bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deciphering the 4 D's: cognitive decline, delirium, depression and dementia – a review
Authors: Insel Kathleen C. , Badger Terry A. 
Published: March 2003

Deciphering the 4 D's: cognitive decline, delirium, depression and dementia – a review Purpose. The purpose of this paper is to assist advanced practice nurses to recognize, identify, and diagnose cognitive change in older adults. Background/rationale. Optimal cognitive function is important for continued independence, and yet changes in cognition are frequently unrecognized among older adults. Cognitive change in older adults can be observed due to age‐related cognitive decline, the development of acute confusion (delirium), depression, dementia and/or a combination of these. When the aetiological source for alterations in cognitive function is delirium or depression, the potential for reversibility mandates that the reason for the cognitive change be identified with steps taken to remedy the situation. Also, early recognition of dementia is an important factor in obtaining timely and appropriate care. These conditions can exist concurrently and may fluctuate making deciphering the reason for the cognitive change problematic. Conclusions. It is essential to understand how the 4 `D's' are expressed and to recognize the potential contributing factors to an observable change in cognitive function for diagnosis and treatment. Recommendations for obtaining a person's history are included.
Nursing as means of governmentality
Authors: Holmes Dave , Gastaldo Denise 
Published: March 2003

Background.  This paper conceptualizes nursing as a health profession in transformation at the beginning of the 21st century. We frame our analysis using Michel Foucault's concept of governmentality. While extensively quoted and used in other disciplines, the work of the late French philosopher has been cited infrequently in the nursing literature. Yet a closer look at his work reveals how Foucault offers a relevant entry point for revisiting nursing theory and nursing practice. Aim of paper.  The aim of this paper is to reflect on nursing practice as it is inscribed within the state's modus operandi. We discuss the prevalent notion that nurses are powerless and suggest they do exercise power in many ways and that they are a powerful group. Results.  In this paper we show how nursing is a means of governmentality of individuals and of the population because its practices contribute to the management of society through a vast range of power techniques. These techniques range from disciplining individuals to promoting discourses that construct desirable subjectivities. Within this perspective, the emergence of political aspects of nursing theory and nursing practice are made explicit. Conclusion.  We explore the limits and potentials of the concept of governmentality to the understanding of nursing as a health profession. This concept can generate a form of critical immobilism, but also promotes a more politically complex understanding of nursing practice.
A qualitative study of the experiences of a group of Hong Kong Chinese women diagnosed with postnatal depression
Authors: Chan Sally Wai‐Chi , Levy Valerie , Chung Tony K.H. , Lee Dominic 
Published: March 2003

Aim of the study.  To examine the lived experiences of a group of Hong Kong Chinese women diagnosed with postnatal depression. Background.  Postnatal depression affects approximately 1 in 10 childbearing women in Hong Kong. However, most studies of postnatal depression have been carried out in Western societies and no qualitative research was found describing the experience of Hong Kong Chinese mothers with postnatal depression. Design.  A phenomenological study was conducted. Data were collected by semi‐structured interviews. A purposive sample of 35 women diagnosed with postnatal depression was interviewed. Interview data were analysed following Colaizzi's phenomenological methodology. Results.  Themes that emerged describing participants' experiences included trapped in the situation, ambivalent towards the baby, uncaring husband, and controlling and powerful in‐laws. Women felt hopelessness, helplessness and loss of control. They were trapped in a situation that had no way of escape except by violent means, such as homicide or suicide. Feelings towards the baby were ambivalent, both hate and love. Several women had injured, or had thought of injuring or killing, their babies and/or themselves. Women's unhappiness was attributed to a noncaring husband, and controlling and powerful in‐laws. Generally, women did not seek help until their depression was diagnosed by screening tests. Conclusion.  This study has revealed insights into how women experienced postnatal depression in Hong Kong, and what they perceived as contributing to their depression. These insights may be used to guide interventions for women and their families to raise awareness regarding the support childbearing women need.
Development and testing of a Faces Scale for the assessment of anxiety in critically ill patients
Authors: McKinley Sharon , Coote Katherine , Stein‐Parbury Jane 
Published: March 2003

Background.  Many patients experience anxiety during treatment in an intensive care unit, but intensive care patients are often not able to respond to existing validated measures of anxiety such as the Brief Symptom Inventory. We have developed a new single item Faces Anxiety Scale made up of drawings of five faces. Aims.  The aims of this study were to: (i) assess the ability of intensive care patients to respond to the Faces Anxiety Scale; and (ii) investigate whether the scale yields ordinal and interval data. Ethics.  The project was approved by two Human Research Ethics Committees. Patients were included in the study if they gave informed consent. Instruments and methods.
(i) Intensive care patients (
n
= 40) were asked to respond to the Faces Anxiety Scale, the anxiety subscale of the Brief Symptom Inventory, and a numerical analogue anxiety scale; and (ii) Hospital and University staff and students (
n = 75) were asked to place the five faces in rank order. A further 100 staff members and students were asked to place each face at a point on a 60‐cm triangular wedge according to the level of anxiety they thought the face showed. Results.
The Faces Anxiety Scale elicited more responses from intensive care patients than the numerical analogue anxiety scale the or anxiety subscale of the Brief Symptom Inventory (36 vs. 25 vs. 17, respectively,
P < 0·0001). In the testing of the order of the scale items, 93% of respondents independently placed the scale items in the order of least to most anxiety as intended in the design of the scale. In the testing for equality of intervals respondents placed the faces relatively equidistant, with no overlap of 95% confidence intervals around the mean distances. Conclusion.  The Faces Anxiety Scale has minimal subject burden, elicits self report from intensive care patients more often than other simple scales, and has evidence of the interval scale properties of rank order and equality between the points on the scale.
Nursing staff and nursing students' attitudes towards HIV‐infected and homosexual HIV‐infected patients in Sweden and the wish to refrain from nursing
Authors: Röndahl Gerd , Innala Sune , Carlsson Marianne 
Published: March 2003

röndahl g., innala s. &carlsson m. (2003) Journal of Advanced Nursing 41(5), 454–461

Nursing staff and nursing students' attitudes towards HIV‐infected and homosexual HIV‐infected patients in Sweden and the wish to refrain from nursing Background. Two decades after the emergence of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), the infection remains enigmatic and shameful. In Sweden, many HIV‐infected persons still encounter attitudes of avoidance. Aims. The aims were to investigate differences between attitudes of nurses, assistant nurses, nursing students and assistant nursing students towards HIV‐infected and homosexual HIV‐infected patients; to measure their fear of contracting HIV; and to investigate whether nurses, assistant nurses, nursing students and assistant nursing students wanted to refrain from caring for HIV‐infected patients. Ethical issues. The participants were informed of the study orally and in writing. Completing and returning the anonymous questionnaires indicated the participants' tacit consent. Research method. The study had a descriptive, comparative quantitative design. The AIDS Attitude Scale was used, along with a questionnaire specially designed for the study. The participants were nurses and assistant nurses from one infectious disease clinic in central Sweden [response rate was 67% (n  = 57)]. Students enrolled in a university nursing programme and students of upper secondary assistant nurses' training [response rate was 62% (n  = 165)] were also included. Findings. In general, both the nursing staff and the nursing students expressed empathic attitudes towards HIV‐infected and homosexual HIV‐infected patients, as well as a low degree of fear of HIV contagion. The findings also showed, in the professional groups, that 36% would refrain from caring for HIV‐infected patients if that possibility existed. The corresponding figure for the student groups was 26%. Limitations. The chosen sample was small and not randomly selected therefore precludes a generalization in a wider context. Furthermore, the questionnaire was untested for reliability and validity, and may have influenced the findings with respect to the wish to refrain from nursing HIV‐infected patients. Conclusion. Suggested guidelines for nursing, mentor‐ship by AIDS‐dedicated nurses, and educational interventions, are given in ‘Implications for nursing and nursing education’.
Doing practice differently: solution‐focused nursing
Authors: McAllister Margaret 
Published: March 2003

Background. Critical thinking and reasoning take many forms; however, a problem‐orientation remains the favoured approach in health care. Purpose. This paper considers the effects of a problem‐orientation and argues that a solution‐orientation fits nursing's interests more closely and represents an exciting way forward in both education and practice. Discussion. Whilst a problem‐focus is criticized by some, it remains largely unchallenged as the guiding light for nursing practice. A major reason is that the problem focused approach has strong cultural roots. It is deeply embedded in our thinking, and has become taken‐for‐granted and not often recognized or debated. Whilst problem‐solving has an important place in helping to diagnose disorder and overcome difficulties, nursing needs to move beyond its borders because the role also concerns problem‐free issues such as health and well‐being. Creativity, imagination and focusing on strengths not problems are also important cognitive processes. Conclusion. A problem‐orientated approach in nursing has had a constraining rather than enabling influence. By refocusing on a solution‐focused approach, we could show how we are different from medicine, and how we aim to do nursing differently through using skills such as engagement, resilience‐building, community development, primary health care and health education.
Quality vs. quantity: energetic and nutritional trade‐offs in parental provisioning strategies
Authors: WRIGHT  , BOTH  , COTTON  , BRYANT  
Published: March 2003

1.  When faced with increased brood demand, parent birds provisioning young in the nest can make a variety of adjustments to their foraging and food allocation strategies. Logical extensions of classic optimal foraging theory predict increased provisioning effort to larger broods to be accompanied by changes in load size, foraging distance from the nest, as well as possible changes in the type and size of prey delivered. 2.  We assessed such behavioural adjustments and their consequences in pairs of European starlings (Sturnus vulgaris) responding to a range of experimental brood sizes. Parents feeding larger broods increased their visit rates by spending less time in the nestbox and less time around the nestbox colony. High visit rates to larger broods were also associated with larger loads per visit and changes in the type of prey delivered to the nest. As a consequence, chicks in large and small broods received similar rates of food intake, but experienced differences in the nutritional quality of their food. Parents feeding larger brood sizes were able to increase their provisioning effort despite feeding in the same foraging sites, travelling at comparable flight speeds and maintaining similar body masses to parents feeding smaller broods. 3.  Parental energetic expenditure, measured through doubly labelled water analyses, showed no effect of the brood size treatment. The greater proportion of indigestible material per gram of food delivered to the larger experimental brood sizes (i.e. soil from the guts of earthworms) was probably responsible for the fact that these chicks grew at slower rates and fledged at lower body masses, although we cannot rule out the possibility of lower growth rates due to higher energetic costs of sibling competition within larger broods. Lighter fledglings from large broods disappeared from the local area earlier in the summer, probably as a result of differential mortality rather than premature natal dispersal. 4.  We discuss the adaptive significance of the provisioning trade‐off between quantity and quality of food items delivered by parents to the nest, with reference to natural variation in foraging conditions and brood demand.
Ontogenetic influences on foraging and mass accumulation by big brown bats (Eptesicus fuscus)
Authors: HAMILTON IAN M. , BARCLAY ROBERT M.R. 
Published: March 2003

SummaryJuvenile flying animals, including bats, often cease increasing, or even decrease in body mass after the onset of flight. The low body mass of juvenile bats may be a result of stresses associated with the initiation of flight, or may be an adaptation to reduce flight costs.To test these hypotheses, the body masses of adults and unknown aged juvenile big brown bats (Eptesicus fuscus) were separately compared in August 1990 through to 1995. It was hypothesized that there should be little variation in the body mass of juveniles from year to year if low body mass is an adaption to reduce flight costs.The foraging behaviour and body masses of bats of known or estimated age were also compared in 1994 and 1995. Ambient temperature at sunset was greater in 1994 than in 1995. It was assumed that prey density and predictability increased with temperature, and hypothesized that if low body mass results from energetic stress, then this should be more apparent in 1995. Using radiotelemetry, the foraging behaviour of juvenile, yearling and adultE. fuscuswas compared in 1994 and 1995 to determine whether young bats attempt to compensate for energetic shortfalls by foraging for longer, or emerging earlier, than adults.Unknown‐aged juveniles did not differ significantly in body mass in August from 1990 through to 1995. Adults were significantly heavier in August in 1990 and 1994 than in 1991, 1993 and 1995. Known‐aged juveniles had lower body mass than adults in 1994, and lower wing loading than adults in 1995. Known‐aged juveniles did not differ in mass between 1994 and 1995, while adults were heavier in 1994.The foraging times for juvenile and adult bats were both significantly related to ambient temperature. However, the slope of this relationship was steeper for weaned juveniles than for adults. The foraging times of yearling and adults bats were not significantly different.The emergence times of juvenile and adult bats did not differ, nor did the emergence times of yearlings and adults. Emergence time did not differ significantly between 1994 and 1995.The results of the study suggest that juvenile bats maintain a low body mass even under conditions that permit adults to accumulate greater fat deposits. Juveniles do not forage earlier or for longer to compensate for poor foraging ability and increased energy expenditures resulting from the onset of flight. This suggests that, by maintaining a low body mass, juveniles reduce flight costs and the risk of predation at a time when flight and foraging are still developing.
Cohort variation in male survival and lifetime breeding success in red deer
Authors: ROSE K.E. , CLUTTON‐BROCK T.H. , GUINNESS F.E. 
Published: March 2003

Summary

We investigated cohort differences in the lifetime breeding success and survival of male red deer Cervus elaphus L. in an increasing population on the Isle of Rum, Scotland.
There were significant differences in survival through different stages of the life span between 15 cohorts of males, ranging between: 0.26–1.00, calf survival through first winter; 0.56–1.00, yearling survival; 0.44–0.94, adult survival. This variation in survival was related to environmental conditions in the cohorts' year of birth, whilst controlling for annual effects.
For 10 cohorts of males with complete lifetime data, mean breeding success also varied significantly, between 0.83 and 3.86. This variation, too, was associated with environmental conditions in the cohorts' year of birth.
Since in many sexually dimorphic mammals, the growth and survival of males is more strongly affected by adverse environmental conditions than that of females, we expected that cohort variation would be more extreme amongst males than females. This was true, for both cohort survival and reproduction.
We expected to observe selection on cohort adult body size, related to survival or reproduction. However, there was no evidence of variation in adult body size between cohorts, nor for relationships between differences in body size between cohorts and measures of survival or breeding success. Cohorts which underwent high intial mortality subsequently experienced higher adult survival than cohorts not subjected to high density‐related selection early in life.
Scale‐dependent correlations between the abundance of Brünnich's guillemots and their prey
Authors: Mehlum Fridtjof , JR George L. Hunt , Klusek Zygmunt , Decker Mary Beth 
Published: March 2003

1. The foraging ecology of Brünnich's guillemots Uria lomvia was studied during the breeding season in south‐eastern Svalbard. In the region of Storfjorden there are two large breeding colonies comprising a total of about 540 000 individuals. These birds forage in the western part of Storfjorden and further to the south. Their main prey are polar cod Boreogadus saida, pelagic amphipods Parathemisto spp. and euphausiids Thysanoessa inermis. 2. A ship‐based transect survey was used to record bird abundance and the acoustically determined biomass of presumed prey. The five transects were divided into 33 segments, each 8–11 km in length. The resolution of the survey was 150 m, and analyses of correlations between predators and prey were performed at length scales from 150 m to 9 km. We differentiated acoustic signals into aggregated and dispersed categories according to the estimated horizontal distribution of presumed prey. 3. Foraging guillemots were consistently more strongly correlated with the aggregated prey than with dispersed prey over scales ranging from 150 m to 9 km. Correlations were weak at small scales (150 m – 1 km) and increased and stabilized at scales of 2–3 km. The spatial scale at which we obtained a shift from weak to strong correlations between guillemots and their prey was similar to the scale at which the spatial variances in both guillemot and prey abundance were high. 4. Guillemots showed low correlations with prey at low prey densities. Similarly, correlations between guillemots and prey were low at low bird densities. The data support the hypothesis that the birds associate with prey patches with densities above a certain threshold, and that ‘regional’ prey abundances affect local use of patches. 5. The numerical aggregative response curves between guillemot and prey density were classified as being neither hyperbolic (type II) or sigmoidal (type III) within the range of prey densities observed in this study. The aggregative response curves were sensitive to spatial scales, which suggest that studies of response curves should be conducted at a range of spatial scales.
The taxonomic distinctness of coastal bottom‐dwelling fish communities of the North‐east Atlantic
Authors: Rogers Stuart I. , Clarke K. Robert , Reynolds John D. 
Published: March 2003

1. New techniques for identifying the average taxonomic range of species assemblages were applied to an extensive dataset of bottom‐dwelling fish in the coastal waters of NW Europe. These taxonomic distinctness indices provided much greater resolution than traditional diversity indices as they incorporated information on taxonomic relationships into an index which measures species dominance. Unlike standard measures of species richness and diversity, the mean value of these statistics is independent of sampling effort, and this allows objective comparisons to be made between samples from studies where sampling effort is not standardized. 2. A reduction in the average taxonomic range between the fauna of western waters of the UK and that of the southern North Sea was consistent with the general decline in species richness observed between these regions, and suggests that these two factors may be spatially positively correlated. Indices calculated for individual samples of fish on a local scale, however, did not all fit this trend. 3. Much of the variability in taxonomic diversity within the coastal waters of NW Europe was caused by the variable geographical distribution of the elasmobranchs. Of all the families which comprise the fish communities, this group has life‐history characteristics which make it most susceptible to impact by commercial trawl fisheries. 4. The use of taxonomic distinctness measures provided additional insights, of relevance to biodiversity assessment, suggesting that they might usefully be applied to other aquatic and terrestrial fauna.
The functional and aggregative responses of a herbivore: underlying mechanisms and the spatial implications for plant depletion
Authors: Rowcliffe J. Marcus , Sutherland William J. , Watkinson Andrew R. 
Published: March 2003

Summary 1. The functional and aggregative responses of dark‐bellied brent geese Branta bernicla bernicla feeding on the green algae Enteromorpha intestinalis and Ulva lactuca are described. 2. Bite rate showed maxima at both high and low algal biomass, although the functional response in terms of biomass intake rate was linear (type‐1). The differences in the shapes of these responses can be explained by the fact that bite size declines with decreasing algal biomass. 3. There was little interference between the geese; the rate of aggression was only weakly related to goose density, and time spent feeding decreased only slightly with increasing density. 4. Geese fed on all parts of the algal bed, showing weak, but significant aggregation in patches of higher algal biomass in both October and November. 5. The observed pattern of aggregation was weaker than that predicted by the ideal free distribution with a low value of interference. 6. Simulation models were used to explore four possible behavioural factors leading to this deviation from predictions: cost of travel between patches, constraints on the perception of patch quality, disturbance and short‐term resource guarding. It is concluded that resource‐guarding is likely to be the most important contributory factor.