bluuebunny/crossref_metadata_2025_split huggingface dataset:
The meaning of women's experience of living with long‐term urinary incontinence is powerlessness
Authors: Hägglund Doris , Ahlström Gerd 
Published: September 2007

Aim.  The aim was to illuminate the meaning of women's experiences of living with urinary incontinence (UI).Background.  Living with long‐term UI means a variety of consequences for everyday life. Women's narratives about their lived experiences are important in enabling nurses to better understand and to help women achieve symptom control. No previous study could be found that has focused on the meaning of women's experience of living with UI from a symptom management perspective.Method.  Fourteen women with UI (range: 34–52 years) who had sought professional help were interviewed. A phenomenological hermeneutic method was used to analyse and interpret the interview texts.Findings.  The women's experiences of living with UI are presented in terms of two interlaced themes of being in a vulnerable situation and striving for adjustment. Being in a vulnerable situation means that the women had no control over UI and experienced powerlessness. The sub‐themes in this case were living with an uncontrolled body, living with incontinence as taboo and experiencing a less satisfying encounter. Striving for adjustment means that the women tried to handle their incontinence in different ways to regain power and continue to live as normal. The sub‐themes here were living in readiness, making urine leakage comprehensible, accepting living with UI and being familiar with the situation.Conclusion.  The meaning of women's experience of living with UI is powerlessness.Relevance to clinical practice.  Nurses should supervise women in pelvic floor muscle training to achieve control over incontinence, thereby helping them regain power. Additionally, Integrated Approach to Symptom Management can help nurses enhance women's self‐care abilities.
Development and evaluation of standardized protocol to prevent nasoenteral tube obstruction in cardiac patients requiring enteral nutrition with restricted fluid volumes
Authors: Matsuba Claudia ST , De Gutiérrez Maria GR , Whitaker Iveth Y 
Published: September 2007

Aims and objectives.  This study sought to assess the impact of a standardized protocol to maintain nasoenteral tube (NET) patency in patients requiring fluid restriction and identify factors associated with tube patency.Background.  Nasoenteral tube obstruction may interrupt nutritional support and prohibit drug administration. Balancing NET patency in the context of fluid restriction can be a challenge.Design and methods.  The impact of the standardized protocol was assessed by using a quasi‐experimental design and an historical control.Results.  Sixty patients receiving nasoenteral feeding as part of their clinical management were enrolled in the study. Nasoenteral obstruction was 8·3%, showing a reduction from the 17·4% observed in the baseline data collection. A key factor associated with tube obstruction was sounding of an infusion pump alarm reflecting the tube patency issues.Conclusions.  While mindful of the limitations of probability sampling, the implementation of a standardized protocol accompanied by staff training reduced the rates of NET obstruction.Relevance to clinical practice.  On the basis of these findings, we conclude that it is possible to maintain the patency of small bore tubes, even in the presence of fluid restriction, with a standardized protocol to guide clinical management.
Overcoming health inequalities by using the Bug Busting ‘whole‐school approach’ to eradicate head lice
Authors: Ibarra Joanna , Fry Frances , Clarice Wickenden , Olsen Alice , Vander Stichele Robert H , Lapeere Hilde , Maryan Jenner , Franks Andrea , Smith Jane L 
Published: September 2007

Aims and Objectives.  The aim of this paper was to illustrate the socially inclusive nature of the Bug Busting ‘whole‐school approach’ to head louse eradication.Background.  In the UK, Belgium and Denmark, persistent head lice in families of all socio‐economic status (SES) is a problem. Since 1995 in the UK and 1998 elsewhere, an educational programme intended to teach families how to detect and treat head lice by using the Bug Busting wet combing method has been organized in some areas. Local schools lead this community strategy for prevention, known as a ‘whole‐school approach’ (UK).Design and methods.  We describe five studies applying the Bug Busting approach, four set in districts where some disadvantaged families live (UK and Belgium) and a fifth set in Denmark. Feasibility and consumer satisfaction are examined. One UK study analyses data on area prescribing for head lice and the impact in a deprived locality of raising the profile of Bug Busting.Results.  We find parental education in Bug Busting enables families of all SES to participate in a ‘whole‐school approach’ to head lice. Best results are obtained when each family has a Bug Buster Kit. This provides all the combs necessary with full instructions on their use with ordinary shampoo and conditioner to detect lice, eradicate an infestation mechanically, or to check the success of any treatment.In the UK, the promotion of the Bug Busting approach is reducing primary care expenditure on treatment for head lice and professional time spent with worried parents. As a result, healthcare providers can give time to the few families who require one‐to‐one guidance.Relevance to Clinical Practice.  Incorporation of the Bug Busting approach to head lice into clinical practice in school communities contributes to sustainable control whilst overcoming health inequalities in participating families.
How do nurses record pedagogical activities? Nurses’ documentation in patient records in a cardiac rehabilitation unit for patients who have undergone coronary artery bypass surgery
Authors: Bergh Anne‐Louise , Bergh Claes‐Håkan , Friberg Febe 
Published: September 2007

Aims.  To describe the use of pedagogically related keywords and the content of notes connected to these keywords, as they appear in nursing records in a coronary artery bypass graft (CABG) surgery rehabilitation unit.Background.  Nursing documentation is an important component of clinical practice and is regulated by law in Sweden. Studies have been carried out in order to evaluate the educational and rehabilitative needs of patients following CABG surgery but, as yet, no study has contained an in‐depth evaluation of how nurses document pedagogical activities in the records of these patients.Methods.  The records of 265 patients admitted to a rehabilitation unit following CABG surgery were analysed. The records were structured in accordance with the VIPS model. Using this model, pedagogically related keywords: communication, cognition/development and information/education were selected. The analysis of the data consisted of three parts: the frequency with which pedagogically related keywords are used, the content and the structure of the notes.Results.  Apart from the term ‘communication’, pedagogically related keywords were seldom used. Communication appeared in all records describing limitations, although no explicit reference was made to pedagogical activities. The notes related to cognition/development were grouped into the following themes: nurses’ actions, assessment of knowledge and provision of information, advice and instructions as well as patients’ wishes and experiences. The themes related to information were the provision of information and advice in addition to relevant nursing actions. The structure of the documentation was simple.Conclusions.  The documentation of pedagogical activities in nursing records was infrequent and inadequate.Relevance to clinical practice.  The patients’ need for knowledge and the nurses’ teaching must be documented in the patient records so as to clearly reflect the frequency and quality of pedagogical activities.
Psychometric evaluation of Self‐Assessed Support Needs of women with breast cancer Scale
Authors: Erci Behice 
Published: September 2007

Aims.  The issue of self‐assessed support needs of women with breast cancer has not been studied enough although it is an important subject for women's health in Turkey. Most of the studies concerning breast cancer patients are about quality of life and life satisfaction. This study aimed to adapt an English version of the Self‐Assessed Support Needs of women with breast cancer Scale for Turkish women with breast cancer and to evaluate its psychometric properties.Design.  A descriptive study.Methods.  The sample consisted of 143 women with breast cancer who attended the outpatient and inpatient oncology clinics. Data were collected by a structured questionnaire including demographic characteristics and the Self‐Assessed Support Needs of women with breast cancer Scale. Item analysis, principal components analysis, internal consistency reliability and Cronbach's alpha were used to measure the psychometric properties of the 54‐item scale.Results.  In the assessment of construct validity, the principal components method of factor analysis was performed. Seven factors were identified with eigenvalues >1 explained 52·1% of the total variance (diagnosis, treatment, support, femininity and body image, family and friends, information and after care). Internal reliability coefficients of these seven factor‐based scales were found to be substantial, ranging from 0·71 to 0·84.Conclusion.  The present study provides evidence of the Self‐Assessed Support Needs of women with breast cancer Scale's validity, reliability and acceptability. This scale should be further evaluated; with a large enough sample size, in different regions in Turkey and diverse populations of world.Relevance to clinical practice.  The scale has potential applications. It can be used both as a research or a regular screening tool with clinical settings. The use of the scale in clinics will enable identification of self‐management activities in patients with breast cancer. Assessment of the self‐assessed support needs of women with breast cancer should be an essential part of nursing practice.
Preparing for pandemic influenza: revisit the basics
Authors: Chan Wai Fong , Wong Thomas KS 
Published: September 2007

Aims and objectives.  This paper attempts to address the global concern of the possible pandemic of influenza and avian influenza. In doing this, some unfounded beliefs related to influenza vaccines and antiviral treatment and prophylaxis are explored. This study also describes the essential measures for getting prepared.Background.  Based on the current epidemiology, availability of vaccines, antiviral prophylaxis and treatment and experience from SARS outbreak, the authors suggested that basic infection control measures should be emphasized to prepare for the pandemic. These measures include personal and environmental hygiene, surveillance and infection control precautions and education.Conclusion.  The authors provide evidence and explanations to demystify pandemic influenza and recommend measures that help to prevent cross infection.Relevance to clinical practice.  Although the preparedness is everyone's business, nurses play a crucial and indispensable role in this exercise. With prepared personnel, facilities and good infection control practices, nosocomial spread of the disease and pandemic can be prevented.
Errors in the administration of intravenous medication in Brazilian hospitals
Authors: Anselmi Maria Luiza , Peduzzi Marina , Dos Santos Claudia Benedita 
Published: September 2007

Aim.  To verify the frequency of errors in the preparation and administration of intravenous medication in three Brazilian hospitals in the State of Bahia.Background.  The administration of intravenous medications constitutes a central activity in Brazilian nursing. Errors in performing this activity may result in irreparable damage to patients and may compromise the quality of care.Design.  Cross‐sectional study, conducted in three hospitals in the State of Bahia, Brazil.Methods.  Direct observation of the nursing staff (nurse technicians, auxiliary nurses and nurse attendants), preparing and administering intravenous medication.Results.  When preparing medication, wrong patient error did not occur in any of the three hospitals, whereas omission dose was the most frequent error in all study sites. When administering medication, the most frequent errors in the three hospitals were wrong dose and omission dose.Conclusions.  The rates of error found are considered low compared with similar studies. The most frequent types of errors were wrong dose and omission dose. The hospitals studied showed different results with the smallest rates of errors occurring in hospital 1 that presented the best working conditions.Relevance to clinical practice.  Studies such as this one have the potential to improve the quality of care.
Putting policy into practice: pre‐ and posttests of implementing standardized languages for nursing documentation
Authors: Thoroddsen Asta , Ehnfors Margareta 
Published: September 2007

Aims and objectives.  To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process?Background.  Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages.Design and method.  A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts.Results.  A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients.Conclusion.  At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages.Relevance to clinical practice.  Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.
The faceless encounter: ethical dilemmas in telephone nursing
Authors: Holmström Inger , Höglund Anna T 
Published: September 2007

Aim.  This paper aims to present the findings of a study designed to describe ethical dilemmas, in the form of conflicting values, norms and interests, which telenurses experience in their work.Background.  Telephone nursing is an expanding part of health care. Telephone nurses in Sweden assess care needs, provide advice, support and information, and recommend and coordinate healthcare resources. Lately, ethical demands on healthcare professionals in general have increased. The reasons include new biomedical competence, an ageing population and constrained resources which have made priority setting a primary concern for doctors and nurses. When ethical problems arise, colleagues need open dialogue. Despite this, nurses lack such a dialogue.Method.  A purposeful sample of 12 female telenurses in Sweden was interviewed twice during 2004 and 2005. The transcribed interviews were analysed thematically.Results.  Five themes were found: talking through a third party; discussing personal and sensitive problems over the phone; insufficient resources and the organization of health care; balancing callers’ information needs with professional responsibility; and differences in judging the caller's credibility.Conclusion.  The present study has identified five different themes in which Swedish telenurses experience ethical dilemmas in their work. This shows how ethical dilemmas in various forms are present in telenursing. Questions of autonomy, integrity and prioritizing are particularly highlighted by the participating nurses. Telenurses in Sweden also experience new ethical demands due to a multicultural society. Although several of the identified dilemmas also occur in other areas of nursing we argue that these situations are particularly challenging in telenursing.Relevance to clinical practice.  The work organization should provide opportunities for ethical competence‐building, where ethical dilemmas in telenursing are highlighted and discussed. Such a strategy might lead to decreased moral uncertainty and distress among telenurses, with positive consequences for callers.
The genealogy and genetic viability of reintroduced Yellowstone grey wolves
Authors: VONHOLDT BRIDGETT M. , STAHLER DANIEL R. , SMITH DOUGLAS W. , EARL DENT A. , POLLINGER JOHN P. , WAYNE ROBERT K. 
Published: September 2007

AbstractThe recovery of the grey wolf in Yellowstone National Park is an outstanding example of a successful reintroduction. A general question concerning reintroduction is the degree to which genetic variation has been preserved and the specific behavioural mechanisms that enhance the preservation of genetic diversity and reduce inbreeding. We have analysed 200 Yellowstone wolves, including all 31 founders, for variation in 26 microsatellite loci over the 10‐year reintroduction period (1995–2004). The population maintained high levels of variation (1995 H0 = 0.69; 2004 H0 = 0.73) with low levels of inbreeding (1995FIS = –0.063; 2004FIS = –0.051) and throughout, the population expanded rapidly (N1995 = 21;N2004 = 169). Pedigree‐based effective population size ratios did not vary appreciably over the duration of population expansion (1995Ne/Ng = 0.29; 2000Ne/Ng = 0.26; 2004Ne/Ng = 0.33). We estimated kinship and found only two of 30 natural breeding pairs showed evidence of being related (averager = –0.026, SE = 0.03). We reconstructed the genealogy of 200 wolves based on genetic and field data and discovered that they avoid inbreeding through a wide variety of behavioural mechanisms including absolute avoidance of breeding with related pack members, male‐biased dispersal to packs where they breed with nonrelatives, and female‐biased subordinate breeding. We documented a greater diversity of such population assembly patterns in Yellowstone than previously observed in any other natural wolf population. Inbreeding avoidance is nearly absolute despite the high probability of within‐pack inbreeding opportunities and extensive interpack kinship ties between adjacent packs. Simulations showed that the Yellowstone population has levels of genetic variation similar to that of a population managed for high variation and low inbreeding, and greater than that expected for random breeding within packs or across the entire breeding pool. Although short‐term losses in variation seem minimal, future projections of the population at carrying capacity suggest significant inbreeding depression will occur without connectivity and migratory exchange with other populations.
Tracing the first step to speciation: ecological and genetic differentiation of a salamander population in a small forest
Authors: STEINFARTZ SEBASTIAN , WEITERE MARKUS , TAUTZ DIETHARD 
Published: September 2007

AbstractMechanisms and processes of ecologically driven adaptive speciation are best studied in natural situations where the splitting process is still occurring, i.e. before complete reproductive isolation is achieved. Here, we present a case of an early stage of adaptive differentiation under sympatric conditions in the fire salamander, Salamandra salamandra, that allows inferring the underlying processes for the split. Larvae of S. salamandra normally mature in small streams until metamorphosis, but in an old, continuous forest area near Bonn (the Kottenforst), we found salamander larvae not only in small streams but also in shallow ponds, which are ecologically very different from small streams. Common‐environment experiments with larvae from both habitat types reveal specific adaptations to these different ecological conditions. Mitochondrial and microsatellite analyses show that the two ecologically differentiated groups also show signs of genetic differentiation. A parallel analysis of animals from a neighbouring much larger forest area (the Eifel), in which larvae mature only in streams, shows no signs of genetic differentiation, indicating that gene flow between ecologically similar types can occur over large distances. Hence, geographical factors cannot explain the differential larval habitat adaptations in the Kottenforst, in particular since adult life and mating of S. salamandra is strictly terrestrial and not associated with larval habitats. We propose therefore that the evolution of these adaptations was coupled with the evolution of cues for assortative mating which would be in line with models of sympatric speciation that suggest a co‐evolution of habitat adaptations and associated mating signals.
A Pseudomonas aeruginosa transcription factor that senses fatty acid structure
Authors: Zhang Yong‐Mei , Zhu Kun , Frank Matthew W. , Rock Charles O. 
Published: September 2007

SummaryCells regulate their membrane phospholipid biophysical properties by the co‐ordinated synthesis of saturated and unsaturated fatty acids. In bacteria, unsaturated fatty acids are produced by the de novo fatty acid biosynthetic pathway anaerobically, or by oxidative desaturation of the existing fatty acids catalysed by desaturases. A transcriptional repressor in Pseudomonas aeruginosa, DesT (PA4890), regulates the expression of an acyl‐CoA desaturase operon (desCB, PA4889 and PA4888). The desCB operon is located adjacent to desT and is transcribed in the opposite direction. The expression level of desCB is strongly and selectively upregulated in a ΔdesT‐deletion strain. Both electrophoresis mobility shift assay and DNase I footprinting analysis demonstrated the existence of two DesT binding sites in the desT–desCB promoter region, P1 and P2. The binding of purified DesT to P2 was enhanced by unsaturated acyl‐CoAs, whereas saturated acyl‐CoAs prevented DesT interaction with P2. The biological importance of this interaction was verified by the upregulation of desCB and desT in cells grown in the presence of stearate and their repression when oleate was present. This unique ligand selectivity allows DesT to sense the physical properties of the cellular acyl‐CoA pool and modulate the expression of the acyl‐CoA Δ9‐desaturase system to adjust fatty acid desaturation activity accordingly.