bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice nurses and older people: a case management approach to care
Authors: Evans Catherine , Drennan Vari , Roberts Julia 
Published: July 2005

Aim. This paper reports on aspects of a study designed to answer the research questions: (i) To what extent do practice nurses use the five cyclical elements of a case management approach when caring for people aged over 75 years? (ii) What determines or deters practice nurses’ use of the cyclical elements of a case management approach in caring for older people?Background. Case management is an approach that uses a cyclical process of assessment, planning, implementation, monitoring and evaluation to provide systematic proactive care to people with complex health and social care needs. In England, specialist practice nurse case managers for older people have been piloted in ten primary care trusts and the posts are to be implemented nationally by 2008. No baseline work has, however, considered the applicability of developing the existing generalist practice nurse workforce.Method. A 26‐item structured postal questionnaire was used to explore both practice nurses’ use of a case management approach when working with older people, and what factors influenced the care provided. A random sample of 500 practice nurses was selected from the Royal College of Nursing Practice Nurse Association member database.Results. A 45% response rate was achieved. Practice nurses assessed, planned and implemented care, but reviewing medication opportunistically and evaluating the care were uncommon. A case management approach was significantly (P = 0·005) more likely to be used in on‐going management activities than in one‐off treatment room care. Practice nurses with postregistration education in district nursing were significantly (P = 0·016) more likely to refer patients to social care services. Lack of time and the central role of the general practitioner were the main reasons for not incorporating case management into practice.Conclusions. The extent to which practice nurses used elements of a case management approach was highly variable and influenced by individual professional expertise, the nature of the consultation and the practice nurse's position in the general practice.
Stress in women with postpartum depression: a phenomenological study
Authors: Leung Sharron , Arthur David G. , Martinson Ian 
Published: July 2005

Aim. The aim of this paper is to report a study of the lived experience of postpartum stress among depressed Hong Kong Chinese mothers.Background. Research consistently relates postpartum stress to the mood and well‐being of mothers during the postpartum period. While several studies have used questionnaires to assess the stress levels of mothers or have identified stressors by asking them to list stressful events, the existing literature lacks in‐depth information on the lived experience of postpartum stress from the perspective of the depressed mother.Methods. The study adopted a phenomenological approach with a purposive sample of 11 depressed Hong Kong Chinese mothers at around the sixth postpartum month. In‐depth interviews were conducted in Cantonese and focused on the stress the mothers experienced during the postpartum period up to the time of the interview. The data were collected in 2000.Results. Living in a metropolitan city under the mixed and sometimes conflicting influences of cultures from the East and the West, Hong Kong Chinese mothers face a unique set of challenges which, if not properly managed, may cause stress and/or depression in the postpartum period. We identified five major postpartum stress themes amongst this group of women: parenting competence, the expectation–experience gap, baby‐minder arrangements, childcare demands, and conflict with culture and tradition.Conclusions. Health care staff should give anticipatory guidance to mothers and their spouses about the culturally prescribed set of rules that proved stressful. Antenatal education classes need to enhanced, and support is needed to help this population of women manage and overcome the challenges in the postpartum period.
Nursing and cancer support groups
Authors: Zabalegui Adelaida , Sanchez Susanav , Sanchez Pablo D. , Juando Clara 
Published: July 2005

Aim.  The aim of this paper is to review the evidence on the effectiveness of support groups by reporting a meta‐analysis of randomized controlled trials evaluating support groups for patients with cancer.Background.  One of the most important nursing aims is to give patients with cancer emotional support and strengthen their adaptation to the disease. According to the literature, support groups for these patients are beneficial.Methods.  Original studies from 14 databases published during the past 20 years in peer review journals were selected. Twenty studies with a randomized clinical trial design constituted the final meta‐analysis sample. Methodological quality of the selected articles was checked using the Jadad Scale and the Checklist of Consort Statement. Demographic data were analysed using the SPSS program, and the heterogeneity calculation and effect size were analysed using the Rev‐Man 4‐.1‐Metaview program.Findings.  The results indicate that participation in a support group is associated with significant improvements in a patient's emotional state (depression and anxiety), illness adaptation, quality of life, and marital relationships.Conclusion.  Support group participation for patients with cancer has a positive impact in various areas. Nurses should promote participation as a crucial part of their care.
Use of complex adaptive systems metaphor to achieve professional and organizational change
Authors: Rowe Ann , Hogarth Annette 
Published: July 2005

Aim.  This paper uses the experiences of a programme designed to bring about change in performance of public health nurses (health visitors and school nurses) in an inner city primary care trust, to explore the issues of professional and organizational change in health care organizations.Background.  The United Kingdom government has given increasing emphasis to programmes of modernization within the National Health Service. A central facet of this policy shift has been an expectation of behaviour and practice change by health care professionals.Methods.  Change was brought about through use of a Complex Adaptive Systems approach. This enabled change to be seen as an inclusive, evolving and unpredictable process rather one which is linear and mechanistic. The paper examines in detail how the use of concepts and metaphors associated with Complex Adaptive Systems influenced the development of the programme, its implementation and outcomes.Findings.  The programme resulted in extensive change in professional behaviour, service delivery and transformational change in the organizational structures and processes of the employing organization. This gave greater opportunities for experimentation and innovation, leading to new developments in service delivery, but also meant higher levels of uncertainty, responsibility, decision‐making and risk management for practitioners.Conclusion.  Using a Complex Adaptive Systems approach was helpful for developing alternative views of change and for understanding why and how some aspects of change were more successful than others. Its use encouraged the confrontation of some long‐standing assumptions about change and service delivery patterns in the National Health Service, and the process exposed challenging tensions within the Service. The consequent destabilising of organizational and professional norms resulted in considerable emotional impacts for practitioners, an area which was found to be underplayed within the Complex Adaptive Systems literature. A Complex Adaptive Systems approach can support change, in particular a recognition and understanding of the emergence of unexpected structures, patterns and processes. The approach can support nurses to change their behaviour and innovate, but requires high levels of accountability, individual and professional creativity.
The skill mix practice model for nursing: measuring outcome
Authors: Lee Tso‐Ying , Yeh Mei‐Ling , Chen Hsing‐Hsia , Lien Gieng‐Hueu 
Published: July 2005

Aim.  This paper reports a study examining the outcome of personnel costs and quality of care after implementing the skill mix practice model for nursing.Background.  In response to ever‐tightening government budgets and changes in health insurance reimbursement, it may be necessary for hospitals to reassess their practice models to remain competitive and maintain quality of care.Method.  Using a pre‐ and post‐test quasi‐experimental design with questionnaires, participants were recruited at a teaching hospital in Taiwan. Questions were included on both patient satisfaction with nursing care and nurse satisfaction with nursing aides. The data were collected in 2003.Results.  The cost of implementing the skill mix practice model with 22 nurses and seven nursing aides was 2·7% lower than when only using 25 nurses. In addition, there was a statistically significant difference in patient satisfaction and in nurse satisfaction with the performance of the aides. There was no statistically significant difference in the pre‐ and post‐test outcome measures of both the incidence of falls and the medication error rate.Conclusion.  To decrease costs and increase quality of care, the skill mix practice model is worthy of consideration for clinical nursing care. This study presents an investigation of the first hospital implementation of the skill mix practice model for nursing in Taiwan, and the results of which can serve as a reference model for hospital nursing practice reform.
Adapt or adopt: developing and transgressing the methodological boundaries of grounded theory
Authors: Cutcliffe John R. 
Published: July 2005

Aims. While acknowledging that there is an existing debate regarding the nature of grounded theory, the aim of this paper is to highlight a number of common and key areas/issues where adaptation/adoption of Glaserian grounded theory in nursing‐related studies often occurs. These issues are: the differences between conceptual description and conceptual theory; beginning the study with a ‘general wonderment’ or a more defined research question; establishing the credibility of the theory; identifying a basic psycho‐social process and emerging vs. forcing.Background. Since the development and introduction of grounded theory in 1967, the number of studies, in a wide range of disciplines including nursing, that purport to be using a grounded theory method has grown enormously. While Glaser and Strauss acknowledged then that it was entirely appropriate for the methodology to evolve and develop, some of the studies that claim to be based on grounded theory methodology share little methodological similarity, and at times, bear only a passing resemblance to Glaserian grounded theory.Discussion. Some methodological transgressions in papers that purport to be grounded theory studies are such that it would be inaccurate to term the resulting method grounded theory at all. Instead such studies are more accurately thought of as a form of qualitative data analysis. Such transgressions include a study that has no evidence of conceptualization; one that does not identify a basic psycho‐social process; and one that moves from ‘emerging’ to ‘forcing’. Other methodological adaptations of grounded theory, such as beginning the study with more than a general wonderment and broadening the approach to establishing the credibility of the theory, are more in keeping with Glaser and Strauss’ position on the evolution of the method. In such cases, it is necessary to distinguish such methods from ‘pure’ Glaserian grounded theory, and it would be prudent and methodologically accurate to describe the resulting method as ‘modified’ grounded theory.
Avian Mobbing Response is Restricted by Territory Boundaries: Experimental Evidence from Two Species of Forest Warblers
Authors: Betts Matthew G. , Hadley Adam S. , Doran Patrick J. 
Published: July 2005

AbstractPredator mobbing has been viewed as an adaptation to reduce the risk of predation, however, factors influencing mobbing behaviour are still debated. We report on the results of an experiment with Dendroica caerulescens and Dendroica virens designed to determine (1) whether mobbing response by forest songbirds during the breeding season is restricted by territory boundaries, (2) the distance songbirds will move in response to anti‐predator mobbing calls, and (3) whether reproductive status, age, and time of the breeding season determine the distance moved to mob. We did not detect an effect of reproductive status, age, or time of breeding season on the distance moved by birds to mob. All birds responded to the mobbing playback within their territory (defined by territorial defence in relation to specific song playbacks). The maximum distance moved within a territory to engage in mobbing ranged from 25 to 175 m ( = 72 ± 6 m). Three of 37 birds responded to playbacks outside their territory boundaries. In all three cases, maximum movement distances outside territories were short (25 m). Thus, for two species of warblers, mobbing is highly constrained by territory boundaries during the breeding season. This finding is congruent with arguments that mobbing is primarily a selfish behaviour, at least with respect to conspecifics. Our results also provide support for the ‘move‐on’ hypothesis.
Courtship in the Zig‐Zag Salamander (Plethodon dorsalis): Insights into a Transition in Pheromone‐Delivery Behavior
Authors: Picard Amy L. 
Published: July 2005

AbstractCourtship in plethodontid salamanders includes the delivery of male courtship pheromones by two distinct modes. Within the eastern Plethodon clade of the tribe Plethodontini, members of the Plethodon cinereus species group use an ancestral ‘vaccination’ mode of delivery, while members of the P. glutinosus group use an olfactory delivery mode. In order to shed light on this transition in delivery mode, I observed courtship behavior in P. dorsalis, a species that is phylogenetically intermediate to the P. cinereus and P. glutinosus groups. My observations indicate that P. dorsalis also is intermediate to the P. cinereus and P. glutinosus species groups in terms of courtship behavior. The context of delivery of male courtship pheromones in P. dorsalis is similar to that of the P. cinereus species group; however, the mode of pheromone delivery in P. dorsalis is olfactory. Thus, a transition in the context of pheromone delivery underlies the more obvious change in pheromone delivery mode. I discuss these findings in terms of the evolution of courtship pheromone delivery across the eastern Plethodon clade. I also report the first observations of ‘premature’ spermatophore deposition by male plethodontids.
New regulatory mechanisms for human extravillous trophoblast invasion
Authors: FUJIWARA HIROSHI , SATO YUKIYASU , NISHIOKA YOSHIHIRO , YOSHIOKA SHINYA , KOSAKA KENZO , FUJII HARUKO , TATSUMI KEIJI , EGAWA MIHO , ZENG BIN‐XIANG , FURUKAWA KAZUMI , HIGUCHI TOSHIHIRO 
Published: July 2005

Human extravillous trophoblasts (EVT) invade maternal deciduas and reconstructed maternal spiral arteries during early placentation. However, the precise regulatory mechanisms to induce EVT invasion toward arteries and/or to protect EVT from further invasion have not been well understood. Recently, it was found that EVT that had already ceased their invasion, specifically expressed cluster of differentiation (CD9) and dipeptidyl peptidase IV (DPPIV) on their cell surface. In addition, EVT migrating to maternal spiral arteries expressed CC chemokine receptor type‐1 (CCR‐1), which is a chemokine receptor for regulated on activation normal T cell expressed and secreted (RANTES) and so on. CD9 is associated with integrin molecules on the cell surface and is considered to modulate integrin function. In contrast, DPPIV is a cell surface peptidase that can metabolize RANTES at extracellular sites before its accessing to the chemokine receptors. In vitro functional assay showed that CD9, DPPIV and RANTES are involved in the regulation for EVT invasion. From these findings, it can be proposed that CD9 and DPPIV, including chemokines, are new regulatory factors for human extravillous trophoblasts. (Reprod Med Biol 2005; 4: 189–195)
Food intake and leptin concentrations of lactating rats nursing various sized litters
Authors: SAITO TORU R. , SUZUKI MITSURO , AOKI‐KOMORI SHINOBU , TANAKA MINORU 
Published: July 2005

Purpose:   Leptin, the obesity (ob) gene product, has been proposed as an adipose‐related satiety factor. It might act as a signal, from peripheral adipose stores to the central nervous system, to decrease food intake and increase energy expenditure. Conversely, low leptin concentrations after fasting or energy restriction might act to increase food intake. The present study investigated the role of the suckling stimulus in the mechanisms regulating body weight, food consumption and leptin concentration in lactating rats nursing different sized litters.Methods:   The day of parturition was designated as day 0 of lactation. The rats were allocated randomly to three groups and the number of pups per litter was adjusted within one day of birth to eight (Group A), four (Group B) and two (Group C), with equal numbers of both sexes. From day 1 to day 10 of lactation, the separate weights of the mothers and pups, and the mothers’ food intake were measured daily. On day 10, the rats were decapitated and blood was collected from the mothers for measurement of serum concentrations of leptin by ELISA.Results:   Food intake by the mothers in Groups B and C decreased by about 20% and 30%, respectively, by day 10 of lactation, compared with Group A, but the serum leptin concentrations of those in Group C increased by about 80%, compared with Groups A and B. There was a high positive correlation between leptin concentration and fat pad weight.Conclusion:   The findings suggest that the smaller litter in Group C reduced the energy cost of lactation, which induced an increase in the serum leptin concentration. (Reprod Med Biol 2005; 4: 203–206)
In vitro fertilization outcome in severe ovarian hyperstimulation syndrome: An age‐matched contemporaneous control study
Authors: NG SOON PHENG , RASHID MR ZAINUL , KUMAR JOTHI , NG SOON CHYE 
Published: July 2005

Aim:   Ovarian hyperstimulation syndrome (OHSS) is a potentially life‐threatening, iatrogenic complication of assisted reproduction and has been associated with poor in vitro fertilization outcome. The aim of the present study was to evaluate the pregnancy rate and outcome following severe OHSS, at a single center over a three‐year period.Methods:   The incidence of severe OHSS at the IVF Center, National University of Singapore, in Singapore, was 4% (48 cases over 1200 cycles) during the period of 1997–2000. The present retrospective study compared 48 cases of severe OHSS to 144 age‐matched, contemporaneous controls without OHSS.Results:   The total gonadotropin required for severe OHSS group was found to be lower than for that of controls (2664.06 ± 768.29 IU vs 3349.58 ± 2003.73 IU), although duration of stimulation was similar. The OHSS group was associated with a fivefold increase (OR 5.293, 95% CI: 2.116–13.238) in pregnancy rate compared to controls (87.5% vs 56.9%; P < 0.05). Late OHSS was more common (38/48 cases) and had a pregnancy rate of 97% per embryo transfer. There was no significant difference in the multiple pregnancy (54% vs 48%; P > 0.05) and miscarriage rates (14% vs 7.3%; P > 0.05) between the groups.Conclusion:   Severe OHSS at our center were mostly late onset. The pregnancy rate was significantly higher, but multiple pregnancy and miscarriage rates were not significantly increased when compared to the age‐matched contemporaneous controls. (Reprod Med Biol 2005; 4: 207–211)
Analysis of criteria for metabolic syndrome in a population‐based study of Japanese‐Brazilians
Authors: Rosenbaum P. , Gimeno S. G. A. , Sanudo A. , Franco L. J. , Ferreira S. R. G. ,   for the Japanese‐Brazilian Diabetes Study Group
Published: July 2005

Objective:  Criteria for metabolic syndrome (MS) differ particularly regarding the definition of central obesity and consequently, there could be differences in the assessment of cardiovascular risk. We estimated the prevalence of metabolic syndrome, compared the agreement of the World Health Organization (WHO) criteria with the standard and a modified National Cholesterol Education Program (NCEP) criterion and investigated whether additional factors were associated with the diagnosis of the syndrome in a Japanese descendant population.Methods:  In this cross‐sectional, population‐based survey, 1166 Japanese‐Brazilians (533 men, 633 women) aged 57.4 ± 12.4 years with mean body mass index (BMI) and waist of 25.2 ± 4.0 kg/m2 and 84.5 ± 10.6 cm, respectively, were included. McNemar and kappa statistics were used to assess the concordance between WHO criteria with the standard and a modified NCEP criteria (waist of 90 and 80 cm, for men and women, respectively). In logistic regression analysis, a number of metabolic variables and albumin‐to‐creatinine ratio were included to test independent associations with metabolic syndrome defined by the modified NCEP criteria.Results:  According to WHO, 55.4% (95% CI 52.5‐58.2%) of the subjects had MS and to NCEP 47.4% (95% CI 44.6‐50.0%). WHO criterion detected 48.3% of central obese subjects while NCEP only 14.0%. Kappa statistics showed a good strength of agreement (k = 0.67, p < 0.01) between WHO and NCEP standard definitions of MS. Using the modified NCEP criterion for Asians, more subjects with metabolic syndrome were identified (58%) and agreement with WHO was improved (k = 0.72, p < 0.001). However, similar Framingham risk scores were attributed to the subsets of subjects classified by any of the three criteria. Areas under the receiver operating characteristic curves, obtained for the modified waist values to diagnose metabolic syndrome according to WHO, were > 0.80 and corresponded, respectively, to sensitivity and specificity of 63 and 83% for men and 77 and 72% for women. In final logistic regression model, age, male sex, BMI and homeostasis model assessment‐insulin resistance but not with albumin‐to‐creatinine ratio (ACR) were independently associated with the syndrome.Conclusions:  High prevalence of MS, independent of the criterion considered, was found in this Japanese‐Brazilian population. The replacement of waist cutoff by those proposed by WHO for Asians lead to this diagnosis in a higher number of subjects with elevated cardiovascular risk. Our data did not support that ACR should be included in the classical definition of MS in Japanese descendants as previously suggested by WHO.