bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring painful experiences: impact of emotional narratives on members of a qualitative research team
Authors: Lalor Joan G. , Begley Cecily M. , Devane Declan 
Published: November 2006

Aim. This paper reports a study of the impact of emotional narratives on the well‐being of members of a qualitative research team during the conduct of sensitive research.Background. Qualitative data are frequently collected from participants using repeated in‐depth interviews when exploring sensitive issues such as loss and grief. The research process can evoke highly emotional responses in the participant and others involved in the study. While consideration has been given to the impact of the research process on participants when a highly affective component is involved, relatively little attention has been given to research team members’ experiences.Method. Through analysis of fieldwork records from a grounded theory study of the experiences of women who were carrying a baby with a foetal abnormality, we discuss the affective issues arising in conducting sensitive research. Data sources included two reflexive journals, written comments from two transcribers and the transcript of an interview with the research supervisor.Findings. The core category of ‘Connecting with the data’ emerged, to which each substantive category relates. Three substantive categories –‘bearing to watch,’‘bearing to listen’ and ‘bearing to support’– emerged as independent but inter‐related aspects of the research process as experienced by the researcher, transcribers and supervisor. Methods of protecting the research team and the integrity of the study when the substantive issue is highly emotive are discussed.Conclusion. The emotional impact of research on participants is normally considered prior to the conduct of any sensitive research, and efforts are made to protect them. The potential for researchers, transcribers and supervisors to be harmed should also be carefully considered when planning a project with significant affective elements.
Effectiveness of non‐pharmacological interventions for fatigue in adults with multiple sclerosis, rheumatoid arthritis, or systemic lupus erythematosus: a systematic review
Authors: Neill Jane , Belan Ingrid , Ried Karin 
Published: November 2006

Aim.  This paper reports a systematic review of non‐pharmacological interventions for fatigue in adults with three common autoimmune conditions.Background.  A considerable proportion of people with multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus experience compromised quality of life due to fatigue. Recent reviews of pharmacotherapies for fatigue in these conditions remain inconclusive, and systematic evidence for effectiveness of non‐pharmacological interventions was unavailable. Our paper addresses this gap.Methods.  The literature search used the key words fatigue, energy, multiple sclerosis, rheumatoid arthritis and systemic lupus. It included 19 electronic databases and libraries, three evidence‐based journals, two internet search engines, was dated 1987–2006, and limited to English. Non‐pharmacological experimental studies about fatigue comprising more than five adults were included. Meta‐analysis was not possible due to diverse interventions and outcome measures, therefore studies were analysed by types of interventions used to reduce fatigue.Results.  Of 653 hits, 162 papers were reviewed, and 36 met the inclusion criteria. Thirty‐three primary studies reported 14 randomized controlled trials and 19 quasi‐experimental designs. Most interventions were tested with people with multiple sclerosis. Exercise, behavioural, nutritional and physiological interventions were associated with statistically significant reductions in fatigue. Aerobic exercise was effective, appropriate and feasible for reducing fatigue among adults with chronic autoimmune conditions. Electromagnetic field devices showed promise. The diversity of interventions, designs, and using 24 different instruments to measure fatigue, limited comparisons.Conclusion.  Low impact aerobic exercise gradually increasing in intensity, duration and frequency may be an effective strategy in reducing fatigue in some adults with chronic auto‐immune conditions. However, fatigue is a variable and personal experience and a range of behavioural interventions may be required. Well‐designed studies testing these promising strategies and consensus on outcome fatigue measures are needed.
Somali and Oromo refugee women: trauma and associated factors
Authors: Robertson Cheryl Lee , Halcon Linda , Savik Kay , Johnson David , Spring Marline , Butcher James , Westermeyer Joseph , Jaranson James 
Published: November 2006

Aim.  This paper reports a study identifying the demographic characteristics, self‐reported trauma and torture prevalence, and association of trauma experience and health and social problems among Somali and Oromo women refugees.Background.  Nearly all refugees have experienced losses, and many have suffered multiple traumatic experiences, including torture. Their vulnerability to isolation is exacerbated by poverty, grief, and lack of education, literacy, and skills in the language of the receiving country.Method.  Using data from a cross‐sectional population‐based survey, conducted from July 1999 to September 2001, with 1134 Somali and Oromo refugees living in the United States of America, a sub‐sample of female participants with clearly identified parenting status (n = 458) were analysed. Measures included demographics, history of trauma and torture, scales for physical, psychological, and social problems, and a post‐traumatic stress symptom checklist.Findings.  Results indicated high overall trauma and torture exposure, and associated physical, social and psychological problems. Women with large families reported statistically significantly higher counts of reported trauma (mean 30, P < 0·001) and torture (mean 3, P < 0·001), and more associated problems (P < 0·001) than the other two groups. Women who reported higher levels of trauma and torture were also older (P < 0·001), had more family responsibilities, had less formal education (P < 0·001) and were less likely to speak English (P < 0·001).Conclusion.  These findings suggest a need for nurses, and especially public health nurses who work with refugee and immigrant populations in the community, to develop a more comprehensive understanding of the range of refugee women's experiences and the continuum of needs post‐migration, particularly among older women with large family responsibilities. Nurses, with their holistic framework, are ideally suited to partner with refugee women to expand their health agenda beyond the biomedical model to promote healing and reconnection with families and communities.
Phylogenetic biogeography of the leafy liverwort Herbertus (Jungermanniales, Herbertaceae) based on nuclear and chloroplast DNA sequence data: correlation between genetic variation and geographical distribution
Authors: Feldberg Kathrin , Hentschel Jörn , Wilson Rosemary , Rycroft David S. , Glenny David , Heinrichs Jochen 
Published: November 2006

AbstractAim  The cosmopolitan genus Herbertus is notorious for having a difficult taxonomy and for the fact that there is limited knowledge of species ranges and relationships. Topologies generated from variable molecular markers are used to discuss biogeographical patterns in Herbertus and to compare them with the geological history of continents and outcomes reported for other land plants.Location  Africa, Asia, Azores, Europe, southern South America, northern South America, North America, New Zealand.Methods  Phylogenetic analyses of nuclear ribosomal internal transcribed spacer and chloroplast (cp) trnL–trnF sequences of 66 accessions of Herbertus and the outgroup species Triandrophyllum subtrifidum and Mastigophora diclados were used to investigate biogeographical patterns in Herbertus. Areas of putative endemism were defined based on the distribution of species included in the analyses. Maximum parsimony analyses were undertaken to reconstruct ancestral areas and intraspecies migration routes.Results  The analyses reveal species‐level cladograms with a correlation between genetic variation and the geographical distribution of the related accessions. The southern South American Herbertus runcinatus is sister to the remainder of the genus, which is split into two main clades. One contains the Neotropical–African Herbertus juniperoideus and the New Zealand/Tasmanian Herbertus oldfieldianus. An African accession of H. juniperoideus is nested within Neotropical accessions. The second main clade includes species that inhabit Asia, the Holarctic, Africa, and northern South America. Maximum parsimony analyses indicate that this clade arose in Asia. Herbertus sendtneri originated in Asia and subsequently colonized the Holarctic and northern South America. An Asian origin and colonization into Africa is indicated for H. dicranus.Main conclusions  The current distribution of Herbertus cannot be explained by Gondwanan vicariance. A more feasible explanation of the range is a combination of short‐distance dispersal, rare long‐distance dispersal events (especially into regions that faced floral displacements as a result of climatic changes) extinction, recolonization, and diversification. The African Herbertus flora is a mixture of Asian and Neotropical elements. Southern South America harbours an isolated species. The molecular data indicate partial decoupling of molecular and morphological variation in Herbertus. Biogeographical patterns in Herbertus are not dissimilar to those of other groups of bryophytes, but elucidation of the geographical ranges requires a molecular approach. Some patterns could be the result of maintenance of Herbertus in the inner Tropics during glacial maxima, and dispersal into temperate regions in warm phases.
Fish species diversity among spatial scales of altered temperate rivers
Authors: Pegg Mark A. , Taylor Ronald M. 
Published: November 2006

AbstractAim  The alteration of flowing systems over the past century has led to significant changes to the processes that drive these complex environments as well as to the scales at which these processes act. Recently, efforts have begun in earnest to restore some semblance of ecosystem diversity, but there is little understanding of exactly on what spatial scale or scales biotic diversity is responding. We investigated the manner in which fish diversity is partitioned at multiple spatial scales in two rivers in the central United States.Location  The Missouri and Illinois rivers of the central United States.Methods  We analysed how fish diversity was partitioned within the Illinois River and Missouri River systems by sampling each river under hierarchical frameworks that allowed analysis at section (large), reach (intermediate), and site (small) scales. We tested the hypothesis that there are scale‐dependent responses of fish diversity using an additive partitioning approach.Results  Site alpha diversity was significantly higher than expected in both the Illinois and Missouri rivers. The relative contribution of alpha diversity to total diversity at a given spatial scale increased for the Illinois River, but not for the Missouri River, in that the highest alpha diversity contribution peaked at the reach scale. Diversity patterns from both rivers suggest that diversity at the site scale plays a significant role in determining the overall diversity in these systems. However, there is a substantial contribution at larger scales that warrants consideration when attempts are being made to protect or restore diversity and other ecosystem parameters.Main conclusions  Understanding the variation of diversity in riverine systems is crucial for providing insight not only into how biotic communities respond to scale‐dependent factors, but also into the underlying abiotic and biotic factors that generate patterns of diversity across scales. These insights, in turn, are important for ensuring that restoration and management activities are targeting the appropriate scales for remediation. A lack of understanding of this issue could have negative outcomes for the recovery of a community in a restoration scenario, as well as resulting in a low economic return on restoration investments, which could hinder future efforts.
Meta‐analysis of the effects of respiratory rehabilitation programmes on exercise capacity in accordance with programme characteristics
Authors: Oh HyunSoo , Seo WhaSook 
Published: November 2006

Aims and objectives.  This study was performed to investigate the effects of respiratory rehabilitation programmes on exercise capacity in terms of the programme type, the protocol used and other programme characteristics.Background.  As the suitable rehabilitation programmes have not been specified, diverse programmes are provided in clinics.Design.  Meta‐analysis of the primary study resultsMethods.  A computerized search through MEDLINE and CINHAL in addition to tracking down references cited in bibliographies of primarily searched studies were performed to obtain sample studies. Finally 19 research reports were examined.Results.  The results of meta‐regression showed that the combined effect size of the programmes on exercise capacity was unaffected by forced expiratory volume (in one second), age, the duration and frequency of the programme, or study quality. In addition, the results of meta‐anova indicated that the combined effect size was not affected by (i) whether a programme was hospital based or not, (ii) whether a programme was lower‐extremity or combined low‐ and upper‐extremity exercise training, (iii) measurement time, and (iv) exercise intensity.Conclusions.  The effects of programmes on exercise capacity were not differed in terms of the places where rehabilitation programmes were applied, programme content, measurement time, exercise target sites of body, and the duration and frequency of the programme.Relevance to clinical practice.  The results of the present study can provide objective data when constructed or applied on a respiratory rehabilitation programme in clinics.
Co‐ordination of the discharge planning process in critical care
Authors: Watts Rosemary , Pierson Jane , Gardner Heather 
Published: November 2006

Aim and objectives.  This article reports on the current discharge planning beliefs in relation to the co‐ordination of the discharge planning process in the critical care environment in the health care system in the state of Victoria, Australia. As there is a paucity of previous studies examining discharge planning in critical care nursing knowledge about the phenomena is consequently limited.Background.  The study reported here is part of a larger study exploring critical care nurses’ perceptions and understanding of the discharge planning process in the health care system in the state of Victoria, Australia. While a number of different discharge planning models are reported in the literature there is no agreement on the most effective or the most efficient model.Design.  An exploratory descriptive research design was used for this study.Methods.  A total of 502 Victorian critical care nurses were approached to take part in the study. A total of 218 participants completed the survey, which represented a nett response rate of 43·4%. The data from the questionnaire were entered into the Statistical Package for Social Sciences (SPSS) Base 10.0. This allowed calculation of descriptive statistics and statistical analysis using chi‐square test for goodness‐of‐fit.Results.  While just over half the participants reported that the discharge planning process in their unit was co‐ordinated by a combination of personnel that included a nurse, just under half the participants believed that this was an appropriate model. Another key finding was of those participants who worked in critical care units using primary nursing, just over half responded that the bedside nurse/primary nurse co‐ordinated the discharge planning process while just under half responded that a combination of health care team members, including a nurse, co‐ordinated the process. Overall there was little support for the designated discharge planning nurse to co‐ordinate the process.Conclusions.  The findings presented here suggest critical care nurses need to examine who has the ultimate responsibility of co‐ordinating the critical care patient's discharge plan irrespective of the nursing model employed within the critical care ward. There is the need to ensure that when discharge planning becomes everybody's responsibility it ultimately does not become no‐one's responsibility.Relevance to clinical practice.  If discharge planning practices are to be changed with the introduction of new discharge planning models in the critical care environment then it is important not only to know current practice but also the perceptions of critical care nurses in terms of who they believe should co‐ordinate the discharge planning process.
Adherence to drug treatment in association with how the patient perceives care and information on drugs
Authors: Ulfvarson Johanna , Bardage Carola , Wredling Regina A‐M , Von Bahr Christer , Adami Johanna 
Published: November 2006

Aim.  This study was to explore concordance with drugs prescribed and the patient's self‐reported drug consumption, in relation to the older patient's perceived care and information given.Background.  Lack of adherence to prescriptions may lead to therapeutic failure with risks for relapse, unnecessary suffering and increased costs.Design.  A cross‐sectional study with structured interviews of 200 patients who had recently been treated in a medical ward.Methods.  Patients’ medical records were studied to obtain information on their current use of drugs. The data were analyzed by logistic regression, adherence being the dependent response variable.Results.  The mean age of the study group was 79 years. The number of drugs reported in the medical chart ranged from one to 17 with a mean of 6·9. The patients reported a drug consumption ranging from 0 to 24 with a mean of 7·3. When comparing the interview results with the information in the medical charts, 30% of the patients showed adherence. An association was found between adherence and self‐reported health status. Patients in the non‐adherent group reported a higher consumption of drugs. Patients felt that the opportunity to ask questions of either the responsible physicians or of the nurses was influential in decreasing risk.Conclusion.  In this study, the patient's total drug consumption was considered. The study showed a large discrepancy between the drugs stated in the medical chart and patient's self‐reported drug consumption. The study failed to show that perceived information or educational level had an impact on the results but implicate that the quality of information influences adherence.Relevance to clinical practice.  It is of importance to recognize patients at risk for non‐adherence. Decreased health status and many drugs are the main risk factors for patients being non‐adherent, and should be recognized as such.
A review of the use of insulin protocols to maintain normoglycaemia in high dependency patients
Authors: Jane Whitehorn L 
Published: November 2006

Aim.  This paper critically examines the evidence base for and issues involved in the introduction of an insulin protocol to maintain normoglycaemia in patients within a medical/surgical high dependency ward.Background.  A growing body of evidence has linked hyperglycaemia to worsened clinical outcomes. This has led to intravenous insulin protocols becoming a new standard of care in intensive care units. However, the use and benefits of insulin protocols within high dependency units have not yet been addressed in the literature.Methods.  The literature was examined for the 10‐year period up to January 2005. The databases searched were MEDLINE, OVID, CINHAL, the British Nursing Index, the EBSCO collection, the COCHRANE library, the Department of Health, and guidelines within the Scottish Intercollegiate Guidelines Network and National Institute for Clinical Excellence using the key words insulin, protocol, hyperglycaemia, critical care, intensive care and high dependency.Results.  The literature reports that both medical and surgical intensive care patients treated with intravenous insulin protocols to maintain normoglycaemia experienced significantly reduced mortality and morbidity. Resulting hypoglycaemic episodes were limited with no incidence of patient deterioration. A review of published intravenous insulin protocols used in intensive care settings revealed their safe and effective use in nurse to patient ratios similar to those present in high dependency units.Conclusions.  In the light of this evidence, it would seem safe and ethically correct to enable high dependency patients to benefit from this cheap intervention. An insulin protocol tailored for the glycaemic control of high dependency patients has been suggested, although it may have to be commenced in conjunction with other fluid and nutrition protocols to safeguard the risk of hypoglycaemic events. Further research into the safety and benefit of insulin protocols in high dependency populations is required.Relevance to clinical practice.  The stress of critical illness often leads to hyperglycaemia, which is linked to worsened clinical outcomes. Both medical and surgical intensive care patients treated with intravenous insulin protocols to maintain normoglycaemia experienced significantly reduced mortality and morbidity. This paper identifies that, to date, no research into the benefits of glycaemic control in high dependency populations has been published. The case for the introduction of insulin protocols into high dependency units is therefore examined and an insulin protocol suggested.
Review of advanced nursing practice: the international literature and developing the generic features
Authors: Mantzoukas Stefanos , Watkinson Sue 
Published: November 2006

Aim. The aim of this article is to review the nursing literature on the notion of advanced nursing practice (ANP) and consequently provide clarifications on the concept of advanced nurse practitioner by developing its’ generic features.Background. This paper commences by critically reviewing the concept of advanced nursing practice as it is portrayed within the literature. From this review, a series of contradictions emerged in terms of definitions and roles. On further analysis of the literature the core aims and goals of the ANP are revealed.Methods. An informative and narrative systematic literature review was undertaken, using specific inclusion and exclusion criteria. The mass of retrieved material was carefully screened and methods of data saturation were used. Consequently, the material was read, re‐read and indexed as to develop seven thematic units that formed the generic features of the ANP.Findings. The generic features that emerged are: (i) the use of knowledge in practice, (ii) critical thinking and analytical skills, (iii) clinical judgement and decision‐making skills, (iv) professional leadership and clinical inquiry, (v) coaching and mentoring skills, (vi) research skills and (vii) changing practice.Conclusion. Reviewing the literature on the concept of ANP, a great variety of definitions, conceptualizations and roles emerged. Nonetheless, on a closer reading, a common goal was identified, which was the attainment of practice and professional autonomy via ANP roles for enhanced practice provision. Eventually, from the reviewed literature, seven generic features of the ANP were developed, thus providing clarification to the role and the characteristics of the ANP.Relevance to clinical practice. Clarifying the confusion surrounding advanced nursing practice and gaining an in‐depth understanding of its’ generic features would facilitate practitioners, practice educators and clinical managers to develop those skills that would allow them or their staff or students to practise at an advanced level.