bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salivary pH changes during soft drinks consumption in children
Authors: Sánchez G. A. , Fernandez De Preliasco M. V. 
Published: December 2004

Summary. Dental erosion seems to have increased, perhaps partly as a result of an increase in the consumption of soft drinks.Aim. The aim of this study was to measure salivary pH, flow rate and buffering capacity before and after soft drinks intake in children with erosive lesions and to compare these to equivalent values for healthy caries‐free individuals.Design. The study was conducted as a case‐control study using standard salivary tests. Thirty children with erosion and 30 age and sex‐matched children free from erosion and active caries were included in this study.Methods. Salivary flow rate was measured through expectoration into a graduated tube, salivary buffering capacity through colourimetric procedures and salivary pH using a digital pH meter.Results. Results showed significant differences between cases and controls for salivary pH, flow rate, buffering capacity, maximum pH drop and minimum pH reached after soft drinks intake.Conclusions. It is concluded that all the factors studied are involved in dental erosion and that preventive care is mandatory for children who frequently drink these kinds of beverages.
Valuing both critical and creative thinking in clinical practice: narrowing the research–practice gap?
Authors: Seymour Beth , Kinn Sue , Sutherland Norrie 
Published: December 2004

Background. Nurturing critical thinking skills in the classroom is considered an important educational activity. It is believed that critical thinking skills are transferable and that they can be applied in practice when appraising, evaluating and implementing research. That more nurses than ever before have been judged academically knowledgeable in research has not guaranteed the transfer of such knowledge to practice.Aim of the paper. This paper discusses some of the reasons for the failure to narrow the gap between research and practice. In particular we argue that, if nurses are encouraged to develop creative and generative thinking alongside their critical thinking skills, then the art of nursing will have fuller representation in education, research and practice.Discussion. The successful development of critical thinking skills for academic purposes does not necessarily mean that these skills are used in practice in relation either to research or clinical decision‐making. This suggests that the transferability of critical thinking skills is less than straightforward. Indeed, there has been little narrowing of the research–practice gap since students started to learn critical thinking for academic purposes. However, we propose that thinking skills can be encouraged in the context of practice and that regular educational events, such as journal clubs, can contribute to developing critical thinking in the practice environment.Conclusions. The research–practice gap will reduce only if research becomes part of practitioners' ideology, which includes the art and science of nursing. Critical and creative thinking are prerequisites to narrowing the disjuncture between research and practice, and we suggest that educators and practitioners explore structured ways of meeting together to appraise literature as a possible means of making use of their thinking and knowledge in clinical practice.
Downsizing and reorganization: demands, challenges and ambiguity for registered nurses
Authors: Hertting Anna , Nilsson Kerstin , Theorell Töres , Larsson Ullabeth Sätterlund 
Published: December 2004

Background.  The 1990s were characterized by substantial financial cuts, and related staff redundancies and reorganizations in the Swedish health care sector. A large hospital in Sweden was selected for the study, in which downsizing had occurred between 1995 and 1997. The number of staff in the hospital was reduced by an average of 20%, and 10% were relocated to other departments.Objective.  The aims of this study were to explore registered nurses’ experiences of psychosocial ‘stressors’ and ‘motivators’, and how they handled their work situations, following a period of personnel reductions and ongoing reorganization.Method.  Interviews were undertaken with 14 nurses working in one Swedish hospital. Nurses were interviewed in 1997 about the recent and last round of redundancies, and were followed up 1 year later in 1998 and again in 2001. Interviews were audiotaped, transcribed and analysed for thematic content.Results.  Five themes emerged in relation to nurses’ perceived stressors, motivators, and coping options: ‘distrust towards the employer’, ‘concurrent demands and challenges’, ‘professional ambiguity, ‘a wish for collaboration’, and ‘efforts to gain control’. A common feature was duality and ambiguity in nurses’ descriptions of the phenomena studied, meaning that identified themes had underlying sub‐themes with both negative and positive dimensions.Conclusions.  The concurrence of ‘ever‐growing job demands’ and ‘work going unrewarded’ contributed to a feeling of being taken advantage of by the employer. The ‘waste of human resources’ and ‘competence drain’ that followed redundancies provoked anger. Unfulfilled collaboration with doctors was a major stress producer, which related to both the downsized work organization, and the complex ‘deference‐dominance’ doctor–nurse relationship. The well‐being of nurses depends on being an equal/parallel health professional in a comprehensive team that shares knowledge and improves collaborative care of patients. A consciously formulated nursing philosophy emerged as a health‐promoting resource. This study demonstrates the importance of analysing feelings relating to professional ambiguity and gaining influence in a gender‐related, hierarchical environment, and the need to support professional assertiveness in relation to superiors and doctors. It is also important to stress considerations that relate to differences in the age, care philosophy, and psychosocial health conditions of nurses.
Leisure time activity of Mexican Americans with diabetes
Authors: Wood Felecia G. 
Published: December 2004

Background.  Diabetes is a worldwide health problem with increasing prevalence, particularly among ethnic minorities. Activity is a major component of diabetes management that can help to prevent the deadly complications of the disease. Assessment of the activities in which individuals with diabetes from specific ethnic groups such as Mexican Americans engage may facilitate identification of strategies to encourage activity among those who do not participate in activity or have only minimal, sporadic participation.Aims.  The aims of this research were to determine: (1) What proportion of Mexican Americans with diabetes do and do not exercise? (2) What are the preferred types of leisure time activity by gender and age? (3) What the relationship is between leisure time activity and treatment of diabetes?Methods and instrument.  A secondary analysis of data from the third National Health and Nutrition Examination Survey (NHANES) (1988–1994) was conducted to explore leisure time activities of self‐identified Mexican Americans with diabetes.Results.  Mexican American adults in this study indicated gardening (33·7%) and walking (31·5%) as the leisure time activities in which they engaged most frequently in the month preceding data collection. Gardening and walking were frequent leisure activities of study participants for all categories of pharmacological management of the diabetes. Many did not participate in any leisure time activity in the month preceding data collection. Only six of every 10 Mexican Americans (61%) with diabetes exercised. Males (n = 136; 71%) were more likely to engage in physical activity than females (n = 171; 54%).Limitations.  Only leisure time activity was assessed; occupational activity and household activity were not included. Data were based on self‐report rather than an objective measure of subject activity. Subject knowledge of the need for activity as a component of diabetes management was not assessed and may not be recognized as an integral part of care.Conclusions.  Diabetes is a significant health problem for many ethnic groups, including the Mexican American population, and regular physical activity is a critical component of disease management. Facilitating activity in this ethnic group is integral to controlling complications of this chronic disease.
Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods
Authors: Maxton Fiona J. C. , Justin Linda , Gillies Donna 
Published: December 2004

Background.  Monitoring temperature in critically ill children is an important component of care, yet the accuracy of methods is often questioned. Temperature measured in the pulmonary artery is considered the ‘gold standard’, but this route is unsuitable for the majority of patients. An accurate, reliable and less invasive method is, however, yet to be established in paediatric intensive care work.Aim.  To determine which site most closely reflects core temperature in babies and children following cardiac surgery, by comparing pulmonary artery temperature to the temperature measured at rectal, bladder, nasopharyngeal, axillary and tympanic sites.Method.  A convenience sample of 19 postoperative cardiac patients was studied.Interventions.  Temperature was recorded as a continuous measurement from pulmonary artery, rectal, nasopharyngeal and bladder sites. Axillary and tympanic temperatures were recorded at 30 minute intervals for 6 1/2 hours postoperatively.Study limitations.  The small sample size of 19 infants and children limits the generalizability of the study.Results.  Repeated measures analysis of variance demonstrated no significant difference between pulmonary artery and bladder temperatures, and pulmonary artery and nasopharyngeal temperatures. Intraclass correlation showed that agreement was greatest between pulmonary artery temperature and temperature measured by bladder catheter. There was a significant difference between pulmonary artery temperature and temperature measured at rectal, tympanic and pulmonary artery and axillary sites. Repeated measures analysis showed a significant lag between pulmonary artery and rectal temperature of between 0 and 150 minutes after the 6‐hour measurement period.Conclusions.  In this study, bladder temperature was shown to be the best estimate of pulmonary artery temperature, closely followed by the temperature measured by nasopharyngeal probe. The results support the use of bladder or nasopharyngeal catheters to monitor temperature in critically ill children after cardiac surgery.
Effectiveness of acupressure in improving dyspnoea in chronic obstructive pulmonary disease
Authors: Wu Hua‐Shan , Wu Shiao‐Chi , Lin Jaung‐Geng , Lin Li‐Chan 
Published: December 2004

Background.  Patients with chronic obstructive pulmonary disease (COPD) suffer from dyspnoea in their daily life and this may be increased by anxiety. Acupressure may promote relaxation and relieve dyspnoea. Thus, it is appropriate to explore the effectiveness of acupressure on dyspnoea in patients with COPD.Aims.  To compare outcomes of acupressure using sham acupoints on different meridians and ganglionic sections with that using true acupoints, in patients with COPD who are living at home.Methods.  Patients diagnosed with COPD were selected from a medical centre and three regional hospitals in Taipei. A randomized block experimental design was used. Using age, sex, pulmonary function, smoking, and steroid use as matching factors, 44 patients were randomly assigned either to a true acupoint acupressure or a sham group. The true acupoint acupressure group received a programme to decrease dyspnoea. Those in the sham group received acupressure using sham pressure points. Both acupressure programmes consisted of five sessions per week lasting 16 minutes per session, extending over 4 weeks for a total of 20 sessions. Before acupressure was initiated and at the conclusion of the 20th session, the Pulmonary Functional Status and Dyspnoea Questionnaire‐modified scale and the Spielberger State Anxiety scale were administered, and a 6‐minute walking distance test was performed. Physiological indicators of oxygen saturation and respiratory rate were measured before and after every session.Results.  The results of this study showed that the pulmonary function and dyspnoea scores, 6‐minute walking distance measurements, state anxiety scale scores, and physiological indicators of the true acupoint acupressure group improved significantly compared with those of the sham group.Conclusions.  The findings suggest that acupressure can be used as a nursing intervention to improve dyspnoea in patients with COPD.
Nursing home care: changes after supervision
Authors: Hansebo Görel , Kihlgren Mona 
Published: December 2004

Background.  An intervention project was conducted in three nursing home wards in Sweden. Most patients had severe dementia. The intervention consisted of supervision for individualized and documented nursing care, based on multidimensional assessment.Aim.  To illuminate changes in carers’ approach after the intervention.Methods.  Several data collections were conducted across the intervention and consisted of nursing documentation, patient life stories as told by carers, video recorded interactions, stimulated recall interviews and a questionnaire. Both quantitative and qualitative methods were used in the analyses.Findings.  The findings from the different methods mirrored each other and added to the credibility of the intervention. Communicated knowledge about patients improved in nursing documentation and also as told by carers. Carers were differently skilled in managing the complexity of nursing care situations before as well as after the intervention, but the intervention contributed to developing carers in ‘confirming nursing care’. They also improved in their ability to verbalize reflections about their everyday life with patients with dementia.Conclusion.  Supervision made it possible for carers to share their lived experiences about their day‐to‐day life with patients, which could promote personal and professional development and thus improve care quality. It also appeared that a detailed assessment tool used as part of the nursing process contributed to seeing a patient as a real person behind a dementia surface.
Spirituality and child development: a concept analysis
Authors: Smith Joanna , McSherry Wilfred 
Published: December 2004

Background. If children are to be given the opportunity to develop to their full potential, fostering spiritual growth must be part of the process of caring for them. However, the meaningful application of spiritual care in everyday practice is fraught with difficulties. In addition to a lack of understanding of the term itself and of the expression of spirituality, in child health these difficulties are further compounded by the stage of a child's development.Aim. The aims of this paper are to explore spiritual awareness in children by providing examples of the expression of spiritual beliefs in relation to the developmental stage of the child, and to identify the implications of the findings for clinical practice.Method. A model of concept development, using the cyclical process of ‘significance’, ‘use’ and ‘application’ was applied, and formed the philosophical underpinnings for the paper. This framework is particularly relevant to child health, as there is little evidence to draw on, particularly in relation to a child's spiritual needs.Findings. Five primary research papers which met the inclusion criteria were reviewed, and provided examples of spiritual beliefs and their manifestations in children. The examples highlighted the diversity and complexity of children's thinking.Conclusions and recommendations. Health care professionals working with children should receive education about the spiritual needs of children. Assessment tools should be developed to facilitate detailed assessment of children's spiritual needs. Professionals need to listen to and communicate with children at different stages of development if spiritual distress is to be identified. Families’ health care beliefs should be respected and considered when planning care.
Nurses’ perceptions of their pharmacology educational needs
Authors: King Rachel L. 
Published: December 2004

Background.  Pharmacology education in nursing has become increasingly important as nurses’ roles in administering, prescribing and educating patients about their medications have grown. Some authors have expressed concern at the lack of science teaching in nurse education, and others have suggested that there is a theory–practice gap in this area of the curriculum.Aim.  This paper reports a study to explore nurses’ pharmacology education needs by identifying nursing roles that require pharmacology knowledge, and nurses’ preparation for practice from preregistration pharmacology education.Method.  A qualitative approach was used to collect data from a purposive sample of 10 qualified nurses from an emergency admissions unit in a city in the north of England. Semi‐structured interviews were transcribed verbatim and categorized using Burnard's 14 stages.Findings.  This study revealed a limited understanding of the subject, and dissatisfaction with the teaching of pharmacology, with resulting anxiety on qualifying. Nursing roles identified as requiring pharmacology knowledge included drug administration, patient assessment, nurse prescribing, and patient medication education.Conclusion.  The findings suggest that, although nurses have a limited understanding of pharmacology, they recognize the need for pharmacology knowledge in practice. Improved pharmacology teaching might increase nurses’ confidence in performing drug administration, patient education, and nurse prescribing, and decrease anxieties related to these roles.
Hospital care of children in four countries
Authors: Shields Linda , Nixon Jim 
Published: December 2004

Background. While perceptions of parents and staff about care of hospitalized children have been explored in developed countries, little research has examined these in developing countries. Assumptions about family‐centred care are often based on Western values, with little evidence of how cultural constructs affect care delivery in developing nations.Aim. This paper reports a study to provide evidence from which culturally‐appropriate hospital care for children can be delivered.Methods. Using a rigorously devised and trialed questionnaire, attitudes of staff and parents about the way children are cared for in children's hospitals in four countries were examined and subjected to a four way analysis: parents and staff within and between developed and developing countries.Results. There were no questions where all parents and staff in both developed and developing country groups were in complete agreement. However, there was some indication that, while culture plays a major role in paediatric care delivery, basic concepts of family‐centred care are similar.Conclusions. The findings are limited by the sampling strategy. Nevertheless, while differences were found between parents’ and staff's expectations of the delivery of care to children in hospitals, similarities existed and the influence of culture cannot be ignored. Education programmes for staff and parents should reflect these influences to ensure the optimum delivery of family‐centred care, regardless of where the hospital is situated.
Nurses and the ‘therapeutic relationship’: caring for adolescents with anorexia nervosa
Authors: Ramjan Lucie Michelle 
Published: December 2004

Background.  Research studies suggest that hospital programmes for young people diagnosed with anorexia nervosa have high readmission rates and limited effectiveness. Nurses caring for these adolescents face a particular set of problems in seeking to establish therapeutic relationships.Aim.  This paper reports a study with the original aim of providing rich data on the development of therapeutic relationships between adolescents diagnosed with anorexia and paediatric nurses. However, it was discovered that paediatric nurses were struggling to develop therapeutic alliances with these adolescents. The study was then modified to explore the difficulties and obstacles hindering the formation of therapeutic relationships in this context.Method.  The study used naturalistic inquiry. The 10 participants were Registered Nurses from the acute wards of an Australian children's hospital with at least 2 years’ experience of caring for adolescents with anorexia nervosa. The data were collected using semi‐structured interviews that were recorded on audiotape and then thematically analysed both manually and with the aid of the NUD*IST computer package.Findings.  Participants described how they struggled to develop therapeutic relationships in this clinical environment. Three themes emerged: (1) ‘Struggling for understanding’ explores the difficulties nurses experienced in coming to terms with the complexities of a diagnosis of anorexia nervosa and its recovery processes. (2) ‘Struggling for control’ examines the power struggle between nurses and patients and the mutual distrust that often developed between them as a consequence of this struggle. (3) ‘Struggling to develop therapeutic relationships’ describes the difficulties some nurses had in establishing therapeutic alliances with these adolescents.Conclusion.  Recommendations are made for improving the nursing component of hospital treatment programmes for adolescents with anorexia nervosa in the direction of more genuinely therapeutic relationships.
Contribution of cAMP to the inhibitory effect of non‐steroidal anti‐inflammatory drugs in rat uterine smooth muscle
Authors: Hidalgo A. , Cantabrana B. , Pérez‐Vallina J. R. 
Published: December 2004

Summary

The effect of the non‐steroidal anti‐inflammatory drugs naproxen, mefenamic acid, phenylbutazone, pioroxicam and tolmetin on the vanadate (0.3 mM)‐induced tonic contraction, as well as the modifications of these effects by the G‐protein inhibitor pertussis toxin, and the inhibitors of protein kinase A, Rp‐cAMPS (Rp‐Adenosine 3′,5′‐cyclic monophosphothioate triethylamine salt) and protein kinase C, H‐7 [1(5‐isoquinolynilsulfonyl)‐2‐methyl‐piperazine], have been assayed to study the possible nature of intracellular mediators contributing to the inhibitory effects of NSAIDs in rat uterine smooth muscle incubated in medium lacking calcium plus EDTA. The effect of phorbol 12, 13‐dibutyrate on vanadate contraction and its modification with H‐7 has also been examined.
Naproxen (6‐600 μM), mefenamic acid (6—300 μM), phenylbutazone (6‐300 μM), piroxicam (6—600 μM) and tolmetin (6—600 μM) produced concentration‐dependent relaxation of vanadateinduced tonic contraction. The potency order, in acordance with their respective IC50 values was: phenylbutazone ≥ mefenamic acid ≥ naproxen > tolmetin ≥ piroxicam.
The relaxant effects of naproxen, Phenylbutazone, piroxicam and tolmetin were significantly antagonized with pertussis toxin (50 ng ml‐1), Rp‐cAMPS (100 μM) and H‐7 (1 μM). However, the effect of mefenamic acid was unmodified by the three drugs. This suggests that the effect of mefenamic acid and other NSAIDs occur by different mechanisms.
Phorbol 12,13‐dibutyrate relaxed the vanadate contraction but the maximal relaxation achieved (54.8 ± 8.3%, n = 4) was lower than those induced with the NSAIDs. On the other hand, H‐7 (1 μM) did not modify the relaxant effect of phorbol 12, 13‐dibutyrate. This suggests that H‐7 behaves as a PKA, but not a PKC inhibitor, under the present experimental conditions.
The relaxation by naproxen, phenylbutazone, piroxicam and tolmetin is presumably produced by increasing cAMP because the effects of these are antagonized with Rp‐cAMPS and H‐7, and by pertussis‐toxin‐sensitive mechanisms.