bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of quality of life in patients with uncontrolled vs. controlled acromegaly using the Acromegaly Quality of Life Questionnaire (AcroQoL)
Authors: Trepp Roman , Everts Regula , Stettler Christoph , Fischli Stefan , Allemann Sabine , Webb Susan M. , Christ Emanuel R. 
Published: June 2005

SummaryObjective Acromegaly is a chronic disease with an important impact on quality of life. An acromegaly disease‐generated quality of life questionnaire (AcroQoL) has recently been developed. We aimed to confirm reliability, construct validity and disease‐specificity of the AcroQoL questionnaire. Second, we investigated the effect of remission status on health‐related quality of life (HRQoL) in patients with acromegaly.Design and patients Using a prospective, cross‐sectional design, 33 patients with treated acromegaly and 22 patients with treated hormone‐inactive pituitary adenoma under stable replacement therapy completed the German version of the AcroQoL questionnaire.Measurements and results Cronbach's alpha analysis showed high reliability of the total score and the different scales and subscales in patients with acromegaly (alpha ranging from 0·83 to 0·93, item‐total correlation 0·41–0·84). Patients with hormone‐inactive pituitary adenoma showed lower reliability (alpha ranging from 0·17 to 0·75). Exploratory factor analysis in patients with acromegaly suggested a two‐factorial solution with item distribution largely matching the scaling of the original Spanish questionnaire. Multiple regression analysis revealed significantly lower results of the total score and the different scales and subscales (indicating worse HRQoL) in patients with persistent acromegalic activity compared to patients with acromegaly in remission or discordant remission status. Consistently, IGF‐I was an independent negative predictor of the different scores of the questionnaire.Conclusions The AcroQoL questionnaire represents a reliable, construct valid and disease‐specific tool for assessing health‐related quality of life in patients with acromegaly. Patients with biochemically uncontrolled acromegaly showed significantly lower HRQoL than patients with acromegaly in remission or discordant remission status.
Rapid turnover of GATA‐2 via ubiquitin‐proteasome protein degradation pathway
Authors: Minegishi Naoko , Suzuki Norio , Kawatani Yukie , Shimizu Ritsuko , Yamamoto Masayuki 
Published: June 2005

Transcription factor GATA‐2 is expressed in a number of tissues, including hematopoietic stem and progenitor cells, and is crucial for the proliferation and survival of hematopoietic cells. To further characterize the function of GATA‐2, we examined the cellular turnover mechanism of GATA‐2. In P815 cells, the half‐life of endogenous GATA‐2 was found to be as short as 30 min after cycloheximide treatment. This short half‐life was reproducible in other hematopoietic and neuroblastoma cell lines with moderate variation. We also found that ultraviolet (UV)‐C irradiation markedly represses the GATA‐2 protein level by facilitating the degradation process. Since treatment of the cells with the proteasome inhibitor MG132 or clasto‐Lactacystin substantially abrogated the effects of cycloheximide and UV‐C irradiation and increased the expression level of both endogenous and transfected GATA‐2, the degradation of GATA‐2 seems to occur through the proteasome pathway. Structure‐function analyses with the GAL4‐DNA binding domain (GBD)‐GATA‐2 fusion protein and GATA‐2 deletion mutants suggested that the protein degradation regulatory elements of GATA‐2 reside in three regions, two of which overlap with the transactivation domain. We also detected poly ubiquitinated forms of GATA‐2. Taken together, these results demonstrate that GATA‐2 is turned over rapidly through the ubiquitin‐proteasome pathway.
Pressure ulcer risk factors in patients undergoing surgery
Authors: Lindgren Margareta , Unosson Mitra , Krantz Ann‐Margret , Ek Anna‐Christina 
Published: June 2005

Aim.  This paper reports a study to identify risk factors associated with pressure ulcer development among a mixed group of adult patients undergoing surgery.Background.  Few studies have been carried out with patients undergoing surgery to assess the risk of pressure ulcer development, and so there is a little knowledge of the risk factors for this group. However, studies among non‐surgical patients have shown that nutritional predictors such as low serum albumin level and low body mass index (BMI) are of great importance. An additional predictive factor may be low blood pressure. It is important to study these predictors further among patients undergoing surgery, using techniques such as multiple regression techniques, designed to identify the most important predictors for pressure ulcer development.Methods.  A prospective comparative study was carried out in 1996–1998 with 286 adult patients undergoing surgical treatment. The data were collected from patient records by Registered Nurses preoperatively, for seven days postoperatively and thereafter once a week for up to 12 weeks. Perioperative data were also collected. The Risk Assessment Pressure Sore Scale was used, and data were collected on general physical condition, activity, mobility, moisture, food intake, fluid intake, sensory perception, friction and shear, body temperature and serum albumin.Results.  Forty‐one (14·3%) patients developed pressure ulcers during the observation period. The most common type was non‐blanchable erythema. Those who developed pressure ulcers were significantly older, weighed less, and had a lower BMI and serum albumin. More women than men developed pressure ulcers. Risk factors identified in multiple stepwise regression analyses were female gender, American Society of Anaesthesiologists (ASA) status or New York Heart Association (NYHA) status and food‐intake.Conclusion.  Special attention, with regard to risk of pressure ulcer development, should be paid to patients undergoing surgery who have low ASA or NYHA scores, low food intake and/or are women.
Impact of tele‐advice on community nurses’ knowledge of venous leg ulcer care
Authors: Ameen Jamal , Coll Anne Marie , Peters Melanie 
Published: June 2005

Aim.  This paper reports a study assessing the impact of the provision of expert tele‐advice to community nurses in enhancing their knowledge of leg ulcer care.Background.  Community nurses have traditionally been responsible for the care of patients with leg ulcers. However, access to expert medical and nursing advice has been restricted to the local hospital environment. The introduction of e‐health and telemedicine have created opportunities to provide online and immediate access to wound care expertise from centres of excellence to primary health care staff in managing patients’ wounds in their own home.Method.  A stratified randomized controlled trial was used to examine community nurses’ knowledge before and after the provision of expert tele‐advice. A knowledge measurement tool comprised of 40 multiple‐choice questions was adopted, with correct responses identified by a panel of wound care experts. The questions covered the three themes of dressings, management and physiology, with different levels of difficulty categorized as easy, medium or difficult. The tool was administered before and after the intervention (12 weeks) to both the experimental and control groups.Results.  Statistically significant improvements were observed only for the experimental group in the areas of dressings and management, as well as in the medium level questions. No statistically significant improvement was seen for the easy questions, as there was little room for improvement because of preintervention high scores. For the difficult questions, it was thought that more time would be needed for a more positive outcome.Conclusions.  The results suggest that tele‐advice can be of great benefit to community nurses in enhancing their knowledge in the practice of leg ulcer care. This will have significant implications for more efficient use of human resources and cost effectiveness in wound care.
Diabetes in children and adolescents from ethnic minorities: barriers to education, treatment and good metabolic control
Authors: Povlsen Lene , Olsen Birthe , Ladelund Steen 
Published: June 2005

Aim.  This paper reports an investigation to establish whether metabolic control is different in children and adolescents from ethnic minorities with type 1 diabetes compared with young Danish patients, and to learn about factors affecting their opportunities to achieve good metabolic control.Background.  The prevalence of diabetes in children and adolescents from ethnic minorities in Denmark is increasing. Having a different ethnic background has frequently been described as a risk factor for poor metabolic control, but whether the risk is represented by the ethnicity and immigration itself or in combination with other factors is unclear.Methods.  The study included data (gender, age, diabetes duration HbA1c, number of incidents of severe hypoglycaemia and ketoacidosis) from a national register including 919 Danish and 58 children and adolescents from ethnic minorities, questionnaires to all 20 Danish paediatric diabetes centres and questionnaires to 38 families of other ethnic backgrounds completed by professional interpreters. The study was conducted in 2001–2002.Results.  HbA1c was significantly higher in children and adolescents from ethnic minorities (mean 9·05 ± 1·4%) compared with Danish patients (mean 8·62 ± 1·3%; P = 0·018). There was no significant difference in HbA1c among the different ethnic groups, nor in the prevalence of severe hypoglycaemia or ketoacidosis. Patients from different ethnic minorities were unevenly distributed throughout the country, and generally the centres provided limited specialized knowledge and support. The questionnaires completed by the parents revealed limited schooling, lack of professional education and a major need for interpreters; these characteristics were especially prevalent among the mothers.Conclusions.  Young patients from ethnic minorities have significantly poorer metabolic control compared with Danish patients, and patients with an immigrant background are seen as a vulnerable group with different needs and probably fewer chances of achieving good control. Special education for health care professionals as well as projects to improve methods, quality and knowledge should be encouraged in order to provide tailored support to members of individual ethnic groups. We recommend that the use of professional interpreters should become the gold standard in health care provision to all immigrant families.
Quality of life, disability and handicap in patients with toxic oil syndrome
Authors: Martín‐Arribas Ma Concepción , De Andrés Copa Pilar , De La Paz Manuel Posada 
Published: June 2005

Aim.  This paper reports an investigation of the quality of life of patients most severely affected by toxic oil syndrome and the association between quality of life and disability variables, handicaps and depression.Background.  In 1981, an epidemic occurred in Central and Northwestern Spain. The illness, now called toxic oil syndrome (TOS), appeared to be caused by consumption of oil mixtures containing rapeseed oil denatured with aniline and affected over 20,000 individuals. Today, it is classified as a chronic disease that has resulted in a large number of sequelae.Method.  From the 1031 people classified with permanent disability, a random sample of 292 individuals was selected. A structured interview was carried out to investigate the clinical aspects. The Nottingham Health Profile Questionnaire was used to assess quality of life. To study the relationship between quality of life and disability, handicap and depression, a univariate analysis was carried out. The chi‐square test was used for inter‐group comparisons. A P‐value of 0·05 was adopted as the limit for inclusion of a variable in the multivariate analysis. Multivariate analysis was undertaken using logistic regression.Results.  Two hundred and fourteen patients were interviewed (79% response rate). Mean age was 59·3 (sd: 12·7) years. Quality of life mean score was 52·8 (sd: 22·6). The variables associated with poorer quality of life perception were depression [odds ratio (OR) = 9·66, confidence interval (CI) = 3·71–25·15], role‐related disabilities (occupation role: OR = 2·82 CI = 1·28–6·22) and mobility (bending/picking up: OR = 4·74, CI = 2·31–9·72), as well as economic problems (OR = 1·62, CI = 1·07–2·46).Conclusion.  The quality of life of those most severely affected by TOS is poor. Their health profile is characterized by depression and important functional and psycho‐social disabilities that limit daily living activities and social roles, and are related to self‐perceptions of poor quality of life.
An evolutionary concept analysis of caring
Authors: Brilowski Gail A. , Cecilia Wendler M. 
Published: June 2005

Aim.  The aim of this paper is to identify the core, enduring attributes of nursing caring in order to increase understanding of the concept and to identify its implications for research and practice.Background.  Caring is considered a core concept in nursing as a practice discipline. During the past 20 years, research into nurse caring has been evolving, but the concept of caring remains ambiguous.Methods.  Using a rigorous evolutionary method of concept analysis, the concept caring was examined for its significance, use and application as it has unfolded over time, between 1988 and 2002. After applying inclusion and exclusion criteria and a sampling method, a total of 61 articles was included in the final analysis.Results.  Defining attributes, antecedents, and consequences of caring were identified. Core attributes included relationship, action, attitude, acceptance and variability.Conclusion.  Identification of the core attributes of concepts, including caring, allows nurses to determine appropriate research questions, develop theory and identify practice priorities at a time of increasing demands and constrained resources.
HIV/AIDS and the workplace: perceptions of nurses in a public hospital in South Africa
Authors: Smit Ria 
Published: June 2005

Aim.  The purpose of this article is to report a study of the perceptions and experiences of nurses caring for people living with HIV/AIDS in the public health sector in South Africa.Background.  The number of people living with HIV/AIDS in South Africa has escalated at an alarming rate. Many people being hospitalized are HIV positive, and hence nurses are in more regular and prolonged contact with people suffering from HIV/AIDS than is the case in other working environments. Although studies focusing on nurses’ experiences of caring for patients with HIV/AIDS have been done in numerous countries, little is known about nurses’ views in Africa, and South Africa in particular. To ensure quality care for patients with HIV/AIDS, it is important to understand nurses’ experiences of nursing HIV‐positive patients and how they may influence their attitudes towards these patients.Method.  A qualitative approach was used, the primary method of data collection being in‐depth interviews. These interviews were conducted with 35 nurses at a public hospital in the Gauteng province of South Africa in 2002–2003.Findings.  Seven themes were identified: helplessness, emotional stress and fatigue, fear, anger and frustration, occupational‐related concerns, empathy, and self‐fulfilment.Conclusions.  Increased understanding of the stresses and rewards experienced by these nurses can contribute to policy development in this area. It is also important to provide appropriate preregistration and continuing education and support for nurses working in this field, and to ensure that the working environment is adequate in terms of resources.
Depressive symptoms in long‐term care residents in Taiwan
Authors: Lin Li‐Chan , Wang Tyng‐Guey , Chen Miao‐Yen , Wu Shiao‐Chi , Portwood Michael J. 
Published: June 2005

Aim.  This paper reports a study to investigate the prevalence of and risk factors for depressive symptoms in elders in long‐term care facilities in Taiwan.Background.  Depression has been identified as a major health concern and is very common among frail elders in Western nursing homes. It is under‐diagnosed, and may be associated with eating difficulties and subsequent malnutrition, functional ability and sociodemographic factors. There have been no previous studies of these issues in Taiwan.Methods.  Residents of 18 long‐term care facilities were recruited. Those able to communicate in the Mandarin or Taiwanese dialect, resided in long‐term care facilities including skilled nursing facilities and intermediate care facilities, and who scored three or above on the Short Portable Mental Status Questionnaire were selected. Data were collected using the Geriatric Depression Scale, Barthel Index and Masticatory Index, and age, duration of institutionalization, and level of impaired swallowing were also measured.Results.  The number of participants identified as depressed was 267 (52·05%). There was no significant difference noted relating to age, gender, duration of institutionalization, type of institution, mental status and masticatory ability between the depressed and non‐depressed groups, but significant differences of functional status and impaired swallowing between the two groups were found. However, functional status, impaired swallowing, and type of institution were three independent factors associated with depressive symptoms after controlling for all other factors.Conclusions.  Future studies on the detection of symptoms of depression should use a validated observational measure to overcome under‐reporting of symptoms by the frailest residents.
Nurses’ and midwives’ assertive behaviour in the workplace
Authors: Timmins Fiona , McCabe Catherine 
Published: June 2005

Aim.  This paper reports a study describing the assertive behaviour of a group of professional nurses and midwives and exploring potential barriers and facilitators to the use of assertiveness skills in the workplace.Background.  As nurses and midwives move away from traditional roles, it is increasingly being recognized that they need to behave in an assertive manner. Much literature supports the use of assertive behaviour in clinical practice. Although specific individual assertive behaviours and skills have been examined in many settings, little empirical evidence exists about the frequency and use of assertiveness skills by nurses and midwives in the workplace. While there is evidence on barriers to the use of assertive skills, there is little information about factors that may facilitate their use.Method.  A survey design was adopted, using a 44‐item questionnaire to collect data from a 2·5% random sample of nurses/midwives registered with the National Nursing Board of Ireland. The data were collected in 2003.Results.  While respondents frequently complimented their colleagues and often allowed them to express opinions, they were less accomplished at expressing their own opinions or making requests. Assertive behaviours were used more frequently with nursing/midwifery colleagues than with management/medical colleagues. Most used assertiveness skills with other grades of staff in their own profession. Responsibility to patients/clients emerged as a supporting factor for using assertive behaviour. Managers, the work atmosphere and fear were viewed as obstacles.Conclusion.  Nurses and midwives needs to learn how to behave assertively, and this should be included in both pre‐ and post‐registration education programmes. As use of assertiveness skills was reported to be least frequent with nurse/midwife managers, local policies and guidelines may be needed to encourage clinical practitioners to act autonomously and as client advocates.
The social construction of ‘reproductive vulnerability’ in family planning clinics
Authors: Hayter Mark 
Published: June 2005

Aim.  The aim of this paper is to report a study exploring the discursive construction of contraceptive use within nurse consultations with women in family planning clinics.Background.  This paper takes as its starting point the lack of a contraceptive ‘strand’ to the literature on the discursive construction of the female body generally, and the female reproductive system specifically, within health care practice. The literature in this field concentrates on pregnancy, menstruation and menopause, and the manner in which contraceptive use is discursively constructed is under‐explored. Furthermore, the literature on nurse–women consultations in family planning clinics is also limited, with the current literature concentrating on assessing clinical skills rather than discourse.Methods.  Using a grounded theory methodology to explore how nurses educate women about contraception in family planning clinic, 49 consultations were audio‐taped in two large family planning clinics in the United Kingdom (UK).Findings.  Open coding and subsequent axial coding resulted in the emergence of three elements of contraceptive education. One concerned reproductive anatomy, another reproductive physiology and a third education about contraceptive functioning. These three axial codes were formed into a core category: ‘body education/reproductive vulnerability’. Within the consultation, nurses linked the ‘vulnerable’ reproductive system with the requirement for contraceptive ‘protection’. This approach seems linked to ensuring women's future contraceptive use.Conclusion.  The discourse employed by nurses differs from the body discourse aimed at menopause and menstruation. These areas of women's health were constructed as disintegrating, malfunctioning and failing, whereas reproductive vulnerability suggests a fully functioning, active system, in need of restraint. However, this discourse still constructs the female body as fundamentally weak and unstable, requiring contraception to protect it and prevent transgression.
Relationship between quality of care, staffing levels, skill mix and nurse autonomy: literature review
Authors: Currie Veronica , Harvey Gill , West Elizabeth , McKenna Hugh , Keeney Sinead 
Published: June 2005

Aims.  This paper reports a literature review exploring the relationship between quality of care and selected organizational variables through a consideration of what is meant by perceptions of quality, whose perceptions are accorded prominence, and whether changes in staffing, skill mix and autonomy affect perceptions of quality.Background.  Three basic ideas underpin this literature review: the growing focus on quality improvement in health care, concerns about the quality of care, and the move towards patient involvement and consultation. Of particular interest is the way in which changes in nurse staffing, skill mix and autonomy may affect the delivery of quality patient care.Methods.  A search was conducted using the CINAHL, Medline and Embase databases. Key words used were quality of health care; quality of nursing care; nurse; patient; skill mix; nurse–patient ratio; outcomes; adverse health care events and autonomy. The objective was to draw together a diverse collection of literature related to the field of health care quality. Papers were included for their relevance to the field of enquiry. The original search was conducted in 2003 and updated in 2004.Findings.  Quality of care is a complex, multi‐dimensional concept which presents researchers with a challenge when attempting to evaluate it. Traditional nursing assessment tools have fallen out of use, partly because they have failed to provide opportunities to engage with and access the views of patients or nurses. There is also evidence that patient satisfaction as an indicator of quality is compromised on a number of fronts. There is conflicting information on how nurses and patients think about quality. Research looking at the relationship between the selected organizational variables and perceptions of quality also suffers from a number of limitations. We argue that there is a requirement for more patient‐centred research exploring perceptions of quality and differences in nurse staffing, skill mix and autonomy.