bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic reasoning processes using patient simulation in different learning environments
Authors: WONG THOMAS K. S , CHUNG JOANNE W. Y 
Published: March 2003

• The purpose of the study was to explore the diagnostic reasoning process among nursing students with different learning environments.• A case‐study design was adopted. Twenty subjects were randomly drawn from the last year of a pre‐registration nursing programme in two institutions, 10 from a university and 10 from a nursing school. They were asked to complete the Bigg's Study Process Questionnaire and identify the differential diagnosis for the three simulated scenarios.• The results showed no significant difference in study approaches between the two groups. Two subjects from the university made an incorrect differential diagnosis, as did one from the nursing school.• Subjects from the university showed a mix of horizontal (66.6%) and vertical reasoning patterns (33.4%), while those from the nursing school used horizontal (100%) reasoning patterns.• The results indicated that all subjects from the nursing school adopted backward chaining strategies (horizontal) for decision‐making, i.e. hypothesis‐driven. About a third of the subjects from the university adopted forward chaining strategies (vertical), i.e. data‐driven.• The study did not show any particular advantages from either of the two learning environments in terms of study approach. However, it highlighted the variations in decision strategies among students in the university setting.
Barriers to and facilitators of research utilization among Finnish Registered Nurses
Authors: ORANTA OLLI , ROUTASALO PIRKKO , HUPLI MAIJA 
Published: March 2003

• The aim of nursing research is to produce a sound foundation for evidence‐based nursing; the job of nurses is to make the best possible use of that foundation and apply the knowledge produced to the practice of nursing.• The purpose of this study was to identify and describe barriers to and facilitators of research utilization from the point of view of Finnish Registered Nurses.• The BARRIERS Scale was administered to 316 nurses in two major hospitals; 253 nurses returned the questionnaire, giving a response rate of 80%. The structured data were processed with SPSS 9.0, and the unstructured data were interpreted using the method of content analysis.• The main barriers to research utilization identified by the respondents were: the fact that most research is published in a foreign language; that physicians will not co‐operate with implementation; and that statistical analyses are difficult to understand. The facilitators mentioned most often were nurses' positive attitudes and abilities. Other important facilitators included the support and activity of a ward sister as well as encouragement, a favourable attitude and collaboration on the part of all staff members.• The findings are discussed in relation to the Finnish healthcare context and nurse education, and evidence‐based nursing practice.
Interprofessional relations: case studies of working relationships between Registered Nurses and general practitioners in rural Australia
Authors: BLUE IAN , FITZGERALD MARY 
Published: March 2003

• Interprofessional working relationships of nurses and doctors have been discussed in the literature but are less frequently the subject of research.• A review of international research on nurse–doctor professional relationships conducted over 30 years (1966–99) shows that the relationship is of interest predominantly to nurses.• From a series of interviews with nurses and doctors, as part of a case study of four rural health services, harmonious working relationships between nurses and doctors were examined.• Further analysis reveals many aspects of nurse–doctor relationships that are traditional and common across many contexts. There are, however, some aspects that are specific to the rural nature of the working context and relate well to contemporary advances in nursing knowledge and confidence.
A proposal that patients be considered honorary members of the healthcare team
Authors: EDWARDS CAROL 
Published: March 2003

• Most research on cross‐boundary issues in healthcare focuses on boundaries between groups of healthcare professionals, or between different healthcare settings. This paper considers the boundary between healthcare professionals and their patients, as complementary providers of care to the individual.• Following major surgery, patients now spend the vast majority of their rehabilitation period in their own homes. This raises questions about where to draw the boundary around a healthcare intervention, and how to allocate and support responsibility for care once the patient is home.• This paper reports the findings of a study within orthopaedic surgery that followed patients from a few weeks before their surgery to 3 months afterwards, recording their interpretations of their healthcare experiences.• Most patients were keen to take responsibility for playing their part in trying to optimize the outcome of their surgery, but many were frustrated by lack of information and support to allow them to fulfil this role to their satisfaction.• Reconceptualization of patients as honorary members of the healthcare team may facilitate the development of a framework within which the potential contribution of patients to their own care could be valued and supported more effectively. This would contribute towards optimizing patient outcomes and increasing patient satisfaction with care.
Refusing analgesics: using continuous improvement to improve pain management on a surgical ward
Authors: Carr Eloise C. J. 
Published: March 2003

Summary•  Despite advances in pain control many patients experience moderate to severe pain whilst in hospital. Contributory factors include inadequate assessment and documentation of pain, as well as patient and professional misconceptions.•  A 28‐bedded surgical ward in a District General Hospital in the South of England was the setting for the project. A small preliminary audit of pain on this ward indicated that some patients experienced postoperative pain, which was not effectively controlled. A ‘continuous improvement’ framework was used to increase understanding of the problem and identify an aim for the project, which was to reduce the number of patients refusing analgesics when offered by nurses.•  An audit to ascertain how many patients refused analgesia revealed that, of 133 patients offered, 93 (70%) refused. Using the ‘Model for Improvement’ (Langleyet al., 1996) a number of changes were introduced, including a patient information sheet, regular documented pain assessment and an innovative staff education programme. To evaluate if the changes in practice had been successful, further audit data were collected from 167 patients. Sixty‐three (44%) accepted analgesics, indicating a significant decrease in the number refusing (P = 0.005).•  This small project demonstrated that continuous improvement methodology can improve the management of pain and quality of care for patients. Such an approach brings practitioner and patient into meaningful understanding and offers solutions which are realistic, achievable and sustainable over time. Despite finite resources and increased pressure on staff it is possible to motivate people when they feel they have ownership and change is meaningful.•  Continuous improvement methods offer an exciting, feasible, patient‐centred approach to improving care.
Consumer evaluation of five new sweet potato (Ipomea batatas) varieties
Authors: Opare‐Obisaw C. , Danquah A. O. , Doku E. V. , Boakye B. B. , Ansah‐Kissiedu D. 
Published: March 2003

AbstractFive new sweet potato varieties, 91/62, 84/17, 91/198, 82/123 and Injala White, known to be less sweet were evaluated by a 15‐member panel to determine their acceptance as staple food items in Ghana. The results of the experiment revealed that there were significant differences among all the quality characteristics of the five new sweet potato varieties. However, all the varieties were accepted as staple food, with some being preferred more than others. In terms of flavour and colour, variety 91/198 was most preferred, while variety 91/62 was the most preferred with regard to texture and taste. The overall acceptability showed that variety 91/198 was the most preferred one, which also was the one with the least sugar content. In fact, varieties 91/198 and 91/62 always emerged as the best two varieties, with most of their qualities preferred among the five studied. On the whole, the Injala White variety was the least accepted.
Sources of plants colonizing experimentally disturbed patches in an acidic grassland, in eastern England
Authors: Pakeman R. J. , Attwood J. P. , Engelen J. 
Published: March 2003

1 The sources of propagules for regeneration in an acidic grassland were identified from analysis of differences in colonization between plots subject to surface (0–5 cm) soil disturbance and plots where surface soil had been replaced by ‘seed‐free’ soil from deeper soil horizons (30–35 cm), and between plots with and without the removal of rabbit pellets. 2 After 1 year, 10 species had a significantly higher cover on plots where the seed bank had been left intact. These included Agrostis capillaris (the dominant species prior to disturbance), Myosotis arvensis and Veronica arvensis. 3 Five species, including Sagina apetala, Senecio jacobaea and Veronica arvensis, showed significantly higher cover on plots where rabbit pellets were left in situ. 4 From calculations it appeared that rabbit‐dispersed seeds accounted for 15% of the developing higher plant cover, other means of dispersal from outside the plot accounted for 40%, and regeneration from the seed bank accounted for 45%. 5 Similar calculations suggested that three higher plant species, Geranium molle, Myosotis arvensis and Senecio jacobaea, appeared to depend most on non‐rabbit dispersed seed for colonization of bare ground. 6 High concentrations of Urtica dioica in pellets contrasted with its poor establishment in the experiment. However, the other common species in the pellets, Sagina apetala, Senecio jacobaea and Veronica arvensis, all established in greater numbers on the plots where the pellets were not removed. 7 Seed bank content correlated well with the pattern of regeneration for Agrostis capillaris, Holcus lanatus, Myosotis arvensis and Veronica arvensis. However, removal of the seed bank did not have a significant effect on the regeneration of either of the most common species in the seed bank, Rumex acetosella and Sagina apetala. 8 No species appeared to be reliant on only one mechanism for regeneration from seed in disturbed areas in this community.
Demography of the invasive woody perennial Prosopis glandulosa (honey mesquite)
Authors: Golubov Jordan , Mandujano María Del Carmen , Franco Miguel , Montaña Carlos , Eguiarte Luis E. , Lopez‐Portillo Jorge 
Published: March 2003

Summary 1 To assess the effect of annual environmental variability on the long‐term population dynamics of the invasive woody perennial Prosopis glandulosa var. torreyana (honey mesquite), we employed elasticity analyses of annual, mean and periodic matrix models. Growth, survival and reproduction were recorded for 1306 individuals in a 1‐ha plot over a 4‐year period. The volume of each individual was estimated, and transition matrices with nine size classes were constructed. Standard matrix analysis was performed, and the relative importance of individual life‐cycle components to changes in the finite rate of population increase (λ) was determined. 2 Periodic matrix analysis projected a 29% annual increase in population size (λ= 1.29), while annual projection λ‐values varied between 0.99 and 1.44. For both methods, elasticity of seedling recruitment was always very low in all 4 years, and the highest elasticities were generally associated with permanence in the same size class. 3 Periodic and annual projections predicted similar elasticity patterns, with the relative contribution to a change in λ of different demographic processes changing between ‘good’ and ‘bad’ years. However, annual matrices identified two bad years, with fecundity and growth elasticity decreasing relative to survival, whereas periodic analysis identified only one such year, and elasticity changes were seen only in fecundity and survival.
The demographic role of soil seed banks. I. Spatial and temporal comparisons of below‐ and above‐ground populations of the desert mustard Lesquerella fendleri
Authors: Cabin Robert J. , Marshall Diane L. 
Published: March 2003

Summary 1 Although seed banks may often affect the colonization, succession and structure of surface plant communities, few studies have investigated the demographic relationship between seeds in the soil and above‐ground plant populations over space and time. We examined this relationship in the perennial mustard Lesquerella fendleri between 1991 and 1994 within a New Mexico desert ecosystem characterized by open patches of soil (intershrub areas) interspersed with dominant creosote (Larrea tridentata) shrubs (subshrub areas). 2 For the first 2 years of the study, Lesquerella soil seed, surface plant and seed production densities were greater in subshrub vs. intershrub areas. Within the subshrub areas, there were more Lesquerella soil seeds and surface plants in the northern and central microsites, compared with the southern and perimeter microsites, respectively. The mean density of the subshrub seed bank did not increase following large inputs of new seeds (2400 seeds m−2) in the summer of 1992. In contrast, virtually all of the relatively modest Lesquerella intershrub seed production at this time (169 seeds m−2) appeared to survive, so that for the remainder of the study most soil seeds were found in the intershrub sites. This spatial reversal of seed bank densities preceded a similar switch in the relative densities of the Lesquerella sub‐ and intershrub surface plant populations in the last 2 years of the study. 3 This study supports the hypothesis that desert seed bank patchiness contributes to surface plant patchiness, but does not support the idea that seed banks are comprised primarily of seeds produced during favourable reproductive periods. Because there was a closer spatial match between Lesquerella soil seeds and surface plants than between soil seeds and seed production, the above‐ground population may be limited to sites favourable for soil seed persistence.
Seed dynamics of the mast seeding tussock grass Ampelodesmos mauritanica in Mediterranean shrublands
Authors: Vilà Montserrat , Lloret Francisco 
Published: March 2003

Summary 1 The Mediterranean perennial grass Ampelodesmos mauritanica may have the potential to expand its range. We analysed temporal variability of its reproductive components (seedfall, seed bank, seed predation, seed germination, seedling emergence, survival and growth) in three microsites (open areas, beneath Ampelodesmos and beneath shrubs) at two sites. 2 Reproductive components prior to seedling emergence were both closely linked and very similar between microsites within a site. Seedling survival and growth differed between microsites, being lowest in open areas. Recruitment patterns cannot therefore be predicted from seedfall. 3 Abundant seed production in 1996 was followed by successful germination and high seedling survival. In the following (non‐masting) year, although Ampelodesmos has a low‐density persistent seed bank, recruitment was much lower because germination was low and post‐dispersal seed predation was high. 4 Our results suggest that Ampelodesmos reproduction is episodic. Expansion of its distribution may be triggered by intermittent seedling recruitment following masting, but is otherwise constrained by seed limitation, post‐dispersal seed predation and a loss of viability in the seed bank.
Convective gas flow and internal aeration in Eleocharis sphacelata in relation to water depth
Authors: Sorrell Brian K. , Tanner Chris C. 
Published: March 2003

Summary 1 The objective of this study was to examine how increasing water depth in the field affects the aeration achieved by convective gas flow in an emergent aquatic sedge (Eleocharis sphacelata). 2 We compared internal pressurization, convective gas flow, changes in internal gas composition, and differences in plant morphology at three depths (0.75–0.90 m, 1.40 m, and 2.15–2.65 m) in an oligotrophic lake. 3 Internal pressures generated in the aerial tissue of the influx culms were similar at all depths, but the convective inflows increased with depth due to lower resistances to convective flow in the plants growing in deeper water. In contrast, rates of flow returning up the efflux culms decreased with depth, due to a decrease in ratio of influx : efflux culms with depth. 4 Respiration lowered the oxygen concentration in the stagnant internal gas at night, with predawn concentrations highest at the shallowest site and lowest at the deepest site. Low oxygen concentrations also persisted longer after dawn in plants at the deep site than at the other sites due to the large volume of stagnant gas that had to be expelled relative to the flow rates. 5 By 14.00 h, the stagnant gas had been flushed from the plants at all depths, and oxygen concentrations were close to atmospheric values throughout. The two factors apparently responsible for maintaining high oxygen concentrations when convective flow was operating were (i) morphological changes at the deep site that reduced the resistance to flow, and (ii) dissolution of carbon dioxide produced in respiration into the external medium. 6 The data indicate that the average oxygen concentration maintained internally over a 24‐h cycle by convective flow decreases significantly with depth, suggesting that oxygen stress due to gas transport limitations may be one of the factors limiting depth penetration in this species and other emergent aquatic plants.
Spatial growth and population dynamics of a perennial tussock grass (Achnatherum calamagrostis) in a badland area
Authors: Guàrdia Roser , Raventós José , Caswell Hal 
Published: March 2003

Summary 1 Achnatherum calamagrostis (L.) Beauv. is a perennial, tussock forming grass which is conspicuously successful as a pioneer in badlands in submediterranean areas. We analysed its population dynamics using a matrix population model that is intermediate between traditional demographic models and fully spatially explicit models. 2 Tussocks are considered as a set of spatial units, each classified according to the number and state (seedling, juvenile or adults) of the tillers it contains. The growth rate (λi) determined from the model estimates the spatial spread of A. calamagrostis as a rate of increase in the number of occupied quadrats. 3 We constructed six projection matrices from data for populations on two substrate types, in 2 years with differing climatic conditions and considering the whole life cycle or eliminating sexual reproduction or vegetative multiplication. 4 All the matrices predicted growth rates greater than one. Sexual reproduction was an important process for spatial spread in A. calamagrostis, unlike many other perennial grasses. In contrast, new colonization by vegetative reproduction contributed little to spatial growth of populations, although some expansion may still be possible in the absence of sexual reproduction. 5 A. calamagrostis, like other tussock‐forming plants, exhibits a conservative tactic of slow spread. Tiller dynamics serve mainly for consolidation and maintenance of the plant in already occupied space and sexual reproduction is the main way to ensure colonization of new safe‐sites. Climatic conditions influenced growth rates which increased during non‐drought years above the near maintenance value seen in drought years.
Primary and secondary stem growth in arctic shrubs: implications for community response to environmental change
Authors: Bret‐Harte M. Syndonia , Shaver Gaius R. , Chapin F. Stuart 
Published: March 2003

Summary1 Shrubs are among the tundra plants most responsive to environmental change. We measured primary and secondary stem growth in a retrospective analysis of ramets of three codominant shrubs (Betula nana, Salix pulchra, and Ledum palustre ssp. decumbens) exposed to long‐term field treatment with greenhouses and N + P fertilizers at Toolik Lake, Alaska.2 Ramets of Salix had the greatest primary stem growth under control conditions, because of their relatively high branching rate. Under fertilization, however, Betula produced much more primary stem growth than the other species, because axillary buds that would have grown as short shoots in control ramets were instead stimulated to produce long shoots (structural branches). There appeared to be a trade‐off between allocation to length per stem segment and number of stem segments produced in a given year, for both Betula and Ledum.3 Although secondary growth in stems is the largest component of above‐ground net primary production in forests, it is often ignored in shrub‐dominated ecosystems. We derived an expression for secondary growth in shrubs based on distributions of stem mass and length with age, and allowing for experimentally induced changes in secondary growth rate.4 There was good agreement between measured ramet stem mass and calculated values for all three species, validating our mathematical analysis of secondary growth.5 Fertilization greatly increased the relative rate of secondary growth only in Betula, consistent with observed accumulations of its stem mass in ecosystem‐level quadrat harvests. Secondary growth of Betula was a major component of ecosystem NPP in fertilized plots and probably contributes significantly to ecosystem carbon storage.6  The increase in its secondary growth enabled Betula to become dominant under fertilization, whereas the inability of older stems of Ledum to respond in this way prevented it from growing into the canopy.
Role of dispersal in the recruitment limitation of neotropical pioneer species
Authors: Dalling J. W. , Muller‐Landau H. C. , Wright S. J. , Hubbell S. P. 
Published: March 2003

Summary

We examined the importance of seed dispersal in predicting the pioneer seedling composition in recent gaps in a forest plot on Barro Colorado Island (BCI), Panama. We characterize seed dispersal for 13 taxa from seed rain data collected over 13 years in 200 mesh traps, and for an additional species from germination from soil samples collected in one year. We describe seedling distribution patterns from a complete census of all seedlings of these 14 taxa present in 36 treefall gaps.
A maximum likelihood model, incorporating both distance to adult trees and tree size, fitted observed seed rain to traps quite well for all taxa.
The ability to predict seedling recruit number per gap varied greatly among taxa. For 8 of 14 taxa, regression models incorporating predicted seed rain were significantly better predictors of seedling recruitment than models in which recruitment probability was assumed constant in all sites.
To see if variation in local dispersal patterns determined the community composition of gaps, we examined the relative abundances of these 14 pioneer taxa in the 36 gaps. We found that taxon abundances were significantly positively correlated with abundances predicted from seed dispersal models and seed–seedling regressions for 27 out of 36 gaps.
Overall, we find evidence that limited seed dispersal is an important factor contributing, together with factors affecting post‐dispersal recruitment success, to seedling distribution patterns in gaps.