bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency nurses’ knowledge of perceived barriers in pain management in Taiwan
Authors: Tsai Feng‐Ching , Tsai Yun‐Fang , Chien Chih‐Cheng , Lin Chia‐Chin 
Published: March 2007

Aims and objectives.  To explore knowledge of and perceived barriers to pain management among emergency nurses in Taiwan.Background.  Pain is the most common patient complaint in emergency departments. Quality care of these patients depends on the pain knowledge and pain management skills of emergency nurses. However, no studies have explored emergency nurses’ knowledge of and perceived barriers to pain management in Taiwan.Design and methods.  Nurse subjects (n = 249) were recruited from nine hospitals chosen by stratified sampling across Taiwan. Data were collected using the Nurses’ Knowledge and Attitudes Survey‐Taiwanese version, a scale to assess perceived barriers to pain management and a background information form.Results.  The overall average correct response rate for the knowledge scale was 49·2%, with a range of 4·8–89·2% for each survey question. The top barrier to managing pain was identified by these nurses as ‘the responsibility of caring for other acutely ill patients in addition to a patient with pain. Knowledge of pain management had a significant, negative relationship with perceived barriers to pain management and a significant, positive relationship with extent of clinical care experience and total hours of prior pain management education. In addition, scores for knowledge and perceived barriers differed significantly by the nursing clinical ladder. Perceived barriers also differed significantly by hospital accreditation category.Conclusions.  Our results indicate an urgent need to strengthen pain education for emergency nurses in Taiwan.Relevance to clinical practice.  The pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese emergency nurses.
Meta‐synthesis of caring in nursing
Authors: Finfgeld‐Connett Deborah 
Published: March 2007

Aim. The aim of this investigation was to enhance the understanding of the concept of caring.Background. Despite many analyses and studies of caring, the concept is not fully understood. This lack of clarity is unsettling given that caring is suggested to be the essence of nursing and a component of nursing's guiding paradigm. Meta‐synthesis methods offer a way to push the understanding of caring forward using existing research findings.Design. Qualitative meta‐synthesis.Method. Meta‐synthesis and grounded theory strategies were adapted to synthesize findings from 49 qualitative reports and six concept analyses of caring.Results. Results from this work indicate that caring is a context‐specific interpersonal process that is characterized by expert nursing practice, interpersonal sensitivity and intimate relationships. It is preceded by a recipient's need for and openness to caring, and the nurse's professional maturity and moral foundations. In addition, a working environment that is conducive to caring is necessary. Consequences include enhanced mental well‐being among nurses and patients, and improvements in patients’ physical well‐being.Relevance to clinical practice. It appears that caring has the potential to improve the well‐being of patients and nurses. It is recommended that healthcare agencies and educational institutions devote more resources to cultivate the caring among employees and students.Conclusions. The findings explicate a cohesive process of caring. They provide insight into the human attributes and clinical milieu that are necessary for caring to emerge. They also offer clarity regarding the therapeutic benefits of caring.
A European survey of enteral nutrition practices and procedures in adult intensive care units
Authors: Fulbrook Paul , Bongers Anke , Albarran John W 
Published: March 2007

Aims.  The aim of this survey was to gain an overview of enteral nutrition practices and procedures of European adult intensive care units and to describe current trends.Background.  Currently, little is known about nutritional practices in European intensive care units and whether they match existing guidelines.Design.  Survey.Methods.  A 51‐item questionnaire about nutritional assessment and enteral feeding was distributed to 383 intensive care units in 20 countries.Results.  A total of 380 (99·2%) questionnaires were returned. Most intensive care units (86·5%, n = 320/370) did not use a nutritional risk score and 35·8% (n = 133/371) conducted daily assessments of nutritional status; body weight and serum albumin were the commonest measures. Checking the position of the feeding tube using auscultation of injected air was widespread (72·6%, n = 275/373). Most units used a clinical protocol and under half were supported by a nutritional support team.Conclusion.  There are some variations in enteral nutrition practices across European intensive care units. Involvement of nurses in performing nutritional assessments or developing clinical protocols was minimal. The use of outdated procedures for checking feeding tube placement is a concern. There is scope for further development of nutrition guidelines in European units.Relevance to clinical practice.  This study is relevant to all nurses working in critical care areas. The findings suggest that when an intensive care unit is supported by a nutritional support team it is more likely that a nutritional score will be used and nutritional assessments will be made daily. Many intensive care practices do not conform to international guidelines for enteral feeding. Nutritional assessment and the use of nutritional risk scores are areas that would benefit from further application in intensive care. This study may provide an impetus for intensive care units to review their nutrition assessment practices and to advance evidence‐based guidelines, developed by multi‐professional teams, which ensure the safe and effective management of patients receiving enteral nutrition.
A review of the evidence for suboptimal compliance of healthcare practitioners to standard/universal infection control precautions
Authors: Gammon John , Morgan‐Samuel Heulwen , Gould Dinah 
Published: March 2007

Aims.  The review examines from international research: the extent to which practitioners comply with infection control precautions; the pertinent issues that are considered influential in compliance; what strategies have been evaluated to instigate positive behaviour changes amongst practitioners and the effect of these interventions.Background.  Internationally, standard/universal precautions (UP) are regarded as fundamental in the prevention and control of infection, and effective in protecting practitioners and patients. However, adherence has been problematic and the practice of standard/UPs is globally suboptimal.Design and methods.  Literature review where relevant evidence was identified using several electronic databases, from 1994 to 2006, with number of key terms utilized. Data were extracted by using key headings, which facilitated analysis.Results.  Thirty‐seven studies were appraised. Twenty‐four related to measuring practitioner compliance and 13 studies that evaluated the effect of a research intervention on compliance. In addition, other studies were included which examined the specific reasons for suboptimal compliance, or discussed infection control precautions generally.Conclusions.  Compliance to infection control precautions is internationally suboptimal. The evidence confirms that compliance to specific aspects of standard/UPs varies, and practitioners are selective in their application of recommended practice. Compliance does improve following a structured intervention; however, research fails to indicate for how long the intervention affects practitioner compliance, or whether compliance after a period of time returns to the norm. Several reasons for non‐compliance are discussed, and recommendations for future research are suggested.Relevance to clinical practice.  Suboptimal compliance has significant implications for staff safety, patient protection and the care environment. Infection control teams and researchers need to consider the reasons for non‐compliance and provide a supportive environment that is conducive to the routine, long‐term application of standard precautions.
Diagnostic approach and significance of inducible nitric oxide positivity in human cutaneous leishmaniasis caused by leishmania tropica
Authors: Atık Esin , Kuk Salih , İnandi Tacettin 
Published: March 2007

AbstractAim  To determine the usefulness of polymerase chain reaction (PCR) in the diagnosis of leishmaniasis and to emphasize the importance of inducible nitric oxide (iNOS).Materials and methods  Twenty‐nine patients with cutaneous leishmaniasis diagnosed according to clinical criteria who live in rural areas of Antakya‐Hatay/Turkey were included in this study. Twenty‐five patients free of leishmaniasis were accepted as a control group. Punch biopsies and smears were obtained from lesions of the patients in the study group. Half of each punch biopsy specimen was processed in routine tissue processing. After routine tissue processing hematoxylin‐eosin and iNOS immunohistochemical staining were applied. The remaining half of the biopsy specimens was studied by PCR method. INOS‐positive stained macrophages were determined.Results  The positive detection rates in 29 cases of cutaneous leishmaniasis (CL) were 96.5% by PCR, 86.2% by direct microscopic evaluation of biopsy and 58.6% by direct visualization of smear in this study. iNOS reaction was mildly positive in three cases, moderately positive in six cases and strongly positive in 20 cases.Conclusion  iNOS yielded positive reaction in all cases but this positivity showed differences with respect to the age of the lesions or the effect of iNOS on the immune mechanism. This reveals an inverse correlation between iNOS reactivity and duration of lesion (Spearman correlation r = −0.53, P = 0.003). There was no correlation between iNOS reactivity and patient age (Spearman correlation: r = 0.13, P = 0.5). In terms of gender, there was no association with iNOS.
First case of hepatitis C virus transmission by a red blood cell concentrate after introduction of nucleic acid amplification technique screening in Germany: a comparative study with various assays
Authors: Kretzschmar E. , Chudy M. , Nübling C. M. , Ross R. S. , Kruse F. , Trobisch H. 
Published: March 2007

Background and Objectives  Pooled nucleic acid amplification techniques (NAT) and donor screening for anti‐hepatitis C virus (HCV) have reduced the diagnostic window period of HCV infection in the blood donor population from about 12 to 1 or 2 weeks. During that time, HCV RNA is hardly detectable by pooled or individual donation NAT. Here we describe a case of transfusion‐acquired HCV infection from an extremely low‐titre donation. After a repeat donor tested positive for HCV, a look‐back procedure was initiated. A recipient of a red cell concentrate from the previous donation was identified and found to be infected with HCV as well. We compared several commercial NAT systems for their ability to detect the viraemic plasma.Materials and Methods  Molecular analyses of HCV in donor and recipient samples were performed. The HCV‐transmitting plasma was tested using different commercially available qualitative and quantitative NAT assays.Results  HCV transmission was verified by molecular analyses and was assigned to genotype 2b. NAT with various commercial HCV assays detected the infection erratically in individual donations. However, the detection rate was not directly related to the claimed sensitivity of some HCV NATs.Conclusions  HCV transmission can be caused by donations that escape NAT detection even when tested in an individual donation. Comparison of different assays led to results that did not necessarily reflect the expected sensitivities. The need for standard materials representing further HCV genotypes is discussed.
Reference materials for the evaluation of pre‐mortem variant Creutzfeldt–Jakob disease diagnostic assays
Authors: Cooper J. K. , Ladhani K. , Minor P. D. 
Published: March 2007

Background and Objectives  A standard panel of materials is needed for the evaluation of assays being developed for the diagnosis of variant Creutzfeldt–Jakob disease.Materials and Methods  Tissues from human and animals incubating transmissible spongiform encephalopathy disease have been prepared, aliquoted and where possible characterized by in vitro methods.Results  A standardized preparation of materials has been generated.Conclusions  Large‐scale preparations of tissues and blood fractions can be used to directly compare the sensitivities of assays using different formats.
Effect of cropping systems on cereal stemborers in the cool‐wet and semi‐arid ecozones of the Amhara region of Ethiopia
Authors: Wale M. , Schulthess F. , Kairu Eunice W. , Omwega Charles O. 
Published: March 2007

Abstract1 Field experiments were conducted on maize and sorghum at three locations in the Amhara state of Ethiopia to determine the effects of mixed cropping on stemborer infestation, borer natural enemies and grain yields. In the cool‐wet ecozone of western Amhara, sole maize was compared with maize intercropped with faba bean, mustard, potatoes and cowpea. In the semi‐arid ecozone of eastern Amhara, the trial was conducted on both maize and sorghum with the companion crops haricot bean, sesame, cowpea and sweet potatoes.2 The results showed that the predominant borer species in western and eastern Amhara were, respectively, Busseola fusca and Chilo partellus. In Addis Zemen, western Amhara, maize intercropped with mustard and potatoes had significantly lower pest numbers and percent tunnelling than other intercrops and the maize monocrop during the vegetative stage. In eastern Amhara, the cropping system did not significantly affect pest densities but damage to stem, ear or heads tended to be greatest when cereals were intercropped with sweet potatoes.3 Parasitism of C. partellus by the braconid Cotesia flavipes was greater on maize than sorghum, and on maize it was greater with sweet potatoes than in other intercrops or sole maize. Cocoon mass number per plant did not vary significantly between treatments.4 There were significant differences between treatments in yields of both sorghum and maize (per plant and per unit area) with the lowest yields observed when they were intercropped with a tuber crop.5 The results suggest that simultaneous planting of the crop species selected has little advantage over monocropped maize.
Designing out vulnerability, building in respect: violence, safety and sex work policy
Authors: Sanders Teela , Campbell Rosie 
Published: March 2007

AbstractOne recent finding about the prostitution market is the differences in the extent and nature of violence experienced between women who work on the street and those who work from indoor sex work venues. This paper brings together extensive qualitative fieldwork from two cities in the UK to unpack the intricacies in relation to violence and safety for indoor workers. Firstly, we document the types of violence women experience in indoor venues noting how the vulnerabilities surrounding work‐based hazards are dependent on the environment in which sex is sold. Secondly, we highlight the protection strategies that indoor workers and management develop to maintain safety and order in the establishment. Thirdly, we use these empirical findings to suggest that violence should be a high priority on the policy agenda. Here we contend that the organizational and cultural conditions that seem to offer some protection from violence in indoor settings could be useful for informing the management of street sex work. Finally, drawing on the crime prevention literature, we argue that it is possible to go a considerable way to designing out vulnerability in sex work, but not only through physical and organizational change but building in respect for sex workers rights by developing policies that promote the employment/human rights and citizenship for sex workers. This argument is made in light of the Coordinated Prostitution Strategy.
Diagnostic Procedures and Surgical Treatment of Craniodorsal Coxofemoral Luxation in Calves
Authors: STARKE ALEXANDER , HERZOG KATHRIN , SOHRT JAN , HAIST VERENA , HÖHLING ANDREA , BAUMGÄRTNER WOLFGANG , REHAGE JÜRGEN 
Published: March 2007

Objective—To report use of ultrasonographic examination of the coxofemoral joint, a surgical technique for repair of craniodorsal coxofemoral dislocation, and outcome.Study Design—Clinical case reports.Animals—Calves (n=4) with coxofemoral luxation.Methods—Craniodorsal coxofemoral luxation was diagnosed by physical examination, radiographic, and ultrasonographic findings. Open surgical reduction of the femoral head was performed using a modified caudal approach.Results—Craniodorsal luxation of the femoral head and the presence of an intact femoral neck were confirmed by ultrasonography. All luxations were successfully reduced and reluxation did not occur. At follow‐up, 1 heifer had calved and 1 was 5 months pregnant. One calf died of bronchopneumonia 6 days after surgery. One calf had severe coxofemoral degenerative joint disease diagnosed (ultrasonography, radiography, and arthrocentesis) 3 months after surgery and confirmed by necropsy.Conclusion—Ultrasonography proved to be a simple and effective non‐invasive technique for diagnosis of coxofemoral luxation. Immediate surgical intervention in hip dislocation in calves is necessary to avoid unnecessary trauma to subchondral structures. In calves, open instead of closed surgical reduction appears preferable because it allows access to the acetabular cavity for removal of debris.Clinical Relevance—Ultrasonography should be considered a supplementary but not an alternative to radiographic examination for diagnosis of coxofemoral luxation and for follow‐up examinations after reduction.
Endoscopic Resection of Dorsal Spinous Processes and Interspinous Ligament in Ten Horses
Authors: DESBROSSE FRANCIS G. , PERRIN ROLAND , LAUNOIS THOMAS , VANDEWEERD JEAN‐MICHEL E. , CLEGG PETER D. 
Published: March 2007

Objective— To describe endoscopic surgical subtotal resection of the dorsal spinous processes (DSP) and interspinous ligament in horses.Study Design— Descriptive clinical study.Animals— Adult horses (n=10) with back pain and impinging dorsal spinous processesMethods— Diseased portions of DSP and interspinous ligament were resected by endoscopic surgery, using Destandau Endospine to create a surgical space and provide triangulation for the endoscope, suction cannula, and surgical instruments. Medical records of 10 horses with pain attributable to DSP pathology treated by endoscopic resection of DSP were reviewed to determine intra‐ and postoperative complications and outcome.Results— Affected portions of DSP were successfully resected with minimal hemorrhage. Limited periosteal reaction was noticed after 3 months in 2 horses. Nine horses had no complications and returned to full work within 8 weeks; 1 developed a subcutaneous abscess, which was successfully managed, and returned to work after 3 months. Surgical resection improved presenting clinical signs and owner's complaint although 2 horses did not return to previous performance levels.Conclusion— Resection of DSP and interspinous ligament can be successfully performed endoscopically in horses. Hemorrhage was minimal but reduced visibility. Complications were minimal and most horses returned to work by 8 weeks.Clinical Relevance— Endoscopic resection of DSP is a safe and reliable surgical procedure in horses.
Treating vasomotor symptoms of menopause: The nurse practitioner’s perspective
Authors: Alexander Ivy M. , Moore Anne 
Published: March 2007

AbstractPurpose: This article reviews the pathophysiology of vasomotor symptoms (VMS) of menopause and current management options.Data sources: Current scientific literature.Conclusions: In most menopausal women, loss of ovarian function results in VMS, including hot flashes, night sweats, and mood and sleep disturbances. Hormone therapy (HT) has been the mainstay of VMS treatment for many years, but safety concerns raised by publication of the Women’s Health Initiative (WHI) results have dramatically reduced the use of this treatment. Since the WHI published its findings, attention has focused on other novel treatments for menopausal symptoms, including low‐dose oral or transdermal HT and agents such as selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, gabapentin, and clonidine. Many women also use complementary and alternative medications to manage VMS, but little evidence from controlled clinical trials supports their efficacy.Implications for practice: The increasing number of alternative treatments for VMS requires improvement in patient–provider communication about treatment risks and benefits, individualization of treatment to meet patient needs and attitudes, and careful follow‐up to ensure adherence to potentially effective therapy. Nurse practitioners play a leading role in patient evaluation, discussions, and management to help women achieve control over bothersome VMS that dramatically impact their quality of life.
Are Dietary Intakes and Eating Behaviors Related to Childhood Obesity? A Comprehensive Review of the Evidence
Authors: Newby P. K. 
Published: March 2007

Childhood obesity is a serious problem for increasing numbers of children around the world. According to the International Obesity Task Force, 1 of 10 schoolaged children worldwide is overweight or obese, a number totaling 155 million; of these, 2-3% (30-45 million) are obese. Prevalence is highest in the Americas and Europe, followed by the Near/Middle East, with smaller but growing numbers in the Asia-Pacific and Sub-Saharan regions of the world.In the United States, which provides the data for much of this report, prevalence continues to rise. The most recent nationally representative data indicate that 33.6% of individuals aged 2-19 years were overweight and 17.1% were at risk for overweight in 2003-2004, compared to 28.2% and 13.9% in 1999-2000, respectively. In this age group, the prevalence of overweight or at risk for overweight was highest among Mexican Americans (56.2%), followed by Non-Hispanic blacks (55.1%) and Non-Hispanic whites (49.8%), and a higher percentage of males were overweight (18.2%) compared to females (16.0%).
TNFpolymorphisms modify endotoxin exposure-associated longitudinal lung function decline
Authors: Zhang Hongxi , Hang Jingqing , Wang Xiaorong , Zhou Wei , Sun Bixiong , Dai Helian , Su Li , Christiani David C 
Published: March 2007

Objectives:Endotoxin exposure induces airway inflammation, hyper-responsiveness and higher expression of tumour necrosis factor (TNF). This study was conducted to investigate whetherTNFpolymorphisms modify the effect of endotoxin exposure on chronic declines in lung function.Methods:Associations betweenTNFandLTApolymorphisms, endotoxin exposure and lung function were analysed in 263 cotton workers and 230 silk workers as a reference group, who were prospectively followed for 20 years. Multiple linear regression models were used to assess the association, with adjustment for smoking and other covariates.Results:Endotoxin exposure was associated with faster lung function decline among genotypes associated with higher TNF expression levels, with estimates of annual FEV1change in relation to endotoxin exposure of –2.9 ml and –6.8 ml in theG/GandG/A+AAgenotypes, respectively, for theTNFpolymorphism; and –2.0 ml, –4.0 ml and –3.6 ml inA/A,A/GandG/Ggenotypes, respectively, for theLTApolymorphism. When joint effects of endotoxin exposure and smoking were considered, the effect modification ofTNFandLTApolymorphisms was prominent in never smokers.Conclusions:TNFandLTApolymorphisms may modify the association between occupational endotoxin exposure and longitudinal lung function decline, which was more clearly observed in never smokers.