bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral health in children undergoing liver transplantation
Authors: Sheehy Evelyn C. , Roberts Graham J. , Beighton David , O’Brien Graham 
Published: March 2003

Aims. To determine the prevalence of dental caries in children undergoing liver transplantation and to compare the plaque, gingivitis, and gingival overgrowth indices and oral mucosal lesions in children before and after liver transplantation. Patients and methods. Patients undergoing liver transplantation at King’s College Hospital were examined before transplantation, at 3 and 106 days post‐transplantation. Healthy children from the Greenwich Health District, south‐east London, were matched to the liver transplant patients by age, gender, socio‐economic factors and the presence or absence of active dental caries. Results. Twenty‐seven liver transplant patients (mean age: 7 years and 10 months; SD 3 years and 5 months) and 27 controls (mean age: 8 years and 6 months; SD 3 years and 7 months) were examined. The mean dmft and DMFT scores were 2·3 (SD 4·1) and 0·8 (SD 1·4), respectively, in the liver transplant patients, and 1·2 (SD 2·2) and 0·9 (SD 1·5), respectively, in the controls. There were no significant differences between either the mean plaque or gingivitis indices for the primary and permanent teeth in patients before and after transplantation. There were no significant differences between the liver transplant patients and the controls for either mean plaque or gingivitis indices at each examination time. Gingival overgrowth was present in 41% of liver recipients receiving cyclosporin with or without nifedipine, but not in the majority receiving tacrolimus at the final examination. Oral mucosal lesions were absent in both the patients and controls at each examination time. Conclusions. The oral health of the children undergoing liver transplantation was inadequate. Funding and implementation of an oral health care programme must become a priority for all children before and after liver transplantation.
A three‐dimensional method of visualizing the temporomandibular joint based on magnetic resonance imaging in a case of juvenile chronic arthritis
Authors: Kitai N. , Kreiborg S. , Murakami S. , Bakke M. , Møller E. , Darvann T. A. , Takada K. 
Published: March 2003

Summary. Aim. The purpose of this study was to present a new visualizing method for temporomandibular joint (TMJ) pathology in 3D at several condylar positions and to apply the method to a case of juvenile chronic arthritis (JCA) with previously diagnosed bilateral TMJ disorder and to a subject without signs and symptoms from the TMJ. Subject. The 20‐year‐old female patient had suffered from polyarticular JCA from the age of 6 years 8 months. The present study is based on a follow‐up examination after the completion of orthodontic treatment with the Herbst appliance. Both TMJs were examined using magnetic resonance imaging (MRI) at closed and open mouth positions. The mandibular condyle, the glenoid fossa and the articular disc were segmented and 3D reconstruction of these structures was carried out. Results. The condyle was characterized by an increased sagittal diameter with osteophyte‐like formation at the anterior aspect of the condylar head and flattening of the superior surface. The depth of the glenoid fossa was reduced and the articular eminence was remarkably flat. The articular disc was markedly diminished and posteriorly placed on the condylar head. The distance of the condylar path during mouth opening was reduced and the curvature of the condylar path was quite flat. The disc moved slightly posteriorly on the condylar head and remained in the glenoid fossa during mouth opening. Conclusion. The imaging modality described improves visualization of TMJ morphology and gains insight into the TMJ pathology of the JCA patient, adding to understanding of the clinical problems.
Caries risk analysis: considering caries as an individual time‐dependent process
Authors: Kalwitzki M. , Weiger R. , Axmann‐Krcmar D. , Rosendahl R. 
Published: March 2003

Summary.Aim.To estimate the probability that a tooth does not develop a cavitated lesion (= end‐stage caries) within time periods of interest. Additionally it was of interest to assess the heterogeneity between patients, in relation to the time periods required for their teeth to develop a cavitated lesion.Design .A prospective study using patient data of a clinical pedodontic course.Sample and methods .Forty‐one patients who had been followed for at least 3 years were selected. Before initiation of therapy, affiliation to a specific risk group was checked. Nine individuals who had belonged to a high‐risk group on test were excluded. Of 1968 teeth, 1378 were eligible for data evaluation. The statistical techniques applied originate from time‐to‐event analysis methods, including a parametric frailty approach providing estimates of the relative caries risk for each individual to develop a cavitated lesion.Results In the selected group of patients the probability that a tooth remained free of a cavitated lesion within five years ranged from 0·89 to 0·95 applying a 95% confidence interval. In the present sample the true caries risk of the patients to develop a cavitated lesion varied considerably although such variation was not expected from the individual examinations at baseline.ConclusionThe frailty model accounts sufficiently for the heterogeneity of each patient. The applied time‐to‐event methods facilitated reliable estimation of both the probability that a tooth remains free of a cavitated lesion within a certain time and the relative caries risk of an individual to develop a cavitated lesion.
Creating effective nursing partnerships: relating community development to participatory action research
Authors: Lindsey Elizabeth , Sheilds Laurene , Stajduhar Kelli 
Published: March 2003

Creating effective nursing partnerships: relating community development to participatory action research The purpose of this article is to demonstrate the importance of creating effective partnerships between nurses practising community development (CD) and nurses engaged in participatory action research (PAR). To that end, an overview of the theoretical principles of CD and PAR is provided and the central tenets of each methodology explored. This is followed by a discussion of the similarities and differences inherent in CD and PAR which derive from the same theoretical and philosophical foundation; that of critical social theory. Examples of two research projects highlight the relationship between CD and PAR and demonstrate the value of creating effective practitioner/researcher partnerships. Finally, some of the lessons learned in creating these important partnerships will be presented. Although this call for practitioner/researcher alliance is not new, what is new is the central role the practising nurse could take in research. Creating partnerships between practising nurses and nurse researchers advances the opportunity to actualize responsive and effective PAR and to fulfill nursing's social contract.
Recording skills practice on videotape can enhance learning — a comparative study between nurse lecturers and nursing students
Authors: Minardi Henry A. , Ritter Susan 
Published: March 2003

Recording skills practice on videotape can enhance learning — a comparative study between nurse lecturers and nursing students Video recording techniques have been used in educational settings for a number of years. They have included viewing video taped lessons, using whole videos or clips of tapes as a trigger for discussion, viewing video recordings to observe role models for practice, and being video recorded in order to receive feedback on performance from peers and tutors. Although this last application has been in use since the 1960s, it has only been evaluated as a teaching method with health care professionals in the past 10 years and mostly in the areas of medical and counsellor education. In nurse education, however, use of video recording techniques has been advocated without any empirical evidence on its efficacy. This study has used nursing degree students and nurse educationalists to categorize statements from four cohorts of students who took part in a 12‐day clinical supervision course during which their interpersonal skills were recorded on videotape. There were two categories: positive and negative/neutral. Analysis of the data showed that between 61% and 72% of the subjects gave an overall positive categorization to the statements in the questionnaire. Chi‐square tests were significant for all groups in both categories. This suggests that both nursing students and nurse lecturers thought that course participants’ statements expressed a positive belief that video tape recording is useful in enhancing students’ ability to learn effective interpersonal skills in clinical supervision.
Nurses’ perceptions of collaborative nurse–physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit
Authors: Higgins Linda W. 
Published: March 2003

Nurses’ perceptions of collaborative nurse–physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit This prospective correlational study examined nurses’ perceptions of collaborative nurse–physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit, adjusting for risk. The convenience sample consisted of 175 patient transfer decisions. Charts and computerized databases were used to collect patient information, and a questionnaire developed by the investigator was used to obtain demographic data from the 42 medical intensive care nurses. An adapted version of the Decision About Transfer scale served to measure the nurses’ perceptions of collaboration and satisfaction with respect to specific patient transfer decisions, as well as decision task complexity, and the Acute Physiology and Chronic Health Evaluation was utilized to adjust for patient risk. Information Processing Theory guided the study.Hierarchical logistic regression analyses first showed that the nurses’ perceptions of collaboration were not a significant predictor of patient outcomes. Furthermore, the analysis also showed that decision task complexity and the nurses’ years of critical care experience did not significantly moderate the contribution of nurses’ perceptions of collaboration to patient outcome prediction. Finally, a Pearson product moment correlation coefficient of 0·28 revealed a statistically significant (P = 0·000), positive relationship between the nurses’ perceptions of collaboration and their satisfaction with the decision making process about decisions to transfer.
Social support: factors to consider when designing studies that measure social support
Authors: Hutchison Catherine 
Published: March 2003

Social support: factors to consider when designing studies that measure social support Research into the area of social support has been associated with confusion and concern. Much of the previous work in this area has inherent and serious difficulties, especially with regard to measurement issues surrounding the concept and with study design. However, it is paramount that social support research is further developed to allow effective interventions by health care professionals to influence positive outcomes in patient care. It is only by adopting a rigorous approach to social support research that its full potential can be achieved, that it can result in the positive promotion of recovery from mental and physical illness and that it can then become an important tool for the health care professional. This paper aims to clarify research issues relating to social support definition, measurement and study design, including methodology, selection of instruments and analysis. Guidance will be provided concerning the important factors to consider to achieve a well‐designed study to measure social support.
Still attractive after all these years? Magnet hospitals in a changing health care environment
Authors: Buchan James 
Published: March 2003

Still attractive after all these years? Magnet hospitals in a changing health care environment This paper examines the research base for ‘magnet hospitals’— hospitals that have a good reputation for recruitment and retention of registered nurses. It also assesses the extent to which the concept of the magnet hospital continues to have relevance to nursing in the United Kingdom (UK). The study reviews previous research, examines recent trends in nursing employment, and reports on case studies conducted as fieldwork research. The early research on magnet hospitals, conducted in the 1980s in the United States of America (USA), is reassessed in the light of subsequent cost containment driven changes in the USA nursing labour market and in the organization of USA hospitals. Many of these changes have impacted on nursing staff, with increases in workload, and with changes in skill mix, particularly as a result of increased use of care assistants. Similar developments have been happening in the UK. The paper examines the extent to which the concept of the magnet hospital can retain validity in this changing health care environment. Case studies in 14 USA magnet hospitals were conducted in 1997. The results highlight that, as a result of hospital reorganization and merger, some of these hospitals no longer exhibit core characteristics of ‘magnetism’, whilst others have retained these characteristics despite organizational change. The paper concludes by cautioning that the concept of the magnet hospital continues to have a relevance to the management of nursing resources, but that the research base, with some notable exceptions, continues to be weak and that there is a need for monitoring and a process of re‐ accreditation to maintain a ‘live’ register of magnet hospitals.
The impact of seclusion on the treatment outcomes of psychotic in‐patients
Authors: LeGris  , Walters  , Browne  
Published: March 2003

The impact of seclusion on the treatment outcomes of psychotic patients The controversial practice of seclusion for the treatment of the acutely emotionally ill continues despite a lack of proven effectiveness. This retrospective cohort study examined the impact of seclusion alone and in combination with other important patient‐centred treatment variables (medications), disease severity variables, psycho‐social and demographic variables that best predicted outcome (as defined by length of hospital stay and reduced pathology at discharge) for a group of consecutively admitted psychotic in‐patients. Comparisons of baseline and outcome measures for secluded and non‐secluded cohorts were made via t‐test analysis, and patient‐related variables were entered as groups for stepwise regression analysis to determine those factors that could best predict outcome. Data were collected via a comprehensive chart review of 85 patients with psychosis, who were consecutively admitted over an 8‐month period to a psychiatric in‐patient unit of a general community hospital in southern Ontario, Canada. Bigelow’s Psychiatric Symptom Assessment Scale (PSAS) was applied to the chart admission and discharge data to determine both initial pathology scores and pathology change scores. Investigator‐developed global rating scales measured the early pharmacological and psycho‐social variables of interest. Although seclusion itself did not appear to be associated with any more or less improvement in mental status at discharge, seclusion was associated with a 12‐day increase in length of hospital stay, raising additional questions about its therapeutic effectiveness. Early medication response together with seclusion predicted 16% of the total variance of length of hospital stay (P = 0·0011) while baseline pathology, being married and being employed together predicted 66% of reduced pathology at discharge (P = 0·00001). Secluded subjects experienced an earlier age of illness onset, were employed or full‐time students, exhibited poorer attitude towards hospital, were more likely to be substance or drug abusers, received greater doses of chlorpromazine‐equivalent medications, and had longer lengths of hospital stay than their non‐secluded cohorts. Two predictive regression equations were formulated on the basis of these results. This study has raised several questions for further prospective investigation, has validated previous findings in the literature, and has produced new findings that may be of interest to administrators and clinicians providing quality care to this high‐risk population.
‘Coming out’ as a life transition: homosexual identity formation and its implications for health care practice
Authors: Taylor Bridget 
Published: March 2003

‘Coming out’ as a life transition: homosexual identity formation and its implications for health care practice This paper explores the formation of homosexual identity through the complex transitional process of ‘coming out’. Linear developmental models are discussed as is the influence of societal norms on identity formation. In considering the implications for professional practice the author challenges the heterosexism in health care and suggests ways in which health care professionals can provide a supportive environment for gay men and lesbians.
Help or hindrance? Single, unsupported mothers’ perceptions of health visiting
Authors: Knott Mary , Latter Sue 
Published: March 2003

Help or hindrance? Single, unsupported mothers’ perceptions of health visitingAlthough there have been studies of clients’ perceptions of health visiting, the views of single, unsupported mothers about the health visiting service have been under‐researched. Therefore, this study investigated their views using semi‐structured interviews with 12 single, unsupported mothers identified by health visitors within one National Health Service Community Trust. The data were analysed using Burnard’s (1991) thematic content analysis, which enabled a number of identifiable themes to emerge. Findings showed that the participants perceived the health visiting service as being concerned almost exclusively with babies and there was a general lack of understanding about the broader role of the health visitor. Clinics were seen as places to visit to weigh the baby but not as a contact point with a health visitor. Some health visitors were perceived as being judgemental in attitude and not necessarily interested in the clients as individuals. Participants considered that health visitors should be friendly, interested, able to promote their confidence and offer individualized advice. Overall the study suggests that health visitors may not be utilizing all dimensions of their role with single, unsupported mothers and may not be communicating effectively with them about this. The study also shows that single, unsupported mothers wish to be treated in the same way as other mothers but at present some feel that they are stigmatized and treated differently. The paper concludes with an outline of the implications of the findings and recommendations for practice and future research.
Clinical supervision and managerial supervision: some historical and conceptual considerations
Authors: Yegdich Tania 
Published: March 2003

Clinical supervision and managerial supervision: some historical and conceptual considerations The current lack of consensus among authors in the United Kingdom on the concept of clinical supervision continues unabated, although enthusiasm for its implementation is being questioned by those who would be supervized. The literature now reports confusion among practitioners on the differences between clinical and managerial supervision, and supervision and therapy. This paper addresses the differences between clinical and managerial supervision by revealing nursing’s history of clinical supervision. It is argued that until the current underlying conceptual ambiguities are identified and corrected, clinical supervision remains at risk of deteriorating into managerial supervision.
An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancer
Authors: Balneaves Lynda G. , Long Bonita 
Published: March 2003

An embedded decisional model of stress and coping: implications for exploring treatment decision making by women with breast cancerTreatment decision making by women with breast cancer has been recognized to be an inherently stressful process. However, past decisional theory and research has failed to fully elucidate the personal, transactional, and relational nature of choice behaviour. The purpose of this paper is to explore an embedded decisional model of stress and coping that locates key assumptions ofJanis & Mann’s (1977) conflict‐theory model of decision making withinLazarus & Folkman’s (1984) transactional framework. Through combining decisional and stress and coping theories, a model is developed that addresses the theoretical limitations of the conflict‐theory model and provides greater specificity within decision‐making research. The paper examines the complexity of treatment decision making within the context of the constructs of causal antecedents, primary appraisal, secondary appraisal, coping, and adaptational outcomes. Examples specific to women with breast cancer are provided to illustrate the potential application of the embedded model. The implications of this inclusive and comprehensive decisional theory for future knowledge development and research in the area of treatment decision making are also discussed.
Improving continuity of care across psychiatric and emergency services: combining patient data within a participatory action research framework
Authors: Heslop Liza , Elsom Stephen , Parker Nyree 
Published: March 2003

Improving continuity of care across psychiatric and emergency services: combining patient data within a participatory action research framework Presented with the concerns of emergency department nurses about providing appropriate and co‐ordinated care for patients seeking mental health services, a Monash University School of Nursing, Victoria, Australia, research team chose a participatory action research strategy. Jointly executed with staff from the Peninsula Health Care Network, the research process brought together in a number of fora multiple disciplines involved in the care and management of psychiatric patients. The participatory action research process itself was the first step in remedial action. Through it, participants and management gained a firmer view of the issues facing Frankston Hospital Emergency Department staff in dealing with psychiatric patients, and in securing their access to suitable pathways of care. Other research outcomes included: a compilation of summary statistics showing patterns of use by psychiatric patients of Frankston Hospital’s Emergency Department; beginning discussions about pathways of care for these patients; and the development of a screening tool to be used by the triage nurse for at‐risk psychiatric patients presenting to the Emergency Department.