bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical and surgical nurses’ perceptions of their level of competence and educational needs in caring for patients with cancer
Authors: McCaughan Eilis , Parahoo Kader 
Published: March 2003

• Recent proposals recommend that cancer patients are cared for, as much as possible, in specialist cancer units and centres.• However, a large number of these patients will still be admitted to medical and surgical wards of general hospitals at one time or other. Yet little is known about the knowledge and skills of nurses dealing with this group of patients.• A survey design was used to assess the self‐reported level of competence, in a number of activities relating to their work with cancer patients, among medical and surgical nurses (n=106) in a district general hospital in Northern Ireland. It also aimed to identify their self‐reported educational needs in caring for this group of patients.• Results showed that these nurses cared for people with a range of cancers.• While they reported an above‐moderate level of competence, they also rated their level of competence higher in physical than in psychosocial care.• Among their self‐perceived educational needs were more knowledge, and skills in psychosocial care, communication, dealing with side‐effects of treatment and pain management.
Nurses’ first encounters with parents of new‐born children – public health nurses’ views of a good meeting
Authors: Jansson Annkristin , Petersson Kerstin , Udén Giggi 
Published: March 2003

•  The nurse’s view of the first meeting with parents of new‐born children may have consequences for the quality of future contact. A good start will lay a solid foundation for a lasting relationship, and have an affect on the nurse’s work to support parents and children and to promote health. We do not know what nurses mean by a ‘good meeting’.•  The aim of this study was to discover how nurses view the first meeting as a general preventive measure aimed at all parents and their new‐born children.•  Four focus groups interviews were held with nurses from different primary health care areas in the county of Skåne, southernmost Sweden.•  Analysis of the content in the transcribed interview texts disclosed eight subcategories: good contact/reciprocal relationship; willingness to listen; guest/equal roles; time/peace and quiet; the family in its environment; socio‐cultural aspects; confirmation/support; and individual advice.•  Three categories were established: creating trust; creating a supportive climate; and creating a picture of the family’s life situation.•  The home visit was seen as an important way to establish trust and obtain a picture of the family’s life situation, which was in turn essential for creating a supportive climate.
Women’s lived experience of breast biopsy: a phenomenological study
Authors: O'Mahony Mairin 
Published: March 2003

• This study aimed to explore Irish women’s lived experience of breast biopsy with a view to gaining a deeper understanding of their individual experiences and the meanings that it holds for them.• A phenomenological approach from a Heideggerian hermeneutical perspective was used. Study participants were eight women aged 22–54 years who had experienced a recent breast biopsy with benign diagnosis. Data were collected using in‐depth interviewing. The work ofBenner (1994), together with guidelines fromMorse & Field (1996)andBurnard (1991)were used to guide the process of data analysis.• Themes which emerged from the data were: ‘Finding the lump’, ‘Waiting, not knowing’, ‘knowing’, ‘Getting back to normal’ and ‘Reflections’. Women’s feelings of initial distress followed by relief permeate these themes.
`Seeking': a key activity for new family carers of stroke survivors
Authors: BRERETON LOUISE , NOLAN MIKE 
Published: March 2003

• Stroke is one of the major causes of disability in the United Kingdom and considerable numbers of stroke survivors need help and support from family carers.• The sudden and unexpected nature of stroke means that there is very little time for family members to prepare for a caring role.• This paper draws on data from 37 interviews with 14 new carers of stroke survivors and highlights the uncertainty and lack of confidence that family members experience in adopting a caring role.• During the initial period following the stroke carers engage in a number of different `seeking' activities in order to try and ensure that they feel competent, confident and safe to provide care and that they understand the likely future demands they may face.• Rather than being facilitated by staff, carers' efforts often go unnoticed or are overlooked, resulting in carers feeling that they are `going it alone'.• Staff need to be more aware of carers' `seeking' behaviour and actively encourage the formation of partnerships with family members.
Pathogenesis of urinary tract infections: a review
Authors: MOORE KATHERINE N. , DAY RENE A. , ALBERS MARILYN 
Published: March 2003

• Pathogenesis of urinary tract infections (UTIs) is not well‐understood. In this paper, we review the current understanding of UTIs, particularly in relationship to individuals using intermittent catheterization.• Relationships exist between the human host, infectious agent and the environment. In the human host, the urethra connects the bladder to potential infectious agents on the perineum. A high‐pressure zone exists within the urethra at a point where the urethra passes through the urogenital diaphragm. This zone creates a natural barrier to ascent of organisms colonized in the distal urethra and the bladder itself has natural defences against invading organisms.• The interaction of host defences with bacteria (infectious agent) determines whether or not the bacteria persist. A small number of bacteria and some types of bacteria are controlled more effectively by natural bladder defence mechanisms and frequent bladder emptying than a large number of bacteria.• Eschericia coli, coliforms and enterococci are considered common bacterial causes of UTIs and are found in high numbers on the perineum. Intermittent catheterization is an effective way of bladder emptying but as an invasive procedure it remains a risk factor in the development of UTI.
Psycho‐affective disorder in intensive care units: a review
Authors: HEWITT JEANETTE 
Published: March 2003

• This paper reviews the literature related to the Intensive Care Unit (ICU) Syndrome. The intention of the paper is to explore the range of psychotic and affective phenomena that may be observed in practice, together with the management of contributory stressors.• Patients experience a range of psycho‐affective disturbances that may be triggered by drugs, the environment, dehumanizing practices and sleep deprivation. Symptoms do not always disappear following discharge and further research is required to determine the long‐term psychological effects of an ICU.• Comprehensive assessment of the patient's psychological state, using an appropriate tool, is necessary and should form an integral part of ongoing care.• Interventions identified include eradication of dehumanizing behaviour, modification of environmental stimuli, effective communication and therapeutic touch.• Where possible, communication needs should be addressed prior to admission, and patients and their families prepared for the unfamiliar world of the ICU.
Development of a short form of the Quality from the Patient's Perspective (QPP) questionnaire
Authors: LARSSON BODIL WILDE , LARSSON GERRY 
Published: March 2003

• Patients' views on the quality of care are important and it is desirable that these can be assessed using short, yet valid and reliable instruments.• The aim of the work reported here was to develop and test a short version of an established questionnaire: Quality from the Patient's Perspective (QPP).• Patients (n=162, 79% response rate) receiving care at medical and surgical departments in two Swedish hospitals responded to the original QPP as well as to a newly developed short version. An ethical research committee approved the study.• Pearson correlations were computed between the long and short forms and differences between means were analysed with t‐tests. Reliability was estimated by computing Cronbach alpha coefficients.• Correlations of acceptable size were found between the short form and the original QPP. The short form also had acceptable reliability coefficients.• The strengths of the work are that the items in the short version are derived from a patient perspective and are formulated in words used by patients; the items still have a theoretical foundation, which makes the interpretation of results more meaningful; global formulations such as `What do you think about your care?' have been avoided; the short format should make the questionnaire more attractive for many patients to respond to.• Limitations are that results indicate that the short form does not fully measure what the long form does. Therefore, when the short form is used in practice, a two‐step procedure is suggested, where a follow‐up is done with a selection of items from the original long form. This selection could be restricted to areas where problems may be suspected, based on the results from the short form.
Changes in practice at the nurse–doctor interface. Using focus groups to explore the perceptions of first level nurses working in an acute care setting
Authors: Jones Angela M. 
Published: March 2003

Summary• A unique combination of factors has recently triggered a rapid change in the clinical practice of nurses in the UK.• This study was carried out to explore the consequences of changing practice at the nurse–doctor interface, as perceived by first level nurses working in an acute care setting in the UK.• Qualitative data were collected using focus group interviews and analysed thematically.• Findings suggest that role change to these nurses is represented by a ‘shift’ in the practice of technical activities from junior doctors and a corresponding delegation of nursing activity to care assistants.• It is suggested that the wholesale incorporation of technical interventions into the role of the nurse without an increase in the number of qualified nurses is turning nursing back to a task system of care delivery.• This has the potential to depersonalize patients and reduce work satisfaction for nurses.
Educating young consumers – a food choice model
Authors: Hamilton Jennifer , McIlveen Heather , Strugnell Christopher 
Published: March 2003

AbstractIt has been acknowledged that it is only by obtaining a more detailed understanding of food choice that people’s diets can be improved. In Northern Ireland, research into food choice has been limited yet the Province has the second highest rate of heart disease in the world, indicating the need for change. This study investigated the food choices of 9‐ to 17‐year‐olds in Northern Ireland and the influential factors. A range of research techniques were employed incorporating both qualitative and quantitative methods, namely observations, focus groups, picture associations, dietary case studies and questionnaires. The research indicated that the dietary patterns adopted by this group are characterized by a high consumption of fat, yet the reduction of fat tends to dominate the overall strategy for the prevention of obesity and lowering the risk of coronary heart disease. In addition, a high consumption of sugar products was evidenced along with a distinct dislike for healthier alternatives such as fruit and vegetables. The ‘skipping’ of meals, especially breakfast and a high prevalence of snacking was also apparent. However, these eating habits were found to be affected by various factors such as age and gender, emphasizing the complex nature of food choice. The findings from this research enabled the development of a model relating to the food choices of 9‐ to 17‐year‐olds in Northern Ireland, highlighting the influential factors and subsequent health implications.
The impact of lianas on tree regeneration in tropical forest canopy gaps: evidence for an alternative pathway of gap‐phase regeneration
Authors: Schnitzer Stefan A. , Dalling James W. , Carson Walter P. 
Published: March 2003

Summary 1  Regeneration in forest canopy gaps is thought to lead invariably to the rapid recruitment and growth of trees and the redevelopment of the canopy. Our observations, however, suggest that an alternate successional pathway is also likely, whereby gap‐phase regeneration is dominated by lianas and stalled in a low‐canopy state for many years. We investigated gap‐phase regeneration in an old‐growth tropical forest on Barro Colorado Island (BCI) in Panama to test the following two hypotheses: (i) many gaps follow a pathway in which they remain at a low canopy height and are dominated by lianas and (ii) the paucity of trees in this pathway is a function of liana density. 2
We surveyed a total of 428 gaps of varying ages (c. 5, c. 10, and 13+ years old) and identified those which followed the conventional pathway of regeneration and others that remained stalled in a low‐canopy state for many years and were dominated by either lianas or palms. Each of these pathways will likely have different successional trajectories that will favour the growth of a distinct suite of mature species and ultimately result in contrasting species composition. 3  The successional pathway of liana‐dominated, stalled gaps is common throughout the forest. We estimate conservatively that 7.5% of the gaps that form each year will follow this pathway, probably due to the suppression of tree regeneration by lianas, and that many of these stalled gaps will persist for much longer than 13 years. Consequently, a high proportion of gaps in the forest at any given time will be stalled. Furthermore, liana tangles, which persist in the tropical forest understorey for extended periods of time, almost certainly originate in these gaps. 4  Liana abundance was positively correlated with pioneer tree abundance and diversity while negatively correlated with non‐pioneer tree abundance and diversity. Thus, lianas appear to inhibit non‐pioneer tree survival while indirectly enhancing that of pioneer trees. 5  Lianas are abundant in many types of tropical and temperate forests and a successional pathway involving liana‐dominated, stalled gaps may therefore be frequent and widespread.
Tree recruitment at theNothofagus pumilioalpine timberline in Tierra del Fuego, Chile
Authors: Cuevas Jaime G. 
Published: March 2003

Summary1 Nothofagus pumilioforms an abrupt alpine timberline (AT) at 690 m a.s.l on Balseiro mountain, 54 °S, Tierra del Fuego, Chile. Fruit and seed rain (quantity and quality), emergence, density and survival of seedlings were studied across an altitudinal gradient (450–740 m) from within the forest to above the AT.2 Fruit rain generally declined with altitude but increased between 630 and 690 m before falling sharply beyond the AT. The proportion of seed‐bearing fruits, seed viability and seed mass also declined with increasing altitude, but showed no recovery in the vicinity of the AT.3 Fruit rain decreased exponentially with distance into the alpine zone, so that effective dispersal rarely exceeded 20 m beyond the AT and few of these fruits contained seeds.4 Seedling emergence and density decreased with altitude both within the forest and into the alpine zone so that seedlings were found no more than 10–20 m above the AT. Even in 1996, when fruit production was high, successful seedling recruitment was limited to lower altitudes.5 There was little correlation between altitude and the percentage survival of naturally occurring seedlings within the forest. However, transplanted seedlings survived better at the AT itself than immediately inside the forest, and showed high mortality in the alpine zone.6 The most severe bottlenecks for tree recruitment within the forest appeared to be seedling emergence and seed production. Above the AT, seed viability and emergence were the principal bottlenecks.7 Although not all demographic variables declined altitudinally, the overall probability of adult establishment decreased with increasing altitude and became very low once the protection by the tree canopy became unavailable. A demographic model explaining the origin and abrupt character of the AT studied is presented.
Testing patterns of zonation in mangroves: scale dependence and environmental correlates in the Sundarbans of Bangladesh
Authors: Ellison Aaron M. , Mukherjee Barid B. , Karim Ansarul 
Published: March 2003

Summary 1 Associations between abiotic variables and patterns of species distribution and abundance are a major preoccupation of community ecologists. In many habitats, this association is manifest in discrete zones of vegetation. 2 We used statistical methods to examine tree species distribution patterns in relatively undisturbed regions of the Sundarbans of Bangladesh. We tested the hypothesis that mangroves occur in discrete zones with respect to elevation. These data were gathered with explicit attention to local and regional differences in edaphic characteristics so that species‐environment relationships could be analysed at several spatial scales. 3 Correlations were also assessed between mangrove species composition and edaphic variables that co‐vary with elevation, i.e. salinity, field capacity, cation exchange capacity, percentage silt, and mangrove physiognomic category (slope, basin, levee and flat). 4 Quantitative statistical analysis using randomization techniques failed to detect species zonation along any of 33 individual 200‐m transects, within 1‐km2 blocks, or within 1200‐km2 regions. 5 Canonical correspondence analysis relating edaphic variables to species distributions accounted for a total of only 24% of the variance in species composition. 6 Our data suggest that the absence of zonation in the Bangladesh Sundarbans reflects the underlying biology of the system and is not an artefact of long‐term human disturbance.
Macrophyte decline in Danish lakes and streams over the past 100 years
Authors: Sand‐Jensen Kaj , Riis Tenna , Vestergaard Ole , Larsen Søren Erik 
Published: March 2003

Summary 1 Freshwater habitats in cultivated and densely populated lowland regions of Europe have experienced profound changes during the last 100 years. We take advantage of the long interest in aquatic plants in Denmark to compare the submerged flora in lakes and streams in 1896 and 1996. 2 Most of the lakes which contained a diverse submerged vegetation 100 years ago now have the high phytoplankton biomasses and summer transparencies below 2.0 m characteristic of eutrophication. The majority of 17 lakes included in both old and recent studies have lost all or most of their submerged species. Species richness for those lakes that were vegetated did not, however, differ significantly between old and recent studies. 3 Species richness declined markedly in the 13 streams included in both studies. Over all sites, there was also a significant decline of species richness per locality. Potamogeton species declined from 16 to 9, despite an 8‐fold increase in the number of sites surveyed. 4 Similar compositions and rank‐abundances of Potamogeton species in lakes and streams studied 100 years ago reflect suitable growth conditions and mutual exchange of propagules. Today, low habitat diversity and frequent disturbance in streams and low recruitment from lakes favours only robust, fast‐growing species capable of regrowth following weed cutting and dredging. 5 A positive interspecific relationship observed in the contemporary stream vegetation between mean local abundance and number of occupied sites was probably promoted by redistribution of plants as a result of disturbance and efficient dispersal in the interconnected stream network. 6 The freshwater macrophyte flora in north‐west Europe presently includes a high proportion of rare species which are threatened by extinction. Both species typical for oligotrophic conditions (e.g. P. filiformis and P. polygonifolius) and another group of large, slow‐growing species (e.g. P. alpinus, P. lucens, P. praelongus and P. zosterifolius), were once common but are now infrequent, while other transient species have remained rare (e.g. P. acutifolius, P. colouratus, P. densus and P. rutilus). The presence of many species that barely survive in small and distant populations will make re‐assembly of submerged aquatic communities difficult.
Intensity of intra‐ and interspecific competition in coexisting shortgrass species
Authors: Aguiar Martín R. , Lauenroth William K. , Peters Debra P. 
Published: March 2003

Summary

Bouteloua gracilis and Buchloë dactyloides are dominant species in the shortgrass steppe. Previous studies have suggested that these species have similar resource requirements and, as there is no temporal segregation in growth, we suggest that competition for below‐ground resources should be intense. Classical competition theory predicts that, under stable conditions, coexistence of species with similar requirements can occur if intraspecific competition is more intense than interspecific competition. We therefore compared the competitive abilities of the two species under both inter‐ and intraspecific conditions, another determinant of coexistence in plant communities.
A 3‐year experiment was conducted in a small homogeneous area and a separate 2‐year experiment was conducted in a larger area. In both experiments, a hexagonal planting design was used to achieve all possible combinations of species and to control plant size and neighbourhood asymmetries at the start of the experiment. Half the target plants were grown within steel cylinders to reduce below‐ground competition.
We found similar results in the two experiments. Plant biomass and seed production were always higher in plants growing with reduced competition, although seed production was quite variable. Relative competition intensity did not differ between intraspecific and interspecific competition.
Our results suggest that competition between these coexisting shortgrasses is intense, but do not support the prediction of a difference between intra‐ and interspecific competition. We discuss alternative explanations.
The expansion history of a sexual and asexual species ofCortaderiain California, USA
Authors: Lambrinos John G. 
Published: March 2003

Summary The expansion histories of two South American species ofCortaderia, similar in morphology but differing profoundly in their breeding systems, were compared in California, USA. Both species were introduced to California in the mid‐1800s, but herbarium records indicate that the sexualC. selloanahas expanded spatially at twice the rate of the asexualC. jubata. The invasiveness ofC. selloanahas increased over time, whereas that ofC. jubatahas remained relatively constant. Populations ofC. selloananow occupy more vegetation types and more non‐ruderal habitats thanC. jubata. Populations ofC. selloanahave experienced directional morphological change, whereas the morphology ofC. jubatahas been constant over the 90 years for which preserved specimens are available. The invasion of an alien species appears to be a malleable process, rather than a singular event. Species traits, such as inbreeding, can be advantageous at some stages but disadvantageous at others. Alien species also adjust over time to the novel and diverse selective regimes that they encounter as they expand spatially. Sexual species may have a greater ability to adjust to diverse selective landscapes relative to asexual species.