bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ataxia-Telangiectasia-Mutated (
ATM
) Gene in Head and Neck Squamous Cell Carcinoma
Authors: Ai Lingbao , Vo Quynh N. , Zuo Chunlai , Li Liwen , Ling Wenhua , Suen James Y. , Hanna Ehab , Brown Kevin D. , Fan Chun-Yang 
Published: March 2006

Abstract
The Ataxia-telangiectasia-mutated (ATM) gene product is a well-characterized tumor suppressor that plays a key role in maintenance of genomic stability. We have recently documented that the ATM promoter is a target for epigenetic silencing in cultured tumor cells. Here we show that aberrant methylation of the ATM promoter occurs in a significant percentage (25%) of head and neck squamous cell carcinomas. The presence of methylated ATM promoter shows a statistically significant correlation with an earlier age of initial diagnosis and decreased overall survival, particularly in early-stage tumors. These findings indicate that ATM promoter hypermethylation occurs in head and neck squamous cell carcinoma, and this feature is a potentially useful prognostic marker in this tumor type.
p53 Codon 72 Polymorphism and Cervical Neoplasia
Authors: Koushik Anita , Platt Robert W. , Franco Eduardo L. 
Published: March 2006

Abstract
The Arg/Arg genotype versus Arg/Pro or Pro/Pro at codon 72 of the p53 gene has been implicated as a risk marker in cervical neoplasia. However, research on this topic has produced controversial results. We reviewed the published literature to summarize the association and to identify methodological features that may have contributed to the heterogeneity. Information on specific methodological features of studies addressing this topic published between 1998 and 2002 were obtained. Study-specific odds ratios (ORs) were combined in a meta-analysis, assuming random effects. To identify characteristics that significantly contributed to heterogeneity, we used meta-regression analysis. We identified 50 articles, of which 45 were included in the meta-analyses and regressions. No evidence of association or heterogeneity was detected for preinvasive lesions. For invasive cervical cancer with undefined histology, the Arg/Arg genotype was not found to affect risk (OR, 1.1; 95% confidence interval (CI), 0.9–1.3). However, a slightly increased risk was observed for squamous cell carcinoma (OR, 1.5; 95% CI, 1.2–1.9) and adenocarcinoma (OR, 1.7; 95% CI, 1.0–2.7). Meta-regression analysis identified that the most important factor contributing to heterogeneity among results for invasive lesions was departures from Hardy-Weinberg equilibrium in the control group. Summary ORs for studies in equilibrium were essentially null. A possible susceptibility role by the p53 codon 72 polymorphism at a late carcinogenetic stage in cervical cancer cannot be ruled out. However, various methodological features can contribute to departures from Hardy-Weinberg equilibrium and consequently to less than ideal circumstances for the examination of this polymorphism. Future investigations require appropriate attention to design and methodological issues.
Association between Insulin-Like Growth Factor-I
Authors: Sandhu Manjinder S. , Gibson J. Martin , Heald Adrian H. , Dunger David B. , Wareham Nicholas J. 
Published: March 2006

Abstract
Several prospective observational studies have suggested that elevated circulating IGF-I levels are associated with an increased risk of cancer. These observations may provide a potential mechanism through which previously identified metabolic and anthropometric factors, such as obesity and elevated insulin and glucose levels, may operate. We therefore examined metabolic and anthropometric influences on circulating levels of insulin-like growth factor-I (IGF-I), insulin-like growth factor-binding protein-1 (IGFBP-1), and the IGF-I:IGFBP-1 ratio in a middle-aged population of 349 men and 492 women. IGF-I showed only modest inverse associations with indices of adiposity. However, we found that low IGFBP-I levels and an increased IGF-I:IGFBP-1 ratio were strongly associated with increased levels of insulin and glucose in men and women. Body mass index was also positively related to the IGF-I:IGFBP-1 ratio in men (P &lt; 0.001) and women (P &lt; 0.001), independent of metabolic correlates of IGFBP-1 and IGF-I. Similarly, waist:hip ratio and waist circumference were also associated with an increased IGF-I:IGFBP-1 ratio and low circulating IGFBP-1 levels. These findings suggest that individuals with greater fat mass and upper body obesity may have elevated levels of bioavailable or free IGF-I, which could, in part, mediate the reported associations among metabolic and anthropometric factors and cancer risk.
Clinical supervision: What is going on in West Wales? Results of a telephone survey
Authors: Jenkins Ergys , Rafferty Mic , Parke Silan 
Published: March 2006

This research was designed to identify successful models of clinical supervisory practice and the problems encountered by practitioners following the incorporation of clinical supervision into their practice. The survey population of 35 was a self-selected sample out of 118 practitioners who had completed the Welsh National Board validated diploma level module in clinical supervision. These practitioners had completed the module organised by the School of Health Science at Swansea at eight sites across Mid and West Wales between February 1995 and June 1997. Work on the study began in March 1997 and was completed in March 1998. The study employed semi-structured telephone interviews which sought information on practitioners' experiences, and how their clinical supervision was organised in practice. The data were analysed by quantification, and by description of the responses by repeated independent analyses. Finally, the key themes were organised into 'narrative types'. The findings are presented in three parts relating to the three functions of supervision: support, learning, accountability. Key findings include: •The method was suitable and effective •Community practitioners are generally better placed than their counterparts in acute hospitals to undertake effective supervision •Time and organizational support are crucial factors •The need for, and value of, clinical supervision was universally acknowledged by those interviewed. Recommendations relating to the findings are included.
The use of narrative in the study of caring: A critique
Authors: Priest Helena M. 
Published: March 2006

Within nursing and the allied professions there is an extensive and growing literature that aims to uncover the meaning of caring and its application in practice. Review of the literature reveals a wide range of data collection and analysis methods, including measurement and multivariate analysis, concept analysis, content analysis, Q-sort methodology, the repertory grid technique, case study, ethnographic and phenomenological approaches. It is argued that while all approaches make a valid contribution, appropriate methods for nurses of obtaining rich data about the meaning and practice of caring are those which permit the researcher to enter the world of the nurse and explore perceptions as expressed through stories. Reference is made within this paper to the use of narrative in an ongoing research study which explores nurses' perceptions and experiences of psychological care-giving and the ways in which these develop throughout nurse education programmes. However, the main purpose of this paper is to present arguments for and against the use of the narrative method, concluding with a brief discussion of methodological choice applied to the study of caring.
Violent incidents in a forensic adolescent unit: A functional analysis
Authors: McDougall Tim 
Published: March 2006

This paper reports on a survey which identified categorised and measured the relative frequency of specific antecedents before, and the consequences following, violent incidents in an adolescent forensic unit during a two-year period. Retrospective analysis of 219 violent incidents involved the examination of incident forms, nursing-process records and accident reports. Antecedents and precipitating factors were also recorded. The results demonstrated that the vast majority of incidents were precipitated by several observable antecedents or precipitating factors (186, 85%). Only a small proportion of the violent incidents were preceded by a single risk indicator (21, 9.5%) and a minority were reported to have occurred in the absence of observable antecedents (12, 5.5%). The severity of violent incidents was rated on a four-point scale but no significant correlation was found between category or frequency of antecedent and the violent act itself. The consequences for the young person following acts of violence were also documented, and the results show that the large majority of incidents were followed by increased staff observation (197, 90.5%). Coercive interventions such as physical restraint (177, 80.8%) or idiosyncratic sanctions (88,40.2%) were commonly recorded. A significant proportion of violent incidents did not appear to be followed by staff intervention, sanction or punishment (80, 36.5%). Finally, results are considered against research and best practice evidence, and suggestions for further studies are presented. Organisational interventions, strategies for the management of aggression and violence, and a staff training needs analysis are also indicated.
Quality in nursing care: Context, complexity and the role of professions
Authors: Normand Charles , Doagllas Hannah-Rose , Castelnuovo Enmanuela 
Published: March 2006

Requests for quality and affordability have driven healthcare reforms in the UK and elsewhere at all levels of the system. The introduction of some aspects of private markets in healthcare has paved the way to transfers of organisational know-how across the private and public sector. However, the concept of quality has a wider meaning in the public sector, incorporating social as well as individual goals. Furthermore, the incentives needed to achieve improvements in quality are different between the sectors. The notion of quality incorporates contrasting, even paradoxical ideas: it can be seen as a notion of achieving standards and norms on the one hand, and on the other, as enhancing variability and adaptability to changing environments. While the public sector appears to be moving towards the former, the private sector is moving in the opposite direction. Improving the quality of nursing care means finding quality improvement technologies which can incorporate aspects of healthcare that are among the most difficult to define and measure. This may be a reason why nurses have been less successful than doctors at controlling the quality agenda for their profession. Initiatives in the private sector which focus on adaptability and flexibility may be worth exploring in order to identify innovative ways of capturing important aspects of nursing care which cannot be standardised.
Pre-operative visiting in Wales: A study of its prevalence and nature
Authors: Coleman Mick , White Jean 
Published: March 2006

A telephone survey was completed involving senior nurses from all NHS theatre units in Wales that carry out routine scheduled surgery (n=19).The survey examined whether these units had pre-operative visiting regimes, constraints and barriers to pre-operative visits and the nature, content, timing and staffing of any visits that were undertaken. A purposive sample of respondents from the telephone survey (n=6) was interviewed further and a content analysis of the transcribed interviews completed. The results indicate that only a small percentage of patients undergoing surgery actually receive a pre-operative visit. When visits are carried out their content does not reflect the evidence of effectiveness in the research literature. The reasons for this apparent non-utilisation of research evidence are explored in the paper and recommendations are made as to how this situation could be altered.
Health-related quality of life assessment in end-stage renal failure
Authors: Piillips Louise , Davies Simon J. , White Edward 
Published: March 2006

End-stage renal failure (ESRF) is a life-threatening condition and survival can be maintained only with renal replacement therapy. Furthermore, the complications of ESRF, its treatment and co-existing diseases have been found to have a significant impact on the physical health of patients. It is well documented that the health status of the renal patient population is worse than that of the general healthy population; for this reason the assessment of quality of life of ESRF patients has received considerable attention.During the 1990s, the focus of health assessment moved away from the disease itself towards health status and wellbeing. The widespread use of the 36-item short-form (SF-36) questionnaire has promoted this. In ESRF studies from data using the SF-36 questionnaire it has been shown that it is the physical functional component of health that is most affected by the patient's condition, with co-morbidity having a significant impact.There is growing consensus that health-related quality of life is more than just an assessment of health status. Rather, it is the relative importance given by the individuals themselves to the impact of the disease on their life. While this approach is emerging, some of the tools which have been developed to measure individualised quality of life require further scientific validation for use with the ESRF population.
Changes in student nurses' approaches to studying
Authors: Howard David , Hayes Maiy, , Solomonides Ian , Swannell Malcolm 
Published: March 2006

This research identified the approaches to studying preferred by student nurses, determined whether these changed during the Diploma of Higher Education in Nursing (DipHE Nursing), and which approaches to studying were associated with greater academic achievement. Two cohorts of student nurses were sampled. Cohort 1 (n=40) completed the 44-item Revised Approaches to Studying Inventory RASI (Tait and Entwistle, 1996) at the end of the course and was interviewed. Cohort 2 (n=76) completed the RASI twice, once at the beginning of the course and again following the first year. In keeping with research reported elsewhere (Swannell, 1992; Richardson, 1995; Devlin, 1996; Solomonides, 1996), an association between age and preference for the deep approach to studying was observed. It was also found that student nurses changed their approaches to studying during the course to favour the deep approach. This occurred as the theory became relevant to their concepts of nursing. As those students who preferred the deep approach attained higher assessment grades than those who preferred the surface approach, the paper recommends strategies to encourage the deep approach to studying from the outset of the course.
Empowerment and disempowernent: Models of staff/patient interaction
Authors: Faulkner Mark 
Published: March 2006

This study aimed to develop valid models of empowerment and disempowerment relevant to staff/patient interaction as a means of generating a greater understanding of how these concepts are expressed in healthcare. This involved submitting the concepts of empowerment and disempowerment to an act frequency approach (Buss and Craik, 1983). Using this approach, registered nurses (n=38) were asked to nominate empowering and disempowering acts relevant to staff/patient interactions, yielding a list of 98 acts. Following this, older hospitalised people (n=20) were asked hypothetically to judge these acts as to the extent they would be 'control giving' if personally experienced. The 20 highest scoring acts for each concept were then incorporated into an act frequency observation scale. Using this composite scale, older hospitalised people (n=102) were asked to judge how often they had encountered each act over a pre-determined period of time. Act frequencies for each concept were then submitted to a principal components factor analysis. The principal components of empowerment were identified as 'promoting patient independence,' 'promoting information exchange' and 'being aware of patient needs'; and for disempowerment, 'impeding patient collaboration in care planning,' 'domination' and 'indifference to patient needs'. Models of these concepts illustrate the therapeutic and non-therapeutic aspects of interpersonal care.
Service co-ordination: A successful model for the delivery of multi-professional services to children with complex needs
Authors: Tait Tom , Beattie Anette , Dejnega Suzi 
Published: March 2006

Multiple agencies and professions provide services to children with complex needs but there is a need for such services to be well coordinated. A multi-agency approach to achieving greater co-ordination of services was developed in the city of Leicester and the counties of Leicestershire and Rutland. The project introduced regular planning meetings with families and agreed that parents would hold the multi-agency family service plans and records, and that families themselves, if they wished, could act as co-ordinators for their child. A study was devised to test whether the aims of the project had been achieved. It was based on individual and group inteviews with parents and professionals, and examined the experiences and perceptions of services co-ordination among paricipants. The aims of the project proved to be similar to six crucial elements of key working devised by Mukherjee et al. (1999). Both agreed that parents and professionals should have equal status, value and influence, and parents were perceived as important partners. The comments from parents and professionals taking part in the project indicated their satisfaction with the way the new scheme worked, which confirmed for the researchers that the aims had been achieved. Recommendations are made for future models of service co-ordination.
A concept analysis of practice development
Authors: Garbett Rob , McCormack Brendan 
Published: March 2006

The term 'practice development' is widely but inconsistently used in British nursing, addressing a broad range of educational, research, and audit activity, but there appears to be little consensus as to what practice development actually involves. Such lack of clarity means that the increasing number of nurses whose work involves addressing practice development issues can have difficulty in focusing their efforts. To try to clarify the concept of practice development and to describe the focuses of practice development work and the approaches used, a concept analysis was conducted. Both primary and secondary data were gathered and analysed in the study. One hundred and seventy seven items of published literature were gathered and analysed. Focus group interviews were carried out involving 60 practice developers. In addition, 25 clinical nurses were interviewed about their experiences of being involved in practice development. This paper describes the identified purposes, attributes and outcomes of practice development. Practice development activities are described as addressing the effectiveness of care through the transformation of care practices and cultures. Practice development is described as a systematic, rigorous activity underpinned by facilitation processes. The outcomes of practice development can be described in terms of changes in the behaviours, values and beliefs of staff involved. Parallels between practice development and current policy imperatives are outlined.
Nursing informatics and practice development
Authors: Clambers Mary 
Published: March 2006

The nature of healthcare is changing, and as society becomes more technologically driven, it is important for nursing to take a leading role. This paper briefly considers the history of nursing informatics from its development in the 1960s. The role of technology in nursing practice is discussed, together with the contribution it can make to enhancing the knowledge and skills of nurses. Studies that have looked at the attitudes of nurses towards this new technology are then discussed. A consideration of how nursing informatics can advance practice development follows, illustrated using the examples of three nursing informatics projects — the Assisting Carers using Telematics Interventions to meet Older persons' Needs (ACTION) project, HeartCare, an internet-based cardiac recovery support service for patients at home following cardiac surgery, and a study to consider the effectiveness of telemedicine as a support system to encourage breastfeeding.
An assessment of lead R&D nursing roles in acute trusts and an evaluation of their status within the NHS research agenda
Authors: Browne Natasha , Harris Ruth , Hunt Jane , Kelly Daniel , Kelley Kate , Pearce Susie , Plant Hilary , Richardson Alison , Sitzia John 
Published: March 2006

For over a decade, the need to develop a robust evidence base for nursing, midwifery and health visiting through research has been part of the UK government's R&D strategy. Progress has been slow and little is known about the organisational reality of the most recent strategies. This study aimed to investigate the nature of posts with named responsibilities to lead and develop nursing and midwifery research activity, based in acute NHS hospital trusts. Data were obtained through telephone interviews with directors of nursing services, and a postal survey of relevant staff. Fifty two people responsible for nursing and midwifery R&D were invited to complete the questionnaire, of whom 34 responded. The majority of trusts were able to name an individual responsible for leading nursing R&D, although the remit of the role varied considerably. The effectiveness of implementing any national research strategy is likely to be constrained by the lack of consistency regarding nursing research roles, a factor that may also be implicated in the lack of progress in securing a meaningful contribution to NHS research from nursing R&D.
The organisation of cancer nursing services in the UK: A review of current practices
Authors: Richardson Alison , Miller Morven , Potter Helen 
Published: March 2006

The reorganization of cancer services in recent years has presented cancer nursing with a range of organisational and developmental challenges. It is therefore encouraging to note that the specialty has evolved to the extent that an efficient and effective cancer nursing workforce is now acknowledged as a prerequisite for the provision of high-quality cancer care (Department of Health, 1995; 2000a; 2000b). However, despite the advances there has been little evaluation of the critical issues faced by specialist cancer nurses. This project was undertaken as part of a larger scoping exercise designed to assimilate an evidence base to support the development, delivery and evaluation of UK cancer nursing services. This element of the project aimed to provide information to support the development and organisation of cancer nursing services by focusing on specific aspects of care (DoH, 2000a). The results indicate that lead cancer nurses are striving to ensure that patients are provided with the best quality care through nurses' participation in collaborative endeavours, for example with the primary care and the voluntary sectors. There is still much to be achieved, primarily in the areas of workforce planning, the skill development of non-specialist nurses, and research and development. The evidence demonstrates that cancer nursing will continue to accept the challenges of changing practice, working to ensure that patients receive a high-quality service.