bluuebunny/crossref_metadata_2025_split huggingface dataset:
The human dimension of nosocomial wound infection: a study in liminality
Authors: Gardner Glenn 
Published: March 2003

The human dimension of nosocomial wound infection: a study in liminalityNosocomial wound infection is a disease that has to date been primarily understood through the language of science and biomedicine. This paper reports on findings from a sociological, interpretive study that focused on the experiential dimension of this phenomenon. The illness experience of a nosocomial wound infection is examined within a cultural milieu that values the smooth, untroubled body and alternatively ascribes cultural meaning to a body that has a definable illness. Within this context the person with a chronic wound from nosocomial infection defies normative categorisation and is thus situated outside the patterning of society. The human dimension of nosocomial wound infection includes the private, existential and embodied aspects of living with a chronic, infected wound. This report indicates that the experiential dimension is characterised by an embodied state of liminality. People with this illness live an indeterminate existence that is in‐between health and illness, cure and disease. As such they have no recognised place in the medical or social world.
Reform in public health: where does it take nursing?
Authors: Gibb Heather 
Published: March 2003

Reform in public health: where does it take nursing?The Australian healthcare system is undergoing changes that are impacting tangibly on professional nursing practice. While the evidence is clear that the changes pose a challenge to maintaining standards amidst resource cuts and restructuring, the processes through which these changes occur and the decisions which drive the reforms remain complex and largely obscure. This paper intends to stimulate further thinking and debate among nurses about the effects of these reforms on the conduct of practice, both in terms of our emerging discipline and our ability to conduct clinical nursing practice. It offers a way of understanding the policy ‘reform’ process through an application of policy analysis grounded in critical social theory. The discussion sets out to apply these analytical propositions to specific events that constitute examples of change in the nursing workplace, and to focus on the implications for nurses and health service clientele.
Keeping the lid on infection: infection control practices of a regional Queensland hospital 1930–50
Authors: Madsen Wendy 
Published: March 2003

Keeping the lid on infection: infection control practices of a regional Queensland hospital 1930–50 Nurses have played an important role in infection control practices throughout the past century. However, the desire for minimisation of cross infection has not always been the basis for many of the activities undertaken by nurses within the general ward. This paper is a historical analysis of those practices that formed the basis of infection control within the medical and surgical wards of the Rockhampton Hospital between 1930 and 1950. In particular, those activities dealing with the disposal of body fluids, ward cleaning, aseptic techniques and associated sterilisation of instruments and articles, the nurses’ personal cleanliness and isolation nursing have been addressed. This study has identified economic factors, professional image and local traditions as being influential in the origins and persistence of many activities which may be loosely grouped as infection control measures.
The culture of ‘culture’ in National Health Service policy implementation
Authors: Savage Jan 
Published: March 2003

The culture of ‘culture’ in National Health Service policy implementationThe widespread reference to ‘culture’ in UK NHS policy and organisational literature suggests that culture has, in itself, become a cultural phenomenon. This article draws on anthropological thought to explore this trend, and finds it stems from the way that the term ‘culture’ has become analytically empty. Lack of rigour in the way that culture is conceptualised allows it to be used both to suggest an evolved consensus among the workforce, and to validate the imposition of values and beliefs by management. Such manipulation of ‘culture’ is evident in recent NHS policy demanding cultural change to ensure a flexible, empowered and self‐regulating workforce — the type of workforce not only valued by health services, but pivotal to a post‐Fordist economy. The findings from an ethnographic study are drawn upon to consider the relationship between nurses’ cultural practices, corporate culture shaped by NHS policy, and the requirements of the economic domain. It is suggested that a commitment to post‐Fordist priorities of flexibility, empowerment and self‐regulation is not necessarily matched by any shift in the traditional location of power. The article concludes that greater analytical rigour is necessary to challenge the way in which ‘culture’ is manipulated by policy makers.
A ‘good enough’ nurse: supporting patients in a fertility unit
Authors: Allan Helen 
Published: March 2003

A ‘good enough’ nurse: supporting patients in a fertility unitIn this paper, I discuss the findings of an ethnographic study of a fertility unit. I suggest that caring as ‘emotional awareness’ and ‘non‐caring’ as ‘emotional distance’ may be forms of nursing akin to Fabricius’s (1991) arguments around the ‘good enough’ nurse. This paper critiques caring theories and contributes to the debates over the nature of caring in nursing. I discuss the implications raised for nurses if patients want a practical approach to caring and do not expect an emotionally intimate relationship from nurses.
Procedure manuals and textually mediated death
Authors: Quested Beverleigh , Rudge Trudy 
Published: March 2003

Procedure manuals and textually mediated deathThe procedure manual as a document represents the practice of nursing care. Analysis of such manuals allows us to explore discourses of nursing and the ways in which they frame nursing practice. A critical analysis of a hospital procedure manual using discourse analysis was undertaken. A specific excerpt concerning ‘Last offices’ is used as an example of the institutionalisation of organisational values and beliefs as these influence nursing care. ‘Last offices’ directs nursing practices related to the death of a patient, and the laying out as preparation for the funeral director or coroner. The analysis shows that procedure manuals reproduce hegemonic ideologies of nursing. The analysis also shows how nursing practices are constituted by intersecting forces of differing locations such as the hospital as an organisation, the healthcare system and the wider society within which these function.
Using an interpreter in qualitative interviews: does it threaten validity?
Authors: Kapborg Inez , Berterö Carina 
Published: March 2003

Using an interpreter in qualitative interviews: does it threaten validity?There is an extensive literature on the problem of translating scales for use across cultures, but very little is published on the problems of conducting qualitative interviews in another language with assistance of an interpreter. The aim of this paper is to describe and discuss threats to validity that arise when conducting qualitative interviews using an interpreter. Ten female student nurses in two cities in Lithuania were interviewed about how they perceived their educational program. All interviews were conducted in English with an interpreter. When using an interpreter to conduct interviews, potential threats to validity arise at various points in the interview process. A threat arises when the researcher, whose first language is Swedish, addresses a question in English to the interpreter, another during the translation by the interpreter from English to Lithuanian, and again when the interpreter translates the interviewee’s Lithuanian responses to English. In the last situation, the researcher may not know whether the interpreter has summarized and/or modified the responses. To mitigate these problems, the interpreter should not only have the required linguistic abilities, but also be trained in the research field. The researcher has to be aware of these threats to validity and make efforts to meet and limit their effects.
Meta‐analysis: the glass eye of evidence‐based practice?
Authors: Gregson P. Rodger W. , Meal Andrew G. , Avis Mark 
Published: March 2003

Meta‐analysis: the glass eye of evidence‐based practice?Meta‐analysis was developed as a technique for combining the results of many different quantitative studies: it is often used to produce quantitative estimates of causal relations and/or association between variables. Meta‐analysis is sometimes regarded as a central component of evidence‐based practice. We draw attention to an incompatibility in the epistemology and methods of reasoning in quantitative meta‐analysis and the epistemology and reasoning implicit in expert practice. We argue that this may be because the common perception of meta‐analysis appeals to truth as correspondence; we suggest that rejecting the naïve realism that underpins truth as correspondence allows meta‐analysis to be understood in terms of truth as coherence. We can then develop an account of meta‐analysis that does not depend upon reduction to a mathematical procedure but is an attempt to maximise coherence in beliefs about what works that is consistent with clinical reasoning in expert practice.
A polydiagnostic study of depressive disorders according to DSM‐IV and 23 classical diagnostic systems
Authors: Furukawa Toshi A , Anraku Kazutaka , Hiroe Takahiro , Takahashi Kiyoshi , Yoshimura Reiji , Hirai Toshiyuki , Kitamura Toshinori , Takahashi Kiyohisa 
Published: March 2003

AbstractThe classification of mood disorders is one of the most highly debated topics in modern psychiatry. The introduction of DSM‐III (and its followers) has set a new standard in this controversy but little empirical evidence is available as to how the various classical diagnostic categories of mood disorders by Kraepelin, Schneider, Leonhard, Hamilton, Kielholz, Winokur and others compare with this new standard. The Intensive Prospective Study arm of the Group for Longitudinal Affective Disorders Study has studied a broad spectrum of mood disorders in 23 participating centres from all over Japan with a polydiagnostic semistructured interview called Comprehensive Assessment List of Affective disorders. In this paper we examined how the various classical diagnostic systems of depressive disorders correspond to the DSM‐IV diagnoses, and found the following: (1) The classical ‘neurotic’ or ‘psychogenic’ depressions are diagnosed as major depression and not as dysthymia in DSM‐IV; although dysthymia was dubbed as ‘depressive neurosis’ in DSM‐III, its criteria were not true to the traditional usage of the term. Viewed from the other side of the coin, DSM‐IV can be said to stand in the unitary tradition. (2) Some of the classical diagnostic categories such as Schneider’s depressive psychopathy and Klein’s acute dysphoria as well as modern ones such as Akiskal’s subaffective dysthymia and Angst’s recurrent brief depression were rarely seen in traditional psychiatric treatment settings. (3) Comparisons of the unique diagnostic systems such as those by Leonhard, Winokur and Berner warrant further studies on their validity.
Dementia praecox to schizophrenia: The first 100 years
Authors: Adityanjee  , Aderibigbe Yekeen A. , Theodoridis D. , Vieweg W. Victor R. 
Published: March 2003

AbstractThe historical roots of dementia praecox and schizophrenia are described in the context of current nosology and continuing controversies surrounding this nosology. Relevant books and journal articles were reviewed. The information was obtained through computer searches and cross‐references from previously published papers. If English translations of foreign language articles were available, they were used; if not, the cross‐references were consulted. The psychoses have existed as diagnostic categories from ancient times although their names have changed. Initially, these disorders were considered diseases of the brain, a concept that was swept aside in the United States, influenced by European‐derived psychodynamic theories. American clinicians and investigators simply accepted these theories, showing little interest in testing their underlying principles. In contrast, a narrower Kraepelinian approach was adopted outside the United States, and attempts were made to refine its nosology. Because current data supports a central nervous system aetiology for schizophrenia, the concept of dementia praecox warrants resurrection. The authors suggest abandoning the term schizophrenia in favour of the more broad and generic term dementia praecox. Replacing ‘schizophrenia’ with ‘dementia praecox’ in the 21st century will facilitate further research and help clarify the nosology of various brain disorders currently included in the schizophrenias.
Hippocampus and amygdala volumes in elderly schizophrenic patients as assessed by magnetic resonance imaging
Authors: Sachdev Perminder , Brodaty Henry , Cheang David , Cathcart Stuart 
Published: March 2003

AbstractReduced size of the hippocampus and amygdala has been one of the more consistent morphological findings in schizophrenia, but the question of medial temporal abnormalities in elderly schizophrenia patients has been inadequately addressed. We examined 20 elderly subjects with a DSM‐III‐R diagnosis of schizophrenia, five of whom had a late‐onset schizophrenia (LOS), and compared them with 20 healthy volunteers on magnetic resonance imaging (MRI) and neuropsychological parameters. Hippocampus and amygdala volumes were obtained by manual tracing on T1‐weighted 1.5 mm thick contiguous coronal slices perpendicular to the long axis of the hippocampus. Patients had smaller left hippocampal and right amygdala volumes than comparison subjects, the mean differences being 9.7 and 11.1%, respectively, but the right amygdala volumes were not significantly different after Bonferroni correction. The hippocampus‐amygdala volumes together were smaller in the schizophrenia group bilaterally. In a pilot analysis, the LOS subjects had non‐significantly smaller hippocampus‐amygdala volumes than did the early‐onset schizophrenia (EOS) subjects. For the schizophrenia group, there were significant correlations between amygdala and hippocampus volumes and some neuropsychological performance indices. The findings are consistent with those reported in younger schizophrenics, and are of the same order of magnitude, suggesting that they are not likely to be progressive. This pilot analysis in LOS subjects argues against the condition being secondary to Alzheimer’s disease.
Typus melancholicus and the Temperament and Character Inventory personality dimensions in patients with major depression
Authors: Kimura Satoshi , Sato Tetsuya , Takahashi Toshihiko , Narita Tomohiro , Hirano Shigeki , Goto Miho 
Published: March 2003

AbstractAlthough many clinical studies have been conducted to determine the etiological role and clinical implications of typus melancholicus for unipolar depression, maladaptive personality features in depressive patients have not been well described. This study explores typus melancholicus, as measured by the rigidity subscale of the Munich Personality Test, and maladaptive personality features, as measured by the Temperament and Character Inventory (TCI), in 131 remitted patients with DSM‐IV major depression and 154 normal controls. The patients reported significantly higher scores on rigidity and harm avoidance and significantly lower scores on self‐directedness and cooperativeness. Only 23.6% of the variance of the rigidity scale was explained by the variance of the seven TCI scales, in which only persistence was significantly correlated positively to rigidity. Cluster analysis identified four subgroups, two of which were characterized by a high rigidity score. One of these two subgroups showed no maladaptive personality features, as measured by the TCI, while the other showed high harm avoidance and low self‐directedness. These results indicate that the personality of depressive patients is characterized not only by typus melancholicus but also by maladaptive personality features, that typus melancholicus is not well represented by any TCI scale, and that typus melancholicus and maladaptive personality features can coexist in some depressive patients.
Factors associated with admission to a geriatric hospital in semisuburban southern Japan
Authors: Arai Yumiko , Washio Masakazu , Kudo Kei 
Published: March 2003

AbstractA case‐control study was conducted to evaluate the factors associated with admission to a geriatric hospital. Case studied were 13 Japanese elderly who were admitted to a geriatric hospital because their female caregivers had found it impossible to look after them at home. We used 35 pairs of elderly and female caregivers, who were receiving domiciliary visits by nurses, in the catchment area of the hospital. The present study revealed that elderly with dementia (vs without; Odds ratio = 6.69) and with moderately limited activities of daily living (Barthel Index 61 +) (vs severely limited activities of daily living: Barthel Index 0–60; Odds ratio = 6.62), caregivers being a daughter‐in‐law (vs other kinship; Odds ratio = 6.30), were risk factors.
Affective communication of infants with autistic spectrum disorder and internal representation of their mothers
Authors: Kobayashi Ryuji 
Published: March 2003

AbstractWe have been examining the developmental process of affective communication in infants with autistic spectrum disorders from the viewpoint of relationship disturbance through our developmental and psychopathological studies on autism. In particular, the role of internal representation of the mother in the process of development of affective communication is discussed through the presentation of two cases diagnosed as autistic spectrum disorder in early infancy. In these cases, we postulate approach‐avoidance motivational conflict as the primary factor impeding development of affective communication, focusing therapeutic intervention on this perspective. As a result, attachment behavior was remarkably improved in the children, but affective communication with their mothers was not readily improved. Taking up the mothers’ own internal representation in mother–infant psychotherapy, in particular, the mothers’ problems in attachment behavior with their own mothers in infancy precipitated transition in the mothers’ internal representation of their children, leading to active evolution in mother–child interaction and development in affective communication between mother and child. In this context, the basis and significance of internal representation of both parties being determinants in the quality of mother–child communication are discussed.
A comparison of middle latency auditory‐evoked response in obstructive sleep apnea syndrome before and after treatment
Authors: Miyamoto Tomoyuki , Miyamoto Masayuki , Takekawa Hidehiro , Kubo Jin , Hirata Koichi , Katayama Soichi 
Published: March 2003

AbstractThe ascending reticular activating system seems to be affected by nocturnal hypoxia in obstructive sleep apnea syndrome (OSAS) patients so that their vigilance level is decreased. To evaluate the change in vigilance level in OSAS patients, polysomnography, the Epworth Sleepiness Scale and middle latency auditory‐evoked responses (MLR) were measured before and after treatment in seven men with OSAS (mean age 45.4 ± 12.9 years, mean body mass index 33.3 ± 7.6 kg/m2). After treatment there was significant improvement of nocturnal hypoxia in OSAS. Peak amplitude of P1 in MLR increased after treatment. There was also improvement of the electrical field distribution of MLR on the scalp. The results suggest that the decreased vigilance level in OSAS patients is reversible with treatment.
Amyotrophic lateral sclerosis associated with insomnia and the aggravation of sleep‐disordered breathing
Authors: Takekawa Hidehiro , Kubo Jin , Miyamoto Tomoyuki , Miyamoto Masayuki , Hirata Koichi 
Published: March 2003

AbstractA case of amyotrophic lateral sclerosis (ALS) diagnosed by sleep‐disordered breathing is described. The patient’s chief complaints were insomnia and nocturnal dyspnea after taking a hypnotic drug. On examination, he showed restrictive ventilatory impairment, alveolar hypoventilation and hypoxia. Polysomnographic examination revealed marked hypoxia during REM sleep periods, decreased duration of REM sleep periods, and increased sleep disruption. Amyotrophic lateral sclerosis was diagnosed by the neurological finding of paraspinal muscle weakness and neurogenic changes revealed by needle electromyography and muscle biopsy. The daytime and nocturnal respiratory insufficiency improved after nasal bilevel positive airway pressure therapy. Amyotrophic lateral sclerosis should be suspected as a cause of insomnia and nocturnal dyspnea.
Epidemiology of suicidal ideation and help‐seeking behaviors among the elderly in Japan
Authors: Ono Yutaka , Tanaka Eriko , Oyama Hiroshi , Toyokawa Keiko , Koizumi Takeshi , Shinohe Kiku , Satoh Kyoko , Nishizuka Emiko , Kominato Harue , Nakamura Kenji , Yoshimura Kimio 
Published: March 2003

AbstractThis study offers an analysis of the elderly (over 65 years of age) among a general community population in terms of the percentages of: (i) persons with recurring thoughts of death and/or of committing suicide, and (ii) people who have consulted others, including medical professionals, with regard to these problems. Among 433 elderly over the age of 65 in one community in a town in Aomori Prefecture, 358 agreed to participate in the project. Forty‐four participants (12.3%) responded that they had either ‘thoughts of death’ or ‘thoughts of suicide’, and these thoughts had continued for more than 2 weeks in 12 participants (3.4%). Only 15 of the 44 suicidal elderly responded that they had consulted someone about their problems. Although there are many elderly people exhibiting a subclinical depressive state with recurring thoughts of death or thoughts of suicide, the number of people who consult family members, professionals, or others is very low. This suggests the importance of community networking through educational activities so that people can more readily talk to and support one another.
A 5‐year‐old boy with recurrent mania successfully treated with carbamazepine
Authors: TUZUN UMRAN , ZOROGLU SULEYMAN SALIH , SAVAS HALUK ASUMAN 
Published: March 2003

AbstractIn the present paper the clinical symptomatology and treatment of childhood mania that was first seen in a child at 5 years of age and which re‐emerged at age 7, is reported. The patient presented at the child and adolescent psychiatric outpatient clinic of Istanbul Medical University with the typical symptoms of mania such of hyperactivity, euphoria, irritability, dangerous and risky behavior, decreased sleep, and age‐inappropriate sexual behavior. He was treated with carbamazepine safely and effectively without any major side‐effects. Clinical phenomenology and treatment of the condition are discussed with relevant literature.