bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical composition and functional properties of conophor nut (Tetracarpidium conophorum) flour
Authors: Odoemelam Stevens A. 
Published: July 2003

SummaryFlour produced from whole seeds of conophor nut (Tetracarpidium conophorum) was evaluated for chemical composition and functional properties. The flour was rich in protein (26.3%), fat (46.5%) and some of the essential trace elements. Elements like Cd, Co, Hg, As, Cr, Sn and Sr were not detected. Functional properties were significantly affected by pH and NaCl concentration. The capacity to produce foam was highest in pure water while the capacity to produce an emulsion was maximum at a NaCl concentration of 0.4 m. Nitrogen solubility was lowest at pH 4.0 but showed a remarkable increase on either side of this pH. The capacity to produce foam was pH‐dependent with a minimum at pH 4.0; beyond this pH it increased considerably. The capacity to produce an emulsion increased with pH up to a maximum around pH 12. The flour had a minimum gelation concentration of 8%. This data on functionality suggests that conophor flour may be ideal as a functional ingredient in food systems.
Clinical experience as evidence in evidence‐based practice
Authors: Thompson Carl 
Published: July 2003

Background.  This paper's starting point is the recognition (descriptive not normative) that, for the vast majority of day‐to‐day clinical decision‐making situations, the ‘evidence’ for decision‐making is experiential knowledge. Moreover, reliance on this knowledge base means that nurses must use cognitive shortcuts or heuristics for handling information when making decisions. These heuristics encourage systematic biases in decision‐makers and deviations from the normative rules of ‘good’ decision‐making.Aims.  The aim of the paper is to explore three common heuristics and the biases that arise when handling complex information in clinical decision‐making (overconfidence, hindsight and base rate neglect) and, in response to these biases, to illustrate some simple techniques for reducing the negative influence of heuristics.Discussion.  Nurses face a limited range of types of uncertainty in their clinical decisions and draw primarily on experiential knowledge to handle these uncertainties. This paper argues that experiential knowledge is a necessary but not sufficient basis for clinical decision‐making. It illustrates how overconfidence in one's knowledge base, being correct ‘after the event’ or with the benefit of hindsight, and ignoring the base rates associated with events, conditions or health states, can impact on professional judgements and decisions. The paper illustrates some simple strategies for minimizing the impact of heuristics on the real‐life clinical decisions of nurses.Conclusion.  The paper concludes that more research knowledge of the impact of heuristics and techniques to combat them in nursing decisions is needed.
HIV/AIDS knowledge and risk behaviour in Hong Kong Chinese pregnant women
Authors: Choi Fung Ho , Alice Yuen Loke 
Published: July 2003

Background. With the increase in HIV infection among childbearing aged women in Hong Kong, health department policy‐makers are considering the implementation of antenatal HIV screening to identify infected mothers. However, little is known about women's understanding of HIV/AIDS, and their attitudes towards HIV screening.Aim. The aim of this study was to explore pregnant women's knowledge about HIV/AIDS, their perceptions of risk, risk behaviour and management, and their attitudes towards HIV screening.Methods. A cross‐sectional study was carried out, and all Chinese pregnant women who attended an antenatal clinic of a regional hospital in Hong Kong in the month of December 2000 were invited to complete a questionnaire.Findings. Hong Kong pregnant women had fairly good general knowledge of HIV/AIDS (mean score = 4·8/6), but were less knowledgeable on specific mother‐to‐child HIV transmission (mean score = 3·6/6). There were statistically significant differences between those with different levels of education (χ2 = 19·81; P < 0·001) and between Hong Kong born residents and immigrants from the Chinese mainland (z = −4·03; P < 0·001). Over a third (36·7%) of all pregnant women perceived a risk of contracting HIV. If HIV infection were suspected, over 70% would have HIV screening together with their spouse. If HIV was confirmed, 24% would terminate the pregnancy. As many as 78·5% and 72·8% of women believed that HIV screening should be carried out before marriage and pregnancy respectively. Only 4·7% would choose universal opt‐out antenatal HIV testing.Recommendations. Health educators should provide tailored‐made education programmes for women at risk, particularly those at lower education levels and those who have come from the Chinese mainland, to enhance their knowledge about mother‐to‐child HIV transmission, and to promote awareness of safe sex. Health policy‐makers should consider the possibility of providing pre‐marriage and pre‐pregnancy HIV screening for women.
Patients’ and nurses’ experiences of perioperative dialogues
Authors: Lindwall Lillemor , Von Post Iréne , Bergbom Ingegerd 
Published: July 2003

Background. Previous research has shown that perioperative visiting can aid the planning and implementation of nursing care by giving patients an opportunity to express their expectation and to receive information. This is in turn can reduce anxiety and stress. However, patients and nurses’ experiences of this process have not been studied before.Aim. The aim of the research was to describe and interpret the meaning of nursing care experienced by patients and nurse anaesthetists or operating‐room nurses (referred to as perioperative nurses) through the pre‐, intra‐ and postoperative dialogues.Methods. A hermeneutic approach was used when interpreting text from interviews with 10 patients after the operation and 10 nurses who were asked to write down their experiences after having conducted pre‐, intra‐ and postoperative dialogues with their patients. The interpretation of the whole was: the common quality of the pre‐, intra‐ and postoperative dialogues was continuity and the distinguishing quality was how the patient and nurse experienced continuity.Findings. Continuity in ‘the perioperative dialogue’ from the patients’ point of view is expressed as sharing a story and the body is in safe hands. From the nurses’ point of view continuity means that professional nursing care becomes visible and that continuity gives meaning to the work.Conclusion. If perioperative nurses used the perioperative dialogue they could create continuity for patients and for themselves in the pre‐, intra‐ and postoperative phases. The nurse is, in this context, the continuity and continuity gives the possibility of establishing a caring relationship and caring for the patient in a dignified way.
A chart audit of factors related to urine flow and urinary tract infection
Authors: Wilde Mary H. , Carrigan Mary Jo 
Published: July 2003

Background. Clients with long‐term urinary catheters are at risk for urinary tract infection (UTI) and catheter blockage that disrupt client/family daily activities. The United States Centers for Disease Control guideline strongly recommends keeping urine flowing to help prevent UTI in this population, but little is known about factors associated with urine flow and how they are related to UTI.Aim. The purpose of this descriptive study was to identify urine flow factors contributing to UTI in home care clients who had had an indwelling urinary catheter for at least 3 months.Methods. Twenty‐four records were reviewed from one home care agency. The sample of 12 males and 12 females ranged in age from 31–102 (mean 70 years, sd 17·2) and they had used a catheter from 5 to 105 months (mean 27·9, sd 32).Findings. Catheter blockage and low urine output were the only ‘urine flow indicators’ that were significantly related to UTI. Other ‘urine flow indicators’ were not related to UTI, including bloodstained urine, pulling on the catheter, leakage, and sluggish urine. Thirteen people experienced blockage and 11 did not. Of the 13 with blockage, six had UTI and seven did not, during the 6 months of the review. It was particularly notable that, of the 11 people with no blockage, none went on to experience UTI.Conclusion. This finding raises questions about why some people with blockage developed UTI and some did not. We suggest that nurses taught their clients what to do to get the urine flowing, such as, increasing fluid intake or checking for proper placement. Identifying more information from clients about how they monitor and adjust urine flow will be the next step toward understanding how to prevent UTI in those with long‐term catheters.
Cultural childbirth practices and beliefs in Zambia
Authors: Maimbolwa Margaret C. , Yamba Bawa , Diwan Vinod , Ransjö‐Arvidson Anna‐Berit 
Published: July 2003

Background. Zambia, one of the world's poorest countries, also has one of the highest maternal mortality rates in the world. Most pregnant women in Zambia (96%) attend antenatal care, while 53% deliver at home. This may be related to socio‐economic and cultural factors, but cultural childbirth practices and beliefs in Zambia have been little documented.Aim. The aim of this study was to explore cultural childbirth practices and beliefs in Zambia as related by women accompanying labouring women to maternity units. These social support women were also interviewed about their views on providing companionship to labouring women.Methods. Thirty‐six women accompanying labouring women to urban and rural maternity units in Zambia were interviewed A thematic guide with closed and open‐ended questions was used. EPI INFO, an epidemiological statistical software package, was used to analyse the quantitative data; qualitative data were analysed using content analysis.Findings. Eighteen of the women considered themselves to be mbusas, or traditional birth assistants and the rest said that they followed labouring women to maternity units. Those who considered themselves traditional birth assistants advised childbearing women on appropriate cultural childbirth practices and assisted with deliveries at home. They also advised women on the use of traditional medicine, for example, to widen the birth canal and to precipitate labour. If something went wrong during labour, they relied on traditional beliefs and witchcraft to explain the mishap and expected the woman in labour to confess her purported ‘bad’ behaviour. Twelve of the women were in favour of providing support to labouring women in maternity units and learning about childbirth care from midwives.Conclusion. These social support women, including those who considered themselves as mbusas, lacked understanding of the causes of obstetric complications during childbirth, and had inadequate knowledge of the appropriate management of labour. Culturally‐specific knowledge from this study should be used to guide policy‐makers and health planners in the future development of safe motherhood initiatives in developing countries. Midwives have a unique opportunity to ensure that care given during childbirth is clinically safe and culturally sensitive.
Are we wasting our money on food supplements in elder care wards?
Authors: Gosney Margot 
Published: July 2003

Background.  It is reported that undernutrition in older hospitalized patients is commonly found, but estimates of its prevalence vary. It is also not clear which treatment approaches are best because poor methodology prevents comparison of outcomes between different studies.Rationale.  The rationale of this observational study was to look at typical elder care wards in order to determine what food supplements were being prescribed. We wished to determine whether serum albumin and/or body mass index (BMI) were appropriately related to the prescription of sip feeds and also to determine the palatability of supplements provided.Method.  We monitored the wastage of sip feeds over a 24‐hour period and extrapolated an estimated cost. Ninety‐six patients were studied, including 23 patients with a BMI of less than 20, of whom 30% were on supplementary feeds.Results.  Seventy percentage of prescribed sip feeds were being given to people with a BMI of 20 or more. The mean wastage in this 24‐hour period was 63% (£79·56) in four wards containing 96 older patients.Conclusion.  We concluded that there was no relationship between the numbers of patients with a low albumin and BMI and the prescription of sip feeds. We found compliance to be low (37%) because of poor palatability, with a large number of patients who appeared to require sip feeds not being prescribed them and those who received them wasting more than they drank.
Nurses and ‘difficult’ patients: negotiating non‐compliance
Authors: Russell Sarah , Daly Jeanne , Hughes Emma , Hoog Corinne op't 
Published: July 2003

Background.  There is a large body of nursing literature on patient non‐compliance. While some articles address non‐compliance as a patient problem to be resolved by nursing interventions, there is also a growing number that critique this approach. This reflects the discomfort many nurses feel about the practice of labelling patients as non‐compliant.Aim.  The aim of this discussion paper is to build on the critical nursing literature to offer an alternative to the interventions commonly directed at patients who do not follow health care advice. This alternative approach locates patients within their social context and focuses on those who adapt health care advice to fit with their beliefs, life situation and circumstances. The aim is to encourage nurses to learn about how health care treatments affect patients’lives, and not merely their health.Method.  Specific nursing articles were reviewed to demonstrate the ways in which the concept of compliance is used within the nursing literature. These articles were then used to support an argument that promotes a patient‐centred approach to health care.Conclusion.  A patient‐centred approach involves transferring power and authority away from health care professionals and towards patients. We encourage nurses to take a leadership role by changing the way in which health care is delivered towards a focus on patients’lives. Learning about patients’ lives may assist nurses to offer health information to patients that is more relevant and, therefore, useful.
Health Belief Model and Reversal Theory: a comparative analysis
Authors: Finfgeld Deborah L. , Wongvatunyu Suporn , Conn Vicki S. , Grando Victoria T. , Russell Cynthia L. 
Published: July 2003

Background. In recent years, an increasing number of nurses have demonstrated interest in health behaviour change interventions and research. Despite this heightened enthusiasm, there appears to have been less interest in exploring new and emerging health behaviour change theories.Aim. The goal of this work is to assist clinicians and researchers to make more informed choices about the use of the Health Belief Model and Reversal Theory in their practice settings and research projects.Method. Primary sources were analysed using qualitative data analysis methods in order to compare and contrast the two models. Four comparative categories provided the structure for analysis: origins of models, ways of knowing and behaving, role of health care providers in behaviour change, and desired outcomes.Results. Based, in part, on their historical origins, the Health Belief Model and Reversal Theory offer differing tenets regarding how individuals perceive, understand, and behave. According to Reversal Theory, ways of knowing and behaving are dependent upon innate physiological factors and subjectively structured perceptions. In contrast, the Health Belief Model suggests that health‐related behaviours are largely attributable to cognitive decision‐making processes. As such, health care providers are directed to approach health behaviour change in different ways.Conclusions. Although the Health Belief Model has been widely implemented, Reversal Theory may offer a more comprehensive framework for health behaviour change interventions and research. Clinicians and researchers are urged to learn more about this theory and how it may apply to their areas of practice and research.
Student nurses’ attitudes towards working with older patients
Authors: McKinlay Andy , Cowan Sue 
Published: July 2003

Background. The ageing of the United Kingdom (UK) population means that the care of older people will become an increasingly important part of nurses’ remit. However, employment statistics suggest that this is an unpopular nursing specialism. This may be due to a number of factors, one of which may be nurses’ negative attitudes towards working with older people. This constitutes a potential problem, especially if such attitudes have an impact on the quality of care provided.Aim. To examine the attitudes held by student nurses towards working with older patients.Methods. Questionnaires incorporating Likert‐type scales, two vignettes and demographic questions were designed using the theory of planned behaviour. These were distributed to 172 student nurses undertaking preregistration nursing courses in the UK during the academic session 2000–2001.Results. Student nurses displayed positive intentions towards working with older patients. These were based on their own attitudes and beliefs about what others would wish them to do. Participants believed that their behaviour towards older patients was to a large extent under volitional control. Analysis of the beliefs underlying student nurses’ views showed that they differentiated between those participants who had a relatively positive approach to their work with older patients and those with a less positive approach. In addition, the results offered mixed support for the view that more knowledgeable or experienced nurses hold more positive views towards older people.Conclusions. The findings offer some support for previous studies that have looked at the more general issue of attitudes towards older people. However, the results also indicate that a more rigorous and more highly focused approach to the study of such attitudes is required if the research is to be relevant to the issue of working with older patients. The theoretical, methodological and practical implications of the findings are discussed.
The clinical landscape of critical care: nurses’ decision‐making
Authors: Bucknall Tracey 
Published: July 2003

Background. Many studies have tended to explore individual characteristics that impact on nurses’ decision‐making, despite significant acknowledgement that context is a major determinant in decision‐making. The few studies that have examined environmental influences have tended not to study real decisions in the dynamic and complex clinical environment.Aims. To investigate environmental influences on nurses’ real decisions in the critical care setting.Method. Naturalistic observations and semi‐structured interviews were conducted with 18 critical care nurses in private, public and rural hospitals. Observations and interviews were recorded, transcribed verbatim and coded for themes using content analysis.Results. All clinical decisions were strongly influenced by the context in which the decision was made. Three main environmental influences were identified: the patient situation, resource availability and interpersonal relationships. Time and risk guided all clinical decisions. Nurses established the state of the situation, the time constraints on decisions and the level of risk involved for both patient and nurse.Conclusions. Decision‐making is a manifestation of the landscape and although an increased understanding of the landscape is required, more important is the need to measure the impact of contextual variables on nurses’ decision‐making in order to improve health care outcomes.
The Food Standards Agency's antioxidants in food programme – a summary*
Authors: McKevith B. , Kelly C. , Stanner S. , Hughes J. , Buttriss J. 
Published: July 2003

AbstractBackground  In 2001, the British Nutrition Foundation (BNF) was contracted to evaluate projects from the Antioxidants in Food research programme, now funded by the Food Standards Agency and previously the Ministry of Agriculture, Fisheries and Food. The programme aimed at testing the ‘antioxidant hypothesis’.Methods  The evaluation was conducted with support and guidance from a Steering Group of experts. The final report sets out BNF's recommendations for the future of the Antioxidants in Food research programme.Results  It was recommended that future research should consider a wider scope of potential mechanisms of action of substances within foods; more emphasis should be placed on studying bioavailability of a range of plant derived substances, and the impact of genotype, age and disease should be investigated.Conclusions  The research programme has been important as it has focused attention on disease prevention rather than on treatment, and has helped progress identification of biomarkers. From human observational and intervention studies there is evidence of an association between a diet rich in plant foods (particularly fruit and vegetables) and health benefits. However, as there is no evidence that any particular nutrient or class of bioactive substances makes a special contribution, currently the most prudent public health advice is to increase vegetable and fruit consumption.
What is the problem with breast‐feeding? A qualitative analysis of infant feeding perceptions
Authors: Stewart‐Knox B. , Gardiner K. , Wright M. 
Published: July 2003

AbstractAims and objectives  Breast‐feeding rates are low in Northern Ireland (NI) compared with other regions of Europe. The aim of this study has therefore been to define and explore factors determining infant feeding decisions with a view to the planning of future research and intervention needs.Method  Participants were approached at convenience from the throughput of women attending a large teaching hospital antenatal clinic to take part in focus group discussion.Results  Dominant themes indicated that the main barriers to breast‐feeding are restricted freedom and independence associated with family issues, return to work, societal embarrassment and perceived social isolation. The dialogue suggested that breast‐feeding leads to inability to carry out everyday activities and social exclusion.Conclusions  Incompatible social norms make it difficult for mothers to breast‐feed successfully. This implies that future promotional efforts should take a societal approach.