bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making patients better: a qualitative descriptive study of registered nurses’ reasons for working in surgical areas
Authors: Mackintosh Carolyn 
Published: May 2007

Aims.  To explore the reasons and motivation identified by qualified nurses for working within the surgical area.Background.  Little is known about the career decisions qualified nurses make, although it is clear that some areas of practice are more popular than others. This qualitative descriptive study considers one common area, surgery, and explores the motivation for decisions made by Registered Nurses (RNs) to work in this area.Method.  A sample of 16 RNs working within surgical areas participated in semi‐structured interviews, using a thematic interview schedule. Findings were analysed using the framework suggested by Morse and Field.Results.  Analysis of findings indicates that all participants actively chose to work within surgery and that this was because of the pace and turnover of surgical work, personal satisfaction at the recovery of patients; the close links between this type of work; and participants’ original aims when first entering nursing and participants’ preference of surgery to other areas of nursing work. Participants actively rejected working in areas where patients were likely to suffer from chronic long‐term conditions where recovery was unlikely and felt that these areas were likely to be depressing and unrewarding.Conclusion.  These findings suggest that participants actively chose to work with ‘healthy’ patients in preference to those who may be considered ‘ill’, and this is closely linked to the identified need of participants to be able to ‘make patients better’. Participants were reluctant to work in areas where they would be unlikely to achieve this aim.Relevance to clinical practice.  The reluctance of surgical nurses to work with patients who were considered ‘ill’, in preference to ‘healthy’ patients must be acknowledged. Findings reflect different professional perspectives on the purpose of nursing work and suggest that qualified staff choose their clinical specialism based on their own personal sense of professional purpose, with consequent implications for both the recruitment and retention of qualified staff.
Nurses’ experience with the clinical application of a research‐based nursing protocol in a long‐term care setting
Authors: Simpson Michelle R , Stevens Patricia , Kovach Christine R 
Published: May 2007

Aim.  To describe nurses’ experience with the clinical application of a research‐based nursing protocol (The Serial Trial Intervention) within a long‐term care setting.Design.  A descriptive, qualitative study was conducted with a convenience sample of eight nurses from three nursing homes, who assessed and treated residents with dementia according to the Serial Trial Intervention protocol.Methods.  Each nurse participated in a semi‐structured interview between September 2003 and May 2004. Interviews were audiotaped and transcribed verbatim. Qualitative content analysis of the data, including thematic analysis, was used to identify patterns of experience.Results.  Three themes emerged that offer insight into the factors contributing to implementation of research‐based practice in a clinical setting. These include determining to intervene, pertinent steps of the protocol and facilitators and barriers.Conclusions.  The interplay between the protocol, the residents receiving care, the nurses providing care and the setting in which the care is provided, are interacting to affect the outcomes expected.Relevance to clinical practice.  Nurses who recognize the research process, the need for continual improvement in patient care and who possess competency in comprehensive physical assessment are needed to implement this evidence‐based protocol successfully. The regulatory atmosphere, workload structure and interdisciplinary collaboration are additional factors contributing to the successful use of the Serial Trial Intervention.
The comparison of effectiveness of two modalities of mental health nurse follow‐up programmes for female outpatients with depression in Taipei, Taiwan
Authors: Hsiao Fei‐Hsiu , Yang Tsung‐Tsair , Chen Chiao‐Chicy , Tsai Shang‐Ying , Wang Kuo‐chang , Lai Yu‐Ming , Tsai Chang‐Jer , Chang Wen‐Yin 
Published: May 2007

Aims and objectives.  This study compares the effectiveness of two modalities of mental health nurse three‐month follow‐up programmes: telephone counselling programme and group therapy programme for female outpatients with depression.Background.  The lifetime prevalence of major depression is 15% and is about twice as common in women as in men. Outpatients with depression often discontinue their treatment after the initial visits to their physicians.Methods.  This study used a quasi‐experimental, pre–post‐test comparison group design. Twenty‐six female outpatients with depression were assigned to one of follow‐up programmes: telephone counselling programme or group therapy programme. To qualify for group therapy programme, potential participants were required to come to group sessions weekly. To be accepted into telephone counselling programme, potential participants had to be able to be contacted by phone regularly. Mental health nurse three‐month follow‐up programmes included care management and structured psychotherapy. Patients in telephone counselling programme received 10 regular telephone calls of 30–60 minutes each. Patients in group therapy programme received 12 sessions of weekly group meetings of 90–120 minutes each.Results.  Wilcoxon signed ranks tests provided evidence that the group therapy programme (S = −52·5, p < 0·001; S = 31·5, p = 0·046) and telephone counselling programme (S = −36, p = 0·002; S = 25, p = 0·050) follow‐up programmes were effective in terms of relieving depressed symptoms and improving quality of life. According to Quade's analysis of covariance, telephone counselling programme and group therapy programme appeared to have similar effects of relieving depressed symptoms (F(1,24) = 0·06, p = 0·813) and increasing quality of life (F(1,24) = 0·07, p = 0·792). While there was no significant difference in using emergency services ( = 0·89, p = 0·539) between telephone counselling programme and group therapy programme, the rate of adherence to scheduled outpatient appointments with psychiatrists was higher among patients in group therapy programme than patients in telephone counselling programme ( = 8·67, p = 0·034).Conclusions.  Establishing two modalities of mental health nurse follow‐up programmes in Taiwan could benefit patients with different needs.Relevance to clinical practice.  Mental health nurses specialized in management of depression could provide not only care management but also structured psychotherapy.
Nurse practitioner–client interaction as resource exchange: the nurse's view (NP–client interaction)
Authors: Koeniger‐Donohue Rebecca 
Published: May 2007

Aim.  The aim of this study was to explore nurse practitioner (NP) client encounters from the nurse's perspective using a resource exchange paradigm.Background.  In health care interactions there is a need to examine what is reinforcing from the nurse's perspective.Design.  An exploratory descriptive design was used to address the following research questions: Prior to a clinic visit with midlife female clients what are NPs expectations of resources provided? What resources are actually provided during the visit with the NP and the client? To what extent is there congruence between the NP's expectations and the resources actually provided during a clinic visit?Methods.  The participants included two expert NPs and eight midlife female clients. Data for the study were derived from an initial larger study which examined resource exchange from the client angle and consisted of audio‐taped pre‐ and postencounter interviews with the NPs, audiotapes of the entire clinic visit and field notes recorded by the researcher of the client visits. Content analysis was conducted using ETHNOGRPAH software.Results.  NPs anticipated that a broad range of resources would be provided. The most prominent resources provided across visits were information, services, time and affirmation (that included affirmation itself, reassurance, reinforcement of positive health behaviours, support and feedback). In the more established relationships nurse self‐disclosure was evident.Conclusions.  Resource exchange theoretical formulations can be applied to NP–client interactions to understand and explain the specific nature of resources NPs expect to provide and actually provide.Relevance to clinical practice.  The nature of resources NPs provide, relationship development, types of exchange relationships in clinical practice were identified and posit a beginning typology for NPs to apply in their own clinical practice.
An evaluation of two Rapid Access Chest Pain Clinics in central Lancashire, UK
Authors: Rajpura Arif , Sethi Su , Taylor Martin 
Published: May 2007

AbstractAim  The aim of the project was to assess critically, using Maxwell’s six dimensions, the quality of the services provided by the two Rapid Access Chest Pain Clinics (RACPCs) in Central Lancashire.Methods  Data on the actual use of the clinic was obtained from the two RACPCs. A record linkage exercise between the database of patients from the RACPC and HES/mortality data was performed. Expected use of the clinic was established from the performance of other RACPCs and from published angina incidence figures. Patient and general practitioner views were obtained by conducting questionnaire surveys.Key recommendations  (1) Clinic is providing a valuable service and should be continued. (2) A standardized database should be created which includes ethnicity and final diagnosis. (3) Alternative methods for rapid diagnosis and management of chest pain need to be provided for patients who are not suitable for the exercise electrocardiogram. (4) Referral criteria should be redrafted in order to remove the exclusion criteria for patients with chest pain of longer duration than 3 months. (5) Further resources need to be targeted at cardiology outpatients and revascularizations, as waiting times for patients with a positive test are felt to be too long.
A survey of the practice of stroke doctors in developing transient ischaemic attack services in the UK
Authors: Beech Paula , Greenhalgh Joanne , Thornton Maria , Tyrrell Pippa 
Published: May 2007

AbstractRationale, aims and objectives  (1) To describe current practice in the establishment and running of transient ischaemic attack (TIA) clinics in the UK; (2) to identify whether TIA targets are met; (3) to inform future TIA service development.Methods  A survey distributed to the members of the British Association of Stroke Physicians (BASP).Results  Forty‐one per cent of full BASP members responded to the survey. TIA clinics were being run by 77% of respondents. Of the remainder 75% had plans to do so. Dedicated consultant time for stroke predominated among those involved in clinics (87% vs. 54%). The median time for clinics operation was 36 months. The median time from TIA to appointment was 2 weeks, exceeding national targets. Sixty‐four per cent of clinics were run weekly and 31% more than once a week. Forty‐six per cent stated they ran a one‐stop clinic service yet only 10% said there were no later follow‐up visits. A patient returning for completion of investigations was the most common reason for this (60%). Waits for investigations were reported – 53% indicated a wait for carotid Doppler scanning and 41% indicated this wait was in excess of 1 week.Conclusion  Key areas of concern arising from this survey were that time from TIA to clinic appointment remained outside the national target and there were delays for key investigations. Current service models are inadequate to meet current TIA targets and exploration of alternative service models is required.
Family history of mental illness and frequent mental distress in community clinic patients
Authors: Rohrer James , Rohland Barbara , Denison Anne , Pierce J. Rush , Rasmussen Norman H. 
Published: May 2007

AbstractObjective The objective of this study was to investigate the importance of family history of mental illness as a risk factor for self‐reported frequent mental distress among patients who use community‐based clinics.Design A cross‐sectional survey was distributed to a convenience sample in three community clinics serving largely low‐income patients. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables.Results In this sample of primary care patients, 27.1% had frequent mental distress. Having a family history of mental illness or substance abuse was found to be associated with frequent mental distress in this population [adjusted odds ratio (OR) = 2.24,P = 0.000]. Also associated with increased odds of frequent mental distress were avoiding medical care owing to cost (OR = 1.86,P = 0.003) and obesity (OR = 1.73,P = 0.006).Conclusions Having a family history of mental illness or substance abuse is independently associated with increased odds of frequent mental distress among primary care patients seen in community clinics. Three strategies are suggested for using this information to prevent frequent mental distress: health education via mass communication to the general population of primary care patients being followed in a clinic, health education to at‐risk patients, and targeted screening of clinic patients who have the risk factor.
The role of Clinical Support Workers in reducing Junior doctors’ hours and improving quality of patient care
Authors: Herbertson Rebecca , Blundell Adrian , Bowman Christine 
Published: May 2007

AbstractAim  The aim of the study was to see if the introduction of Clinical Support Workers (CSWs) at a teaching hospital could reduce the medical work intensity for junior doctors without compromising the quality of patient care.Background  The ‘New Deal’ and ‘European Working Time Directive’ have prompted hospitals to take a close look at junior doctors’ hours and work intensity in order to make posts compliant. Following the Department of Health’s publication ‘reducing junior doctors’ hours’, it was felt that certain clinical duties could be shared with nursing staff.Methods  Two audits were undertaken 8 months apart. The first was to determine the areas where the introduction of CSW would make the biggest impact. The second was to determine if this impact had had an effect on the intensity of work carried out by the junior doctors.Findings  The CSW greatly reduced the number of cannulations and venepunctures performed by the doctors without any compromise to patient care.Relevance to Clinical Practice  This study shows that other allied health professionals can be trained to carry out certain tasks that previously were only performed by doctors. This not only reduces the impact on junior doctors’ hours but can also improve patient care, with fewer delays encountered when patients are waiting for a procedure.
Photoselective vaporization of the prostate with the potassium‐titanyl‐phosphate laser in men with prostates of >100 mL
Authors: Rajbabu Krishnamoorthy , Chandrasekara Srinath K. , Barber Neil J. , Walsh Kilian , Muir Gordon H. 
Published: May 2007

OBJECTIVESTo assess the efficacy of photoselective vaporization of the prostate (PVP) in men with prostates of >100 mL and causing bladder outlet obstruction (BOO), using the high‐power 80 W potassium‐titanyl‐phosphate laser (GreenLight PV®, Laserscope, San Jose, CA, USA), which offers rapid tissue ablation with minimal bleeding.PATIENTS AND METHODSWe assessed 54 consecutive patients with prostates of >100 mL (mean 135, sd 42, range 100–300) who had PVP between May 2003 and August 2005. Evaluations before PVP included urine flowmetry, the International Prostate Symptom Score (IPSS), a quality‐of life (QoL) score, prostate‐specific antigen (PSA) level, and prostate volume measured by transrectal ultrasonography (TRUS).RESULTSThe mean (sd, range) duration of PVP was 81.6 (22.9, 39–150) min, the mean energy used for PVP was 278 (60, 176–443) kJ and the mean duration of catheterization after PVP was 23.0 (17.1, 0–72) h. The mean (sd) maximum urinary flow rate improved from 8.0 (3.1) to 18.2 (8.1), 18.5 (9.2), 17.9 (7.8) and 19.3 (9.8) mL/s at 3, 6, 12 and 24 months, respectively. The IPSS and QoL scores showed similar improvements, and there was a statistically significant reduction in PSA level and prostate volume after PVP. There was no major complication and no patient had transurethral resection syndrome or a blood transfusion.CONCLUSIONSThe 80 W KTP laser PVP offers rapid tissue ablation in patients with BOO caused by a large prostate. The short‐ and medium‐term outcomes show that this technique can be a viable alternative to open prostatectomy.
Interannual to decadal changes in area burned in Canada from 1781 to 1982 and the relationship to Northern Hemisphere land temperatures
Authors: Girardin Martin P. 
Published: May 2007

ABSTRACTAim  Temporal variability of annual area burned in Canada (AAB‐Can) from ad 1781 to 1982 is inferred from tree‐ring width data. Next, correlation analysis is applied between the AAB‐Can estimates and Northern Hemisphere (NH) warm season land temperatures to link recent interannual to decadal changes in area burned with large‐scale climate variations. The rationale in this use of tree rings is that annual radial increments produced by trees can approximate area burned through sensing climate variations that promote fire activity.Location  The statistical reconstruction of area burned is at the scale of Canada.Methods  The data base of total area burned per year in Canada is used as the predictand. A set of 53 multicentury tree‐ring width chronologies distributed across Canada is used as predictors. A linear model relating the predictand to the tree‐ring predictors is fitted over the period 1920−82. The regression coefficients estimated for the calibration period are applied to the tree‐ring predictors for as far back as 1781 to produce a series of AAB‐Can estimates.Results  The AAB‐Can estimates account for 44.1% of the variance in the observed data recorded from 1920 to 1982 (92.2% after decadal smoothing) and were verified using a split sample calibration‐verification scheme. The statistical reconstruction indicates that the positive trend in AAB‐Can from c. 1970–82 was preceded by three decades during which area burned was at its lowest during the past 180 years. Correlation analysis with NH warm season land temperatures from the late 18th century to the present revealed a positive statistical association with these estimates.Main conclusions  As with previous studies, it is demonstrated that the upward trend in AAB‐Can is unlikely to be an artefact from changing fire reporting practices and may have been driven by large‐scale climate variations.
Evaluating the potential eye irritancy of shampoos
Authors: BELL MELISSA , HOLMES PAMELA M. , NISBET TIMOTHY M. , UTTLEY MARGARET , ABBE NORMAN J. VAN 
Published: May 2007

SynopsisExperience in a large manufacturing unit showed that splashes of undiluted shampoo only produced transient effects in the eyes of production and packaging staff; over the same period, very few complaints of eye irritation were received from shampoo users, none of which were of a serious nature. Predictive testing is needed to make sure that new formulations are not severe eye irritants though rabbit eye testing may tend to exaggerate the likely human response.Detergent concentration is the principal factor influencing findings in the rabbit eye and an active matter content of 2.5–3.0% (usually representing a 20% aqueous dilution of shampoo) gives the best discrimination between formulations whilst producing no signs of distress in the animals; for typical anionic shampoos, testing at this concentration is recommended, without subsequent rinsing. Rabbit eye tests should never be conducted at higher concentrations until their innocuousness at 20% dilution has been shown and, even then, stronger preparations should only be instilled if they contain new ingredients for which the potential risk in human use are unknown. Conduct of all rabbit eye testing as a comparison with a ‘control’ formulation of equivalent concentration, known to be well tolerated under market conditions, is recommended.For preliminary screening, an in vitro test using freshly‐isolated buccal mucosa cells from human volunteers may be useful, irritancy being assessed by the proportion of cells showing loss of visible nuclei when examined by phase‐contrast microscopy. Evaluation de l'irritation oculaire par les shampooings
The Skin Blood Supply Factor (SBSF): a useful index for hyperaemia‐producing fitness cosmetics
Authors: BILEK P. , DOSKOCZIL S. , GREITER F. , PROKOP L. , SILADIJ T. 
Published: May 2007

SynopsisWhile topical agents cannot really ensure an adequate nutrition of the skin, the natural skin function can at least be stimulated by hyperaemia‐producing substances for topical use, which act on the peripheral circulation and thus promote regeneration and nutrition of the skin.In studies involving male and female sports students a given product was applied to the thighs and abdomen. Prior to and 1 h after application skin temperature was measured at accurately defined sites. The quotient computed between the maximum temperatures at treated and untreated test sites was defined to be the Skin Blood Supply Factor. Within the limits of this definition, maximum temperatures of 32.45° C and 32.25° C in treated and untreated skin areas, respectively, give a Skin Blood Supply Factor of 1.04. This is equivalent to a product‐induced temperature rise of 4%.Our tests showed that for a physiological effect to be achieved the factor must not be lower than 1.02. In view of peripheral vascular function and considering that product application is virtually unlimited, a factor of 1.08 should not be exceeded. Le facteur d'activation de la circulation sanguine cutanée (SBSF): un indice pour le développement de produits cosmetiques hyperhemiants.
The gas chromatographic determination of humectants
Authors: CHAMBERS N. , CROPPER E. , PUTTNAM N. A. 
Published: May 2007

SynopsisA rapid gas chromatographic method is described for the simultaneous determination of glycerol, sorbitol or mannitol in a variety of raw materials or finished products.The method is based upon the direct conversion, normally without predrying, of sample humectants into their acetate derivatives by bomb reaction with acetic anhydride in the presence of pentaerythritol added as internal standard. The resultant acetates are determined by g.l.c.; a complete determination requires about 30 min. The method, as described, is not applicable to samples containing borax or boric acid derivatives. Le dosage d'humectants par chromatographie en phase gazeus
Biochemical effects of unsaponifiable lipidic components of avocado and soya bean administered percutaneously on the connective tissue components of hairless rat skin
Authors: LAMAUD EVELYNE , ROBERT ALEXANDRE M. , WEPIERRE JACQUES 
Published: May 2007

SynopsisThe unsaponifiable lipidic fractions of avocado and soya bean were administered percutaneously, on the dorsal skin of hairless rats for 15 days, in a 5% sweet almond oil solution. This treatment produced a modification of dermal connective tissue components. The biochemical analysis showed an increase of soluble proteins, especially of salt soluble collagen together with a decrease of proteins insoluble in neutral buffer. The ratio, soluble proteins:insoluble proteins, increases as well as the ratio soluble collagen: insoluble collagen. These modifications can be considered as a result of the activation of connective tissue metabolism.The above results are in agreement with those obtained when the unsaponifiables were administered per os to rats. Effets biochimiques, sur le tissu conjonctif sous cutané des insaponifiables de soja et d'avocat adminstrés par voie percutanée chez le rat sans poils