bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demand for nursing competencies: an exploratory study in Taiwan's hospital system
Authors: Tzeng Huey‐Ming , Ketefian Shaké 
Published: June 2003

Summary• Along with increasing complexity of nursing services, hospital employers are demanding qualified and competent staff nurses for high quality clinical care. In Taiwan, disparities in the demand for competent nurses by employers and the supply produced by nursing educators still exist and require attention. A comprehensive understanding of the specific needs of Taiwan's medical care system for nursing services would help bridge the current gap between demand for and supply of competently trained nurses.• This exploratory study investigated hospital employers' perceptions of the extent to which the nursing skills identified by Cleary et al. [Image: Journal of Nursing Scholarship (1998)20(4):39–42] were needed for staff nurses in Taiwan's medical care system. There were a total of 21 nursing competencies and classification on these items was also implemented.• A cross‐sectional, quantitative, survey design was conducted. Subjects' participation was voluntary, an information leaflet and an informed consent form was included in the questionnaire. A total of 89 nursing employers (nursing directors, associate directors, supervisor, or head nurse) participated, resulting in a 42.6% response rate.• Factor analysis grouped these skills into three factors: basic‐level patient care, intermediate‐level patient care and basic management, and advanced‐level patient care and supervision. This study confirmed that levels of nursing competencies needed differed by type of hospital accreditation. These levels also varied depending on types of services provided, employers' professional titles and tenure of currently employed nurses.• The questionnaire developed for this study could be used as one of the tools to communicate demand and supply of nursing competencies between nurse educators and employers. These competencies could be used to develop a checklist for evaluating adequacy of nursing programmes in order to meet nurses' new roles and responsibilities and improve nursing care quality in the fast‐changing health care environment in Taiwan.
The experience of sexuality for individuals living with multiple sclerosis
Authors: Gagliardi Barbara A. 
Published: June 2003

Summary• Little is known of the experience of sexuality among people living with multiple sclerosis (MS).• This Roy Adaptation Model‐based study focused on identifying the experiences of sexuality reported by individuals living with MS.• A qualitative, naturalistic case study method was employed.• Five women and three men diagnosed with MS were interviewed by telephone three times over a period of 1 year. The telephone interview guide consisted of a series of structured questions.• Analysis of the telephone interview transcripts revealed three themes. The theme, ‘How I Feel About My Appearance’, reflected elements of the Roy model physiological, self‐concept, role function and interdependence modes. The theme, ‘I Have Feelings About My Sexuality’, reflected the self‐concept and interdependence modes, and the theme, ‘Sexuality For Me Has Both Negative and Positive Emotions’, reflected the self‐concept and interdependence modes.• The small sample size precludes generalization of the results to all individuals living with MS.• Nurses and other health care providers need to recognize that sexuality is an important issue for individuals with MS. Researchers should continue to examine experiences of sexuality in a larger sample of individuals with MS and also should begin to examine the effects of nursing interventions, such as support groups and individual counselling, on feelings about sexuality in individuals with MS.
‘It's like an explosion in your life…': lay perspectives on stress and myocardial infarction
Authors: Clark Alex M. 
Published: June 2003

Summary• Psychological difficulties are common after myocardial infarction (MI). These difficulties are most often represented to patients through cardiac rehabilitation services and the literature offered to patients after MI as being related to ‘stress’ and its management. However, no research has examined what MI patients understand by the term ‘stress’ or how congruent lay views of stress are with those evident in the professional literature.• The aim of the study reported here was to examine post‐MI patients' views of stress, its functioning and relationship to their MI.• As patients' views of stress were sought, qualitative interviews were used. A philosophical approach was taken (critical realism) that recognizes the legitimacy of both professional and lay perspectives. Data were generated in 44 semistructured interviews with 14 MI patients who were interviewed 48 hours, 1 week, 1 month and 3 months after hospital admission.• While participants described their experiences after MI as being difficult, to convey this they used everyday terms such as fear, fright and worry. Rather than viewing stress as being a consequence of their MI, they perceived it to be a common cause of heart problems.• Many considered stress as having a more influential role than other risk factors, such as smoking and diet. They expressed a wide variety of sophisticated and diverse views of stress and its functioning. Each of these views placed different weighting on the roles of social, personal and situational factors in contributing to the stressful reaction. Parallels were apparent between these lay accounts and theories of stress developed in the professional literature.
Medication calculation skills of nurses in Finland
Authors: Grandell‐Niemi Heidi , Hupli Maija , Leino‐Kilpi Helena , Puukka Pauli 
Published: June 2003

Summary • The aim of this study was to describe the medication calculation skills of nurses in Finland. We tried to ascertain how nurses evaluate their own medication calculation skills and how these self‐evaluations are associated with various background factors and the actual level they score in a calculation test. • In the spring of 2000, nurses (n = 546) in one Finnish university hospital completed a questionnaire specially developed for this study. The instrument included structured questions, statements and a medication calculation test. The response rate was 56%. Data analysis was based on descriptive statistics. • The nurses found the mathematics and dosage calculation easy and interesting but the pharmacology difficult. They evaluated their own mathematical and dosage calculation skills as sufficient, although it had certain shortcomings. • The youngest nurses (20–29 years) evaluated their mathematical and dosage calculation skills as sufficient and they also succeeded in the calculation test. Basic (High School) education was associated with better calculation skills. • The findings of this study support the need and importance of checking and maintaining one's medication calculation skills.
Agency nursing work in acute care settings: perceptions of hospital nursing managers and agency nurse providers
Authors: Manias Elizabeth , Aitken Robyn , Peerson Anita , Parker Judith , Wong Kitty 
Published: June 2003

Summary• There is a paucity of research in investigating agency nursing work from the perspectives of hospital nursing managers and agency nurse providers.• This exploratory paper examines the hospital nursing managers' and agency nurse providers' perceptions and experiences of agency nursing work.• Individual, in‐depth interviews were conducted with three agency nurse providers and eight hospital nursing managers. Because of the lack of previous research in this area, an exploratory, semi‐structured interviewing technique was deemed appropriate.• Three major themes emerged from interview data: planning for ward allocation, communication and professionalism.• In planning for ward allocation, hospital managers were primarily concerned with maintaining adequate numbers of nursing staff in the ward settings. A major concern for agency nurse providers was inappropriate allocation of temporary staff.• Communication was valued in different ways. While hospital managers focused on communication between the agency nurse and other permanent members of the health care team, agency providers were concerned with exchanges between agencies and hospital organizations, and between the agencies and agency nurses.• For both groups, responsibility for professional development and the status of agency nursing as a career choice for graduate and experienced nurses were the focal aspects for consideration.• A limitation of this study is the small number of individual interviews conducted with hospital nursing managers and agency nurse providers. Nevertheless, the findings represent the views of 11 individuals in senior managerial roles.• The findings reinforce the need to enhance collaboration between hospitals and nursing agencies, and to examine how divergent views of agency nursing work could be reconciled – with the aim of providing quality patient care.
Indices for studying urinary incontinence and levator ani function in primiparous women
Authors: Antonakos Cathy L. , Miller Janis M. , Sampselle Carolyn M. 
Published: June 2003

Summary• Urinary incontinence (UI) is a complex phenomenon that is prevalent in pregnant and parous women and requires the use of sophisticated measures to adequately reflect functioning of the continence system.• The purpose of this study was to develop reliable and valid measures of UI and levator ani function for use in research and clinical settings.• A Leakage Index (LI) and a Levator Ani Function Index (LAFI) were developed using data from a longitudinal study of primiparous women. Reliability and validity tests were conducted to: (i) estimate the internal consistency reliability of each index, (ii) determine whether the indices captured change in continence status and pelvic floor function during pregnancy through 1 year postpartum, and (iii) estimate association between the indices as a test of predictive validity.• Cronbach's alpha ranged from 0.72 to 0.84 for the LI and from 0.53 to 0.79 for the LAFI across the six data collection time points of the study. Average LI scores increased late in pregnancy and decreased postpartum, though not significantly. Average LAFI scores decreased significantly at 35 weeks gestation (t = 4.84, P = 0.000) and increased significantly at 12 months postpartum (t = −3.51, P = 0.002) relative to baseline. The LI and LAFI were significantly associated at 20 weeks gestation (Pearson r = −0.40, P = 0.007) and at 6 weeks postpartum (Pearson r = −0.33, P = 0.029).• The findings suggest the LI and LAFI are reliable and valid measures of UI and levator ani function in primiparous women, which can be used with confidence in clinical and research settings.
Lived experiences of eating problems for patients with head and neck cancer during radiotherapy
Authors: Larsson Maria , Hedelin Birgitta , Athlin Elsy 
Published: June 2003

Summary• Only a small proportion of cancer patients undergo radical radiotherapy to the head and neck, but their needs are particularly complex. Although extensive research describes the side‐effects of radiotherapy to the head and neck, few studies focus on patients' subjective experiences of eating problems and the impact these have on the patients' daily life.• In this study a phenomenological approach was used, as the purpose was to acquire deeper understanding of head and neck cancer patients' lived experiences of eating problems, their consequences in daily life and patients' strategies of coping with these problems.• Eight patients from two radiation therapy departments in mid‐Sweden were interviewed in an open dialogue. Data analysis was based on Colaizzi's method.• Eating problems experienced were captured in two interrelated main themes: ‘Ability to chew and swallow’ and ‘Will and desire to eat’. The eating problems were found to cause a number of severe consequences in daily life. These are incorporated into one main theme: ‘The way of life is disturbed’. Ways to cope with this disturbance were captured in one main theme: ‘Trying to see the end – To survive’.• This study identifies the need to view eating problems as a complex phenomenon in a specific context including the individual patient's life situation. The findings create the opportunity to develop nursing interventions based on patients' own needs. To facilitate this, a specialist nurse should be responsible for reviewing patients regularly throughout radiation therapy. Intervention studies are needed to provide optimal clinical guidelines.
Meanings of giving touch in the care of older patients: becoming a valuable person and professional
Authors: David Edvardsson Jan , Sandman Per‐Olof , Rasmussen Birgit H. 
Published: June 2003

Summary• Touch is central to nursing and health care workers frequently touch their patients, consciously or unconsciously in their interactions with them. Most literature has studied touch from a patient perspective, thus inquiry about professionals' experiences are rare.• The aim of this study was to illuminate meanings of giving touch in nursing care of older patients.• To understand the meaning of lived experiences of giving touch in care of older patients, interviews with 12 health care professionals in northern Sweden were analysed using a phenomenological–hermeneutic approach influenced by the philosophy of Ricoeur.• The findings show that giving touch in the care of older patients is a transforming experience, where one suddenly perceives oneself as both a valuable person and professional who no longer powerlessly confronts patients' haunted and disrupted bodies, but who, by means of touch, has gained power to ease this suffering.• The experience also transforms the way one regards older patients. Instead of seeing a severely demanding patient suffering from dementia and/or pain, one is able to see the person behind the disease as a human being, like oneself.• A relationship described as calm, friendly and humane is created between caregiver and patient when giving touch, a relationship that transcends the moment of touch and influences one's way of caring. This understanding is presented using the theoretical framework of the philosophy of Marcel.• Giving touch has the power to shed new light on health care professionals' experiences of caring for older patients suffering from dementia and/or pain, giving them the power to be a valuable person and professional.
Critical care nurses' use of decision‐making strategies
Authors: Aitken Leanne M. 
Published: June 2003

Summary• Effective decision‐making has the potential to facilitate improvements in health care. This paper reports several aspects of a study which used ‘thinking aloud’ within a concept attainment framework to examine the decision‐making processes of expert critical care nurses in relation to haemodynamic monitoring.• The purpose of this study was to examine whether hypotheses were used in the decision‐making process and, if so, were hypotheses deactivated when no longer relevant. In addition, the strategies that were used during the decision‐making process were examined.• Eight expert critical care nurses consented to participate in the study after ethics clearance was obtained from both the University and Hospital ethics committees.• The majority of expert critical care nurse participants in this study demonstrated extensive use of hypotheses to explain the relationship between attributes and concepts.• There was no evidence of specific deactivation of hypotheses when they were no longer relevant.• Participants demonstrated use of a range of decision‐making strategies, with a Focus Gambling Strategy being the most common. The reason for using different decision‐making strategies was not clear and may represent variation between decision‐makers or between scenarios for each individual decision‐maker.• Recommendations are made to help improve critical care nurses' decision‐making.
Murine intestinal migrating motor complexes: longitudinal components
Authors: Powell A. K. , Bywater R. A. R. 
Published: June 2003

AbstractSpontaneous migrating contractions have been described in the circular muscle of the isolated mouse colon and terminal ileum, however, spontaneous events equivalent to these have not been reported in the longitudinal muscle. The longitudinal muscle shortenings in the colon and ileum, which are of similar form, frequency and pharmacology to the circular muscle colonic and ileal migrating motor complexes (CMMCs and IMMCs), are recorded in the present study. The spontaneous ileal and colonic longitudinal muscle shortenings appear to be neurally organized as they are abolished by tetrodotoxin (1 μmol L−1), hexamethonium (500 μmol L−1) and morphine (1 μmol L−1). Endogenously released nitric oxide slowed the frequency of spontaneous ileal and colonic longitudinal muscle shortenings and 5‐hydroxytryptamine increased their frequency. Hyoscine (1 μmol L−1) abolished longitudinal shortenings in the ileum and reduced the amplitude of longitudinal shortening by ∼44% in the colon. Shortenings were effectively abolished by nifedipine (1 μmol L−1). Surgical sectioning of the colon identified that each region of the colon contracted longitudinally in an independent fashion; the distal colon contracted to the greatest amplitude and lowest frequency. The longitudinal preparation is suitable to initially assess the actions of novel pharmacological agents on spontaneous, neurally coordinated, CMMCs and IMMCs in emptied isolated murine intestines.
The role of the cytoskeleton in capacitaftive calcium entry in myenteric glia
Authors: Lin T. , Zhang W. , Garrido R. , Segura B. , Hu Y. , Guzman E. , Mulholland M. 
Published: June 2003

AbstractCapacitative calcium entry (CCE) is the process by which intracellular calcium is replenished from the external milieu upon depletion of intracellular stores. CCE is thought to participate in chemotaxis, proliferation and cell signalling. A physical interaction between intracellular stores and the plasma membrane is postulated to regulate CCE. We hypothesized that cytoskeletal disruption alters this interaction, inhibiting CCE in enteric glia. Cultured myenteric glia from neonatal guinea‐pigs were treated with cytochalasin D (10 μmol L−1), a microfilament disrupting agent, nocodazole (20 μmol L−1), a microtubule disrupting agent, or vehicle (dimethyl sulphoxide). Intracellular calcium changes were measured using fura‐2 microfluorimetry. To evaluate the rate of cation re‐entry, barium was substituted for calcium because barium is not sequestered internally. Cytochalasin D‐treated glia had diminished CCE responses (57 ± 3 nmol L−1) compared with controls (97 ± 7 nmol L−1) as did nocodazole‐treated glia (30 ± 2 nmol L−1) vs controls (77 ± 6 nmol L−1). The proportion of cells demonstrating CCE abolition was greater in the cytochalasin (50 ± 8%) and nocodazole‐treated (89 ± 2%) groups compared with controls (21 ± 2%, 40 ± 9%, respectively). Cytochalasin D and nocodazole treatment diminished the rate of cation re‐entry based on diminished barium entry in treated vs control cells. From this study, we conclude that disruption of cytoskeletal elements diminishes calcium influx essential to calcium store repletion in myenteric glia.
Pro‐inflammatory (IL‐1β, IL‐18) cytokines and IL‐8 chemokine release by PBMC in response to Echinococcus multilocularis metacestode vesicles
Authors: Eger Alexandra , Kirch Astrid , Manfras B. , Kern P. , Schulz‐Key H. , Soboslay P. T. 
Published: June 2003

SUMMARY In humans infected with Echinococcus multilocularis, larval metacestodes will develop, proliferate and progressively infiltrate the surrounding host tissues by exogenous budding of parasitic microvesicles or cell lines which detach from the original tumour and thus become transported through blood or lymph vessels into other organs. Cellular effector mechanisms constitute the most effective means to restrict parasite persistence and proliferation, and here we demonstrate that E. multilocularis vesicle antigens will induce pro‐inflammatory, regulatory and chemokine release by PBMC from patients. The pro‐inflammatory cytokines IL‐1β and IL‐18 were reduced in echinococcosis patients, regulatory IL‐10 was similar, but parasite vesicle‐induced IL‐8 was dominant and clearly elevated in patients. Such selective and opposite dynamics of inflammatory cytokines and chemokine release may prevent overwhelming and pathogenic inflammation, and constitute an appropriate response for attraction of effector cells into the periparasitic tissues with the capacity to limit E. multilocularis metacestode proliferation and dissemination.
Antigenemia is associated with low antibody response to carbohydrate determinants of a filarial surface antigen
Authors: Bal M. S. , Beuria M. K. , Mandal N. N. , Das M. K. 
Published: June 2003

SUMMARYThe IgG response to a filarial surface antigen (DssdI) was evaluated in circulating antigen (Og4C3 test) positive and negative individuals from the Wuchereria bancrofti endemic region of Orissa, India. Circulating filarial antigen (CFA) positive individuals exhibited depressed antibody levels to DssdI and individuals with high antibody levels were invariably CFA negative. Low IgG levels to DssdI are associated with CFA positivity irrespective of microfilaraemia and clinical status. Thus asymptomatic microfilaraemic individuals with antigen positivity exhibited low IgG levels similar to symptomatic (chronic filariasis with elephantiasis, hydrocele) or asymptomatic amicrofilaraemic individuals with antigenemia. Western blot analysis revealed a band of approximately 210 kDa reactive with CFA‐negative, but not with CFA‐positive sera. DssdI was subjected to mild periodate oxidation to investigate the role of carbohydrate epitopes. The treatment considerably reduced the antigenic recognition of DssdI, stressing the immunodominance of carbohydrate residues of DssdI in infection‐free individuals. In contrast, individuals with active infection failed to produce such antibodies to filarial surface carbohydrates.
Characterization of a recombinant immunomodulatory protein from the salivary glands of Dermacentor andersoni
Authors: Alarcon‐Chaidez Francisco J. , Müller‐Doblies Uwe U. , Wikel Stephen 
Published: June 2003

SUMMARY The gene encoding a 36‐kDa (p36) immunomodulatory protein present in saliva of Dermacentor andersoni was cloned in prokaryotic and eukaryotic expression vectors. A polymerase chain reaction (PCR)‐generated cDNA lacking signal peptide was cloned into the Escherichia coli expression vector pET28 and a similar sequence was cloned into pIB/V5‐His‐TOPO expression vector for stable transfection of insect cells, High 5™. The 26‐kDa molecular mass of p36 expressed by bacteria is in agreement with that predicted from the translated full‐length cDNA sequence. Eukaryotic‐cell‐expressed p36 consisted of multiple forms with molecular masses between 34 and 36 kDa. These multiple forms were attributed to differences in post‐translational modifications. N‐linked mannose was detected on insect‐cell‐expressed and tick‐derived p36. Multiple bands remained after endoglycosidase removal of N‐linked sugars, indicating the presence of other modifications. Both bacterial‐ and insect‐cell‐expressed p36 reacted on immunoblots with polyclonal antibodies raised against tick‐derived p36. Insect‐cell‐expressed p36 suppressed T‐lymphocyte‐mitogen‐driven in vitro proliferation of splenocytes from tick‐naïve mice in a dose‐dependent manner. Bacterial‐cell‐expressed p36 lacked immunomodulatory activity.