bluuebunny/crossref_metadata_2025_split huggingface dataset:
An investigation of the oral status and reported oral care of children with heart and heart‐lung transplants
Authors: Al‐Sarheed M. , Angeletou A. , Ashley P.F. , Lucas V.S. , Whitehead B. , Roberts G.J. 
Published: March 2003

Aim. To investigate the oral health status and oral microflora of children who have received heart and heart‐lung transplants. Parental knowledge and current practice of oral health procedures by the child were also investigated. Sample and method. Thirty‐five children attending the Cardio‐Thoracic Transplant Unit, Great Ormond Street Hospital for Children were included. Measurements were compared with children matched by age and gender attending the trauma clinic at the Department of Paediatric Dentistry, Eastman Dental Hospital. Teeth were examined for the presence or absence of caries or enamel defects. Plaque deposition, gingivitis, gingival bleeding and gingival enlargement were measured and a swab was taken to look at the oral microbial flora. A questionnaire was used to assess parental knowledge of dental health procedures and the current practice of these. Results. There were no significant differences between transplant and control children in caries experience, plaque or gingivitis. Children with heart or heart‐lung transplants had significantly greater numbers of enamel defects and more gingival enlargement than control children, children in the heart transplant group had significantly more gingival bleeding. There was little difference in the dental knowledge and reported behaviour of the transplant group compared to the control group. Conclusion. The dental needs of heart and heart‐lung transplant patients treated at the Great Ormond Street Hospital for Children were similar to those of the control group in this study, however further improvement could be made in educating parents and children on the importance of caries prevention and good oral hygiene.
The influence of three Erbium:YAG laser energies on the in vitro microleakage of Class V compomer resin restorations
Authors: Roebuck E.M. , Whitters C.J. , Saunders W.P. 
Published: March 2003

Summary.
Objectives. To investigate the influence of three Erbium:YAG pulse energies (200 mJ, 240 mJ, and 300 mJ with a 100 mJ dentine finish) on the microleakage of Class V compomer restorations (Compoglass). Design. In vitro study Sample and methods. Sixty‐one extracted human premolar teeth were randomly allocated to three groups (according to pulse energy). Each tooth hosted one test cavity prepared with one of the three Er:YAG pulse energies using a pulse repetition rate of 5 Hz and a pulse duration of 250 μs, and one control cavity prepared with a conventional diamond bur in a high‐speed hand piece. Both cavities were placed at the cervical margin of the tooth and were restored and finished according to the manufacturer’s instructions. Each tooth was then stored in 0·12% thymol solution at 37 °C for three months, before being thermocycled through water baths between 5 °C and 55 °C for 240 cycles. Microleakage was assessed using a methylene blue dye penetration technique and was quantified using a score 0 (none) to 4 (to and into the axial wall). The data was analysed using the Kruskal–Wallis and Mann–Whitney U‐tests. Results. Leakage was seen in all groups at both the dentine and enamel margins. There were no statistically significant differences in leakage (P < 0·05) at either the enamel or dentine margins, except for the 240 mJ lased enamel margins. This group performed significantly better than the enamel margins prepared with 200 mJ (P = 0·03) and the 300/100 mJ (P = 0·01) laser energies as well as the conventionally prepared enamel margins (P < 0·001). Conclusion. Cavity preparation with this Erbium:YAG laser did not influence the microleakage of Compoglass restorations adversely. Different pulse energies were required for optimum cavity sealing at the enamel and dentine margins and for different materials.
Children choosing between general anaesthesia or inhalation sedation for dental extractions: the effect on dental anxiety
Authors: Arch L.M. , Humphris G.M. , Lee G.T.R. 
Published: March 2003

Summary.
Aim. To compare the levels of dental anxiety experienced by children having dental extractions using general anaesthesia (GA) with those having extractions using local anaesthesia and inhalation sedation (IHS) when offered a programmed choice between the two techniques prior to treatment. Design. Structured interview with child at pre‐treatment and at one week (approximately) follow up. Setting. Community: primary health care centre. Subjects. Children aged 9–15 years referred to a local NHS Trust dental clinic (n = 88). Intervention. Child and parent provided with information about IHS and its benefits over GA for the assistance in tolerating extraction of teeth and provided with a choice of procedure. Main outcome measure. An eight question modified child dental anxiety scale. Results. Full information was received from 76 children giving an 86% response rate. Post‐operative dental anxiety was lower in children who had chosen (with their parent) IHS in comparison to those who had chosen general anaesthesia (P < 0·05). Dental anxiety remained unchanged in the group who chose to have their extractions under GA. Conclusion. Children and their parents who select IHS as opposed to GA to assist in extractions demonstrate less psychological distress.
Conventional versus resin‐modified glass‐ionomer cement for Class II restorations in primary molars. A 3‐year clinical study
Authors: Hübel S. , Mejàre I. 
Published: March 2003

Summary. Objective. To compare the clinical performance of two glass‐ionomer cements (GICs)for Class II restorations in primary molars: a conventional cement (Fuji II®) and a resin‐modified cement (Vitremer®).Design. Split mouth and random assignment to the two materials were used for the majority of the molars.Sample and methods. Forty consecutive 4–7‐year‐old children were included. One operator made 115 restorations: 53 with Vitremer and 62 with Fuji II. The restorations were evaluated clinically, radiographically and from colour photographs.Results. The cumulative success rate of the Vitremer restorations was 94% and that of the Fuji II restorations 81%. The difference is statistically significant. The risk of a failed restoration was more than five times higher with Fuji II than with Vitremer as the restorative material. Of the 13 unsuccessful restorations, seven had lost their retention, four had secondary caries, and two were fractured.Conclusions. The resin‐modified GIC offered advantages over the conventional GIC for restoring approximal caries in primary molars.
Health and illness beliefs of Greek Cypriots living in London
Authors: Papadopoulos Irena 
Published: March 2003

Health and illness beliefs of Greek Cypriots living in London This paper describes some of the findings of a qualitative study into the health and illness beliefs of Greek Cypriots living in London. Data were collected through group and individual in‐depth interviews and were analysed using the grounded theory approach of constant comparison and saturation. Two of the six themes which were identified are discussed in this paper. The findings provide the reader with important insights into Greek Cypriots' beliefs of health and illness. The paper argues that the understanding of such beliefs from a cultural perspective is vitally important for all those involved in the provision of health care to this group.
Patients’ views on quality of care: do they merely reflect their sense of coherence?
Authors: Larsson Bodil Wilde , Larsson Gerry 
Published: March 2003

Patients’ views on quality of care: do they merely reflect their sense of coherence? The aim was to explore the relationship between patients’ perceptions of the quality of care and their sense of coherence. The sample consisted of 782 Swedish in‐patients at a gynaecological, a medical, an orthopaedic, and a surgical department. The median age was 59 years and 55% of the patients were women. Data were collected using the Quality from the Patient’s Perspective (QPP) Questionnaire and the Sense of Coherence Questionnaire. The QPP consists of 61 items designed to measure the following four quality dimensions: the medical‐technical competence and the degree of identity‐orientation in the actions of the caregivers, the physical‐technical conditions and the socio‐cultural atmosphere of the care organization. Each question is posed in two different ways in the QPP; one measures perceived reality of the item in question and one the subjective importance the patient ascribes to it. Results showed that patients’ ratings of perceived reality covaried systematically with their sense of coherence. This was particularly the case on questions rated by experts to be more abstract and emotionally loaded. Patients’ ratings of the subjective importance of the items were weakly related to their sense of coherence. The results are discussed in terms of negative affectivity and culturally shared ideals regarding quality of care.
Clinical guidelines in nursing, midwifery and the therapies: a systematic review
Authors: Thomas  , McColl  , Cullum  , Rousseau  , Soutter  
Published: March 2003

Clinical guidelines in nursing, midwifery and the therapies: a systematic review Background While nursing, midwifery and professions allied to medicine (PAMs) are increasingly using clinical guidelines to reduce inappropriate variations in practice and ensure higher quality care, there have been no rigorous overviews of their effectiveness in relation to these professions. We identified 18 evaluations of guidelines which met established quality for evaluations of interventions aimed at changing professional practice. This paper describes characteristics of guidelines evaluated and the effectiveness of different dissemination and implementation strategies used. Methods Guideline evaluations conducted since 1975 which used a randomized controlled trial, controlled before‐and‐after, or interrupted time‐series design, were identified using a combination of database and hand searching. Findings It is mostly impossible to tell whether the guidelines evaluated were based on evidence. The most common method of guideline dissemination was the distribution of printed educational materials. Three studies compared different dissemination and/or implementation strategies: findings suggest educational interventions may be of value in the dissemination of guidelines and confer a benefit over passive dissemination.
An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancer
Authors: Balneaves Lynda G. , Long Bonita 
Published: March 2003

An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancerTreatment decision making by women with breast cancer has been recognized to be an inherently stressful process. However, past decisional theory and research has failed to fully elucidate the personal, transactional and relational nature of choice behaviour. The purpose of this paper is to explore an embedded decisional model of stress and coping that locates key assumptions of Janis and Mann’s conflict‐theory model (CTM) of decision making within Lazarus and Folkman’s transactional framework. Through combining decisional and stress and coping theories, a model is developed that addresses the theoretical limitations of the CTM and provides greater specificity within decision‐making research. The paper examines the complexity of treatment decision making within the context of the constructs of causal antecedents, primary appraisal, secondary appraisal, coping and adaptational outcomes. Examples specific to women with breast cancer are provided to illustrate the potential application of the embedded model. The implications of this inclusive and comprehensive decisional theory for future knowledge development and research in the area of treatment decision making are also discussed.
Patients’ evaluation of pain and nurses’ management of analgesics after surgery. The effect of a study day on the subject of pain for nurses working at the thorax surgery department
Authors: Dahlman Gull‐Britt , Dykes Anna‐Karin , Elander Gunnel 
Published: March 2003

Patients’ evaluation of pain and nurses’ management of analgesics after surgery. The effect of a study day on the subject of pain for nurses working at the thorax surgery department The aims of this investigation were: to describe patients’ evaluation of pain and the treatment of pain after thorax surgery via sternotomy; to repeat the evaluation with another group of patients following a study day for nurses, featuring pain and pain treatment; and to examine whether the study day influenced the nurses in their treatment of pain. The investigation included daily evaluation of pain using a visual analogue scale (VAS), and an interview with the patients before discharge, where they were asked to review their experience of pain and its treatment. The nurses on the thorax surgery ward and on the intensive care unit (ICU) completed a questionnaire before and after the study day. Finally, a retrospective study of the case notes of the patients taking part was carried out. The results of the investigation showed a low assessment of pain by most patients during the daily evaluation. Asked to recall their pain when interviewed, the rating was higher. A small group of patients had more evident pain than others. When administering opiates the ICU nurses often chose a lower dose than the standing order prescribed. After the study day the nurses gave larger doses of intravenous opioids and the patients experienced less pain.
Vital signs and nurses’ choices of titrated dosages of intravenous morphine for relieving pain following cardiac surgery
Authors: Chuk Peter Kai‐Cheung 
Published: March 2003

Vital signs and nurses’ choices of titrated dosages of intravenous morphine for relieving pain following cardiac surgery Postoperative pain, if unrelieved, will impede patients’ recovery. A theoretical model of factors which influence nurses’ choices of titrated dosages of intravenous (IV) morphine was constructed for this study. This study aimed to examine whether or not a patient’s vital signs would influence nurses’ choices of titrated dosages of IV morphine for relieving pain following cardiac surgery. A survey design with a vignette and questionnaire method was used to collect data. The vignette developed by McCaffery & Ferrell was modified and adapted for this study. It described the pain reports and vital signs of two patients on postoperative day 1 following cardiac surgery. Convenience sampling was used to seek voluntary participation from 29 registered nurses working in the cardio‐thoracic intensive care unit of a private hospital in Sydney, Australia. A protocol of the unit allowed nurses to titrate IV morphine against the pain of patients following cardiac surgery. The results showed that the pain assessment of the two patients in the vignette documented by the nurses were not consistent. The titrated dosages (a bolus dosage and a maintenance dosage) chosen by the nurses for the patient with slightly elevated vital signs differed significantly from the titrated dosages chosen by the same group of nurses for another patient with vital signs at the lower end of the stable range (t=3·33, d.f.=25, P < 0·01 for a bolus dosage and t=3·73, d.f.=25, P < 0·01 for a maintenance dosage). Different risk factors were stated by the nurses in titrating the bolus and maintenance dosages of IV morphine. The importance of accepting patients’ verbal reports of pain as well as the provision of optimal dosages of IV morphine for pain relief is highlighted. A disadvantage of using a vignette and questions method is that the patients’ clinical status is somewhat unreal. Further studies, however, were also recommended.
Testing a rating scale of video‐taped consultations to assess performance of trainee nurse practitioners in general practice
Authors: Bond Senga , Beck Sian , Cunningham William F. , Derrick Sally , Healy Barbara , Holdsworth Sue , Lawson Justin , Rawes Geoffrey , Sargeant Jean , Steen Nick 
Published: March 2003

Testing a rating scale of video‐taped consultations to assess performance of trainee nurse practitioners in general practice Background: Nurse practitioners (NPs) in the United Kingdom are taking on some of the consultation work previously done by general practitioners (GPs) without there being any established professional standards that they must achieve before doing so. There is a need to develop and test methods of assessing their consultation performance for reasons of professional accreditation and patient safety. Aims: 1. To make independent summative assessments of trainee nurse practitioners’ (TNPs) consultation performance. 2. To assess the validity and reliability of an existing video‐taped assessment tool. Method: Four TNPs taking part in the EROS (extended roles of staff) study video recorded seven or eight consecutive consultations with typical patients during one surgery. Each consultation was rated nine times by members of a panel comprising eight independent GP trainers, four NPs and the GPs and TNPs in the EROS practices. A rating scale developed by Cox & Mulholland was used for the purpose. Results: Eight of the 37 items and four consultations had more than 10% missing data, mean = 7·7 items per rater. Factor analysis yielded a single factor solution explaining 32·6% of the variance and indicated that items could be summed to provide a single score. Internal consistency was high, alpha coefficient = 0·92. Individual differences between raters in scoring consultations were taken into account in providing a score for each consultation. Scores obtained were found to cluster at the positive end of the distribution indicating a high level of performance. Greater differences were found between scorers than between consultations. Conclusions: This instrument is appropriate for scoring NP consultations and this small sample was rated as showing a uniformly high standard of performance. Some items could be deleted since they do not feature in the range of consultations currently performed. If this or a similar tool was to be adopted more widely for summative rating purposes then it should be tested rigorously for validity and reliability, training should be given to raters and criteria provided by which to make judgements.
Evaluation of an innovative curriculum: nursing education in the next century
Authors: Ben‐Zur Hasida , Yagil Dana , Spitzer Ada 
Published: March 2003

Evaluation of an innovative curriculum: nursing education in the next century The present research focused on an interim evaluation of a new nursing curriculum made by first‐ and second‐year undergraduates. Study 1 examined the assessments made by 90 students of the new, actual programme of their studies, as well as an ideal one, on 21 bipolar criteria reflecting the developing changes in health care practices and higher educational processes in western society. The results of study 1 indicated that students perceived the actual programme as compatible with health care changes, but lacking in terms of the learning process. Study 2 investigated the same assessments among 105 registered nurses who evaluated the traditional nursing programme under which they were trained as well as an ideal one. The results of study 2 showed that registered nurses perceived past curricula as lower than the ideal on both health care and process of learning. The results of this interim evaluation imply that the new nursing curriculum follows health care trends, but a shift in the educational process is required.
Inequalities in service provision: an examination of institutional influences on the provision of district nursing care to minority ethnic communities
Authors: Gerrish Kate 
Published: March 2003

Inequalities in service provision: an examination of institutional influences on the provision of district nursing care to minority ethnic communities This paper reports on the selected findings from a larger ethnographic study of the provision of district nursing care to patients from different ethnic backgrounds. The two‐stage study was undertaken in an English community National Health Service (NHS) trust serving an ethnically diverse population. The first stage comprised an organizational profile in order to analyse the local policy context, including specific responses to ethnic diversity. Data were collected by means of in‐depth interviews with managers. The second stage entailed a participant observational study focusing on six district nursing teams. Purposive sampling was used to identify four teams with high minority ethnic caseloads and two teams with predominately white ethnic majority caseloads. Interview transcripts and field‐notes were analysed by drawing upon the principles of dimensional analysis. The paper focuses upon institutional influences on the provision of care to minority ethnic communities. An analysis of the allocation of district nursing resource to different general practitioner (GP) practices identified marked inequalities in the district nursing provision which impacted upon the services provided to minority ethnic patients. Single‐handed, inner city GP practices with a large minority ethnic practice population received a much smaller allocation of nursing staff than single group practices serving a smaller and predominately white practice population. The reasons why this situation existed are explored and an explanation offered as to why it had not been rectified. Observation of caseload management indicated that despite differences in the size of the practice populations served by the respective teams, all patients referred for nursing care received it. However, several covert processes appeared to limit the caseload size of those teams with large practice populations so that it remained manageable within the limited nursing resource available. It is concluded that although nurses at an individual level did not appear overtly to disadvantage minority ethnic patients, institutional forces conspired to perpetuate the disadvantage experienced by minority ethnic communities.
The first line of response for people who self‐poison: exploring the options for gut decontamination
Authors: Clegg Theresa , Hope Kevin 
Published: March 2003

The first line of response for people who self‐poison: exploring the options for gut decontamination The trend for increasing numbers of self‐poisoning incidents has been noted and a variety of policy initiatives have been launched. Nurses, particularly in emergency room environments occupy a pivotal place in the chain of response to such acts. Any such response needs to be firmly rooted in evidence‐based practice yet the initial management of self‐poisoning often involves a consideration of procedures, the application of which can vary enormously. This paper offers some contextual information prior to a critical perspective of management modes, namely emesis, lavage, the use of activated charcoal and whole bowel irrigation. A comparison of the relative advantages and disadvantages of each mode precedes suggestions for nursing practice.