bluuebunny/crossref_metadata_2025_split huggingface dataset:
An analysis of the experiences of clinical supervision on Registered Nurses undertaking MSc/graduate diploma in renal and urological nursing and on their clinical supervisors
Authors: Kilcullen Nora 
Published: May 2007

Aims.  The aim of this study was to elicit clinical supervisors’ and supervisees’ experiences of clinical supervision while undertaking MSc/Graduate Diploma Programme in Renal and Urological Nursing.Background.  Formal systems of clinical supervision have not been implemented in the Republic of Ireland. There is a growing awareness of their effectiveness in enhancing analytic skills and in helping to retain staff in clinical practice. Clinical supervision was incorporated in the MSc/Graduate Diploma Programme to enhance professional growth and development for students.Design.  A qualitative descriptive research design was used in this study.Methods.  A purposive sample of 10 Registered Nurses participated in the study; five were clinical supervisors and the other five were supervisees. The study was undertaken at a large teaching hospital in the Republic of Ireland. Data were collected by semi‐structured interviews and analysed using content analysis.Results.  Following data analysis, six major categories emerged. These were, ‘positive aspects’‘negative aspects’, ‘factors, which had an impact on the process of clinical supervision’, ‘support’, ‘formal systems of clinical supervision’, ‘reflective practice in groups’.Conclusions.  There was a general feeling that clinical supervision was a good experience for many members of this study group. The concept of clinical supervision was perceived as an inappropriate term to encompass the complexity of the clinical supervision sessions. This begs the question: is clinical supervision a practice with no name or should it be called something else? Giving a practice an appropriate name may empower registered nurses to implement this practice with confidence.Relevance to clinical practice.  The findings of this study have implications for management and for the clinical environment, in terms of supporting and preparing practitioners to develop their critical and analytic skills.
Nurses’ knowledge of pain
Authors: Wilson Benita 
Published: May 2007

Aim.  The aim of this study was to establish if postregistration education and clinical experience influence nurses’ knowledge of pain.Background.  Inadequacies in the pain management process may not be tied to myth and bias originating from general attitudes and beliefs, but reflect inadequate pain knowledge.Design.  A pain knowledge survey of 20 true/false statements was used to measure the knowledge base of two groups of nurses. This was incorporated in a self‐administered questionnaire that also addressed lifestyle factors of patients in pain, inferences of physical pain, general attitudes and beliefs about pain management.Method.  One hundred questionnaires were distributed; 86 nurses returned the questionnaire giving a response rate of 86%. Following selection of the sample, 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data were analysed using SPSS.Results.  The specialist nurses had a more comprehensive knowledge base than the general nurses; however, their knowledge scores did not appear to be related to their experience in terms of years within the nursing profession.Conclusion.  Whilst educational programmes contribute to an increase in knowledge, it would appear that the working environment has an influence on the development and use of this knowledge. It is suggested that the clinical environment in which the specialist nurse works can induce feelings of reduced self‐efficacy and low personal control. To ease tension, strategies are used that can result in nurses refusing to endorse their knowledge, which can increase patients’ pain.Relevance to clinical practice.  Clinical supervision will serve to increase the nurses’ self‐awareness; however, without power and autonomy to make decisions and affect change, feelings of helplessness, reduced self‐efficacy and cognitive dissonance can increase. This may explain why, despite educational efforts to increase knowledge, a concomitant change in practice has not occurred.
Development and validation of a learning needs assessment scale: a continuing professional education tool for multiple sclerosis specialist nurses
Authors: While Alison , Ullman Roz , Forbes Angus 
Published: May 2007

Aim.  To develop and validate a learning needs assessment scale.Background.  Learning needs analysis is a central component of continuing professional development but there is a lack of psychometrically developed learning needs assessment tools. Self‐assessment questionnaires are emerging as a key method. The development of a learning needs analysis scale for multiple sclerosis specialist nurses is described.Design.  A psychometric approach comprising the three phases of the development and testing of the scale are outlined.Method.  Phase 1: Item identification using a literature review; postal survey of stakeholders (n = 320), 20 nurse interviews; four nurse focus groups; five telephone interviews with people with MS. Phase 2: Refinement of draft scale and establishing face and content validity testing using an expert panel. Phase 3: Testing of draft scale using data from a postal survey (n = 47 MS specialist nurses) to assess the feasibility and effectiveness of scale, internal consistency and construct validity. Test–retest reliability was assessed using data from 17 MS specialist nurse respondents to calculate intra‐class correlation coefficients.Results.  The data from the different study phases informed scale refinement. The validity and reliability of the scale was confirmed through testing.Conclusion.  The study provides an example of how a robust learning needs assessment scale may be developed for a specialist area of nursing practice to be used in conjunction with more subjective approaches.Relevance to clinical practice.  High quality nursing care depends upon a competent nursing workforce that engages in continuing professional development. This study provides an example of a psychometrically developed learning needs assessment scale to inform continuing professional development needs of nurses working in a specialist area of practice.
Development of explicit criteria for prioritization of hip and knee replacement
Authors: Escobar Antonio , Quintana José M. , Bilbao Amaia , Ibañez Berta , Arenaza Juan C. , Gutiérrez Luis , Azkárate Jesús , Güenaga Jose I. , Vidaurreta Ignacio 
Published: May 2007

AbstractRationale and aims  Among the problems to the publicly funded national health services are the waiting lists. Patients who need elective surgery generally have long waiting times before treatment. We aimed to develop a new prioritization tool for primary hip and knee replacement.Methods  Criteria were developed using a modified Delphi panel process. We convened a panel of nine members who scored the scenarios created by the research team and by patient focus groups. We studied the level of agreement among the panelists and the contribution of the variables to the ratings of the panel using linear and logistic regression models. The priority scores of the variables and their levels were synthesized using the optimal scaling and standard linear regression methods.Results  Seven variables, pain on motion, walking functional limitations, abnormal findings on physical examination, pain at rest, other functional limitations, social role, and other pathologies that could improve with joint replacement, were considered to create the different scenarios. The panel scored 192 scenarios. The disagreement among the panelists was very low (1%) with an intra‐class correlation coefficient of 0.72. Of the 192 scenarios, 45.8% were scored as urgent, 35.4% as preferred and 18.8% as ordinary. The variables that contributed most to the scores were pain on motion and walking functional limitations. When optimal scaling and regression techniques were applied, similar results were obtained.Conclusion  This tool can evaluate and prioritize patients on a waiting list for hip or knee replacement. We also provide a simple and easy way to use an algorithm to estimate the treatment priority for individual patients.
Work‐up for infectious diarrhea after allogeneic hematopoietic stem cell transplantation: single specimen testing results in cost savings without compromising diagnostic yield
Authors: Kamboj M. , Mihu C.N. , Sepkowitz K. , Kernan N.A. , Papanicolaou G.A. 
Published: May 2007

Abstract: Background. Diarrhea is a common complication of allogeneic bone marrow transplantation. Microbiologic stool studies are frequently ordered to rule out infectious etiology. The utility of examining multiple stool specimens per diarrheal episode has not been examined.Methods. We performed a retrospective review of 169 adult and pediatric patients who underwent hematopoietic stem cell transplantation at Memorial Sloan‐Kettering Cancer Center from January 1, 2000 though December 31, 2001, who had at least 1 microbiologic stool study. We report on the incidence of enteric pathogens in our population and diagnostic yield of stool studies. A diarrheal episode was defined as a 14‐day period from the date of the first stool study. Cost savings analysis was based on projected savings from implementation of proposed guidelines to the study population.Results. A total of 1649 stool tests were performed (mean 10.6 tests per patient). An infectious cause of diarrhea was found in 45 (28.8%) patients. Diagnostic yield was 6.2% for Clostridum difficile toxin assay, 12.9% for viral cultures, and 1.3% for rotavirus enzyme immunoassay. Bacterial cultures for enteric pathogens, examination for parasites, and rotavirus antigen assay combined had 0.5% positive yield.Conclusions. Testing of multiple specimens per diarrheal episode did not increase diagnostic yield. The estimated cost savings by implementing single testing for each type of stool study per diarrheal episode was $49,764 annually (in 2001 US dollars). Judicious use of stool tests to evaluate diarrhea results in significant cost savings without compromising diagnostic yield.
Diffusion through skin and model systems
Authors: DYER A. , HAYES G.G. , WILSON J. G. , CATTERALL R. 
Published: May 2007

SynopsisA new approach has been made to the investigation of diffusion through skin. The experimental procedure is to arrange for a self‐exchange of radioactively labelled compounds through a skin or model membrane. A new mathematical solution for D*, the self‐diffusion coefficient for the molecule, is computed and the variation in self‐diffusion parameters noted with temperature, skin type, and model membrane. Some thermal analyses are given. La diffusion a travers des modèles de peau
Methods for water resistance testing of sun protection products
Authors: GREITER F. , BILEK P. , DOSKOCZIL S. , WASHÜTTL J. , WURST F. 
Published: May 2007

SynopsisWater resistance of sun protection products has been found to be best determined by the following methods:(1) Tests for determining UVL filter adherence to merino wool; this gives a rough value for orientation. Values in excess of 6% are suggestive of satisfactory adherence. (2) Tests for determining water resistance of sunscreen products on pig skin constitute a further essential step. Values in excess of 50% provide a realistic basis for tests in humans.In addition to filter adherence the product base, i.e. primarily the emulsifiers, are of special significance. Adequate results can be obtained with both W/O and O/W systems.Tests on volunteers are best done at the time of determining the sun protection factor, i.e. when simulating the events during a 2–3 h sunbath. Simulation should involve a single application of the test product in a pre‐defined quantity and all activities conmmonly done in sunlight, e.g. swimming, as well as intermittent exercises to induce sweating.Values are considered as excellent, if 1 MED is not exceeded after 3 h exposure. Sun protection products with this characteristic qualify as adequate ‘all‐day’ sunscreen for individuals with average sensitivity. Methodes pour mesurer la résistance à l'eau des produits anti‐solaires
Normal use levels of respirable cosmetic talc: preliminary study
Authors: AYLOTT R. I. , BYRNE G. A. , MIDDLETON J. D. , ROBERTS M. E. 
Published: May 2007

SynopsisThis preliminary study was undertaken to provide data from which a more comprehensive investigation to establish the safety in‐use of cosmetic talcs could be designed. Methods for collecting and analysing respirable talc generated during the use of loose face powder and adult and baby dusting powders were established.Respirable particles in the air were separated from larger size particles by means of a cyclone and were collected on membrane filters. The collected dust was dissolved in acid and the solution was analysed for magnesium by atomic absorption spectroscopy. From the results the concentrations of talc in the air samples were calculated.The method was used to monitor the in‐use levels of a range of cosmetic talcs. Mean concentrations in air sampled for 5 min from the start of use of Chinese grades and Italian 00000 grades of talc formulated for use as loose face powder, adult dusting powder and baby dusting powder were 0.48, 1.13 and 0.21 mg m−3, respectively. Higher levels were found with micronised adult dusting powder (mean concentration 1.9 mg m−3).There was no evidence that the presence of perfume in the talc or the ambient relative humidity in the range 54–74% during use affected the levels of respirable talc, but high relative humidity <90% reduced the amount of respirable talc. Utilisation des talcs cosmetiques: étude préliminaire des teneurs en talc respirable
E.S.R. study of free radicals formed in skin proteins by u.v. irradiation
Authors: MEYBECK A. 
Published: May 2007

SynopsisIn order to better understand the mechanisms of action, of sunlight on skin, a study of the free radicals formed by irradiation of its protein constituents, has been undertaken. Samples of stratum corneum keratin and of skin collagen have been u.v. irradiated, in a vacuum, at – 196°C, then transferred to an electron spin resonance spectrometer (E.S.R.). The E.S.R. signals have then been recorded at – 160°C and at increasing temperatures in order to follow the transformations of primary free radicals into secondary species more stable at room temperature.For keratin, u.v. rays produce radicals of the type ‐NH‐CHR at low temperature but it is not possible to identify them more precisely. These free species react with combined glycine of neighbouring protein chains to form ‐NH‐CH‐CO‐(I) radicals, the E.S.R. spectrum of which can be observed from –60°C onwards. In the presence of air, rather unstable peroxide radicals are formed.For irradiated collagen, the E.S.R. signals recorded at increasing temperatures show in addition to (I) some evidence of alanine free radicals (‐NH‐CH‐CH3 at – 160°C and ‐NH‐C(CH3)‐CO‐ from ‐20°C onwards).These results allow a better understanding of the mechanisms which lead to premature ageing of the skin through sunlight exposure and to the transformation of collagen into even more cross‐linked proteins. In addition, this study of the free radicals formed in stratum corneum keratin, allows a more refined discussion of the protective effect of skin melanin pigments. Etude par R.P.E. des radicaux libres formés par action de la lumière ultra‐violette sur les protéines de la peau
Dispersions of lamellar phases of non‐ionic lipids in cosmetic products
Authors: HANDJANI‐VILA R. M. , RIBIER A. , RONDOT B. , VANLERBERGHIE G. 
Published: May 2007

SynopsisAlthough aqueous dispersions of lipids in the form of particles having a lamellar structure (liposomes) are already known as excellent vehicles for pharmaceutical substances, their usefulness in cosmetic formulations has not been demonstrated. The present work shows the advantages obtained by application of such systems to the skin, and in particular the use of non‐ionic lipids in aqueous dispersions.Thus, in comparison with classical formulations such as emulsions, these systems exhibit lower toxicity and permit closer control of the availability of active substances at the stratum corneum. As examples, compositions suitable for skin moisturising and for tanning products are presented. Dispersions de phases lamellaires de lipides non‐ioniques en cosmétique
Moulding techniques in lipstick manufacture: a comparative evaluation
Authors: DWECK A. C. , BURNHAM C. A. M. 
Published: May 2007

SynopsisThis paper examines two methods of lipstick bulk manufacture: one via a direct method and the other via stock concentrates.The paper continues with a comparison of two manufactured bulks moulded in three different ways – first by split moulding, secondly by Rotamoulding, and finally by Ejectoret moulding.Full consideration is paid to time, labour and cost standards of each approach and the resultant moulding examined using some novel physical testing methods. The results of these tests are statistically analysed.Finally, on the basis of the gathered data and photomicrographical work a theoretical lipstick structure is proposed by which the results may be explained. Etude comparative des techniques de moulage dans la fabrication des rouges à lèvres
P‐aminobenzoic acid as a sunscreen and its behaviour on the skin
Authors: LEVEE GORDON J. , SAYRE ROBERT M. , MARLOWE EDWARD 
Published: May 2007

SynopsisPABA (p‐aminobenzoic acid), a highly regarded sunscreening agent, has recently been shown to exhibit different absorption characteristics when applied to excised hairless mouse epidermis than when in dilute alcoholic solution. In the present study the cause of the differences was investigated.The results show that at normal application amounts, considerable quantities of randomly dispersed PABA micro‐crystals exist on the skin surface. The forward scattering spectrum of PABA on skin resembled more closely that of micro‐crystalline aggregates than that of PABA in solution.
Safety evaluation of gums and thickeners used in cosmetic formulations
Authors: GUILLOT J. P. , GIAUFFRET J. Y. , MARTINI M. C. , GONNET J. F. , SOULÉ G. 
Published: May 2007

SynopsisSafety tests have been carried out on gums and thickeners, continuing a study involving commonly used cosmetic ingredients (1, 2, 3, 4). The ocular and cutaneous tolerance tests have been conducted on the rabbit following the official French methods (5, 6) but with some complements or modifications (1, 2, 3, 4, 7). The test substances (listed in Table 1) were products from various suppliers and of different types and grades. None of the fifty samples tested provoked pathological lesions of the ocular mucous membrane; nevertheless, corneal irritation was noted with silicates, silica and bentonite, probably due to mechanical effect, when applied at relatively high concentration. The highest score on the primary cutaneous irritancy test (moderately irritant) was that for the gelled volatile hydrocarbon solvents. The repeated application test was continued for 6 weeks: no significant pathological reaction was observed. Only a slight intolerance was noted with the gels of volatile hydrocarbons and isopropyl myristate, but the irritant reactions were significantly reduced compared to those previously observed with the pure oils (1, 2). Consequently, based on these data, it can be concluded that the use of gums and thickeners involved in this publication presents no hazard for the skin. Evaluation toxicologique d'agents gélifiants et épaississants utilisés en cosmetologie
A President for the European Union: A New Actor in Town?*
Authors: BLAVOUKOS SPYROS , BOURANTONIS DIMITRIS , PAGOULATOS GEORGE 
Published: May 2007

AbstractIn the post‐Constitution EU, the rotating Presidency would be replaced by a hybrid system combining a rotating component with the establishment of a permanent President for the European Council. Using a principal‐agent framework, we look at the supply and demand for formal leadership in the new system, accounting for the substantial institutional change in the format of the Presidency. We then examine the President's effectiveness and efficiency and discuss whether the President, as a new institutional actor, has the potential to evolve into an autonomous political actor in the EU. Our analysis suggests a discernible though by no means unconditional strengthening of the President's potential for an autonomous political role in the new EU institutional architecture.
Why Bother With Inter‐Regionalism? Negotiations for a European Union‐Mercosur Agreement*
Authors: DOCTOR MAHRUKH 
Published: May 2007

AbstractThe article examines why a decade of inter‐regional negotiations failed to result in an EU‐MERCOSUR agreement, notwithstanding motivating factors at the international, national and societal level. It focuses on inter‐regional trade and investment flows to underline the practical value of any agreement, but also considers strategic and ideational issues.
Comparing Non‐Hierarchical Governance in Action: the Open Method of Co‐ordination in Pensions and Information Society*
Authors: LODGE MARTIN 
Published: May 2007

AbstractNon‐hierarchical modes of governance, such as the ‘open method of co‐ordination’ (OMC), require particular prerequisites to operate effectively. This article points to three essential components of any regime, then assesses their operation in two ‘real’ OMCs, pensions and information society. Given the finding of defective regimes, this article argues that the observed patterns are not surprising given the high demands that non‐hierarchical governance places on participants. In addition, the context of the politics of the EU suggests that non‐hierarchical governance is inappropriate as a means of inducing policy reform.
Monetary Integration of the New EU Member States: What Sets the Pace of Euro Adoption?
Authors: ANGELONI IGNAZIO , FLAD MICHAEL , MONGELLI FRANCESCO PAOLO 
Published: May 2007

AbstractHow fast should the new Member States of the European Union (NMS) relinquish their domestic monetary and exchange rate autonomy? While the Maastricht convergence criteria are attracting significant attention (particularly the inflation and deficit criteria), we think the debate should also examine the status of their economic structures and the progress of integration within the EU. Diverse aspects of the monetary integration of the NMS into the euro area are examined. We find less structural convergence is associated with less income convergence. The exchange rate regimes have a bearing on the speed of real convergence: for some NMS, and for some more time, exchange rate flexibility may still serve as a useful shock absorber.
Exchange Rate Regimes and Exchange Market Pressure in the New EU Member States*
Authors: VAN POECK ANDRÉ , VANNESTE JACQUES , VEINER MARET 
Published: May 2007

AbstractEconomic theory has stressed the vulnerability to currency crises of intermediate exchange regimes. ERM II constitutes a fixed but adjustable pegged exchange rate arrangement and can therefore be categorized as an intermediate regime, in contrast to polar regimes such as currency boards and freely floating exchange rates. Our regression results for eight new EU Member States reveal the role of economic fundamentals in explaining exchange market pressure in these countries and confirm the bipolar view on exchange rate regimes. We conclude that the new EU members should not enter ERM II before their fundamentals are strong enough to compensate for the vulnerability of the exchange rate regime. Otherwise the condition for entering EMU, i.e. preceding participation in ERM II without devaluation or serious tensions on the exchange market, could be jeopardized.