bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ‘oriental’ component of the Balkan flora: evidence of presence on the Thracian Plain during the Weichselian late‐glacial
Authors: Magyari E. K. , Chapman J. C. , Gaydarska B. , Marinova E. , Deli T. , Huntley J. P. , Allen J. R. M. , Huntley B. 
Published: April 2008

AbstractAim  To obtain palaeobotanical evidence enabling evaluation of the viability of the hypothesis that the ‘oriental’ element of the Balkan flora reached south‐east Europe from Turkey prior to the Holocene, probably via the Thracian Plain during a late Quaternary glacial stage but no later than the late Weichselian.Location  Ezero wetland, northern Thracian Plain, Bulgaria.Methods  We undertook analyses of pollen and microspores, plant macrofossils, wood fragments and molluscs recovered from sediments deposited in the Ezero wetland during the late Weichselian and Weichselian late‐glacial. Sediment chronology was determined using radiocarbon age estimates.Results  Six metres of sediments were recovered from the basin, of which the lower 3 m, extending from c. 15,450 cal yr bp to the early Allerød, was analysed. A major hiatus occurred after c. 13,900 cal yr bp, the overlying sediments being of late Holocene age. Palaeobotanical evidence indicates predominantly open vegetation during the Weichselian late‐glacial, although macrofossil remains of woody taxa demonstrate the local presence of patches of wooded steppe and gallery forest. Changes in the composition of the steppe vegetation, and in the nature of the sediments deposited in the basin, indicate changes in climatic conditions, especially in the hydrological regime and in the moisture available to vegetation. After an initially relatively moister phase, the final centuries of the late Weichselian were drier, as was a short interval that may correlate with the Older Dryas. Moister conditions characterize intervals corresponding to the Bølling and Allerød sub‐units of the Weichselian late‐glacial interstadial. Although the pollen evidence is thus consistent with that from previous studies of this period in south‐east Europe and south‐west Asia, indicating predominantly open steppe vegetation, the macrofossil evidence indicates the persistent local presence of woody taxa. The woody taxa recorded include Celtis tournefortii‐type and Juniperus cf. J. excelsa, two taxa today characteristic of the wooded steppes of Anatolia and members of the ‘oriental’ element of the southern Balkan flora, as well as Rosaceae Subfams. Maloideae and Prunoideae, Alnus and Fraxinus.Main conclusions  The late Weichselian vegetation of the northern Thracian Plain included patches of wooded steppe that supported members of the ‘oriental’ element of the modern Balkan flora. The presence of such taxa renders viable the hypothesis that they could have reached south‐east Europe from Turkey via the Thracian Plain during glacial times. Such hypotheses in historical biogeography can be evaluated critically using the evidence obtained from plant macrofossil analyses in combination with that from pollen analysis.
Reflections on a ‘virtual’ practice development unit: changing practice through identity development
Authors: Fielding Carol , Rooke Debbie , Graham Iain , Keen Steven 
Published: April 2008

Aims. This paper draws together the personal thoughts and critical reflections of key people involved in the establishment of a ‘virtual’ practice development unit of clinical nurse specialists in the south of England.Background. This practice development unit is ‘virtual’ in that it is not constrained by physical or specialty boundaries. It became the first group of Trust‐wide clinical nurse specialists to be accredited in the UK as a practice development unit in 2004.Design and methods. The local university was asked to facilitate the accreditation process via 11 two‐hour audio‐recorded learning sessions. Critical reflections from practice development unit members, leaders and university staff were written 12 months after successful accreditation, and the framework of their content analysed.Findings and discussion. Practice development was seen as a way for the clinical nurse specialists to realize their potential for improving patient care by transforming care practice in a collaborative, interprofessional and evolutionary manner. The practice development unit provided a means for these nurses to analyse their role and function within the Trust. Roberts’ identity development model for nursing serves as a useful theoretical underpinning for the reflections contained in this paper.Conclusions. These narratives provide another example of nurses making the effort to shape and contribute to patient care through organizational redesign. This group of nurses began to realize that the structure of the practice development unit process provided them with the means to analyse their role and function within the organization and, as they reflected on this structure, their behaviour began to change.Relevance to clinical practice. Evidence from these reflections supports the view that practice development unit participants have secured a positive and professional identity and are, therefore, better able to improve the patient experience.
Shifting roles in nursing – does role extension require role abdication?
Authors: Pearcey Patricia 
Published: April 2008

Aims and objectives.  To discuss findings relating to role extension and loss of nursing care to auxiliary nurses.Background.  There is ongoing discussion in the literature about what nurses’ roles may be and how the extension of role affects patient care. Various models have been devised to measure outcomes and the value of nursing to patients. However, there are limited data on the views of nurses themselves in terms of what they perceive their role to be and what they feel about role change.Design.  A qualitative approach was used with the help of the elements of grounded theory.Methods.  Data were analysed using a constant comparative method with core categories identified. The study described in this paper was the final of three. The first two studies involved student nurses and through theoretical sampling, the third sample was chosen to expand the data gained from the students.Results.  The findings from the student studies indicated concern that the nursing role was being undertaken by auxiliary nurses. The results of the final study, as discussed in this paper, confirmed this. However, one main difference was that qualified nurses were not necessarily unhappy about auxiliary nurses’ role expansion but were concerned that the role of the nurse was moving away from the bedside.Conclusions.  The data suggest that nurses’ roles may be hard to define. An abdication of role, as opposed to delegation of role, seems to be occurring. Critical thinking is needed to ensure this is a decision advocated by clinical nurses.Relevance to clinical practice.  Nurses need to be explicit about what their clinical roles are. This study provides data expressing the views of clinical nurses about role expansion and role abdication and corresponding feelings about it.
Development and psychometric testing of a Chinese version of the Fatigue Scale‐Children in Taiwan
Authors: Chiang Yi‐Chien , Hinds Pamela S , Yeh Chao‐Hsing , Yang Chao‐Ping 
Published: April 2008

Aims.  The aim of this study was to develop and evaluate the psychometric properties of a Chinese version of the Fatigue Scale‐Children (FS‐C‐C).Background.  Cancer‐related fatigue is one of the most distressing and prevalent symptoms reported by paediatric oncology patients during and after their cancer treatment. A reliable and valid instrument to measure fatigue is essential to the successful clinical care of paediatric oncology patients in Taiwan who experience this troubling symptom.Design and methods.  A total of 108 paediatric oncology Taiwanese patients who were aged 7–12 years participated in this cross‐sectional, instrumentation study. The FS‐C was translated into Chinese by using an established translation/back‐translation method. The psychometric testing of the FS‐C‐C included internal consistency, content validity, construct validity, convergent validity, criterion‐related validity and known‐group validity.Results.  The FS‐C‐C achieved an acceptable internal consistency coefficient. Content validity was moderately high (content validity indices ranged from 83–100%). Confirmatory factor analysis supported the three‐factor model as an acceptable model fit (the goodness‐of‐fit index and adjusted goodness‐of‐fit index both were greater than 0·9; normed fit index, 0·89; root‐mean‐square residual, 0·15). Although the results did not support the known‐group hypothesis, the convergent validity, concurrent validity and predictive validity of the FS‐C‐C were supported by significant associations with the PedsQL Multidimensional Fatigue Scale, the Anxious/Depressed subscale of the Child Behaviour Checklist and the generic and disease‐specific scores on the Quality of Life for Children with Cancer instrument, respectively.Conclusion.  Our newly developed FS‐C‐C is a reliable and valid instrument for the measurement of cancer‐related fatigue intensity in Taiwanese children.Relevance to clinical practice.  The FS‐C‐C could provide useful information to guide clinical practice in assessing and managing cancer‐related fatigue in childhood cancer patients in Taiwan.
A best‐evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in‐patient mental health settings
Authors: Baker John A , Lovell Karina , Harris Neil 
Published: April 2008

Aims and objectives.  This paper aims to synthesise published literature of drug use/administration studies of pro re nata psychotropic medications in mental health wards.Design.  The study employed a best‐evidence synthesis review design.Background.  The administration of psychotropic pro re nata medications is a frequently used clinical intervention in mental health wards. Pro re nata contributes to exposing patients to high doses of antipsychotic medication. Despite the frequent use of pro re nata, there is limited evidence of their effectiveness.Methods.  A best‐evidence synthesis review.Results.  Six major themes emerged from the literature: (i) frequency of administration; (ii) administration during the 24‐hour day; (iii) administration associated with length and stage of admission; (iv) rationales for administration; (v) medicines administered (including route of administration); and (vi) effects and side effects of the medicines administered.Conclusions.  Overall findings indicate that the administration of psychotropic pro re nata varies radically and appears to be influenced by many variables.Relevance to clinical practice.  Patients are most likely to receive a benzodiazepine or typical antipsychotic as pro re nata. Pro re nata is an important and under‐researched clinical intervention used in mental health wards.
A systematic review of professional support interventions for breastfeeding
Authors: Hannula Leena , Kaunonen Marja , Tarkka Marja‐Terttu 
Published: April 2008

Objectives.  The objectives of this systematic review were first, to describe how breastfeeding is professionally supported during pregnancy, at maternity hospitals and during the postnatal period. Secondly, to find out how effective interventions are in supporting breastfeeding.Background.  Breastfeeding is an effective way to promote the health of infants. In many countries, the rates for breastfeeding remain lower than recommended. Many studies have examined breastfeeding promotion interventions; some of them are successful and some fail. It is important to find effective combinations of support.Design. Systematic review.Methods.  Search of CINAHL, Medline and Cochrane Central Register databases were conducted for data collection. The search was limited to articles published in Finnish, Swedish and English between the year 2000 and March 2006, focusing on breastfeeding and breastfeeding support interventions. Two reviewers independently analysed 36 articles in the final analysis.Results.  Interventions expanding from pregnancy to the intrapartum period and throughout the postnatal period were more effective than interventions concentrating on a shorter period. In addition, intervention packages using various methods of education and support from well‐trained professionals are more effective than interventions concentrating on a single method.Conclusions.  During pregnancy, the effective interventions were interactive, involving mothers in conversation. The Baby Friendly Hospital Initiative (BFHI) as well as practical hands off ‐teaching, when combined with support and encouragement, were effective approaches. Postnatally effective were home visits, telephone support and breastfeeding centres combined with peer support.Relevance to clinical practice.  Professionals need breastfeeding education and support of their organisations to act as breastfeeding supporters. The BFHI ‐programme is effective and it would be wise to include the core components of the programme in breastfeeding promotion interventions. Mothers benefit from breastfeeding encouragement and guidance that supports their self‐efficacy and feelings of being capable and empowered, and is tailored to their individual needs.
Engaging service users in the development of stroke services: an action research study
Authors: Jones Stephanie P , Auton Malcolm F , Burton Christopher R , Watkins Caroline L 
Published: April 2008

Aims and objectives.  To develop local stroke services by involving, in a meaningful way, those affected by stroke in identifying and prioritising service development issues.Background.  Consideration should be given to including the views of service users in the evaluation and re‐design of services. In stroke, the involvement of patients and carers in the development of services has generally been at a consultative level. There is a need to explore strategies to engage patients and carers more fully with the service development agenda.Design.  Action research.Methods.  Within the Reflection Phase of this action research study patients’ and carers’ experiences of stroke services were explored by semi‐structured interviews and focus groups. In the Planning and Action Phases, externally facilitated workgroups comprising patients, carers and professionals used a synthesis of the data to identify a range of service development priorities, which informed the development of action plans.Results.  Information provision, preparation for transfer of care and the integration of social and leisure activities appear to be priorities for the development of stroke services from the perspective of patients and carers. These findings informed the work of four collaborative workgroups to lead developments in the stroke pathway as follows: stroke prevention and immediate care, early and continuing rehabilitation, transfer of care and long‐term support and information provision.Conclusion.  Stroke patients and carers played a key and meaningful part in the identification and prioritisation of service development issues. External facilitation ensured progress with service development and maintaining patient and carer participation. Several pragmatic recommendations for enhancing the local delivery of stroke services were made.Relevance to Clinical Practice.  With external facilitation it is possible for stroke service users to take a meaningful role in service developments that moves beyond consultation.
Exchanging and countering points of view: a linguistic perspective on school students' use of electronic conferencing
Authors: Coffin C. , North S. , Martin D. 
Published: April 2008

Abstract  The ability to argue is an important academic goal in secondary education. This paper reports on an exploratory study which investigated how asynchronous text‐based conferencing provides a new site for school students to rehearse and develop their skills in argumentation. The study used linguistic tools of analysis to investigate two key questions:

How is argumentation structured in asynchronous text‐based conferencing?
How do students use language to negotiate their position on an issue?

The originality of our study lies in the use of a functional linguistic method of analysis which provides unique insights into how students use language to argue, insights that can inform teaching and learning both in school history (the context for this paper) and more generally. Our interest in language is based on the premise that it is central to the learning process – a premise supported by work in socio‐cultural psychology and systemic functional linguistics.The most significant findings to emerge from the analysis were that (1) counter‐argumentation was rare; and (2b) the more tentatively a claim is phrased the more likely it is that students will challenge or counter it.
Predictors of academic attainments of young people with Down's syndrome
Authors: Turner S. , Alborz A. , Gayle V. 
Published: April 2008

AbstractBackground  Earlier studies of young people with Down's syndrome have investigated a relatively limited range of variables which may influence their academic attainment. The relative strength of such influences and how they may vary during the school career, has also been under‐researched.Aims  The aim of the paper is to identify the contemporary and antecedent predictors of the level of academic attainment achieved by a representative sample of young people with Down's syndrome.Sample  The paper reports data from three studies of 71 young people with Down's syndrome and their families. Mean IQ at the time of the first study (t1) was 40.4. Mean chronological age was 9 years at t1, 14 at t2, and 21 at t3, when all the young people had left school.Methods  The outcome measure was the 58‐item Academic Attainments Index (AAI), comprising three sub‐scales covering reading, writing and numeracy. Predictors of the outcome were derived from questionnaires and interviews from tutors, mothers and fathers. A path analysis approach was used to investigate the pattern of predictors of the outcome over the three studies.Results  Factors predicting greater progress in this measure between t2 and t3 were lower chronological age and attendance at mainstream school. Progress from t1 to t2 was also associated with attendance at mainstream school, as well as with higher t1 mental age, mother's practical coping style and higher child attentiveness. Background factors predicting higher t1 AAI scores were higher mental age, attendance at mainstream school and father's internal locus of control. The path analysis model predicted 48% of the variance in t3 outcome scores. Severity of intellectual impairment was by far the most significant predictor.Conclusion  Limitations to the study include evidence of attrition bias towards more able children, and the need to obtain the t3 outcome measure from tutors for some young people and parents for others. Parents may have over‐estimated abilities. Results are broadly in agreement with other studies, and confirm the pattern reported earlier with this group. Mainstream school attendance had a modest beneficial effect on AAI scores throughout the school career of the children, independently of level of intellectual disability. Identification of predictors of attainment levels and of improvement over time may help parents, teachers and other professionals involved with families of children and young people with Down's syndrome optimise the attainment of such skills.
Social goals and conflict strategies of individuals with mild to moderate intellectual disabilities who present problems of aggression
Authors: Pert C. , Jahoda A. 
Published: April 2008

AbstractBackground A few recent studies have adopted a social cognitive perspective to explore how individuals with intellectual disabilities (IDs), who present problems of aggression, view their social world. The focus has mainly been on participants' perceptions of others' behaviour within conflict situations. The present exploratory study aims to compliment existing research by exploring social cognitive factors that may influence how individuals respond to conflict.Methods Study was carried out with 20 aggressive and 20 non‐aggressive men and women who have a mild to moderate ID. The ‘Social Goals and Strategies for Conflict’ (SGASC) assessment was devised to explore whether group or gender differences could be found in participants' expected outcomes of aggressive strategies, their expected outcomes of submissive strategies and their emotional reaction to these outcomes. Participants' social goals within hypothetical situations of conflict were also explored.Results It was found that aggressive and non‐aggressive participants have different social goals. There were no significant differences for expected outcomes of aggression or submissiveness. Nevertheless, a number of trends suggest that more aggressive participants expect negative outcomes for submissiveness compared with their non‐aggressive peers.Conclusions While the findings of this study are tentative, investigating the social outcomes that are valued by individuals with ID who present problems of aggression appears to be a promising area for further research, with possible implications for clinical assessment and treatment.
A study of complicated grief symptoms in people with intellectual disabilities
Authors: Dodd P. , Guerin S. , McEvoy J. , Buckley S. , Tyrrell J. , Hillery J. 
Published: April 2008

AbstractIntroduction  Previous studies have shown a significant association between familial bereavement and the onset of challenging behaviours and psychopathology in people with intellectual disabilities (ID). However, little work has been done to accurately describe the specific symptoms of grief, in particular symptoms of complicated grief in this population. Consensus criteria for the diagnosis of complicated grief have been drawn up and tested for validity in the general population.Aims  To examine the occurrence of symptoms of complicated grief, and to explore the relationships between complicated grief and bereavement experience.Method  A bereavement history questionnaire and a newly developed measure examining for symptoms of complicated grief were administered to a group of carers of people with mild or moderate ID, who had experienced a parental bereavement within the previous 2 years. The questionnaires were also administered to a matched comparison group, who had not been bereaved.Results/Conclusions  This carer‐based comparison study has revealed that bereaved individuals with ID experience complicated grief symptoms following the death of a parent, with one‐third of the bereaved group experiencing 10 or more clinically apparent symptoms. In addition, complicated grief symptoms were more likely to occur with higher rates of bereavement ritual involvement. These findings have both clinical and research implications.