bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a theory‐based taxonomy of methods for implementing change in practice
Authors: Leeman Jennifer , Baernholdt Marianne , Sandelowski Margarete 
Published: April 2007

Abstract Title. Developing a theory‐based taxonomy of methods for implementing change in practice Aim.  In this paper we present a theory‐based taxonomy of the methods used to implement change in practice.Background.  Implementation research is characterized by inconsistent terminology for the methods employed and inattention to differences in the relevance of methods across different disciplines. Studies of the effectiveness of implementation have yielded mixed results. Positive effects shown have been small. The limited success of many efforts to implement change in practice may be due, in part, to the absence of a framework to guide the use of implementation methods.Method.  A provisional taxonomy of implementation methods, derived from theory and existing taxonomies, was used to content analyse a convenience sample of 43 reports of empirical studies of the implementation of one or more research‐based practice changes involving nurses that had been published between 1995 and 2005. This taxonomy was revised throughout the course of analysis to capture more completely the information in each report.Findings.  Following the analysis, nine of the 11 methods in the provisional taxonomy were retained, two were removed and five new methods were identified. The final taxonomy includes 14 implementation methods organized into five categories: (a) increasing coordination; (b) raising awareness; (c) persuasion via interpersonal channels; (d) persuasion via reinforcing belief that behaviour will lead to desirable results and (e) increasing behavioural control.Conclusions.  The taxonomy presented here differs from prior taxonomies by focusing on nursing and by providing a clear and mutually exclusive guide to implementation methods. By deriving the initial coding strategy from theory, the taxonomy links the methods to theoretical constructs that may inform the selection of methods across different practice changes and settings.
Turkish adaptation of the parental health beliefs scale
Authors: Erci Behice , Tüfekçi Fatma Güdücü 
Published: April 2007

Abstract Title. Turkish adaptation of the parental health beliefs scale Aim.  This paper reports an adaptation of the English version of the Parental Health Beliefs Scale for use with Turkish parents and an evaluation of its psychometric properties.Background.  As a profession, nurses are particularly concerned with cross‐cultural influences that affect the health beliefs of populations. Although the international literature describes questionnaires and specific scales in health promotion and health beliefs, adequate Turkish‐language instruments are scarce. Therefore, suitable instruments need to be developed or adapted for the Turkish parents.Method.  This was a psychometric study. A convenience sample (n = 257) was recruited in 2003 from parents who attended a primary healthcare centre in Erzurum, Turkey. Translation and back‐translation of the original English instrument and content validation by an expert panel were the first two steps. The third step was psychometric testing of the adapted instrument to establish internal consistency, inter‐item correlation and construct validity. Data were collected using the Parental Health Beliefs Scale. Socio‐demographic data were also collected. The investigators visited the centre every workday, and interviewed the samples. The parents read and self‐completed the questionnaire.Findings.  Content validity procedure resulted in a final scale that consisted of 20 items. Cronbach's alpha was 0·75. Factor analysis yielded three factors related to chance, internality and powerful others.Conclusion.  Although acceptable levels of reliability and validity of the Turkish version of the Parental Health Beliefs Scale for parents were reached, cultural factors appeared to play a role in the applicability of the scale. Further validation research is therefore needed before the scale can be recommended for use in nursing research and practice.
Nursing students’ perceptions of learning in the clinical setting of the Dedicated Education Unit
Authors: Ranse Kristen , Grealish Laurie 
Published: April 2007

Abstract Title. Nursing students’ perceptions of learning in the clinical setting of the Dedicated Education Unit Aim.  This paper reports a study to explore nursing students’ experience of learning in the clinical setting of a Dedicated Education Unit using a communities of practice framework.Background.  The Bachelor of Nursing curriculum at the University of Canberra is clinically focused, recognizing the importance of learning to be a nurse in and from practice. A communities of practice framework underpins the philosophy of the Dedicated Education Unit model of clinical practicum.Method.  In this exploratory qualitative study, a convenience sample of 25 second and third year nursing students participated in focus group discussions, conducted in 2004, to share their views of learning in the Dedicated Education Unit, a newly established model of clinical education.Findings.  Three major themes were identified: acceptance, learning and reciprocity, and accountability. Acceptance of students by clinicians assisted students to engage in nursing work. Students acknowledged the importance of peer learning in sharing experiences, reinforcing knowledge and enhancing confidence. Students accepted responsibility for their work and they valued this responsibility, but some questioned whether participation in all aspects of work constituted a learning opportunity.Conclusion.  Engagement and participation in the clinical workplace are valuable for nursing students. Strategies to support learning in the workplace can be shared with students and clinicians. Further research to test the theoretical premises of the communities of practice framework in clinical nursing education is required.
Clinicopathological features of hepatocellular carcinoma evaluated by vascular endothelial growth factor expression
Authors: Amaoka Nozomi , Osada Shinji , Kanematsu Masayuki , Imai Hisashi , Tomita Hiroyuki , Tokuyama Yasuharu , Sakashita Fumio , Nonaka Kennichi , Goshima Satoshi , Kondo Hiroshi , Adachi Yosuke 
Published: April 2007

AbstractAim:  To evaluate the significance of the expression of vascular endothelial growth factor (VEGF), its correlation with clinicopathological variables were studied in the tissue of hepatocellular carcinoma (HCC) and surrounding liver.Methods:  In 56 samples (tumor and non‐tumor liver tissue) collected from 28 patients, VEGF expression was examined by immunohistochemistry and western blot analysis.Results:  The value of VEGF expression by western blotting was correlated with immunohistochemical staining grade. In tumor tissue, the value of VEGF expression correlated with tumor size (P = 0.034), á‐fetoprotein (P = 0.036) and protein induced by vitamin K absence‐II by simple regression, and histological grade (P = 0.0132) by the unpaired t‐test. The level of VEGF expression in non‐tumor liver was found to correlate with the value of serum albumin (P = 0.008), cholinesterase (P = 0.012) and prothrombin activity (P = 0.046). The frequency of simple nodular type in gross appearance decreased in cases with high tumor/non‐tumor (T/N) ratio (P = 0.022), and the degree of portal vein invasion progressed with an increase in the T/N ratio (P = 0.008). The T/N ratio was significantly higher in early recurrence cases (P = 0.0081).Conclusion:  This study on the expression of VEGF might be useful to estimate the liver condition and the clinicopathological features of HCC.
Tumor size is associated with the systemic inflammatory response but not survival in patients with primary operable colorectal cancer
Authors: Crozier Joseph EM , McMillan Donald C , McArdle Colin S , Angerson Wilson J , Anderson John H , Horgan Paul G , McKee Ruth F 
Published: April 2007

AbstractAim:  To examine the relationship between tumor diameter, C‐reactive protein concentrations and survival in patients undergoing surgery for colorectal cancer.Method:  Tumor diameter and pathological characteristics of the resected specimen were assessed in 227 patients. Circulating concentrations of C‐reactive protein were measured prior to surgery.Results:  Ninety‐six patients had an elevated C‐reactive protein concentration (>10 mg/L) prior to surgery. Tumor size was associated with an elevated C‐reactive protein concentration (P < 0.001). C‐reactive protein concentrations (P < 0.001) were associated with poorer cancer‐specific survival.Conclusion:  Prior to surgery, the maximal tumor diameter is associated with an elevated preoperative C‐reactive protein concentration but not survival in patients with primary operable colorectal cancer.
Changing incidence of acute pancreatitis: 10‐year experience at the Royal Children's Hospital, Melbourne
Authors: Nydegger Andreas , Heine Ralf G , Ranuh Reza , Gegati‐Levy Ricardo , Crameri Joe , Oliver Mark R 
Published: April 2007

AbstractBackground and Aim:  The aim of this study was to assess the incidence and etiology of acute pancreatitis at a major pediatric referral center in Australia.Methods:  A 10‐year retrospective audit was conducted at The Royal Children's Hospital, Melbourne, Australia. All patients from 1993 and 2002 with a serum lipase level greater than three times the upper reference range and a history consistent with acute pancreatitis were included.Results:  During the 10‐year period, 279 confirmed cases of acute pancreatitis were identified. The median age at presentation was 10 years (range, 0.2–15.9). In 209 (74.9%) patients, a likely cause of acute pancreatitis was found, including trauma (36.3%), systemic disease (22.2%), metabolic (5.8%), biliary (5.4%), drugs (3.2%), or viral illness (2.2%). In the remaining 70 (25.1%) cases, the pancreatitis was deemed idiopathic. Comparing data from 1993 to 1997 with data from 1998–2002, there was a significant increase in the annual incidence of pancreatitis (24.6 ± 2.3 vs 31.2 ± 6 cases per year; P = 0.04). A linear regression analysis showed a strong association between the incidence and the year of diagnosis (r2 = 0.5775, P = 0.01). This increase was mainly due to a significant rise in idiopathic disease (r2 = 0.83, P = 0.0002) and systemic disease (r2 = 0.41, P = 0.048), whereas the incidence of other causes of acute pancreatitis remained unchanged.Conclusion:  The incidence of acute pancreatitis in children has increased significantly over the past decade. The increase was greatest in children with idiopathic pancreatitis. It remains unclear whether this reflects a true incidence increase or improved clinical awareness.
Revisiting the natural history of chronic hepatitis B: Impact of new concepts on clinical management
Authors: Yuen Man‐Fung 
Published: April 2007

AbstractAppropriate treatment for chronic hepatitis B (CHB) to prevent disease progression and clinical complications requires an accurate knowledge of the natural history of this disorder. In patients who acquire the disease in early life, as is the situation in Asian CHB patients, complications of CHB continue to develop because of the prolonged insidious damage to the liver, even in the low viremic phase. Hepatitis B e antigen seroconversion with hepatitis B virus (HBV) DNA levels just below 105 copies/mL may not be an adequate treatment endpoint for Asian CHB patients. Furthermore, it has been shown that patients with mild elevation of alanine aminotransferase (ALT) levels are already at considerable risk of development of complications. More recent studies have shown that in order to move towards a better disease outcome, CHB patients should have HBV DNA levels at least less than 103 copies/mL, with ALT levels preferably in the range of less than 0.5 times the upper limit of the normal range. Therefore, prolonged, adequate suppression of viral replication should be the practical goal for the treatment of CHB disease in the Asian population.
Coverage and Non-Response Errors in the Uk New Earnings Survey
Authors: Pont Mark 
Published: April 2007

SummaryThe methods underpinning the UK's annual structural earnings survey—the New Earnings Survey—have remained largely unchanged since the survey's inception in 1970. Gradual changes in the labour market over recent years have led to coverage errors in the survey; non-response may also introduce error if it is non-random. The paper describes some of the New Earnings Survey's main non-sampling errors, the effect on survey results and the research that was undertaken by the Office for National Statistics as part of the development of the new Annual Survey of Hours and Earnings to be able to remove or otherwise to account for these errors.
The Effect of School Resources on Pupil Attainment: a Multilevel Simultaneous Equation Modelling Approach
Authors: Steele Fiona , Vignoles Anna , Jenkins Andrew 
Published: April 2007

SummaryImproving educational achievement in UK schools is a priority, and of particular concern is the low achievement of specific groups, such as those from lower socio-economic backgrounds. An obvious question is whether we should be improving the outcomes of these pupils by spending more on their education. The literature on the effect of educational spending on the achievement of pupils has some methodological difficulties, in particular the endogeneity of school resource levels, and the intraschool correlations in pupils’ responses. We adopt a multi-level simultaneous equation modelling approach to assess the effect of school resources on pupil attainment at age 14 years. The paper is the first to apply a simultaneous equation model to estimate the effect of school resources on pupils’ achievement, using the newly available national pupil database and pupil level annual school census.
Robustness of Logit Analysis: Unobserved Heterogeneity and Mis‐specified Disturbances*
Authors: Cramer J. S. 
Published: April 2007

AbstractIn probit and logit models, the β coefficients vary inversely with the variance of the disturbances. The omission of a relevant orthogonal regressor leads to increased unobserved heterogeneity, and this depresses the β coefficients of the remaining regressors towards zero. For the probit model, Wooldridge (Econometric Analysis of Cross Section and Panel Data, MIT Press, Cambridge, MA, 2002) has shown that this bias does not carry over to the effect of these regressors on the outcome. We find by simulations that this also holds for the logit model, even when omitting a variable leads to severe mis‐specification of the disturbance. More simulations show that logit analysis is quite insensitive to pure mis‐specification of the disturbance as such.
Nonlinearities and Fractional Integration in the US Unemployment Rate*
Authors: Caporale Guglielmo Maria , Gil‐Alana Luis A. 
Published: April 2007

AbstractThis paper proposes a model of the US unemployment rate which accounts for both its asymmetry and its long memory. Our approach introduces fractional integration and nonlinearities simultaneously into the same framework, using a Lagrange multiplier procedure with a standard null‐limit distribution. The empirical results suggest that the US unemployment rate can be specified in terms of a fractionally integrated process, which interacts with some nonlinear functions of labour‐demand variables such as real oil prices and real interest rates. We also find evidence of a long‐memory component. Our results are consistent with a hysteresis model with path dependency rather than a non‐accelerating inflation rate of unemployment (NAIRU) model with an underlying unemployment equilibrium rate, thereby giving support to more activist stabilization policies. However, any suitable model should also include business cycle asymmetries, with implications for both forecasting and policy‐making.
On Testing Conditional Sigma – Convergence*
Authors: Egger Peter , Pfaffermayr Michael 
Published: April 2007

AbstractIn a cross‐section where the initial distribution of observations differs from the steady‐state distribution and initial values matter, convergence is best measured in terms of σ‐convergence over a fixed time period. For this setting, we propose a new simple Wald test for conditional σ‐convergence. According to our Monte Carlo simulations, this test performs well and its power is comparable with the available tests of unconditional convergence. We apply two versions of the test to conditional convergence in the size of European manufacturing firms. The null hypothesis of no convergence is rejected for all country groups, most single economies, and for younger firms of our sample of 49,646 firms.
Spatial and temporal population genetic survey of Bulinus globosus from Zanzibar: an intermediate host of Schistosoma haematobium
Authors: Wilkinson S. , Emery A. M. , Khamis I. S. , Mgeni A. F. , Stothard J. R. , Rollinson D. 
Published: April 2007

AbstractIn Zanzibar, the freshwater hermaphroditic snail Bulinus globosus is the intermediate host of the human parasite Schistosoma haematobium. To shed light on the patterns of genetic variation within Bu. globosus, variation at six polymorphic microsatellite loci was assessed to quantify spatial genetic structure within eight populations and temporal changes in a further four populations of the snails. Limited genetic variation was observed within populations, possibly reflecting both partial‐selfing and fluctuations in population size. Although a statistically significant heterozygote deficiency was observed, Bu. globosus appears to be a preferential out‐crosser, which was consistent with the absence of genotypic linkage disequilibria. Genetic variation across populations was substantial, illustrating significant isolation‐by‐distance on a regional scale and that gene flow was restricted to nearby populations. The temporal survey showed that levels of genetic variation and inbreeding changed over a 1‐year period, consistent with field observations of seasonal change. The results strongly support a snail demographic model of population expansion and contraction throughout the year with habitats re‐colonized by aestivating or surviving snails from local refugia. This model might help explain co‐evolution of snails and schistosomes in Zanzibar as local populations of Bu. globosus have varying degrees of susceptibility to S. haematobium.
Synergistic effects of ethanol and hyperthermia on carotid artery vasoconstriction
Authors: Mustafa S. , Thulesius O. , Elgazzar A. H. , Ismael H. N. 
Published: April 2007

SummaryBackground: Heatstroke is a serious condition and clinical studies indicate that vascular stroke increases with excessive consumption of alcohol (ethanol). It was our objective to test the influence of ethanol on cerebral perfusion at normal and higher temperatures.Methods: Recording of isometric tension in rabbit carotid artery strips in organ baths with different concentrations of ethanol at 37°C and during hyperthermia (39–43°C) and scintigraphic cerebral imaging of a radioactive isotope in the control situation and during hyperthermia.Results: Stepwise heating induced reproducible reversible graded contraction, proportional to temperature. At high concentrations (toxic levels), ethanol induced an increase in tension and heating potentiated these responses. Extracellular Mg2+potentiated both heat‐induced contraction and ethanol‐induced contraction while extracellular Ca2+had no effect on these responses. During hyperthermia and ethanol scintigraphic isotope uptake was reduced in cortical and cerebellar regions.Conclusions: Carotid artery vasomotor tone is temperature dependent and heating induces vasoconstriction. Alcohol (ethanol) at 37°C elicited carotid artery contraction at high concentrations (toxic levels) but at any concentration during elevated temperature (39–43°C). Ethanol potentiated the effect of hyperthermia‐induced vasoconstriction and reduced cerebral perfusion as shown by radionuclide imaging. The synergistic effect of ethanol and hyperthermia may induce heat stroke and brain damage.
Rural hospital generalist and emergency medicine training in Papua New Guinea
Authors: Symmons David , Curry Chris 
Published: April 2007

AbstractThe present paper describes the role of the hospital generalist in rural Papua New Guinea (PNG) and the contribution of emergency medicine training to that practice. Generalist practice in Tinsley District Hospital in Western Highlands Province is described, with emphasis on emergency surgery and anaesthesia. The potential of the PNG emergency medicine training programme for preparing generalists is discussed. Tinsley Hospital served a population of 40 000 people, with 4000 admissions and 300–400 operations performed annually. Two doctors and 50 nurses and community health workers provided care with minimal resources. The doctors provided supervision and teaching for nurses, community health workers, hospital administrators and primary health carers, including on long range medical patrols. Over 16 months, doctors performed 243 emergency surgical procedures including orthopaedics, general surgery, obstetrics and gynaecology. The generalist in rural hospitals is required to perform a wide variety of medical tasks in isolated settings yet there is no active postgraduate training programme. The Master of Medicine, Emergency Medicine programme includes rotations through the major disciplines of surgery, anaesthesia, internal medicine, paediatrics, obstetrics and gynaecology. It has the potential to train doctors in PNG for a generalist role as graduates will learn the foundations of the required skills.
Effect of a holiday service reduction period on a hospital’s emergency department access block
Authors: Thomas James , Cheng Nicholas 
Published: April 2007

AbstractObjective:  To study the effect of holiday service reductions, consisting of bed and theatre closures, in a tertiary paediatric hospital on various measures of ED occupancy, including access block.Methods:  Retrospective comparative observational study of all 2142 ED attendances during a holiday hospital service reduction period (the ‘study period’), when the hospital’s bed capacity was reduced by 17% and all elective operating theatres were closed, and all 4255 attendances during two control periods at a major tertiary children’s hospital, using the ED’s information system to collect data. The following outcome measures were derived from the raw data and compared between the control and study groups: proportion of all intended inpatient admissions that were actual inpatient admissions; proportion of intended inpatient admissions that were discharged home from the ED; proportion of all admissions that were ED admissions; access block, that is, the percentage of patients requiring inpatient admission who have a total ED time of greater than 8 h; the mean number of patients in the ED at any particular minute (‘ED occupancy’); median waiting times to reach both the general ward and the operating theatre.Results:  There were no statistically significant differences between the study group and the control group in all of the outcome measures except for access block, which showed a 16% relative improvement (49.8–41.7%) during the study period when compared with the control period (P < 0.01).Conclusion:  At this hospital, unacceptably high levels of ED access block persist both during and outside holiday periods, despite there being mild improvement in access block during the holiday period where bed closures were balanced against the effect of other service cutbacks (e.g. closing operating theatres).