote communities in Northern Canada
Authors: Sevean Pat , Dampier Sally , Spadoni Michelle , Strickland Shane , Pilatzke Susan 
Published: July 2009

Aim.  To explore patients’ and families’ experiences with video telehealth consultations as a method of health care delivery in rural/ remote communities in Northern Canada.Background.  Accessing health services in isolated populations where human resources and infrastructure are constrained by vast geographical landmasses poses challenges and opportunities for nurses, health care providers, patients and families.Design.  A qualitative approach was adopted with a purposeful sample of 10 patients and four family members representative of nine communities.Method.  Selection criteria included patients receiving telehealth visits for a minimum of a year and willing to share their experiences. Data were collected during the winter of 2006 using semi‐structured video taped interviews and analysed using a qualitative thematic content analysis.Results.  Patients and families experiences of their telehealth visits centered on three key themes: lessening the burden (costs of travel, accommodations, lost wages, lost time and physical limitations), maximising supports (access to family, friends, familiar home environment, nurses and other care providers), tailoring specific e‐health systems to enhance patient and family needs.Conclusion.  The benefits of telehealth extend not only to patients and families but are linked to benefits for providers as well as the health care system.Relevance to clinical practice.  This study indicates that video telehealth is an effective mechanism for delivering nursing and other health services to rural/remote communities and can impact positively on the quality of health care. The integration of telehealth practice can enhance the coordination, organisation and implementation of health care services.
The validity and reliability of an instrument to assess nursing competencies in spiritual care
Authors: Van Leeuwen René , Tiesinga Lucas J , Middel Berrie , Post Doeke , Jochemsen Henk 
Published: July 2009

Aim. This study contributes to the development of a valid and reliable instrument, the spiritual care competence scale, as an instrument to assess nurses’ competencies in providing spiritual care.Background. Measuring these competencies and their development is important and the construction of a reliable and valid instrument is recommended in the literature.Design. Survey.Method. The participants were students from Bachelor‐level nursing schools in the Netherlands (n = 197) participating in a cross‐sectional study. The items in the instrument were hypothesised from a competency profile regarding spiritual care. Construct validity was evaluated by factor analysis and internal consistency was estimated with Cronbach’s alpha and the average inter‐item correlation. In addition, the test–retest reliability of the instrument was determined at a two‐week interval between baseline and follow‐up (n = 109).Results. The spiritual care competence scale comprises six spiritual‐care‐related nursing competencies. These domains were labelled: 1 assessment and implementation of spiritual care (Cronbach’s α 0·82) 2 professionalisation and improving the quality of spiritual care (Cronbach’s α 0·82) 3 personal support and patient counseling (Cronbach’s α 0·81) 4 referral to professionals (Cronbach’s α 0·79) 5 attitude towards the patient’s spirituality (Cronbach’s α 0·56) 6 communication (Cronbach’s α 0·71). These subscales showed good homogeneity with average inter‐item correlations >0·25 and a good test–retest reliability.Conclusion. This study conducted in a nursing‐student population demonstrated valid and reliable scales for measuring spiritual care competencies. The psychometric quality of the instrument proved satisfactory. This study does have some methodological limitations that should be taken into account in any further development of the spiritual care competence scale.Relevance to clinical practice. The spiritual care competence scale can be used to assess the areas in which nurses need to receive training in spiritual care and can be used to assess whether nurses have developed competencies in providing spiritual care.
Student engagement in interprofessional working in practice placement settings
Authors: Pollard Katherine 
Published: July 2009

Aim.  To investigate the nature of student engagement in interprofessional interaction while on placement.Background.  Due to continuing emphasis on improving interprofessional collaboration, UK educational establishments are required to offer prequalifying health and social care students interprofessional education in order that they acquire relevant competencies. However, few formal interprofessional education initiatives occur in practice settings and little is known about prequalifying students’ non‐formal learning about interprofessional issues while on placement.Design.  From 2003–2005 an English Faculty of Health and Social Care conducted a qualitative study to explore opportunities for interprofessional learning and working available to students in practice placement settings.Methods.  Case studies were conducted in a coronary care ward, a medical ward for older patients, a maternity unit, a paediatric unit, an integrated community learning disabilities team and a residential facility for adults with challenging behaviour. Gaining access was complex, due to variable student timetables and UK research governance requirements. Sites were therefore selected according to geographical area and timing of student placements. Details of interprofessional interaction (formal and informal) were observed and recorded. Interviews were conducted with a convenience sample of 20 practitioners and 15 students. Data were analysed thematically.Results.  Student experience varied considerably. Contributing factors included the influence of doctors and differing professional cultures; mentors’ support for student engagement in interprofessional working; and individual students’ confidence levels. Most sites were managed by nurses and some senior nurses were proactive in involving students interprofessionally. However, many students lacked systematic support for interprofessional engagement.Conclusions.  Students lack parity of experience concerning interprofessional activity on placement. Where they do not have systematic support, their engagement depends mainly on their own confidence.Relevance to clinical practice.  Senior nurses are ideally placed to promote environments where students can develop interprofessional competencies through systematic interprofessional engagement.
The first experiences of clinical practice of psychiatric nursing students in Taiwan: a phenomenological study
Authors: Hung Bai‐Jin , Huang Xuan‐Yi , Lin Mei‐Jue 
Published: July 2009

Aims and objectives.  The purpose of this study is to understand the experiences of psychiatric nursing students during their first encounters with psychiatric patients in a clinical setting. The objective is to assist educational professionals in mental health to improve teaching strategies.Background.  In clinical settings, student psychiatric nurses have to face complex problems and situations that can result in distress. Sometimes the student nurse will be uncertain of their own ability and this is reflected in a sense of fear on the part of some nurses. However, little research has been conducted into the first clinical experiences of such nursing students in Taiwan.Design.  A qualitative phenomenological study was devised to explore what psychiatric nursing students perceived during their first experiences of clinical practice and narratives were analysed using Colaizzi’s seven‐step method.Method.  A phenomenological approach and purposive sampling were used in the study. Face‐to‐face interviews were conducted to collect the data and during the process of data analysis we established epochs (bracketing) and focused on the reality of the student nurses’ experience to keep the data objective.Results.  Four themes were identified: breaking the stigma of mental illness, developing a trusting relationship with the patient, gaining professional knowledge and skills and the process of student growth.Conclusion.  The findings from this study demonstrate that it is important to understand the perceptions of students during their first experiences of psychiatric nursing in a clinical setting and highlight the importance of educational programs.Relevance to clinical practice.  By understanding the emotional process that psychiatric nursing students may go through during their clinical practice, educators can be better able to design suitable training courses in the future.
A randomised controlled trial of the effects of cryotherapy on pain, eyelid oedema and facial ecchymosis after craniotomy
Authors: Shin Yong Soon , Lim Nan Young , Yun Sung‐Cheol , Park Kwang Ok 
Published: July 2009

Aim.  To identify the effects of cryotherapy on patient discomfort following craniotomy.Background.  Following craniotomy, many patients suffer from unexpected discomfort, including pain, eyelid oedema and ecchymosis. Cryotherapy is regarded as a safe method for managing these postcraniotomy problems.Design.  Randomised controlled trial.Methods.  A total of 97 Korean patients who underwent elective supratentorial craniotomy were randomly assigned to a cryotherapy or a control group. In the cryotherapy group, ice bags were applied to surgical wounds, and cold gel packs were applied to periorbital areas, for 20 minutes per hour, beginning three hours postoperatively and for three days thereafter. The level of patient pain was measured using the visual analogue scale while the eyelid oedema was measured using the Kara & Gokalan’s scale. Ecchymosis was also classified according to its extent.Results.  The level of pain three hours after craniotomy was similar in the cryotherapy and control groups (57·9 vs. 58·7). Three days after surgery, pain had significantly decreased in the cryotherapy group (p = 0·021). After adjusting diagnosis by analysis of covariance (ancova), pain score did not differ significantly between the two groups. The mean eyelid oedema scores were lower in the cryotherapy group than in the control group (0·59 vs. 2·29, p < 0·001), with ancova showing that cryotherapy had a significant effect on eyelid oedema (p < 0·001). Pain (p = 0·047) and eyelid oedema (p < 0·001) in the cryotherapy group were significantly decreased over time. Ecchymosis were significantly less frequent in the cryotherapy (11/48, 22·9%) than in the control (26/49, 53·1%) group (p = 0·003). Logistic regression analysis showed that cryotherapy affected ecchymosis (p = 0·001).Conclusion.  These results indicate that cryotherapy can control pain, eyelid oedema and facial ecchymosis after craniotomy.Relevance to clinical practice.  Cryotherapy, which is both convenient and cost‐effective, can be used to prevent postoperative discomforts in a clinical setting.
Managing capacity issues in clinical placements for pre‐registration nurses
Authors: Murray Sonya C , Williamson Graham R 
Published: July 2009

Aims and objectives. To explore influences on decision‐making concerning placement capacity planning for supporting nursing students in clinical placements. The research questions were:How are decisions relating to capacity planning and management of the learning environment made within the practice areas?What factors were or are perceived as important to take into consideration when making these decisions?Background. It is already known that clinical placements are pivotal to pre‐registration nurse education. The recent large expansion of nurse education places means that more students require clinical placements than previously. This study explored decision‐making about placement capacity amongst mentors in one central English county.Design. A qualitative design using focus groups.Study and methods. Collecting data allowed researchers to engage mentors in discussions concerning their decisions about how many students they could support in practice and the learning environment they could provide. Twenty‐nine active nursing student mentors participated, representing three branches (Adult, Mental Health and Child Health Nursing) from various acute and community settings and professional roles.Results. Three themes emerged relating to capacity management issues in clinical placements:Capacity issues: how decisions are made in relation to capacity planning, by whom they are made and what influences them?Supporting learners and enhancing support in practice.Issues impacting on learning in practice.Conclusions. This study adds further understanding of the need for robust information to support allocation decisions, coupled with greater clinical staff and mentors’ involvement in decisions about student support. The forthcoming Skills for Health Ensuring Quality in Partnership requirements may add authority and structure to student support activities.Relevance to clinical practice. Strategic practice and placement development links and joint appointments between UK NHS trusts and higher education institutions should be considered if placement capacity issues are to be addressed successfully and the quality of students’ placements are to be safeguarded.
Do pressure ulcers influence length of hospital stay in surgical cardiothoracic patients? A prospective evaluation
Authors: Schuurman Jaap‐Peter , Schoonhoven Lisette , Keller B Paul JA , Van Ramshorst Bert 
Published: July 2009

Aim and objective.  The aim and objective of this study was to determine whether the occurrence of pressure ulcers following cardiothoracic surgery increases the length of hospitalisation.Background.  Literature suggests that a pressure ulcer extends the length of hospital stay. The impact of pressure ulcers on length of hospital stay after cardiothoracic surgery is yet undetermined.Design.  Prospective follow‐up study.Methods.  Two hundred and four patients admitted for elective cardiothoracic surgery and with an intensive care unit stay of >48 hours were included in a prospective cohort study. The course of the skin condition in relation to pressure ulcers was monitored during their stay in a teaching hospital. Length of hospital stay was compared between the group with and without pressure ulcers.Results.  Hospital stay for cardiothoracic patients with and without pressure ulcers did not differ significantly (p = 0·23). Patients that developed pressure ulcers had a median hospital stay of 13 days (interquartile range: 9–19) vs. 12 days (interquartile range: 7–15) for patients without pressure ulcers. However, we observed that length of stay in the intensive care unit was significantly (p = 0·005) longer for patients with pressure ulcers. This was not associated with the occurrence of complications. However, the occurrence of pressure ulcers was significantly correlated with length of intensive care support in postoperative care.Conclusion.  Non‐complicated pressure ulcers in postsurgery patients do not significantly increase the length of total hospital stay.Relevance to clinical practice.  Health professionals need to recognise that patients who have undergone major surgery (such as cardiothoracic surgery) are prone to develop pressure ulcers. Despite the fact that pressure ulcers do not necessarily extend hospital stay, monitoring the skin condition remains of crucial importance for prevention and early detection as well as treatment of pressure ulcers and to minimise patient discomfort. Moreover, as pressure ulcers often originate in the operating room, prevention in the operating room should receive more attention.