bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in the chloroplast DNA of Swiss stone pine (Pinus cembraL.) reflects contrasting post‐glacial history of populations from the Carpathians and the Alps
Authors: Höhn Maria , Gugerli Felix , Abran Peter , Bisztray György , Buonamici Anna , Cseke Klara , Hufnagel Levente , Quintela‐Sabarís Celestino , Sebastiani Federico , Vendramin Giovanni Giuseppe 
Published: May 2009

AbstractAim To characterize the genetic structure and diversity ofPinus cembraL. populations native to two disjunct geographical areas, the Alps and the Carpathians, and to evaluate the rate of genetic differentiation among populations.Location The Swiss Alps and the Carpathians.Methods We screened 28 populations at three paternally inherited chloroplast simple sequence repeats (cpSSRs) for length variation in their mononucleotide repeats. Statistical analysis assessed haplotypic variation and fixation indices. Hierarchical analysis of molecular variance (AMOVA), Mantel test, spatial analysis of molecular variance (SAMOVA) andbarrieranalyses were applied to evaluate the geographical partitioning of genetic diversity across the species’ range.Results Haplotypic diversity was generally high throughout the natural range ofP. cembra, with the mean value substantially higher in the Carpathians (H = 0.53) than in the Alps (H = 0.35). The isolated Carpathian populations showed the highest haplotype diversity among the populations originating from the High Tatras (Velka Studena Dolina) and South Carpathians (Retezat Mountains). AMOVA revealed that only 3% of the total genetic variation derived from genetic differentiation between the two mountain ranges. Differentiation among Carpathian populations was higher (FST = 0.19) than among Alpine populations (FST = 0.04). Low, but significant, correlation was found between the geographical and genetic distances among pairs of populations (r = 0.286,P < 0.001). SAMOVA results revealed no evident geographical structure of populations.barrieranalysis showed the strongest differentiation in the eastern part of the species’ range, i.e. in the Carpathians.Main conclusions The populations ofP. cembrawithin the two parts of the species’ range still share many cpDNA haplotypes, suggesting a common gene pool conserved from a previously large, continuous distribution range. Carpathian populations have maintained high haplotypic variation, even higher than Alpine populations, despite their small population sizes and spatial isolation. Based on our results, we emphasize the importance of the Carpathian populations of Swiss stone pine for conservation. These populations comprise private haplotypes and they may represent a particular legacy of the species’ evolutionary history.
The experiences of primary caregivers raising school‐aged children with attention‐deficit hyperactivity disorder
Authors: Lin Mei‐Jue , Huang Xuan‐Y , Hung Bai‐Jin 
Published: May 2009

Aims and objectives.  To understand the experiences of primary caregivers who are bringing up school‐aged children with attention‐deficit hyperactivity disorder. The research findings will help address the problems related to caring for school‐aged children with attention‐deficit hyperactivity disorder.Background.  In Taiwan, the rate of school‐aged children diagnosed with attention‐deficit hyperactivity disorder ranges from 7·9–11·7%. This study is the first, which tries to understand the experiences of primary caregivers who are bringing up school‐aged children with attention‐deficit hyperactivity disorder in Taiwan.Design.  The study used a qualitative phenomenological approach to explore the experiences of caregivers raising school‐aged children with attention‐deficit hyperactivity disorder.Methods.  Purposive sampling and in‐depth, face‐to‐face interviews were used to collect data. The unstructured interview guide allowed the major caregivers to express their experiences of raising school‐aged children with attention‐deficit hyperactivity disorder. When data saturation was reached, the sample size comprised 12 major caregivers. Narratives were analysed according to Colaizzi’s seven‐step method.Results.  Three themes and seven sub‐themes emerged from this study: the burdens of caring (parenting burdens, emotional burdens and family conflicts), the lack of adequate support systems (lack of support from professionals, spouses and other family members) and the mechanisms of coping (cognitive coping strategies and social coping strategies). Furthermore, several other factors that affected the caregivers of children with attention‐deficit hyperactivity disorder are also revealed in the study.Conclusion.  The findings of the study demonstrate the importance of understanding the experiences of primary caregivers, bringing up school‐aged children with attention‐deficit hyperactivity disorder. Improving professional services in family care should be a major concern for all healthcare professionals.Relevance to clinical practice.  The recommendations that have been made based on the findings of this research can be used as a guide to improve the delivery of caring by people who have school‐aged children with attention‐deficit hyperactivity disorder and by the wider family.
Hospital pressure ulcer prevalence rates and number of raters
Authors: Kottner Jan , Tannen Antje , Dassen Theo 
Published: May 2009

Aim.  The purpose of this study was to evaluate the influence of different numbers of nurse raters conducting skin inspection (one or two) on observed pressure ulcer prevalence rates.Background.  Pressure ulcer prevalence and incidence rates are important outcome measures for the quality of care. To ensure reliability and comparability of such rates standardisation of study methods is recommended. It is assumed that data accuracy can be improved if skin inspection is conducted by a team of two raters.Design.  A secondary data analysis of pressure ulcer prevalence data was conducted.Method.  Groups of hospital patients which were examined by one (n = 2420) or two raters (n = 15,009) were compared regarding demographic characteristics, pressure ulcer risk and pressure ulcer prevalence. Logistic regressions were conducted to examine the association between the number of raters (one or two) and the outcome pressure ulcer (yes/no).Results.  Groups of one and two raters were comparable regarding demographic characteristics. There was no statistically significant difference regarding pressure ulcer prevalence between both groups (p = 0·222). There was no relation between the number of raters and the probability of identifying a pressure ulcer patient (p = 0·060).Conclusions.  Pressure ulcer prevalence rates in the analysed studies were not affected by the number of raters. There seems to be no relation between the numbers of nurses conducting skin inspection and observed prevalence rates.Relevance to clinical practice.  Conducting pressure ulcer prevalence studies require a lot of effort and personal costs. Provided that one nurse alone or a team of two nurses rate the existence of pressure ulcers equally it is no longer obligatory to have two raters. This would save resources. However, when patients are restricted in their mobility two nurses are recommended to provide assistance in patient turning.
A randomised controlled trial of a community nursing intervention: improved quality of life and healing for clients with chronic leg ulcers
Authors: Edwards Helen , Courtney Mary , Finlayson Kathleen , Shuter Patricia , Lindsay Ellie 
Published: May 2009

Aims and objective.  The negative impact of chronic leg ulcers on quality of life is well documented. The aim of this study was to determine the effectiveness of a new community nursing model of care on quality of life, morale, depression, self‐esteem, social support, healing, pain and functional ability of clients with chronic venous leg ulcers.Background.  Venous leg ulcers are slow to heal, frequently recur and are associated with pain, restricted mobility and decreased quality of life. Although chronic wound care consumes a large proportion of community nursing time and health care resources, there is little evidence available on the effectiveness of differing models of community care for this population.Design.  Randomised controlled trial.Methods.  We recruited a sample of 67 participants with venous leg ulcers referred for care to a community nursing organisation in Queensland, Australia after obtaining informed consent. Participants were randomised to either the Lindsay Leg Club® model of care (n = 34), emphasising socialisation and peer support; or the traditional community nursing model (n = 33) consisting of individual home visits by a registered nurse. Participants in both groups were treated by a core team of nurses using identical research protocols based on short‐stretch compression bandage treatment. Data were collected at baseline, 12 and 24 weeks from commencement.Results.  Participants who received care under the Leg Club model demonstrated significantly improved outcomes in quality of life (p = 0·014), morale (p < 0·001), self‐esteem (p = 0·006), healing (p = 0·004), pain (p = 0·003) and functional ability (p = 0·044).Conclusion.  In this sample, the evaluation of the Leg Club model of care shows potential to improve the health and well‐being of clients who have chronic leg ulcers.Relevance to clinical practice.  These results suggest further evaluation and implementation of this model is warranted by community health organisations involved in the care of this population.
The lived experience of Dupuytren’s disease of the hand
Authors: Pratt Anna L , Byrne Geraldine 
Published: May 2009

Aims.  To describe patients’ experiences of living with Dupuytren’s disease.Background.  Dupuytren’s disease is a chronic, progressive deformity of the hand which limits active extension of the fingers due to advancing and irreversible flexion deformity. It is estimated that two million people are affected by the condition in the UK. Nurses may frequently encounter patients with this condition in a wide range of settings. However, the disease is neglected in the nursing literature and little is known about patients’ experience of living with the condition.Design.  A phenomenological approach, using Coliazzi’s method, was employed.Method.  Semi‐structured interviews were conducted with six men and one woman diagnosed with Dupuytren’s disease.Results.  Four interlinking themes emerged. Theme 1: Awareness of Dupuytren’s disease describes participants’ experiences of recognising and acknowledging the disease, which often did not occur until functional ability was restricted. Theme 2: Living with Dupuytren’s disease describes how patients coped with the disease and adapted their activities to maintain independence. Theme 3: Deciding on treatment illuminates how patients decided on treatment and highlights a lack of information and support from health professionals. Theme 4: Receiving treatment articulates participants’ experience of surgical treatment and post surgical rehabilitation.Conclusions.  The findings revealed that people living with Dupuytren’s disease receive little information about their condition and possible treatment from health professionals yet high quality and accurate information is required for patients to understand their condition and the treatment options available.Relevance to clinical practice.  People with Dupuytren’s disease do not always recognise their condition until it has significantly progressed. Following diagnosis they need accurate and up‐to‐date information about their condition and treatment options. Nurses have an important role to play in raising awareness of the disease, educating patients about its features and progression and enabling them to become active partners in decisions about treatment.
The impact of stroke consequences on spousal relationships from the perspective of the person with stroke
Authors: Thompson Hilary S , Ryan Assumpta 
Published: May 2009

Aims and objectives.  This paper aims to provide a subjective insight into the experience of stroke recovery within spousal relationships. The aftermath of stroke and its impact on the physical, emotional, psychological and social effects of spousal relationships are explored.Background.  Many studies have examined observable functional recovery following stroke from the perspective of health care professionals. Longer‐term effects of stroke such as changes in role and perception of self can alter significantly the dynamics of spousal relationships. Despite this, little attention has been given to the subjective impact of stroke on spousal relationships.Design.  A qualitative study design was adopted. Individual, audio‐taped interviews were carried out over three months.Methods.  A convenience sample of 16 stroke survivors was recruited from the Stroke Nurse Specialist Register. All participants were over 18 years old and had been discharged from hospital following a diagnosis of stroke. Transcribed interviews were analysed using content data analysis to code and categorise emerging themes.Results.  Poststroke, spousal relationships altered significantly in terms of sexuality, sexual desire and sexual functioning. Within their role of husband or wife, stroke survivors described a lack of control and dramatic changes in their perception of self.Conclusions.  Survivors of stroke experience profound, complex and multi‐faceted difficulties in many areas of their spousal relationships, which are distressing to both them and their spouses. These have a significant impact on each individual’s quality of life particularly in the longer term.Relevance to clinical practice.  Health care professionals and service providers need to understand and recognise the subjective experience of stroke and the complex difficulties that stroke survivors experience within their spousal relationships. It would appear that current service provision does not adequately address the range of needs that the stroke survivors described in this study.
The culture of a Taiwanese nursing home
Authors: Chuang Yeu‐Hui , Abbey Jennifer 
Published: May 2009

Aim. To explore and understand the culture of nursing home life for older residents in Taiwan.Background. The environment, the care providers and the residents all influence how the nursing home operates and performs. The literature has shown that there has been a move from understanding nursing home culture to changing it. However, there is no literature illustrating nursing home culture in Taiwan. It is appropriate to understand the phenomenon before making any changes.Design. Ethnographic methodology was used to understand this phenomenon.Methods. Three methods, participant observation, in‐depth interviews and examination of related documents, were used to collect information from July 2005–February 2006. All the data were recorded in either field notes or verbatim transcripts and were analysed concurrently.Results. Three themes have been generated including collective life, care rituals and embedded beliefs. ‘Living in a public area’, ‘mealtime is the highlight’, ‘every day is the same’, and ‘the ceiling is my best mate’ are used to explain the collective life. Under care rituals, there are ‘the perception of inadequate staffing in spite of legal requirements being met’ and ‘task‐oriented care’. The embedded beliefs can be described by the notions of ‘patients and hospitalisation’ and ‘compromise’.Conclusions. A tedious, monotonous, idle and lonely life is experienced by the residents, and insufficient staffing is obvious, despite the legal staffing requirements being met. This is exacerbated by the provision of care that is task‐oriented rather than individual driven. The residents, whether consciously or not, consider themselves to be the patients of a hospital. They easily compromise to maintain harmony and balance in the nursing home life.Relevance to clinical practice. The findings contribute to the understanding of Taiwanese nursing home culture and filling the gaps in nursing knowledge for the purpose of improving care of residents.
Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units
Authors: Cho Sung‐Hyun , June Kyung Ja , Kim Yun Mi , Cho Yong Ae , Yoo Cheong Suk , Yun Sung‐Cheol , Sung Young Hee 
Published: May 2009

Aim. To examine the relationship between nurse staffing and nurse‐rated quality of nursing care and job outcomes.Background. Nurse staffing has been reported to influence patient and nurse outcomes.Design. A cross‐sectional study with a survey conducted August–October 2007.Methods. The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four‐point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes.Results. The average patient‐to‐nurse ratio was 2·8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3·26; 95% confidence interval, 1·14–9·31) or 2·0–2·5 patients (odds ratio, 2·44; 95% confidence interval, 1·32–4·52), compared with having more than three patients. Perceived adequate staffing was related to a threefold increase (odds ratio, 2·97; 95% confidence interval, 2·22–3·97) in the odds of nurses’ rating high quality and decreases in the odds of dissatisfaction (odds ratio, 0·30; 95% confidence interval, 0·23–0·40), burnout (odds ratio, 0·50; 95% confidence interval, 0·34–0·73) and plan to leave (odds ratio, 0·40; 95% confidence interval, 0·28–0·56).Conclusions. Nurse staffing was associated with quality of care and job outcomes in the context of Korean intensive care units.Relevance to clinical practice. Adequate staffing must be assured to achieve better quality of care and job outcomes.
Evaluating the effects of an Internet education programme on newborn care in Taiwan
Authors: Kuo Su‐Chen , Chen Ya‐Shan , Lin Kuan‐Chia , Lee Tzu‐Ying , Hsu Chi‐Ho 
Published: May 2009

Aim. The objectives of this study were to evaluate an Internet education programme provided to primigravida in the third trimester of pregnancy with the aim of enhancing mothers’ knowledge about newborn care and increasing their maternal confidence.Background. Shorter hospital stays have had an impact on the traditional role of mother–baby nurses in providing education about parenting to their parturient women. Internet education is an efficient way to provide nursing instruction.Design. A randomised controlled trial was used. A total of 118 women receiving prenatal care in a hospital clinic who met study criteria and who consented were assigned randomly to intervention and control groups. The study was conducted at a hospital in Taiwan.Methods. The target population was women at 32–34 weeks gestation, using the Internet on a regular basis. The primigravida were randomly assigned to either the control group (n = 57) or the experimental group (n = 61). Two primary outcome measures were newborn‐care knowledge and maternal confidence.Results. The changes in newborn‐care knowledge were 7·21 for the experimental group, compared with 1·95 for the control group; the difference between the least‐squares means computed byancovawas 5·73 and statistically significant (p < 0·001). The changes in maternal confidence were 8·46 for the experimental group and 3·05 for the control group; the difference between the least‐squares means computed byancovawas 5·94 and statistically significant (p < 0·001).Conclusion. Results suggest that Internet education about newborn care may contribute to greater care knowledge and maternal confidence.Relevance to clinical practice. Internet newborn‐care education programmes can achieve success in promoting newborn care and provide health professionals with evidence‐based intervention.
Living with type 1 diabetes: perceptions of children and their parents
Authors: Marshall Marie , Carter Bernie , Rose Karen , Brotherton Ailsa 
Published: May 2009

Aim.  To explore and describe the experiences of children and their parents living with type 1 diabetes mellitus from diagnosis onwards.Background.  Type 1 diabetes mellitus is a psychologically and behaviourally demanding chronic condition that necessitates children and their parents taking extensive responsibility for managing the condition. Diabetes management involves maintaining a highly effective level of treatment to reduce the risks of short‐ and long‐term complications. Treatment is carried out in the context of daily life, but little research evidence is available about this experience.Design.  A phenomenological study using conversational interview.Method.  A purposive sample of 10 children, (aged 4–17) living with type 1 diabetes mellitus and their parents participated in this study. Participants were from different ethnic backgrounds and at differing lengths of time since diagnosis. Data were generated through conversational interviews and analysed using thematic analysis.Results.  The central theme that was identified was ‘normal’. This was underpinned by four subthemes: transition, attachment, loss and meaning. The notion of ‘normal’ is dominant in the lives of these children and their parents because diabetes not only makes these families different, but also makes their pursuit of ‘normal’ more visible.Conclusion.  These findings highlight that, despite different cultures, ages and lengths of time since diagnosis, families living with diabetes share very similar experiences. Understanding how children and parents create meaning and how this meaning influences their actual and potential health problems, is important if the provision of healthcare is to be effective in meeting their needs.Relevance to clinical practice.  Conducting child‐ and parent‐centred qualitative research allows exploration of the perceptions and understanding of type 1 diabetes mellitus and the meaning ascribed by children and their parents who live with the condition. Diabetes is a lifelong, life‐threatening condition that has a significant impact on children’s and parents’ lives. Developing a deeper understanding of their lives and experiences will enable the delivery of nursing care to meet their specific needs.