bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic ultrasound‐guided tissue sampling by combined fine needle aspiration and trucut needle biopsy: a prospective study
Authors: Wittmann J. , Kocjan G. , Sgouros S. N. , Deheragoda M. , Pereira S. P. 
Published: January 2006

Background and aims:  Endoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) has a diagnostic accuracy of 70–90%, depending on the site under evaluation. In order to improve EUS‐guided tissue sampling a novel 19‐gauge trucut‐type needle has been designed to obtain core biopsies during EUS. We prospectively evaluated the safety and accuracy of EUS‐FNA alone versus combined EUS‐FNA and trucut needle biopsy (TNB) in patients referred to our Unit over a 3‐year period.Patients and methods:  A total of 159 patients underwent EUS‐FNA alone (lesions <2 cm) or the combination of both sampling modalities (lesions ≥2 cm). The adequacy of sampling, sensitivity, specificity and overall accuracies of EUS‐FNA or EUS‐TNB alone and combined EUS‐FNA/TNB were determined.Results:  Adequate samples were obtained by EUS‐FNA, EUS‐TNB and EUS‐FNA/TNB in 91%, 88% and 97% of patients, respectively. From the pancreas (n = 83), adequate samples were obtained by FNA in 94% and by TNB in 81%, compared with 87% and 92% from non‐pancreatic sites (n = 76), respectively. The combination of both techniques resulted in more adequate samples from non‐pancreatic cases than EUS‐FNA alone (P = 0.044). The specificity was 100%. Overall accuracy for EUS‐FNA alone was 77%, for EUS‐TNB alone 73% and for EUS‐FNA/TNB 91% (P = 0.008). For pancreatic sampling, the accuracy of EUS‐FNA alone was 77%, for EUS‐TNB alone 56% and for EUS‐FNA/TNB 83%. For non‐pancreatic sampling, the accuracy for EUS‐FNA alone was 78%, for EUS‐TNB alone 83% and for EUS‐FNA/TNB 95% (P = 0.006). The complication rate was 0.6%.Conclusions:  Combined EUS‐FNA/TNB for lesions ≥2 cm improves adequacy of sampling and diagnostic accuracy compared with either technique alone and is safe.
Effects of nutrient additions on ecosystem carbon cycle in a Puerto Rican tropical wet forest
Authors: LI YIQING , XU MING , ZOU XIAOMING 
Published: January 2006

AbstractWet tropical forests play a critical role in global ecosystem carbon (C) cycle, but C allocation and the response of different C pools to nutrient addition in these forests remain poorly understood. We measured soil organic carbon (SOC), litterfall, root biomass, microbial biomass and soil physical and chemical properties in a wet tropical forest from May 1996 to July 1997 following a 7‐year continuous fertilization. We found that although there was no significant difference in total SOC in the top 0–10 cm of the soils between the fertilization plots (5.42±0.18 kg m−2) and the control plots (5.27±0.22 kg m−2), the proportion of the heavy‐fraction organic C in the total SOC was significantly higher in the fertilized plots (59%) than in the control plots (46%) (P<0.05). The annual decomposition rate of fertilized leaf litter was 13% higher than that of the control leaf litter. We also found that fertilization significantly increased microbial biomass (fungi+bacteria) with 952±48 mg kg−1soil in the fertilized plots and 755±37 mg kg−1soil in the control plots. Our results suggest that fertilization in tropical forests may enhance long‐term C sequestration in the soils of tropical wet forests.
Discursive practices in the documentation of patient assessments
Authors: Irving Kate , Treacy Margaret , Scott Annie , Hyde Abbey , Butler Michelle , MacNeela Padraig 
Published: January 2006

Aim.  This paper reports a study analysing the various functions of nurses’ documentation of patient assessments.Background.  Modes of documentation have received much attention in the nursing press since the integration of the nursing process and nursing models. Previous research has shown that current documentation practices do not consistently promote effective communication and evaluation of patient care. A recent systematic review found no evidence that any particular system of documentation improved this situation. However, nurses’ documentation serves not only to communicate information to others, but also has a political function as a presentation of what is important and ethically ‘right’ to report.Method.  A Foucauldian approach to discourse analysis was used to analyse 45 patient records.Findings.  The findings indicate that nurses employ three discernible discursive practices in the documentation of patient assessments: medical, nursing and informal. Each practice has an effect on the presentation of nursing in the documentation. Because of the complex interplay between these practices, nurses present themselves as aligned with the medical profession, as distinct and professional, and as informal in their descriptions of non‐biological information. The use of these practices appears to be motivated by the type of information being reporting.Conclusion.  Existing literature highlights the functional aspects of nursing documentation. In contrast, this paper explores the way in which nurses, through their documentation, constitute themselves and the nursing profession. In this way, nursing documentation is viewed as a social practice and a conduit through which particular power effects are produced and reproduced, rather than simply a matter of, for example, knowledge, individual choice or good practice.
Client‐centred empowering partnering in nursing
Authors: Brown Darlene , McWilliam Carol , Ward‐Griffin Catherine 
Published: January 2006

Aim.  This paper explores nurses’ experiences 1 year after an organization's commitment to providing a client‐centred and client‐empowering partnering approach to care.Background.  Historically, nurses’ approach to providing care in all nursing contexts has been one of doing for clients, and previous studies have focused more on in‐hospital care than on home care. However, the isolation inherent in in‐home nursing and nurses’ limited professional autonomy and power associated with physician control over patients in home care have been reported, as has their difficulty in finding the meaning and satisfaction of human connectedness and mutuality in nurse–client relationships. Overall, research to date does not inform us about how nurses might make a change toward a more client‐centred and client‐empowering approach to nursing.Methods.  An interpretive phenomenological design was used to elicit in‐depth understanding about Registered Nurses’ experiences of providing care using this innovative empowerment model. A purposefully selected sample of eight Registered Nurses participated in in‐depth interviews. Data were generated during 2002. Hermeneutic analysis was used to elicit themes and patterns emerging from the data.Findings.  Caring, client‐centredness and the context of in‐home care were important in implementing the new partnering approach. Barriers encountered at system, organizational and personal levels distracted nurses from fully comprehending and enacting the approach. After a year, they had begun to contemplate potential strategies for partnering with clients, but had not yet explored the power of their professional autonomy.Conclusion.  Nurses are inclined to practise within the expert model of service delivery. They need to work through issues of professional autonomy and rise to the challenge of exercising their autonomy within the current healthcare context if they are to attend more consistently to client‐centred empowering partnering. The home care setting offers an excellent environment for achieving these aims.
Patients’ assessments of consulting a nurse practitioner: the time factor
Authors: Williams Anne , Jones Melanie 
Published: January 2006

Aim.  This paper reports a study exploring patients’ views about consulting with a primary care nurse practitioner.Background.  United Kingdom based randomized controlled trials comparing the work of doctors and nurse practitioners add considerable weight to the view that patients tend to be more satisfied with primary care nurse practitioner consultations. However, there is a need for qualitative research to explore issues raised by the trials.Methods.  A judgement sample of 10 patients consulting with a primary care nurse practitioner was drawn. In‐depth interviews were conducted and analysed thematically. The data were collected in 2000–2001.Findings.  The following themes were identified in the data: time spent in the consultation; and time as a commodity in patients’ lives. Time matters to patients when they consult on their health, whether it is time to discuss problems or time saved as a result of having issues resolved, thus minimizing further visits. Factors associated with the style and emphasis of consultations are also important.Conclusions.  Understanding the relationship between time, and style and emphasis of consultation may help to explain patients’ satisfaction with primary care nurse practitioners.
Issues in data generation using email group conversations for nursing research
Authors: Kralik Debbie , Price Kay , Warren Jim , Koch Tina 
Published: January 2006

Aim.  The purpose of this paper is to provide an overview of the issues we have confronted when generating and analysing dialogue data by using electronic mail.Background.  The decision to use email for our research arose from our developing understanding of some of the consequences of illness that people living with chronic illness confront in their lives. As researchers, we recognized the potential of the Internet for computer‐mediated communication using email for communication between researchers and research participants.Discussion.  We consider the functional aspects of generating data by email, such as the software needed, and then explore the issues encountered during the research process including ethical considerations, fluctuating participation, participants’ familiarity with using email, facilitating lurkers towards participation, establishing group norms, and the role of the facilitator.Conclusion.  As a collaborative inquiry, email conversation allowed us to spend time with participants over 2 years to explore chronic illness experience. However the scope and viability of computer‐mediated communication as a qualitative method of research remains relatively unexplored, hence this paper.
Nurses’ attitudes towards adult patients who are obese: literature review
Authors: Brown Ian 
Published: January 2006

Aims.  This paper presents a review of all empirical studies focusing on nurses’ attitudes towards adult overweight or obese patients, with the aim of clarifying the dimensions and patterns of these attitudes and the methods by which they have been studied.Background.  Obesity has become a common condition and a major public health concern, but it is often associated with negative attitudes and discrimination. Nurses play a key role in providing support and care to patients who are obese.Methods.  Electronic searches were carried out on seven databases from inception to December 2004, along with hand‐searching of references in relevant studies. The search terms were built around obesity (and related terms), nursing (and its branches) and attitudes (and related terms). Eleven studies met the inclusion criteria. Data were extracted and summarized in tabular form and analysed in relation to the aims of this review during January 2005.Findings.  There is relatively little research about nurses’ attitudes towards obese patients, and the studies reviewed mostly have weaknesses of sampling and measurement. However, they do consistently suggest that a proportion of nurses have negative attitudes and beliefs, reflecting wider stereotypes within Western cultures. There is also a hint of a more complex mix of attitudes among nurses, some of which may counter the consequences of negative attitudes, but these have not been adequately investigated. A number of variables that influence attitudes of nurses can be identified, including age, gender, experience and the weight/body mass index of the nurse.Conclusion.  Further research (both qualitative and quantitative) is needed with more rigorous sampling and, where appropriate, more consistency of measurement. A shift in focus towards the sets of attitudes (positive as well as negative) and behaviours that influence health service quality and outcomes for obese persons would be useful.
Discursive patterns in multiprofessional healthcare teams
Authors: Kvarnström Susanne , Cedersund Elisabet 
Published: January 2006

Aim. The aim of this paper is to report a study exploring how members of multiprofessional healthcare teams talk about their team. Specifically, the team members’ talk was analysed to explore the discursive patterns that emerged and their functions.Background. Over recent decades there has been an increasing demand in Western countries to change care organizations and to coordinate resources and professional competencies to meet the needs of patients/service users better. Because society promotes this kind of work, it may be valuable to explore the self‐presentations of a multiprofessional healthcare team.Methods. A discourse analysis was carried out on existing empirical data from focus group interviews with a member‐identified category sample comprising 32 healthcare professionals in six authentic multiprofessional teams in south‐east Sweden. The analysis focused on the participants’ discursive constructions of multiprofessional teamwork, on the way they talked about their group, and, in particular, on their use of the pronounswe,theyandI.Findings. The constructions of ‘we’ by multiprofessional healthcare teams showed discursive patterns that are here referred to as knowledge synergy and trusting support, which included factors such as cross‐learning and personal chemistry. The pronounwewas also used as a flexible resource to manage expertise, power and leadership within the teams, and it might also function to ease the pressure for consensus.Conclusion. These discursive patterns provided powerful rhetorical resources for team members, both to affirm their choice of membership and to claim superiority in relations with the surrounding community (the others) by linking to a societal discourse that promotes collaboration.
Economics of home vs. hospital breastfeeding support for newborns
Authors: Stevens Bonnie , Guerriere Denise , McKeever Patricia , Croxford Ruth , Miller Karen‐Lee , Watson‐MacDonell Jo , Gibbins Sharyn , Dunn Michael , Ohlsson Arne , Ray Karen , Coyte Peter 
Published: January 2006

Aim. This paper presents the findings of research comparing the incremental costs associated with the provision of home‐based vs. hospital‐based support for breastfeeding by nurse lactation consultants for term and near‐term neonates during the first week of life.Background. A consequence of both consumer demands and increasing health resource constraints is that alternative care delivery models for safe, efficacious and cost‐effective breastfeeding programmes have steadily evolved. To date, the economic impact of the setting (home or hospital) where lactation support is delivered has received little research attention.Methods. Mother–infant dyads were stratified by gestational age as term (>37 weeks gestational age;n = 101) or near term (35–37 weeks gestational age;n = 37) and randomized to standard hospital care and postpartum follow‐up (standard care), or to standard hospital care plus home support from certified nurse lactation consultants (experimental). Data collection occurred at study entry, hospital discharge and at a seventh day postpartum follow‐up session. Costs to the family (out‐of‐pocket and time costs) and to the healthcare system (during hospitalization and after hospital discharge) were measured. Total societal costs were defined as the sum of both family and healthcare system costs.Results. Compared with standard hospital‐based care, home support by nurse lactation consultants showed no statistically significant differences in either time costs to the family or total societal costs. Term infants who received home support had statistically significantly greater postdischarge system costs (P < 0·0001), with a trend towards lower out‐of‐pocket expenses to their families (P = 0·12). There were no statistically significant differences between the two groups in overall combined family and healthcare system costs.Conclusions. These results suggest that the cost of home lactation support programmes were comparable with the costs of hospital‐based standard care. Breastfeeding support at home by lactation consultants should be considered as an option as it was no more costly than support from lactation consultants in the hospital setting. The findings for near‐term infants need to be interpreted with caution, given the small sample size.
Using clinical skills laboratories to promote theory–practice integration during first practice placement: an Irish perspective
Authors: Morgan Raph 
Published: January 2006

Aims and objectives.  This aim of this study was designed to investigate how a select cohort of nursing students experienced their first practice placement in a large Irish teaching hospital. The objectives of this study were to investigate whom do students learn from, what skills they learnt during their first practice placement and to identify if the use of clinical skills laboratories before their first practice placement helped students relate theory to practice during their first practice placement. The aim of this paper is to discuss if the sessions taught in the clinical skills laboratory prior to the first placement helped students integrate theory to practice during their first practice placement.Background.  The debate regarding theory–practice integration has been ongoing in nursing for decades. Many studies across Europe have consistently demonstrated that the use of clinical skills laboratories have helped students integrate theory to practice during practice placements. Others have identified the difficulty students have relating theory to practice. However, as there appears to be a gap in current literature, from an Irish perspective, it is essential to highlight if Irish students can integrate theory to practice during their first practice placement.Design.  A qualitative method incorporating the Heideggarian approach of phenomenology was utilized.Methods.  A purposeful sampling technique was used to select six participants from all first year students. Interviews were conducted using a semi‐structured interview schedule. Data were analysed using the Giorgi method of analysing phenomenological data.Results.  The participants identified that sessions taught in the clinical skills laboratory before the first practice placement, which they identified as ‘basic nursing skills such as taking and recording vital signs and hygiene needs of patients were useful and helped them to integrate theory to practice during their first practice placement. These results are relevant to this paper as they identify the use of teaching sessions in the clinical skills laboratories, enabling students to link theory to practice during practice placements.Conclusions.  Nursing students must be adequately prepared to carry out clinical skills competently and efficiently. Educators and practitioners must display the knowledge and skills required to promote theory–practice integration, to enhance nursing students education, which in turn will optimize high standards of patient care.Relevance to clinical practice.  Clinical skills laboratories are essential to help students develop the collaborative skills required for a profession like nursing. It is essential that students are adequately prepared to carry out clinical skills during their first practice placement, and have the ability to link theory to practice.
Use of technological equipment in critical care units: nurses’ perceptions in Greece
Authors: Kiekkas Panagiotis , Karga Maria , Poulopoulou Maria , Karpouhtsi Irini , Papadoulas Vasileios , Koutsojannis Constantinos 
Published: January 2006

Aims and objectives.  The aim of this study was to determine the perceptions of nurses who work in critical care units about positive and negative effects related to the use of technological equipment and identify relationships between these perceptions and demographic characteristics of participants.Background.  Previous researchers have investigated the perceptions of nursing personnel about the effects of technology on clinical practice. However, most of them focus on specific negative effects. Positive and negative effects have never been studied as a whole.Design.  Critical care nurses were surveyed to elicit their perceptions regarding the use of technological equipment. The instrument comprised a 14‐item questionnaire and a series of demographic characteristics. A five‐point Likert scale was used for each of these 14 questions.Methods.  The questionnaire was administered to 122 nurses working at the four critical care units of a major academic hospital in Patras, Greece, from 1/10/2003 to 31/12/2003. The completion of the questionnaires was achieved by means of a personal interview.Results.  A total of 118 questionnaires were completed. The majority of nurses recognized the positive effects of equipment regarding patient care and clinical practice. At the same time, they agreed that use of equipment possibly leads to increased risk due to human errors or mechanical faults, increased stress and restricted autonomy of nursing personnel.Conclusions.  The use of machines does not add to nursing prestige and this may be related to decreased autonomy. Human errors, mechanical faults and increased stress do not seem to come as a result of time constriction but rather of inadequate education. Undergraduate and continuing education should respond efficiently to the needs of contemporary critical care.Relevance to clinical practice.  Recognition of positive and negative effects of machines through the investigation of perceptions of nurses is the first step before looking for ways of maximizing advantages and facing disadvantages of equipment use.