bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effective Strategies for Implementing a Multicenter International Clinical Trial
Authors: Aitken Leanne M. , Pelter Michele M. , Carlson Beverly , Marshall Andrea P. , Cross Rebecca , McKinley Sharon , Dracup Kathleen 
Published: May 2008

Purpose:

International collaboration in research is essential in order to improve worldwide health. The purpose of this paper is to describe strategies used to administer an international multicenter trial to assess the effectiveness of a nursing educational intervention.
Design:

The study design was a two‐group randomized multicenter international clinical trial conducted to determine whether a brief education and counselling intervention delivered by a nurse could reduce prehospital delay in the event of symptoms suggestive of acute coronary syndrome (ACS) in patients previously diagnosed with cardiovascular disease.
Method:

A flexible but well‐defined project structure showed intervention consistency in five sites among three countries and included experienced project coordinators, multidimensional communication methods, strategies to optimize intervention fidelity, site‐specific recruitment and retention techniques, centralized data management, and consideration of ethical and budgetary requirements.
Findings:

Staff at five sites enrolled 3,522 participants from three countries and achieved 80% follow‐up obtained at both 12 and 24 months.
Conclusion:

Multidimensional approaches to maintain consistency across study sites, while allowing flexibility to meet local expectations and needs, contributed to the success of this trial.
Clinical Relevance:

In order to support appropriate development of an evidence base for practice, nursing interventions should be tested in multiple settings. A range of strategies is described in this paper that proved effective in conducting a multicenter international trial.
Interaction of Duration of Homelessness and Gender on Adolescent Sexual Health Indicators
Authors: Rew Lynn , Grady Matthew , Whittaker Tiffany A. , Bowman Katherine 
Published: May 2008

Purpose:

The purpose of this analysis was to determine the effects of duration of homelessness and gender on personal and social resources, cognitive‐perceptual factors, and sexual health behaviors among homeless youth.
Design:

Cross‐sectional analysis of data collected at baseline from 461 homeless adolescents who participated in a sexual health intervention study was done.
Method:

Data were collected via laptop computers from homeless adolescents (mean age = 19.52 + 1.91 years) in both comparison and intervention groups before the initiation of the intervention.
Findings:

Significant interaction effects were found for personal and social resources F (4, 426) = 2.83, p < .05. Male participants who had been homeless < 6 months had significantly higher scores on social connectedness than did male participants who were homeless > 1 year. Univariate analysis of variance (ANOVA) indicated that both boys and girls who had been homeless > 1 year had greater AIDS knowledge, F (1, 441) = 7.91, p < .01, reported significantly more sexual risk‐taking behaviors, F (1, 396) = 9.93, p < .05, and engaged in fewer safe‐sex behaviors, F (1, 396) = 12.05, p < .05, than did those who had been homeless < 6 months. Univariate ANOVA indicated that female participants had significantly lower levels of perceived health status, F (1, 429) = 12.08, p < .01, significantly greater sexual self‐care behaviors, F (1, 396) = 16.29, p < .01, and significantly higher levels of assertive communication F (1, 396) = 4.03, p < .05 than did male participants, regardless of duration of homelessness.
Conclusions:

The duration of homelessness and gender has both direct and interaction effects on cognitive‐perceptual and behavioral outcomes associated with sexual health.
Clinical Relevance:

Nurses and other healthcare providers working with homeless youth recognize the need to develop brief interventions that address health‐risk behaviors. Findings from this study indicate that gender‐specific interventions should be provided to youth soon after they become homeless.
Testing a Bioecological Model to Examine Social Support in Postpartum Adolescents
Authors: Logsdon M. Cynthia , Hertweck Paige , Ziegler Craig , Pinto‐Foltz Melissa 
Published: May 2008

Purpose:

The purpose was twofold and included examining a bioecological model as a framework to describe social support in postpartum adolescents. The second purpose was to determine the relationship between a comprehensive view of the context of social support and symptoms of depression.
Design:

Cross‐sectional design with convenience sampling (n= 85) of adolescents at 4–6 weeks postpartum, recruited from two community hospitals.
Methods:

Approval was received from the university's IRB (institutional review board), each recruitment site, the adolescent mothers, and their parents or guardians. Data were collected by a research assistant during home visits using a battery of self‐report instruments to measure macro, meso, and microsystems of social support. Demographics, exposure to community violence (macrosystem), social support, social network (mesosystem), and perceived stress, mastery, and self‐esteem (microsystem) were predictor variables. Depressive symptoms were measured by using the Center for Epidemiologic Studies of Depression (CES‐D) Scale.
Findings:

Variables from each system were significant predictors of depressive symptoms but perceived stress was the strongest predictor. Many postpartum adolescents reported that they had been victims of violence. Significant symptoms of depression were identified in 37% of the postpartum adolescents.
Conclusions:

Context is important to consider in comparing international studies of social support. Researchers and clinicians should investigate variables associated with the low incidence of treatment for depressive symptoms in postpartum adolescents.
Clinical Relevance:

Feelings of high self‐esteem and mastery should be fostered in nursing interventions with postpartum adolescents and routine screening for symptoms of depression should be considered in relevant healthcare settings.
Maternal Factors Associated With Child Behavior
Authors: Hall Lynne A. , Rayens Mary Kay , Peden Ann R. 
Published: May 2008

Background:

Knowledge of the relative contributions of risk factors in predicting young children's behavior problems may provide insights for the development of preventive interventions.
Objective:

The purpose of this cross‐sectional study was to identify maternal predictors of children's internalizing and externalizing behaviors in a volunteer sample of 205 low‐income, single mothers with children between 2 and 6 years of age.
Method:

Data were collected on chronic stressors, self‐esteem, negative thinking, depressive symptoms, and child behavior during in‐home interviews with the mothers.
Results:

Mothers' reports of internalizing and externalizing behaviors did not differ by sex or race of the child. Chronic stressors and depressive symptoms, in addition to control variables, explained 27% of the variability in internalizing behavior while these two variables accounted for 21% of the variability in externalizing behavior. For both internalizing and externalizing behavior, chronic stressors exerted the largest total effects. The effects of self‐esteem and negative thinking were indirect, with the latter playing a stronger role. The indirect effect of negative thinking on child behavior was exerted through depressive symptoms, while self‐esteem was linked with child behavior through both negative thinking and depressive symptoms.
Conclusions:

Decreasing mothers' negative thinking, a variable amenable to intervention, may not only decrease a mother's depressive symptoms but also improve her perception of the child's behavior.
Clinical Relevance:

Decreasing mothers' negative thinking may provide a way to reduce their depressive symptoms and result in fewer behavior problems among their young children. Nurses working in primary care and community‐based settings are in key positions to address this problem and improve the mental health of low‐income mothers and positively affect the behavior of their children.
Relative Contribution of Intrapersonal and Partner Factors to Contraceptive Behavior Among Taiwanese Female Adolescents
Authors: Wang Ruey‐Hsia , Chiou Chii‐Jun 
Published: May 2008

Purpose:

To explore the relative contribution of intrapersonal factors (demographic data, sexual history, and self‐efficacy for contraception) and partner factors (perceptions of support from sexual partners for contraception, and relationship power) to contraceptive behaviors among sexually active female adolescents in Taiwan.
Design:

A cross‐sectional design. Female adolescents who have had a steady male sexual partner in the past 3 months (N= 375) were recruited as participants.
Methods:

Questionnaires including demographic data, sexual history, contraceptive behavior, self‐efficacy for contraception, perceptions of support from sexual partner for contraception, and perceptions of relationship power were submitted anonymously for this study.
Findings:

Participants who had their first sexual experience at less than 14 years of age and were from one‐parent families had the least comprehensive contraceptive behavior than did other participants. Number of steady sexual partners was significantly negatively correlated with contraceptive behavior. Self‐efficacy, perceptions of support from sexual partner for contraception, and relationship power all were positively correlated with contraceptive behavior. The important explanatory variables of contraceptive behavior were self‐efficacy, age of first sexual intercourse, intervals between sexual intercourse, and perceptions of support from sexual partner for contraception. These accounted for 39.1% of variance in contraceptive behavior.
Conclusions:

Intrapersonal factors (self‐efficacy, age of first sexual intercourse, and intervals between sexual intercourse) were more important than were partner factors (perceptions of support from sexual partners for contraception and relationship power) in influencing contraceptive behavior among sexually active female adolescents in Taiwan.
Clinical Relevance:

Intervention to increase contraceptive behavior among female adolescents should be focused more on intrapersonal factors than on partner factors.
Maternal Worries, Home Safety Behaviors, and Perceived Difficulties
Authors: Hendrickson Sherry Garrett 
Published: May 2008

Purpose:

The aim of the study was to explore the worries, safety behaviors, and perceived difficulties in keeping children safe at home in a purposive sample of low‐income, predominantly non‐English speaking mothers as a foundation for later nursing interventions.
Design:

This study was a qualitative, descriptive design with content analysis to identify maternal concerns, behaviors, and perceptions of home safety as part of a larger study.
Methods:

Eighty‐two mothers, 64% of whom were monolingual Spanish‐speakers, responded in writing to three semistructured interview questions. When mothers were unable to read and write the researcher wrote the responses, then read the content aloud for verification. A standardized probe for each question was posed to obtain richer responses. Data management included use of the software program NUD*IST and coding analyses following the Miles and Huberman guidelines (1994). Interpretations were translated into English for this report.
Findings:

The major worries were falling, health, kidnapping, and being hit by a car. The leading maternal behaviors were coded as being physically, verbally, and environmentally preventive. Mothers said that it was their role to provide safety, and that this role could be wearisome, such that constant supervision was difficult.
Conclusions:

Low‐income mothers described their worries for their 1 to 4 year‐old children, explored their behaviors for preventing injury, and discussed what made keeping children from harm difficult. Understanding how mothers keep children safe, the barriers to home safety, and effective safety behaviors are important to the health of children.
Clinical Relevance:

The clinical relevance of this study includes building trust as clinicians plan assessment, intervention and evaluation of home safety to encourage dialog about concerns, safety behaviors, and barriers to keeping children from injury.
The Effect of High Nursing Surveillance on Hospital Cost
Authors: Shever Leah L. , Titler Marita G. , Kerr Peg , Qin Rui , Kim Taikyoung , Picone Debra M. 
Published: May 2008

Purpose

: The purpose of this study was to determine the cost of one nursing treatment, surveillance, for older, hospitalized adults at risk for falling.
Design

: An observational study using information from data repositories at one Midwestern tertiary hospital. The inclusion criteria included patients age >60 years, admitted to the hospital between July 1, 1998 and June 31, 2002, at risk for falls or received the nursing treatment of fall prevention.
Methods

: Data came from clinical and administrative data repositories that included Nursing Interventions Classification (NIC). The nursing treatment of interest was surveillance and total hospital cost associated with surveillance was the dependent variable. Propensity‐score analysis and generalized estimating equations (GEE) were used as methods to analyze the data. Independent variables related to patient characteristics, clinical conditions, nurse staffing, medical treatments, pharmaceutical treatments, and other nursing treatments were controlled for statistically.
Findings

: The total median cost per hospitalization was $9,274 for this sample. The median cost was different (p = 0.050) for patients who received high versus low surveillance. High surveillance delivery cost $191 more per hospitalization than did low surveillance delivery.
Conclusion

: Propensity scores were applied to determine the cost of surveillance among hospitalized adults at risk for falls in this observational study. The findings show the effect of high surveillance delivery on total hospital cost compared to low surveillance delivery and provides an example of a useful method of determining cost of nursing care rather than including it in the room rate. More studies are needed to determine the effects of nursing treatments on cost and other patient outcomes in order for nurses to provide cost‐effective care. Propensity scores were a useful method for determining the effect of nursing surveillance on hospital cost in this observational study.
Clinical Relevance

: The results of this study along with possible clinical benefits would indicate that frequent nursing surveillance is important and might support the need for additional nursing staff to deliver frequent surveillance.
Advanced and Specialist Nursing Practice: Attitudes of Nurses and Physicians in Israel
Authors: Brodsky Eithan , Van Dijk Dina 
Published: May 2008

Background

: With the introduction of new and advanced nursing roles, the nursing profession is undergoing dynamic change. Realizing changes will be easier to accomplish if the nursing community and other healthcare professionals welcome the process. Recently the nursing staff mix in Israel has been undergoing a transformation: encouraging registered nurses to enhance their status by acquiring academic degrees and advanced professional training, and initiating the adoption of new nursing roles.
Objective

: Our goal is to evaluate Israeli nurses' and physicians' attitudes to the introduction of new nursing roles and to expanding the scope of nursing practice.
Methods

: Two hundred and fifteen nurses and 110 physicians from three large general hospitals and 15 community clinics filled in a questionnaire.
Findings

: In general the majority of the nurses supported expansion of nursing practice, and such expansion did not cause significant opposition among physicians. However when the task affected patients' health, physicians were less willing to permit nurses to perform skills previously their responsibility alone. In addition, using multiple logistic regressions, support of the expansion of nursing practice was significantly higher among nurses in management or training positions, and among academically accredited nurses. Support for expanded roles was prominent among hospital physicians, graduates from Israeli schools of medicine, and less‐tenured physicians.
Conclusions

: We suggest that confirmation by various groups of physicians and nurses of standardized definitions of the new boundaries in the scope of nursing practice roles could successfully promote development of new roles and facilitate integration of the Israeli healthcare system into the global context of change.
Clinical Relevance

: Inter‐ and intra‐professional collaboration, agreement, and understanding regarding advanced nursing practice roles and their introduction into the healthcare system might improve the relationship between healthcare professions and ultimately increase quality of care and patient satisfaction.
Creating Cross‐Disciplinary Research Alliances to Advance Nursing Science
Authors: Loeb Susan J. , Penrod Janice , Kolanowski Ann , Hupcey Judith E. , Haidet Kim Kopenhaver , Fick Donna M. , McGonigle Dee , Yu Fang 
Published: May 2008

Purpose:

To demonstrate the utility of a developmental approach to building and sustaining cross‐disciplinary research alliances.
Organizing Construct:

Cross‐disciplinary collaborations offer great promise for advancing an evolving program of research. Funding agencies' commitment to interdisciplinary work further heightens these collaborations. Nurse researchers, however, are not necessarily equipped with the knowledge and skills needed to strategically and successfully build and maintain cross‐disciplinary collaborations.
Methods:

Successful strategies for forging, extending, and sustaining alliances are organized using a developmental approach and illustrated by exemplars.
Findings:

The initial phase of forging alliances is focused on creating a limited network to support relatively clear‐cut research goals. The cohesive cross‐disciplinary team is subsequently extended beyond the initial team to strategically address broader research goals. As the team matures, emphasis shifts toward sustaining the team through shared leadership that more actively focuses on the development of the field than the development of individual programs of research.
Conclusions:

The advancement of nursing science requires nurse researchers to rethink the developmental phases of building appropriate research teams. Strategic approaches for forging, extending, and sustaining cross‐disciplinary alliances position nurse researchers as leaders in innovative cross‐disciplinary research. The development of cross‐disciplinary teams supports translational research and, by extension, the science that undergirds practice.
Clinical Relevance:

Research that reflects cross‐disciplinary perspectives is particularly well suited to addressing the complex health issues encountered by patients, families, and communities.
Precision Material Condition Assessments
Authors: HARRIS MICHAEL W. , TRIPPEL ALBERT A. 
Published: May 2008

AbstractOne of the key elements for cost effective and efficient maintenance of today's Navy is the use of material condition assessments as part of the overall Navy's Condition‐Based Maintenance (CBM) philosophy. Through the use of material condition assessments, maintenance managers are able to detect, mitigate, and prevent potential costly and operationally debilitating equipment or systems failures. All Type Commanders (TYCOMs) use CBM assessments to help manage maintenance. This has been accomplished for CNSF N432 by the consolidated visit process, which has an established track record of proven success and is continuing to evolve with new technology and emerging processes, especially in view of the need to “do more with less.” One of the advances made in the material condition assessment process is the increased ability to accurately target problem maintenance objects for assessment. Much like the improvements made in missile technology, whereby the detection and seeker accuracy have evolved to permit pinpoint targeting (thus allowing warheads to become smaller and overall less costly), the improved use of maintenance history data and engineered risk priority business rules allows the material condition assessment process to zero in on problem maintenance objects. Modern missiles can now zoom in on specific buildings as designated targets and no longer need to be as destructive as in the past in order to achieve desired results, thus saving the cost and necessity for larger missiles and warheads. Likewise, today's precision material condition assessments can zoom in on those components within systems that are causing failures and not expend time, effort, and funding on collateral assessments for non‐problem items. A process tool currently being used to provide the precision targeting for material condition assessments is the Maintenance Assessment Index (MAI). This paper will review the background of the MAI, the process by which precision material condition assessments are determined, and how that information is integrated with the consolidated visit process: Hull, Mechanical, and Electrical Readiness Assessment. Success of the MAI is measured by increasing the look‐to‐find and find‐to‐fix ratios executed during the visits. Good systems and components fall off the radar screen, while bad actors are specifically targeted. This paper will also cover the consolidated visit process from agenda building to task loading from the Integrated Class Maintenance Plan, from the use of work order management tools to metrics collection and measures analysis. The ability to adjust the targeting criteria of the material condition assessment has become a powerful weapon for the TYCOM's battle to accomplish more maintenance with fewer resources and yet ensure a high state of material readiness for the fleet.
Aggressive NK cell leukaemia after splenectomy: association with CD95‐resistant memory T‐cell proliferation and recalcitrant clinical course of haemophagocytic syndrome
Authors: Suzuki Shinsuke , Uozumi Kimiharu , Utsunomiya Atae , Ishitsuka Kenji , Masamoto Izumi , Owatari Satsuki , Makino Torahiko , White Yohann , Arima Naomichi 
Published: May 2008

AbstractWe describe a 44‐yr‐old Japanese woman with persistent polyclonal T‐cell proliferation and recalcitrant clinical course of haemophagocytic syndrome (HPS). T cells bearing αβ T‐cell receptors (TCR) expressed increased amounts of CD95 and of CD45RO, which are phenotypically memory T cells. The TCR repertoire was broad and diverse. Regardless of CD95 expression, these cells were resistant to CD95‐mediated apoptosis. Aggressive natural killer cell leukaemia (ANKL) without an association with Epstein–Barr virus was detected 1 month after therapeutic splenectomy that followed 3 yr of immunosuppressive therapy against HPS. The immunophenotype of these leukaemia cells was CD56, CD16dim, CD7, CD45RA and they expressed some CD2, CD8 and HLA‐DR. Moreover, hyperdiploid clones with complex chromosomal abnormalities were also detected. Latent NK‐cell malignancy seemed to cause the CD95‐resistant memory T‐cell proliferation and splenectomy resulted in overt ANKL progression. There should be careful consideration of the risks versus benefits of splenectomy in HPS, in light of the possibility of fatal leukaemia/lymphoma progression.