bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Gender, Education and Experience On Moral Sensitivity in Psychiatric Nursing: a Pilot Study
Authors: Lützén Kim , Nordin Conny 
Published: November 2007

The purpose of this study was to investigate some factors which may influence moral decision-making in psychiatric nursing practice. The Moral Sensitivity Questionnaire, a 30-item, seven-point Likert scale, measures six dimensions that are assumed to be related to moral sensitivity. In scoring, the test is divided into six categories: interpersonal orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing conflict, and reliance on medical authority. Seventy-nine nurses, employed in the same psychiatric district, were included in the sample. Significant differences were found for some items in five of the six categories regarding gender, post-basic nursing education, experience as a mental care worker and type of clinical setting. Le but de cette étude était d'investiguer quelques éléments qui pourraient influencer les décisions morales dans la pratique infirmière psychiatrique. Le Questionnaire de Sensibilité Morale de 30 questions, sept points échelle Likert, mesure six dimensions qu'on assume d'être lié à la sensibilité morale. En marquant les points, le test est divisé entre les six catégories: orientation interpersonnelle, structurant un sens moral, l'expression de bénévolence, la modification de l'autonomie, l'expérience de conflit et dépendance de l'autorité médicale. Soixante-dix neuf infirmiers/ères, employé(e)s dans le même rayon de psychiatrie, ont participé dans l'étude. On a trouvé des différences considérables pour quelques questions dans cinq des six catégories en ce qui concerne le genre, l'éducation avancée, l'expérience d'infirmier/ère psychiatrique et type de cadre clinique. Das Ziel dieser Studie war die Untersuchung einiger Faktoren, die Einfluss haben auf die moralische Entscheidungsfindung in der psychiatrischen Krankenpflege. Der Fragebogen zur 'Moralischen Einfühlsamkeit' ist eine sieben-Punk Likert Skala für 30 Sachaspekte und misst sechs Dimensionen, von denen man annimmt, daß sie zur moralischer Einfühlsamkeit gehören. Für die Auswertung ist der Test in sechs Kategorien eingeteilt: Orientierung zu andem Personen, das Strukturieren moralischer Bedeutungselemente, Wohlwollen ausdrücken, Modifizierung von Selbstbestimmung,
Comprehensive Patient-Family Care: Fact or Fiction?
Authors: Wagner Nurith 
Published: November 2007

The ICN 1973 Code for nurses states that 'Nurses render health services to the individual, the family and the community...'. It goes on to say that, 'The nurse's primary respon sibility is to those people who require nursing care.' Thus, our primary responsibility to provide comprehensive care to patients and their families is a concept we teach and preach, but can it be achieved? In this paper, I would like to present the ethical dilemmas expressed by nurses as inherent in the care of patients and their families, address the difficulties in treating patients and their families in the light of these dilemmas and propose a different approach to dealing with the problem.
Letters to the Editor
Authors: Sellman Derek , Skidmore David 
Published: November 2007

The following two letters were received in response to David Skidmore's article, 'Can nursing survive? A view through the keyhole', which was published in the December 1994 issue of Nursing Ethics. David Skidmore has been asked to reply; his comments follow. Both his and Janet Duberley's letters have been shortened with their consent.
Aristotle, Nursing and Health Care Ethics
Authors: Scott P. Anne 
Published: November 2007

Even a brief consideration of the nature of nursing will indicate that an ethical dimension underlies much, if not all, of nursing practice. It is therefore important that students and practitioners are facilitated in developing an ethical awareness and sensitivity from early in their professional development. This paper argues that Aristotelian virtue theory provides a practice-based focus for health care ethics for a number of reasons. Also, because of his emphasis on the character of the moral agent, and on the importance of perception and emotion in moral decision-making, Aristotelian virtue theory provides a useful supplement to the traditional duty-based approaches to health care ethics analysis, which are increasingly being identified in the literature as having limits to their application within the health care context.
The Ethics of the Health Care Market
Authors: Cooke Mary 
Published: November 2007

The free market theory has as its basis the assumption of equity. This equity is ascribed to both purchasers and providers in a perfectly balanced system so that there are seen to be no 'winners' or 'losers' in the market-place. The health system that is developing in the UK is structured as a managed market, but agency relationships between GPs and health authorities buffer the costing process of goods and therefore may be described as distorting the price. This could also be distorting the ability of the users, who are the real purchasers, from exercising their economic freedom. They may also lose the autonomy to choose goods that suit their particular needs, and equally not to choose those services that they do not want or wish to pay for vicariously (i.e. that the common good is respected by both providers and purchasers). This assumes that users of the service know the level of choice that they have and that not only are providers protected at present by the practices of the purchasers but also entry into the market for new providers is severely curtailed. The exercise of true freedom of the market in economic terms is one of moral obliga tion to provide services that not only have a market value that is affordable and a require ment of the 'common good' but also are historically acceptable for social requirements (i.e. that the services are valued as fundamental tenets of the rights of individuals in soci ety). The expression of this need will therefore be utilitarian (i.e. the users of the services should benefit from them rather than the providers).
Educating Nurses for Their Future Role in Bioethics
Authors: Leavitt Frank J. 
Published: November 2007

The emerging new multidisciplinary and crosscultural field of bioethics will require sen sitive, open-minded professionals to take the lead in hospital ethics, in genetic coun selling, and in the teaching of bioethics to students in nursing, medicine and the basic sciences. Nurses with ward experience who return to university to gain an MA or PhD in bioethics are eminently suited for this leadership role, for they may be more likely than physicians to study for a liberal education to supplement their professional know ledge ; their first-hand experience in nursing is an antidote to the pointless subtleties into which philosophical ethics so often degenerates. When teaching ethics to nurses one must remember that, while some will simply use this knowledge in their own clinical work, others will go on to be teachers and researchers in bioethics. Their training must therefore be broad and interdisciplinary, including real substantive philosophy (as opposed to philosophical ethics), as well as mystical bioethics, religious law, ethics of genetic counselling, clinical approaches to ethical pseudo prob lems, research skills, etc.
Community Nurses and Health Promotion: Ethical and Political Perspectives
Authors: Thomas Jane , Wainwright Paul 
Published: November 2007

This paper brings together ideas from two perspectives on ethics and health promotion. A discussion of the ethical dimension of the health promotion practice of community nurses is set in the wider context of health policy, with particular reference to health gain and individual responsibility. It is widely held that nurses have a key role to play in health promotion and that this is particularly the case for nurses working in primary health care. This assumption is reinforced by policy documents from the World Health Organization, the Department of Health and statutory bodies such as the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. The approach of many nurses to health promotion has tended on the one hand to be somewhat naive and on the other to be authoritarian and didactic; there has been little discussion in the nursing literature of the ethical aspects of health promotion. However, recent developments in nurse education, such as Project 2000 and the consequent changes to preregistration programmes, have resulted in increased attention to both ethics and health promotion within the curriculum.
To Kill or Not to Kill: a Question of Wartime Ethics
Authors: Williams P.T. 
Published: November 2007

In this article, the author describes ethical decision-making in unique circumstances. A dichotomy exists between the dual roles of nurse and disaster manager in a wartime set ting. The circumstances of the situation had never been faced before and no precedents existed for the type of decisions being made. Clearly, professional codes of conduct existed along with international conventions with reference to war. The circumstances required the author to challenge the concepts of teleology and deon tology in a search for the most fitting answers to a unique problem. His aim was to try to create the greatest good out of an impossible situation. The author reflects on his actions in the light of ethical thinking and considers whether his decisions were right.
Chemotherapy induced diarrhea
Authors: Richardson Gillian , Dobish Roxanne 
Published: November 2007

Purpose: To provide a current review of the literature related to chemotherapy induced diarrhea (CID), including clinical assessment, recommended management guidelines and investigational pharmacological approaches for the prevention and treatment of CID. Data sources: A search of MEDLINE, PubMed, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, and Web of Science (1996—2006) databases was conducted using terms such as: chemotherapy, diarrhea, diarrhoea, and irinotecan. Appropriate references from selected articles were also used. The search engine, Google, provided further access to information. Data extraction: The retrieved literature was reviewed to include all articles pertaining to the pathophysiology, assessment and management of CID. Data synthesis: Diarrhea is a debilitating and potentially life-threatening side effect associated with many chemotherapeutic agents. Despite the high incidence and severity of CID, it is often under recognized and poorly managed. A multidisciplinary panel recently updated recommended practice guidelines for the assessment and management of CID. Prompt and aggressive intervention is important in order to minimize the negative consequences of CID, such as dehydration, which may cause interruptions in optimal clinical outcomes or may lead to life-threatening sequelae. Further investigation into the pathophysiology of CID may allow for more directed approaches in the prophylaxis and treatment of CID. J Oncol Pharm Practice (2007) 13: 181—198.
Monitoring rare serious adverse events from a new treatment and testing for a difference from historical controls
Authors: Fay Michael P. , Huang Chiung-Yu , Twum-Danso Nana A. Y. 
Published: November 2007

Background We detail the design of a study to monitor the safety of including albendazole to an existing treatment regimen to eliminate lymphatic filariasis. We wish to show that this new regimen does not increase the rate of a rare serious adverse event (SAE) compared to the old regimen. Controlled but small clinical trials have not detected any increase in the SAE using albendazole, and it is known to have added benefits; therefore, it is unethical to randomize patients to the old regimen. Purpose A sample size for the new regimen is needed to test that the new rate of SAE is noninferior to the historic rate. If the new regimen does have an inferior rate of SAE then we wish to stop the study early. This setup is different from traditional early stopping for efficacy and futility. In that traditional case, the two stopping decisions are relative to the same null hypothesis of equality, while in our setup, we have two different null hypotheses: the noninferiority null and the equality null. When testing the former, we need not stop early if the new regimen appears better because no subjects are receiving the old regimen anymore anyway. When testing the equality of SAE rates, however, we want to stop early if the new regimen has a significantly higher rate of SAE. Methods We create a design that uses an exact difference in proportions test for testing noninferiority, but calculates maximal sample size based on conditional power which treats the historical rates as true rates. The design allows for early stopping if the new treatment appears inferior with respect to SAE rate but makes no corrections for multiple testing. We explore the properties of this naive design without assuming the historical rates are known. Results For our example, we show that our naive design strategy bounds the type I error of the noninferiority hypothesis in all cases and bounds it for the equality hypothesis at 0.05, as long as the true SAE rate is <0.00015. The same design has unconditional power for the noninferiority hypothesis greater than the nominal 80% as long as the true SAE rate for both regimens are <0.00025. Limitations The type I and power results above hold only for our historical sample size of 17 877. We expect similar type I and power properties to hold with studies with SAE rates similar or less (i.e., < 0.00015) and historical sample sizes similar or smaller. Conclusions Our design for comparing very rare historical SAE rates to SAE rates of a new treatment has large power to conclude noninferiority of the new treatment SAE rate when both rates are equal, but allows early stopping if the new SAE rates are worse. Clinical Trials 2007; 4: 598—610. http://ctj.sagepub.com
Design of the PEDS-C trial: pegylated interferon +/- ribavirin for children with chronic hepatitis C viral infection
Authors: Murray Karen F. , Rodrigue James R. , González-Peralta Regino P. , Shepherd John , Barton Bruce A. , Robuck Patricia R. , Schwarz Kathleen B. ,   for the PEDS-C Clinical Research Network
Published: November 2007

Background PEDS-C is the first multicenter placebo-controlled trial for the treatment of chronic hepatitis C (HCV) in childhood that has ever been conducted in the United States (USA). Establishment of the research team, protocol, administrative infrastructure, and ancillary contributors for the pediatric trial took years of planning. Purpose To study the safety and efficacy of pegylated-interferon alpha (PEG-2a) plus ribavirin (RV) with PEG-2a monotherapy in children aged 5 years through 18 years. To assess the health-related quality of life and growth and body composition in children with chronic hepatitis C infection, before, during, and after treatment. Methods Eleven centers of pediatric hepatobiliary clinical research were united in a National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) funded grant with financial support from the Food and Drug Administration (FDA) and a corporate sponsor to conduct the treatment trial. Limitations The most important initial limitation in the design of this complex study was securing the financial support and infrastructural organization, a process that took several years. Challenges faced by the study group included identifying the optimal study design given the limited study population, and determining what ancillary studies could be incorporated into the treatment trial. Conclusions In this article the process taken to design the study and administrative infrastructure, the lessons learned, and the controversial issues deliberated during the planning process are discussed. The evolution of the study and the considerations taken in the development of the protocol are valuable tools which can be applied to pediatric clinical trials in general. Clinical Trials 2007; 4: 661—673. http://ctj.sagepub.com
`Having cancer changed my life, and changed my life forever': survival, illness legacy and service provision following cancer in childhood
Authors: Drew Sarah 
Published: November 2007

Objectives: To explore how having cancer in childhood influences social and personal wellbeing in young adulthood. Methods: Questionnaires (55) eliciting lengthy written responses and in-depth interviews (32) were used with male and female survivors of cancer in childhood (aged between 18 and 28 years). Analysis drew on a combination of grounded-theory techniques and narrative analysis. Results: Three key areas are outlined relating to the characterization of survivorship by participants. These include highlighting survival as not necessarily a simple end to a cancer story, issues relating to post-cancer bodily self-concept and its gendering, and, efforts at managing uncertainties through medical interactions and information gathering. Discussion: Participant stories in this study illustrate that even in long-term survival, cancer is present as a web of ongoing influences from the original disease and treatment, as well as the social and personal aftershocks that can occur well after malignant cells have been controlled. Findings highlight the necessity for complex redevelopment of healthcare services and social support provisions for this growing population.
Extracting unrecognized gene relationships from the biomedical literature via matrix factorizations
Authors: Kim Hyunsoo , Park Haesun , Drake Barry L 
Published: November 2007

Abstract

Background
The construction of literature-based networks of gene-gene interactions is one of the most important applications of text mining in bioinformatics. Extracting potential gene relationships from the biomedical literature may be helpful in building biological hypotheses that can be explored further experimentally. Recently, latent semantic indexing based on the singular value decomposition (LSI/SVD) has been applied to gene retrieval. However, the determination of the number of factors k used in the reduced rank matrix is still an open problem.

Results
In this paper, we introduce a way to incorporate a priori knowledge of gene relationships into LSI/SVD to determine the number of factors. We also explore the utility of the non-negative matrix factorization (NMF) to extract unrecognized gene relationships from the biomedical literature by taking advantage of known gene relationships. A gene retrieval method based on NMF (GR/NMF) showed comparable performance with LSI/SVD.

Conclusion
Using known gene relationships of a given gene, we can determine the number of factors used in the reduced rank matrix and retrieve unrecognized genes related with the given gene by LSI/SVD or GR/NMF.
Production of single chain Fab (scFab) fragments in Bacillus megaterium
Authors: Jordan Eva , Al-Halabi Laila , Schirrmann Thomas , Hust Michael , Dübel Stefan 
Published: November 2007

AbstractBackgroundThe demand on antigen binding reagents in research, diagnostics and therapy raises questions for novel antibody formats as well as appropriate production systems. Recently, the novel single chain Fab (scFab) antibody format combining properties of single chain Fv (scFv) and Fab fragments was produced in the Gram-negative bacteriumEscherichia coli. In this study we evaluated the Gram-positive bacteriumBacillus megateriumfor the recombinant production of scFab and scFvs in comparison toE. coli.ResultsThe lysozyme specific D1.3 scFab was produced inB. megateriumandE. coli. The total yield of the scFab after purification obtained from the periplasmic fraction and culture supernatant ofE. coliwas slightly higher than that obtained from culture supernatant ofB. megaterium. However, the yield of functional scFab determined by analyzing the antigen binding activity was equally in both production systems. Furthermore, a scFv fragment with specificity for the human C reactive protein was produced inB. megaterium. The total yield of the anti-CRP scFv produced inB. megateriumwas slightly lower compared toE. coli, whereas the specific activity of the purified scFvs produced inB. megateriumwas higher compared toE. coli.ConclusionB. megateriumallows the secretory production of antibody fragments including the novel scFab antibody format. The yield and quality of functional antibody fragment is comparable to the periplasmic production inE. coli.
Acute hepatitis associated with Q fever in a man in Greece: a case report
Authors: Pape Magdalini , Xanthis Andreas , Hatzitolios Apostolos , Mandraveli Kalliopi , Savopoulos Christos , Alexiou-Daniel Stella 
Published: November 2007

Abstract
Coxiella burnetii is the causative agent of Q fever. Q fever is a worldwide zoonosis that is responsible for various clinical manifestations. However, in Greece hepatitis due to Coxiella is rarely encountered. A case of Q fever associated with hepatitis is reported here. Diagnosis was made by specific serological investigation (enzyme-linked immunosorbent and indirect immunofluorescene assays) for Coxiella burnetii.
Using protein complexes to predict phenotypic effects of gene mutation
Authors: Fraser Hunter B , Plotkin Joshua B 
Published: November 2007

Abstract
Background
Predicting the phenotypic effects of mutations is a central goal of genetics research; it has important applications in elucidating how genotype determines phenotype and in identifying human disease genes.

Results
Using a wide range of functional genomic data from the yeast Saccharomyces cerevisiae, we show that the best predictor of a protein's knockout phenotype is the knockout phenotype of other proteins that are present in a protein complex with it. Even the addition of multiple datasets does not improve upon the predictions made from protein complex membership. Similarly, we find that a proxy for protein complexes is a powerful predictor of disease phenotypes in humans.

Conclusion
We propose that identifying human protein complexes containing known disease genes will be an efficient method for large-scale disease gene discovery, and that yeast may prove to be an informative model system for investigating, and even predicting, the genetic basis of both Mendelian and complex disease phenotypes.
The Salaried Middle Class in the Corporatist Welfare State
Authors: Gould Arthur 
Published: November 2007

While I recognise that there are many problems involved in defining what I choose to call the salaried middle class (SMC), I will take its constituent elements to be those non-manual career hierarchies which we tend to associate with private and public bureaucracies. Galbraith’s definition of a large corporation’s technostructure comes nearest to what I mean.
‘It extends from the most senior officials to where it meets … the blue and white collar workers whose function is to perform more or less mechanically to instruction or routine. It embraces all who bring specialised knowledge, talent or experience to group decisionmaking’.

My renewed interest in this class has arisen because recent Marxist studies of social policy and the welfare state have left me dissatisfied with the constant emphasis upon capital and labour. It may be, as Parkin has pointed out, that non-Marxist sociology made too much of the manual/non-manual distinction in the past and relegated private property ‘to a theoretical limbo’ .But the reverse is now equally true.
Although Marxists often refer to the new middle class and the ‘new petit bourgeoisie’ their analysis of capitalist society is based upon a dual model of class conflict.