bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comforting strategies used during nasogastric tube insertion
Authors: PENROD JANICE , MORSE JANICE M. , WILSON SHARON 
Published: March 2003

• Nasogastric tube insertion is a procedure that commonly involves discomfort, yet requires the cooperation of the conscious patient.• This study employed qualitative ethology to investigate how comforting strategies were used during the insertion of nasogastric tubes in trauma care.• Practitioners used eight direct and indirect comforting strategies in uniquely patterned styles (technical, affective and blended).• In addition, a form of `team comforting' was implemented as multiple trauma team members made a concerted effort to complete the procedure.• Further study is needed to explicate how the nurse's style affects the behavioural state displayed by the patient.
Testing an oral assessment guide during chemotherapy treatment in a Swedish care setting: a pilot study
Authors: ANDERSSON PIA , PERSSON LENA , HALLBERG INGALILL RAHM , RENVERT STEFAN 
Published: March 2003

• Oral complications are common in patients with haematological malignancies who undergo chemotherapy treatment. A pilot study including 16 haematological patients was carried out to evaluate the oral status using an Oral Assessment Guide (OAG) and to test the reliability of the OAG.• The oral assessments were made daily by registered nurses at a Department of Internal Medicine in Sweden. Once a week a dental hygienist made the oral assessments independent of the registered nurses in order to provide data for calculations of inter‐rater reliability.• All patients had varying degrees of alterations in the oral cavity, especially in the mucous membranes, teeth/dentures and gums. The inter‐rater agreement between the nurses and the dental hygienist was good for saliva and swallow, and moderate for voice and gums.• Assessments to detect alterations in the oral cavity afford the opportunity for early and individualized interventions and may decrease the risk of oral infections. It is necessary to train the nurses to ensure high levels of reliability in the oral assessments. The OAG seems to be a reliable and clinical useful tool for assessing the oral cavity status and determining changes.
Implementing supernumerary learning in a pre‐registration diploma in nursing programme: an action research study
Authors: Joyce Pauline 
Published: March 2003

• The purpose of this study was to develop a framework for implementing supernumerary learning in a preregistration Diploma in Nursing programme in an Irish hospital. Experiences of student nurses (n=31), clinical nursing staff (n=8) and nurse teachers (n=4) were explored, regarding the introduction of supernumerary status in this programme.• An action research approach, employing phenomenological methods for gathering and analysing the data, was used to carry out the study.• A framework for implementing supernumerary learning in a Diploma in Nursing programme was developed, based on the study.• This framework reflects the level of knowledge, skills and attitudes of individuals partaking in supernumerary learning, and the role of the supervisor in the clinical area at each level.• Possible implications of the changing role of the student nurse for nursing practice for education, management and research are suggested.
Do relatives have a right to witness resuscitation?
Authors: Walker Wendy Marina 
Published: March 2003

• A relative’s right to witness resuscitation is the subject of considerable discussion and debate.• This paper explores the presence of relatives in the resuscitation room from a moral and ethical perspective.• The focus of discussion is essentially upon the principle of respect for autonomy vs. what appears to be the counter‐argument, benevolent paternalism.• It is concluded that recognition of a relative’s right to witness resuscitation is dependent upon health care professionals’ willingness to promote the principle of respect for autonomy.
Men living with diabetes: minimizing the intrusiveness of the disease
Authors: Koch Tina , Kralik Debbie , Taylor Jenny 
Published: March 2003

• In this paper we present the findings from the second of four Participatory Action Research (PAR) groups with men and women who have been diagnosed with type two diabetes. The findings of the men’s group are reported here.• People who have received a diagnosis of diabetes must immediately absorb a great deal of information about how to control their diabetes, care for themselves and make lifestyle changes. In this study, we have asked men about this transition and about what it is like to live with diabetes.• We aimed to understand how people with type two diabetes incorporate chronic illness into their lives. Utilizing the processes of PAR, we created a conducive environment for the voices of people with diabetes to be clearly heard in relation to their health.• Men who live with type two diabetes met with a researcher and two Clinical Nurse Consultants, for two hours, once a week, for four weeks, during November 1998.• The men expressed that diabetes had made a positive impact on their lifestyle; they viewed diabetes as part of life and not as an illness. Men chose foods with confidence; their concern about potential complications meant they chose to take better care of themselves. They were confident in their knowledge of diabetes, and while they took responsibility for themselves, being supported by their partner was helpful in managing their diabetes. They managed their life with diabetes by minimizing the intrusiveness of the disease.
Work‐Based Learning as a means of developing and assessing nursing competence
Authors: Flanagan J. , Baldwin S. , Clarke D. 
Published: March 2003

• Work‐Based Learning is the bringing together of self‐knowledge, expertise at work and formal knowledge. It takes a structured and learner‐managed approach to maximizing opportunities for learning and professional development in the workplace.• The development and assessment of nursing competence can be facilitated through Work‐Based Learning, although this may require pedagogic and structural changes within nurse education.• There are a number of conditions which must accompany effective participative learning, and these are discussed in the paper in relation to examples of nursing programmes.• This method of learning and assessment has potential to bridge the gap between theory and practice, and as such it can only be achieved through commitment and partnership between the individual practitioner, clinical services and universities.
From a psychiatric ward to a home‐like setting: the meaning of caring as narrated by nurses
Authors: Pejlert Anita , Norberg Astrid , Asplund Kenneth 
Published: March 2003

• This study presents interviews with nurses 1 and 2 years after they moved to a home‐like setting, compared with results from interviews with nurses before their move. A phenomenological hermeneutic perspective inspired by Ricoeur guided the study. The interviews focused on the meaning of their work, including their view of the client as a person and the care they provide.• The meaning of caring was interpreted in terms of the following themes: ‘being free and entrusted with the task of caring makes a difference’; ‘sharing the activities of everyday life is a natural way of being together’; ‘providing a warm, open and supportive caring atmosphere’, ‘sharing the client’s everyday world with compassion and love, glimpsing possibilities’; and ‘dealing with limiting circumstances in care, the lack of “homeliness”’.• Findings suggest a transformation in the view of care that reveals itself in increased closeness in the client–carer relationship and a change in values. The narratives revealed a caring atmosphere, valuing the client as well as the carer.• The same questions guided all interviews, allowing developments to be followed. The carer and the interviewer thus became increasingly familiar with the situation on each interview occasion and the possibility that this has influenced the study must be taken into consideration. However, the similarity between nurses’ narratives validated their trustworthiness.
A review of the psychosocial predictors of help‐seeking behaviour and impact on quality of life in people with urinary incontinence
Authors: Shaw Chris 
Published: March 2003

•  Although urinary incontinence is common and can have a substantial impact on an individual’s quality of life, few people seek help for this symptom.•  This paper examines a theoretical framework proposed by Shaw (1999) as a possible explanatory model for help‐seeking and the impact of incontinence on a person’s quality of life.•  Although aetiology and symptom severity are important predictors of behaviour and impact of symptoms, they did not explain all the variation and so other predictors proposed by the model were explored.•  Appraisals of illness and coping resources were found to be important moderating factors between the experience of symptoms and subsequent behaviour and outcome in urinary incontinence.•  In the appraisal of symptoms, lack of knowledge of the causes and treatments of urinary incontinence can be a barrier to help‐seeking and successful outcome. Other factors such as personality, group differences, and social support can contribute to the appraisal process.•  Areas for future research and implications for clinical practice are discussed.
Towards the eradication of head lice: literature review and research agenda
Authors: Koch Tina , Brown Marina , Selim Pam , Isam Cathy 
Published: March 2003

• Head lice infestation is a public health issue. In the effort to compile an evidence‐base about the physiology, detection, treatment, effects and management strategies of head lice infestations we reviewed current literature.• This literature signalled significant evidence gaps and these gaps provide incentives for further research.• Our conclusions from the literature are that parents of children are responsible for head lice detection and treatment but have varying access to advice about how best to treat this condition.• Concern is exacerbated by misconceptions surrounding the circumstances of infestation.• Head lice are a low priority for health professionals in Australia, whereas parents and teachers believe the problem necessitates greater attention.• It is important to provide a unified evidence‐based approach to good information.• It is timely for health care professionals to re‐examine and prioritize this public health issue. They should research and work collaboratively towards the eradication of head lice.
Carers' interactions with patients suffering from severe dementia: a difficult balance to facilitate mutual togetherness
Authors: HANSEBO GÖREL , KIHLGREN MONA 
Published: March 2003

• A phenomenological‐hermeneutic approach was used to illuminate carers' video‐recorded interactions in connection with supervision for individualized nursing care.• In order to disclose any changes in the carers' interactions with patients suffering from severe dementia the video recordings were conducted before, during and after the intervention.• The content of the videos was transcribed as a text, mainly verbal communication. Due to the rich data the videos and text were kept together as a whole in every step of the analysis.• After an initial naïve understanding, different subthemes emerged in the structural analyses: promoting competence, struggling for co‐operation, deep communication for communion, showing respect for the unique person, skills in balancing power, distance in a negative point of view, and fragmentary nursing situations.• The overall theme was `Carers' balancing in their interactions, verbal as well as non‐verbal, to promote a sense of mutual togetherness with the patient'.• The supervision intervention contributed to an improvement in carers' skills in balancing in their interactions. In the caring process carers' and patients' shared experiences and, due to patients' disabilities, interactions depended mainly on carers' qualities and capabilities for this confirming nursing care.
The meaning of fatigue and tiredness as narrated by women with fibromyalgia and healthy women
Authors: SÖDERBERG SIV , LUNDMAN BERIT , NORBERG ASTRID 
Published: March 2003

• The aim of this study was to elucidate the meaning of fatigue and tiredness as narrated by women with fibromyalgia (FM) and healthy women. Twenty‐five women with FM were interviewed with a narrative approach about the meaning of the lived experience of fatigue and tiredness. A reference group of 25 healthy women was interviewed about the same topic.• A phenomenological‐hermeneutic method inspired by the French philosopher Ricoeur was used to interpret the interview text.• The meaning of fatigue and tiredness was related differently by women with FM and healthy women. The findings are presented in four major themes for women with FM — the body as a burden, an absent presence, an interfering obstacle and being in hope of alleviation — and in one major theme for healthy women: needing recovery.• Women with FM narrated fatigue as making it obvious that I have a body, instead of I am my body; the lived body becomes urgently present, as an `it'. Healthy women narrated tiredness as a natural phenomenon when they need recovery and time to rest.• The findings are interpreted in the light of the phenomenological work on the lived body by Leder, Toombs and Merleau‐Ponty.
Societal perceptions of community pharmaceutical services in Malta
Authors: Cordina  , McElnay  , Hughes  
Published: March 2003

Objective:
To assess the views of the Maltese general public on services provided by community pharmacies in Malta and their opinions on the proposed extended role for pharmacies
Method:
An interviewer‐administered structured questionnaire was used to interview 912 members of the public (395 males, 517 females)
Results: The majority of respondents (70·8%) visited a pharmacy at least once a month, with females visiting more frequently than males (
P< 0·01). Almost 31% stated that the main reason for visiting a pharmacy was to purchase prescribed medication, while 23·3% said that it was to obtain over‐the‐counter products. Women were more likely than men to be influenced by the pharmacist's advice when selecting an over‐the‐counter product (
P< 0·05). The majority of respondents (62·8%) said that they usually bought their medicines from the same pharmacy and loyalty to a particular pharmacy increased with age. When treating minor ailments, respondents were more likely to consult their doctor or self‐treat rather than seek advice from the pharmacist. The proposed extended role of the community pharmacist found support with the public, e.g. 90·2% felt that the pharmacist should promote health education, with the preferred method suggested being through individual advice; 85·7% were in favour of screening and monitoring services and 85·6% felt that the keeping of patient medication records would be useful. Almost three‐quarters (74·6%) of respondents said that they would be willing to participate in pharmaceutical care programmes. When asked to suggest new activities for community pharmacy, respondents were most in favour of the pharmacist offering more advice on the treatment of minor ailments
Conclusion:
Overall, the results obtained are encouraging and Maltese pharmacists should plan to provide new services to the community in the future
Prescribing of ACE inhibitors for cardiovascular disorders in general practice
Authors: Doyle  , Mottram  , Stubbs  
Published: March 2003

Objective:
To investigate the prescribing patterns for angiotensin converting enzyme (ACE) inhibitors in the management of patients with heart failure and other cardiovascular disorders as part of a local project on heart failure using information collected from a Primary Care Information Initiative
Method:
Patients from a large city‐centre practice, who were receiving an ACE inhibitor or with a diagnosis of heart failure at the time of the study, were identified from medical records. Details of concomitant medical conditions and drug treatment were also recorded
Results:
There was extensive prescribing of ACE inhibitors alone, in the treatment of patients with hypertension, where no contraindications for the use of thiazide diuretics or beta‐blockers could be identified. ACE inhibitors were being prescribed for post‐myocardial infarction patients, but the time for the initiation of treatment was rarely within that recommended in the literature. For those patients diagnosed with heart failure, 60% were not being treated with ACE inhibitors even where there were no contraindications
Conclusion:
It is clear from the results of this study that overall prescribing patterns for ACE inhibitors are not always in accord with evidence from the literature. These findings provide valuable information for the initiation and development of clinical guidelines for prescribers
Review of antithrombotic drug usage in atrial fibrillation
Authors: Ang  , Peterson  , Friesen  , Vial  
Published: March 2003

Background:
The important prophylactic role of antithrombotic therapy against stroke in nonrheumatic atrial fibrillation (AF) has been clearly established in recent clinical trials. There have been suggestions, however, that practice has been slow to change in light of the findings of these trials
Aim:
To review cases of AF at the major teaching hospital in Tasmania, Australia, to determine whether the recommendations from the results of the trials had been translated into local clinical practice
Methods:
A retrospective review of the medical records for consecutive patients who had AF documented on ECG between 1 January and 30 June 1997 was performed. An extensive range of demographic and clinical variables were recorded for patients with chronic or paroxysmal nonrheumatic AF. These included antithrombotic and other drug therapy at admission and discharge from hospital care, risk factors for stroke, contraindications to antithrombotic use, and incidents of ischaemic stroke and bleeding complications that occurred during the period from January 1996 up to 3 months after the hospital admission that was studied
Results: The 228 patients included in the study had a mean (±SD) age of 75·3±10·9 years. Sixty‐eight per cent had chronic AF and 32% had paroxysmal AF. According to two risk stratification criteria, 91% and 86% of the patients with previously diagnosed chronic or paroxysmal nonrheumatic AF (
n=186) had a high risk of developing stroke at the time of admission to hospital care. However, less than one‐third of these patients were receiving warfarin (or warfarin plus aspirin), with almost another one‐third receiving no antithrombotic agent. Of those who were not taking warfarin, about 60% had no apparent contraindication to warfarin. For those high risk patients who had a possible contraindication to warfarin, only approximately one‐third had been prescribed aspirin. Only a slight increase in the use of antithrombotic agents had occurred by the time of discharge from hospital care. The majority of international normalized ratio (INR) values on admission for patients who had been taking warfarin were subtherapeutic. The estimated annual incidence of bleeding complications in patients taking warfarin was 15·0% overall, 5·0% for major bleeds and 3·8% for intracranial haemorrhages
Conclusions:
While a number of published trials have demonstrated that antithrombotic agents confer substantial protection against stroke in patients with nonrheumatic AF, the drugs were underused in our setting. There is a need to improve antithrombotic use and to develop a better monitoring system for the provision of safer and more effective antithrombotic therapy.
Back to the well: the hidden costs of service exclusion for the network poor
Authors: Speak Suzanne 
Published: March 2003

AbstractThis paper discusses the consumption of the everyday services that sustain living in contemporary Britain, many of which are now provided by private sector organizations operating in the global marketplace. It aims to highlight the differential access to and cost of those services to people living stressed and disadvantaged lives in marginalized neighbourhoods. Drawing on recent empirical research, it highlights the way in which the exclusion and marginalization of some customers exacerbates both their financial poverty and the stress associated with it.
Using social and consumer values to predict market‐place behaviour: questions of congruency
Authors: McGregor Sue L.T. 
Published: March 2003

AbstractSocial values and consumption values, although intricately linked, are not exactly the same. Nonetheless, marketers contend that the central premise of social value monitoring is that, if one understands people’s values, one can better predict how they will behave in the market‐place. This paper challenges this assumption because policy analysts and industries are relying on both the consumer and social value profiles at a time when society and the market‐place are undergoing a profound transition. Using Canada as a case study, the general societal values of consumers identified by pollsters are discussed relative to nine consumer values espoused by marketers. This comparative analysis suggests that many of Canadians’ alleged consumer values seem to be in direct conflict with their espoused social values. This conclusion implies that the validity of using social values as a proxy variable or predictor for consumer values needs to be examined by researchers and policy analysts. Also, future dialogue needs to occur about adhering to the convention of monitoring social and consumer values using public opinion polls while not marrying this process with public judgement dialogues. Finally, other countries are urged to examine the situation in their market‐place so as to facilitate cross‐cultural comparative analysis of consumer market‐place values.
Trade‐offs between phlorotannin production and annual growth in natural populations of the brown seaweedAscophyllum nodosum
Authors: Pavia Henrik , Toth Gunilla , Åberg Per 
Published: March 2003

Summary1 The potential cost of polyphenolic (phlorotannin) production in the brown seaweedAscophyllum nodosumwas investigated by testing for phenotypic trade‐offs between phlorotannin content and annual growth. Relationships between tissue nitrogen and phlorotannin content, as well as between tissue nitrogen content and annual growth, were also examined to evaluate the importance of the carbon–nutrient balance in explaining intraspecific variation in phlorotannins.2 Annual shoots were collected from a total of 300 A. nodosumindividuals in natural populations at three sites in each of two study areas, in 2 consecutive years.3 Data were analysed using analyses of covariance (ancovas), which showed that there was a significant negative relationship between phlorotannins and growth in both study areas in both years. Shoots with a relatively high phlorotannin content (> 9% dry weight) had a mean reduction in growth that varied from 25% to 54%, compared with shoots with relatively low concentrations (< 6% dry weight) of phlorotannins.4 Predictions about variation in the cost of carbon‐based chemical defences were supported by regression analyses with subsampled data sets that revealed that the trade‐off between phlorotannins and growth was most pronounced in individuals with relatively high tissue nitrogen levels.5 The relationship between tissue nitrogen and phlorotannin content, as well as between nitrogen content and growth, was weak and variable.6 Production of phlorotannins inA. nodosumunder natural conditions appears to involve a substantial cost in terms of individual growth. This cost varies spatially and temporally, at least partly as a consequence of variation in nutrient availability.7 Tissue nitrogen content is not strongly related to phlorotannin concentration ofA. nodosumindividuals, in contrast with findings for a few other seaweed species.