bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of single dose caudal tramadol, tramadol plus bupivacaine and bupivacaine administration for postoperative analgesia in children
Authors: Gunduz M , Ozcengiz D , Ozbek H , Isik G 
Published: March 2003

Background: Our aim was to compare the effect of single dose caudal tramadol, tramadol plus bupivacaine and bupivacaine on the management of postoperative pain in children. Methods: Sixty‐three children in ASA groups I–II, between the ages of 1 and 5 were evaluated for postoperative pain randomly divided into three groups as follows: In group T, only tramadol was given caudally; in group TB, tramadol–bupivacaine was given caudally; in group B, bupivacaine was given alone. Pain was evaluated by using the paediatric objective pain scale (POPS). Sedation was evaluated with a 5‐point test. There were no differences with age, weight, haemodynamic and respiratory parameters between groups. Results: For 24 h postoperatively, the POPS value showed no statistically significant difference among groups (P > 0.05). Postoperative analgesia was maintained for 24 h. Nausea and vomiting was found to be higher in the tramadol group than in the bupivacaine group and tramadol–bupivacaine group (P < 0.001 and P < 0.01, respectively). Conclusion: Tramadol used caudally is as effective as bupivacaine in the management of postoperative pain in children and the addition of tramadol to bupivacaine, when both drugs were administered caudally, did not prolong the duration of action of bupivacaine and is a safe agent in children.
Parents’ preferences for participation in decisions made regarding their child’s anaesthetic care
Authors: Tait Alan R. , Voepel‐Lewis Terri , Munro Hamish M. , Malviya Shobha 
Published: March 2003

Background: The traditional paternalistic approach to medical decision‐making is moving towards a climate of greater patient and/or surrogate involvement. Despite this, there is considerable debate regarding patient preferences for participation in medical decision‐making and its effect on patient satisfaction and outcome. This study was designed to examine parents’ preferences for participation in decisions regarding their child’s anaesthetic care and to determine if active participation is associated with greater parental satisfaction. Methods: Three hundred and eight parents of children scheduled to undergo elective surgical procedures were asked to complete a questionnaire detailing information regarding their preferences for participation in decisions made regarding their child’s anaesthetic care. Parents were classified as being passive, shared, or active decision makers. Results: Overall, parents evidenced a preference for shared decision‐making with the anaesthetist. Parents preferred to be passive with respect to intraoperative pain management but active with respect to their presence when their child wakes up. There were no differences between active, shared and passive decision‐makers with respect to their satisfaction with anaesthetic care and their participation in decision‐making. However, 32.1% of parents stated that they would have preferred more involvement in decision‐making. These parents were significantly less satisfied with their child’s care than those who felt that their participation had been adequate. Conclusions: This study highlights specific areas in which parents would prefer a more active role in decision‐making and, as such, may serve to focus anaesthetists’ efforts to educate parents with respect to the various options available for their child’s care.
Survey of the use of oesophageal and precordial stethoscopes in current paediatric anaesthetic practice
Authors: Watson Agnes , Visram Anil 
Published: March 2003

Background: The aim of the study was to examine the use of oesophageal and precordial stethoscopes for monitoring in current paediatric anaesthetic practice in the UK and Ireland. Methods: A postal survey of members of the Association of Paediatric Anaesthetist of Great Britain and Ireland was undertaken. Results: One hundred and forty‐five questionnaires were returned with a response rate of 67.4%. Some 35.2% of anaesthetists never use an oesophageal or precordial stethoscope and the majority of the remaining 64.8% use one in less than one‐third of their practice. Conclusions: Use of the stethoscope as a continuous monitor has decreased and most anaesthetists feel it has been superseded by other monitoring. However, almost one‐third of anaesthetists recorded critical incidents they had been involved with where an oesophageal or precordial stethoscope detected the incident early. Complications of these monitoring devices were rare and the main factors limiting their use was the presence of better monitoring, such as pulse oximetry and capnography, and lack of availability.
Downfolding of the epiglottis induced by the laryngeal mask airwayTM in children: a comparison between two insertion techniques
Authors: Tsujimura Yasue 
Published: March 2003

Background: The purpose of this study was to compare the incidence of the downfolding of the epiglottis in children during insertion of the laryngeal mask airway (LMATM) using the standard technique and an alternative technique with the cuff partially inflated. Methods: Eighty paediatric patients were randomized into two groups and were anaesthetized using the LMA inserted with one of the two techniques. Results: There was no difference in the successful rate of insertion, fibreoptic findings and the lowest intraoperative SpO2 between the two groups. Conclusions: The partially inflated cuff insertion technique does not increase the incidence of the downfolding of the epiglottis in children and would be an acceptable alternative to the standard technique.
The effects of an educational programme on the anxiety and satisfaction level of parents having parent present induction and visitation in a postanaesthesia care unit
Authors: CHAN CONNY S. M. , MOLASSIOTIS ALEXANDER 
Published: March 2003

Background: In Hong Kong, some hospitals have established the practice of Parental Presence Induction (PPI) and visitation in Postanaesthesia Care Units (PACU) for children receiving surgery. The literature indicates that parents reported extreme anxiety and discomfort after being present at induction of anaesthesia and suggests that it would seem appropriate to devise a programme of education to reduce anxiety for parents. Methods: A quasi‐experimental pretest and post‐test design was employed. Parents in the experimental group received an educational programme about the role and expectations of parents having PPI and visitation in PACU together with an information pamphlet. The comparison group received routine (verbal) instructions. The Chinese version of the State and Trait Anxiety Inventory and the Parental Satisfaction with Care Questionnaire were used to assess parents' anxiety and satisfaction with care. Results: A total of 50 parents (mostly mothers) were recruited. Twenty‐five were allocated in the intervention group and 25 in the comparison group. The children were aged 1–9 years with a mean age of 2.9 years. There were 46 male and four female children. The results demonstrate that parents who received an education programme reported a decrease in anxiety (P < 0.001) and an increase in their satisfaction with the care provided (P < 0.001). A significant negative relationship (r=−0.61, P < 0.001) between parental anxiety postoperatively and the satisfaction with care score was also obtained, suggesting that lower levels of parental anxiety are associated with higher levels of satisfaction. Conclusions: The study suggests that an educational programme preparing parents for their child's induction of anaesthesia and visitation to the PACU should be offered, as it can reduce their anxiety with the practice of PPI and visitation in the PACU and increase parents' satisfaction with care.
Priorities for disclosure of the elements of informed consent for research: a comparison between parents and investigators
Authors: TAIT ALAN R. , VOEPEL‐LEWIS TERRI , ROBINSON ANGELA , MALVIYA SHOBHA 
Published: March 2003

Background: Disclosure is a key element of the informed consent process. This study examines and compares the priorities for disclosure of the elements of informed consent between parents of paediatric research subjects and investigators. Methods: The study sample comprised 184 parents who had been approached for permission to allow their child to participate in a clinical anaesthesia or surgery study. Parents were asked to rank 11 elements of informed consent that they believed were most important for them to know before allowing their child to participate in a research study. In addition, 38 investigators were asked to rank, in order of importance, the same elements that they felt were most important for parents to know. Results: The results showed that risk was the most important element considered by both parents and investigators. However, parents placed significantly greater importance on knowledge of the potential benefits to their child (direct) and to other children (indirect) compared with investigators, and less importance on the details of the protocol and the element of voluntariness. Conclusions: These results demonstrated differences in the priorities for disclosure of the elements of consent between parents and investigators. As such, they may be important in directing the investigator to focus on the elements that are most important to parents and thus maximize their ability to provide truly informed consent.
Tolerance of the rabbit cornea to an n‐butyl‐ester cyanoacrylate adhesive (Vetbond®)
Authors: Ollivier Franck , Delverdier Maxence , Regnier Alain 
Published: March 2003

Abstract Objective
An n‐butyl‐ester cyanoacrylate adhesive available for veterinary surgery (Vetbond®, 3M) was tested in rabbits for corneal irritation. Procedures
Two experimental procedures were used on 24 rabbits: injection of the adhesive into an intralamellar corneal pocket (n = 10) and application of the glue to a mid‐stromal corneal defect (n = 14). In both experiments the eyes were examined for 20 days for evidence of corneal irritation and tolerance. At the end of each experiment, histopathologic studies were performed on all corneas. Results  The corneal reaction to the intrastromally injected cyanoacrylate was characterized clinically by slight edema and vascularization localized to the vicinity of the adhesive. A moderate foreign body‐type reaction was found histologically. Following application of the adhesive to a central stromal defect, the treated corneas remained totally clear and histopathologic examination showed that the healing process was not altered compared to the controls. The mean retention time of the glue patch was 14 days. Conclusions  Intrastromal injection and surface application to a corneal defect of n‐butyl‐ester cyanoacrylate to a corneal defect induced only a mild inflammatory response and did not interfere with the reparative process. These findings suggest that this surgical adhesive would be acceptable for treating corneal ulcerations in animals.
A single amino acid change in the coat protein of Maize streak virus abolishes systemic infection, but not interaction with viral DNA or movement protein
Authors: Liu Huanting , Andrew  , Lucy P. , Davies Jeffrey W. , Boulton Margaret I. 
Published: March 2003

SummaryFunctional coat protein (CP) is important for host plant infection by monopartite geminiviruses. We identified a proline‐cysteine‐lysine (PCK) motif at amino acids 180–182 of the maize streak virus (MSV) CP that is conserved in most of the cereal–infecting Mastreviruses. Substitution of the lysine (K) with a valine (V) in the CP of MSV to produce mutant MSVCP182V abolished systemic infection in maize plants, although the mutant replicated around the inoculation site and, unlike other MSV CP mutants, enabled single‐stranded (ss) DNA accumulation in suspension cells. The stability of the mutant protein, CP182V, in infected cells was confirmed by immunoblotting, but virions could not be detected. Like the wild‐type (wt) CP, CP182V localized to the nucleus when expressed in insect and tobacco cells, and the Escherichia coli‐expressed protein bound both ss and double‐stranded DNA and interacted with movement protein in vitro. Taken together, these data suggest that mutation of amino acid 182 affects virion formation of MSV, either by affecting encapsidation per se or by affecting particle stability, and that virions are necessary for the long‐distance movement of MSV in maize plants.
Microsatellite markers reflect intra‐specific relationships between isolates of the vascular wilt pathogen Ceratocystis fimbriata
Authors: Barnes Irene , Gaur Anupama , Burgess Treena , Roux Jolanda , Wingfield Brenda D. , Wingfield Michael J. 
Published: March 2003

summary Ceratocystis fimbriata is a serious wilt and canker stain pathogen with a wide geographical distribution and host range that includes both woody and herbaceous plants. Previous studies using hybridization have shown that isolates of C. fimbriata from different hosts and origins differ in colony morphology, pathogenicity and growth rate, as well as conidial state. It has therefore been suggested that distinct strains, linked to host or geographical origin, are encompassed in C. fimbriata. The aim of this study was to develop PCR‐based microsatellite markers for population studies on C. fimbriata. ISSR‐PCR was used to target specific microsatellite regions of DNA from C. fimbriata. These amplified products were cloned and sequenced. Primer pairs were designed from these sequences to flank the microsatellite regions. From 24 primer pairs, 11 polymorphic primers were selected and tested on a number of C. fimbriata isolates representing a wide host and geographical range. Cluster analyses of the results indicate that these markers clearly distinguish between different geographical and host specific populations of C. fimbriata. The results are concordant with sequence data from the internal transcribed spacer (ITS) region of the rDNA operon of the same isolates. These markers will be useful in future studies of C. fimbriata population structure and diversity.
The staff’s experience of the death of a child and of supporting the family
Authors: Kaunonen M. , Tarkka M.‐T. , Hautamäki K. , Paunonen M. 
Published: March 2003

AbstractThe purpose of the study was to describe how staff members experience the death of a child and how they support the grieving family. The goal is to find means to improve supporting activities in the university hospital. The data for this study were collected with a questionnaire given to the staff who encounter the death of a foetus or infant at their work (n = 102). The questionnaire contained both structured and open‐ended questions. Altogether, 69 members of the staff (68%) answered the questionnaire. The open‐ended questions were analysed using content analysis. The staff experiences of a child’s death manifested themselves in grief, feelings of injustice, experiences of one’s limited resources, and relief. About half (51%) of the respondents estimated that they were able to support families rather well. Education in supporting the grieving family increased the ability to support families. Social support for families included emotional, informational, and concrete support. The majority of the staff expected support from colleagues after the death of a child. The study results show that the hospital staff supports the grieving family, but also recognizes their inadequacy as supporters. The staff also needs support in order to be able to support the grieving family.
Caring as experienced by minority ethnic patients
Authors: Cortis J. D. 
Published: March 2003

AbstractInternational nursing literature associates ‘nursing’ as inextricably linked with ‘caring’. However, as Leininger (1995) suggests, although caring is a universal phenomenon, its manifestation is very much dependant on culture. For caring to be effectively received, the conceptualization of caring at both individual and community level needs to be realized in practice. This paper focuses on a qualitative research study on a sample of 20 male and 18 female respondents from Pakistani communities in Bradford, West Yorkshire. UK, using face‐to‐face in‐depth semi‐structured interviews. The significance of ethno–linguistics, or the relationship between language and culture, has been addressed by a number of anthropologists. People associate what is meaningful to them as defined by their culture. By eliciting various linguistic terms used for ‘care’ terms and applied to health and ‘well‐being’, the cultural meanings within an ‘emic’ perspective, as well as variability of the use of the care terms in different contexts, could be discovered. Hence the first stage of this study focused on the respondents’ understanding and perceptions of caring. Care themes and patterns emerged to form seven themes. The same sample was later facilitated in exploring their recent experiences of ‘care’ as delivered by nurses in hospital. The findings suggest that a lack of congruence between patients’ expectations and experiences of caring received from nurses did exist. The paper concludes by suggesting possible strategies to address the identified deficits, for example a cultural knowledge base and enhancing assessment skills in nurses.
A tale of teaching in two cities
Authors: Kater V. 
Published: March 2003

Abstract Internationally, nurses are health care educators, in institutions, clinics and field sites. This article describes a cross‐cultural experience of sharing health care teaching methodologies, between a nurse from Israel and a small group of Ethiopian nurses in Addis Ababa. These nurses were working to prepare groups of Ethiopian Jews, through health education, for the transition to life in Israel. It is a prime example that nursing is without borders. This period of teaching produced a mutual learning experience of great value for the local nursing staff and visiting lecturer, which may provide useful insights for other nurses working in cross‐cultural conditions.
Transformational leadership: moving total quality management to world‐class organizations
Authors: Trofino A. J. 
Published: March 2003

AbstractTransformational values and competencies will become critically important by the year 2001 if we are to achieve a health system that fosters community well‐being and basic care for all, financed through a combined public–private partnership that is cost effective and uses treatments that unite body, mind and spirit. This article will focus on the use of transformational leadership as a strategy to move health‐care organizations beyond traditional values and approaches by building upon the core values of total quality management (TQM). Learning organizations will emerge and finally world‐class organizations will evolve, combining the characteristics of total quality and learning organizations, and more. A world‐class organization can be described as being the best in its class or better than its competitors in the community, state, nation or world.
Career planning and development for nurses: the time has come
Authors: Donner G. J. , Wheeler M. M. 
Published: March 2003

AbstractDevelopments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career‐development activities that will enable nurses to continue to provide high‐quality care in ever‐changing health care systems.
Community development and health project: a 5‐year (1995–1999) experience in Mozambique, Africa
Authors: Ferrell B. J. A. G. 
Published: March 2003

AbstractThe Community Development and Health Project (1995–1999) in Mozambique, East Africa, was undertaken to help alleviate the dire circumstances of daily life following years of internal warfare. The project was supported by the International United Methodist Church and was administered by the Mozambique Conference of the United Methodist Church, Chicuque Rural Hospital and Cambine Health Center. The target population, whose daily survival depended on subsistence farming, lived throughout the country, in particular in rural areas, far from health care facilities. The Project Content included the following topics: basic education in personal and environmental hygiene; proper nutrition using locally available food products; methods of agriculture that would ensure the best use of the land for growing nutritious food; economic methods to guarantee a supply of safe drinking water; disease prevention/home treatment; maternal child health; self‐esteem issues; and establishing a representatively inclusive community‐development committee. Indigenous women, the ‘promotoras/os’, were selected from their communities, attended a 4‐week training session and then returned to their homes as ‘Promotoras/os of Community Development and Health’.
Student characteristics and subculture trends in interpersonal skills workshops
Authors: Gilmartin J. 
Published: March 2003

AbstractThe aim of this study was to explore the experiences of student nurses when learning interpersonal skills and to examine the impact of small group work. A qualitative methodology was used. The sample comprised 50 student nurses who were undertaking the preregistration diploma course. In‐depth interviews were employed to collect the data. The findings indicated that many students resisted learning owing to a range of personal characteristics that influenced the learning process. A student typology was constructed which highlighted four types of student characteristics that emerged from the data. Significant characteristics relating to each type of student behaviour are emphasized. This report also combines the student typology with the emergence of three distinct subcultures that frequently both interrupt and enhance learning. In presenting the subcultures the implications for group work are considered in conjunction with study limitations.