bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating research for use in practice: what criteria do specialist nurses use?
Authors: French Beverly 
Published: March 2005

Aim.  This paper reports a study identifying the criteria chosen by nurses to evaluate whether to use research in practice. This work is part of a larger project on the process of research use by nurses.Background.  Prescriptive models of research utilization direct practitioners to evaluate a range of criteria to assess the fit of the research to current practice. Criteria relating to the research, task and nursing context are specified, but it is not known whether nurses use these criteria in practice.Method.  Three different groups of nurse specialists from a number of health care providers in the North West of England were studied. The specialists were involved in a series of meetings at a local university to construct evidence‐based policy recommendations for practice. The discussion was analysed to identify the evaluation criteria they used to assess what should be done in the practical setting.Findings.  Three sets of evaluative criteria were identified relating to the research, the task and the fit of the task with the nursing context, and included relevance and quality of the research, effectiveness, practicality, effort and the impact of the task on client and staff, feasibility and fit with the status quo, and the availability of nursing control and feedback from practice. Criteria were domain‐, task‐ and context‐specific.Conclusions.  Three frames of reference for decisions relating to the use of research are identified: the debate between efficiency and effectiveness in health care, the difficulties of risk management and the responsibility for risk, and research use as a strategy for control in contested arenas. These frames of reference reflect how nurses are judged in a political and organizational context. Attempts to influence research uptake need to take into account how research is perceived and evaluated by practitioners and how it serves their purposes.
Nurse‐led models of chemotherapy care: mixed economy or nurse–doctor substitution?
Authors: Fitzsimmons Deborah , Hawker Sheila E. , Simmonds Peter , George Steve L. , Johnson Colin D. , Corner Jessica L. 
Published: March 2005

Aim.  This paper reports a study exploring the perspectives of people affected by cancer (service users) and health care professionals’ about current medical consultant‐led services and the acceptability of a proposed nurse‐led ambulatory chemotherapy service.Background.  A number of studies have evaluated a nurse‐led model of cancer care delivery but little work has been undertaken in chemotherapy settings. Furthermore, many of these studies give little information on how the perspective of users was incorporated in the design and evaluation of these services.Methods.  Service users (n = 26) and health care professionals (n = 22) were recruited across the South East of England. A qualitative study was undertaken… Using a semi‐structured interview schedule, participants were asked to give their perceptions of current chemotherapy services and the potential of a nurse‐led service. A thematic analysis of data was undertaken.Findings.  This paper focuses on the theme of the current and future context of a chemotherapy service. Three sub‐themes were identified: contextualizing roles, defining therapeutic outcomes, and demonstrating effectiveness. All interviewees saw this role as different but complementary to the role of medical staff. There were mixed opinions from service users and professionals on the acceptability of nurse‐led chemotherapy provision. In defining potential outcomes of nurse‐led care, service users described benefits in terms of service and economic outcomes. Professionals saw additional benefits in terms of patient‐based outcomes. Professionals and service users expressed the need for appropriate education of nurses for this role and rigorous evaluation of any new service before widespread implementation.Conclusions.  Understanding the perspective of users is imperative when re‐designing cancer nursing services. Implementation of nurse‐led models in chemotherapy services should be preceded by staff education and followed by systematic evaluation.
Body care experienced by people hospitalized with severe respiratory disease
Authors: Lomborg Kirsten , Bjørn Agnes , Dahl Ronald , Kirkevold Marit 
Published: March 2005

Aim. The paper gives a theoretical account of experiences of assisted personal body care (APBC) in hospitalized patients with severe chronic obstructive pulmonary disease (COPD).Background. Body care has been identified as a central but underestimated area of nursing. Hospitalized patients with severe COPD suffer from breathlessness on exertion and are dependent on help with personal body care. Studies have described patient strategies for managing breathlessness and preferences regarding nursing care during hospitalization. Yet the problems that patients can experience because of their inability to manage personal body care by themselves have not previously been explored. This study explored patients’ experiences of being assisted with personal body care.Methods. A grounded theory methodology was used with a convenience sample of 12 patients. Data were gathered from participant observation of sessions of APBC, in‐depth interviews after the observed sessions and measurement of breathlessness perceived by patients before and after the sessions.Findings. The patients perceived body care as a significant daily activity that needed to be carried out in order to preserve their integrity. Dependency and breathlessness, however, impeded the performance of body care activities and patients were struggling for self‐preservation. They managed APBC by using a threefold strategy ofnot letting go,coping with dependency, andminimizing the risk of escalating breathlessness. Two dilemmas were identified as being inherent to the strategy.Conclusion. Increased knowledge of the complexities involved in providing assistance might improve nurses’ ability to facilitate patients in managing APBC. Dependency is a central issue to address in order to support patients’ efforts to preserve integrity and resolve dilemmas inherent to the strategy they use.
Initiation and continuation of breastfeeding: theory of planned behaviour
Authors: Swanson Vivien , Power Kevin G. 
Published: March 2005

Aims.  This paper reports a study investigating new mothers’ subjective norms in relation to both breast‐ and bottle‐feeding. The influence of norms on women's infant feeding decisions and the relative influence of social referents at varying degrees of social distance were assessed.Background.  Increasing breastfeeding initiation and continuation rates is a key challenge for health educators. The perceived influence of other people's views (subjective norms), including the views of women's partners and health care professionals, is an important predictor of infant feeding behaviour.Methods.  Semi‐structured questionnaires were administered to 203 new mothers in central and northern Scotland and followed‐up by postal questionnaire at 6 weeks. Infant feeding intentions, feeding behaviour at birth and follow‐up, behavioural beliefs and subjective norms for both breastfeeding and bottle‐feeding were assessed. The data were collected in 1998–1999.Results.  Subjective norms were important determinants of initiation and continuation of breastfeeding for breast‐ and bottlefeeders. Breastfeeders rated close social referents as more in favour of bottle‐feeding and more against breastfeeding at follow‐up, whereas bottlefeeders’ ratings did not change. Partner's and nurses’/midwives’ views were an important influence at baseline and follow‐up. Breastfeeding ‘continuers’ perceived their partners as more pro‐breastfeeding at 6 weeks. Discontinuers perceived more overall social pressure to bottle‐feed. However, sampling limitations may have led to over‐representation of the views of breastfeeders at baseline and follow‐up.Conclusions.  Nurses and midwives have a crucial role in communicating positive views on breastfeeding to new mothers at different time points. Future interventions to promote breastfeeding could adopt a broad social approach, encouraging positive norms for existing and potential mothers and fathers, families and people in general.
Individualized care, quality of life and satisfaction with nursing care
Authors: Suhonen Riitta , Välimäki Maritta , Leino‐Kilpi Helena 
Published: March 2005

Aims.  This paper reports a study of the maintenance of individualized care from surgical patients’ point of view and examines associations between individualized care, patient satisfaction with nursing care, and health‐related quality of life.Rationale.  There is preliminary evidence that individualized care is effective from patients’ point of view, and is associated with improved patient outcomes, such as patient satisfaction and quality of life. However, individualized care has mainly been studied from the vantage‐point of nurses’ experiences.Methods.  In this cross‐sectional, descriptive, correlational study the data were collected with surgical adult patients (n = 279, response rate 93%) in surgical wards in Finland using self‐administered questionnaires including the Individualized Care Scales, Patient‐Satisfaction Scale, and Finnish versions of the Nottingham Health Profile and EuroQol 5D. Associations between individualized care, satisfaction with care and health‐related quality of life were examined. Cronbach's alpha values and item analysis were used to evaluate the psychometric properties of the instruments, especially the Individualized Care Scales.Results.  The more often patients felt they received support for individuality through specific nursing interventions, the higher the individuality of care received. Secondly, the more individualized patients regarded their care, the higher the level of reported patient satisfaction with nursing care. However, the correlation between individualized care and health‐related quality of life was fairly low, albeit statistically significant.Conclusion.  Individualized care may produce positive outcomes, such as patient satisfaction. Further research is needed to explore individualized care in relation to health‐related quality of life.
Pressure ulcers: guideline development and economic modelling
Authors: Legood Rosa , McInnes Elizabeth 
Published: March 2005

Aim.  This paper presents the development process for clinical guidelines on the use of pressure‐relieving devices (beds, mattresses and overlays), with emphasis on incorporating economic evidence.Background.  Previous UK guidelines on the use of pressure‐relieving devices to prevent pressure ulcers have not considered whether any recommendations made are cost effective. The routine inclusion of cost effectiveness evidence in guidelines is a recent policy development, and there has been little research into its potential role in the guideline process.Methods.  We systematically reviewed the literature to assess both the clinical and cost effectiveness of pressure‐relieving devices for prevention of pressure ulcers. Where there was sufficient evidence on the comparative clinical effectiveness between alternative devices, economic modelling was undertaken to assess comparative cost effectiveness. A guideline development group (comprising both clinicians and patient representatives) reviewed all the available evidence to formulate clinical practice guidelines and recommendations for further research.Results.  Studies showed that caring for people vulnerable to developing pressure ulcers on high‐specification foam mattresses compared with standard hospital mattresses significantly reduced their risk of developing a pressure ulcer. Cost effectiveness modelling indicated that, because of savings accruing through treating fewer pressure ulcers, high‐specification foam mattresses are likely to cost less overall and are more effective. The resulting clinical practice guideline was uncompromising on the use of high‐specification foam mattresses as the minimum provision in patients vulnerable to pressure ulcers. Significant weaknesses were identified in both the quality and availability of evidence for most of the other pressure relieving devices considered.Conclusions.  Cost effectiveness assessment was an integral part of the guideline development process. It clarified the shortcomings of some of the clinical effectiveness evidence and helped in formulating pragmatic clinical practice recommendations.
Stress in carers of individuals with dementia and Community Mental Health Teams: an uncontrolled evaluation study
Authors: Hoskins Sid , Coleman Mick , McNeely Dave 
Published: March 2005

Aim.  The aim of this was to evaluate the effectiveness of interventions provided by a Community Mental Health Team (CMHT) in reducing stress in carers of individuals with dementia.Background.  The CMHT had been created to working specifically with older people with mental health problems and their carers. Following initial multidisciplinary assessment a range of interventions were provided to both clients and carers according to assessed need. There is an established need for mental health services to focus on the need of carers and the study attempts to see if the interventions provided were useful in reducing carer stress.Method.  The study used a time series design over a 2‐year period on all referrals to the CMHT. All carers of individuals with dementia or clearly identified memory problems were invited to participate and a total of 26 carers consented and participated in all stages of data collection. Data were collected on initial assessment, as well as 3 and 6 months following the initial assessment using the Caregiver Strain Index (CSI). A questionnaire was also administered which collected basic demographic information and details of symptoms demonstrated by the carer's relatives.Results.  On initial assessment the mean CSI score for the overall sample was 9·23. The mean CSI reading at 3 months (6·63) and 6 months period (4·12) demonstrated statistically highly significant reductions in carer stress (P = 0·000). A linear stepwise regression analysis of the impact of the different interventions on reductions in the CSI scores showed a statistically significant relationship between respite care and reduction in carer stress (B = 1·705, t = 2·586, P = 0·017).Conclusion.  The results add support to the role of multidisciplinary community based services for individuals with dementia, offering a range of interventions to both clients and their carers, in reducing carer stress. The authors also argue for the routine use of the CSI in such teams as means of monitoring the well‐being of carers as well as evaluating the effectiveness of service delivery.
Full‐field strain mapping by optical correlation of micrographs acquired during deformation
Authors: QUINTA DA FONSECA J. , MUMMERY P. M. , WITHERS P. J. 
Published: March 2005

SummaryOptical correlation is an emerging strain‐mapping technique that allows full‐field surface strain mapping by comparing the images of the same region before, during and after deformation. The fundamental aspects of optical correlation are presented, with emphasis on the applicability of the technique to the analysis of micrographs obtained during in situ deformation studies. Without considering specific algorithms, this paper discusses important practical issues such as accuracy and spatial resolution and how these are affected by image quality and other experimental difficulties. The technique was used to analyse image sequences obtained during in situ deformation tensile tests on two very different materials: antler bone and ferritic steel. As the technique does not require patterns or coatings to be applied on the surface of interest, the strain maps obtained could be used to relate strain heterogeneity to the underlying microstructure.
Imaging orientational order and lipid density in multilamellar vesicles with multiplex CARS microscopy
Authors: WURPEL G. W. H. , RINIA H. A. , MÜLLER M. 
Published: March 2005

SummaryMultiplex coherent anti‐Stokes Raman scattering (CARS) microscopy is used to measure the width of the orientational order distribution of lipid acyl chains within a three‐dimensionally confined microscopic probing volume. A theoretical model is developed to describe and simulate the polarization‐dependent measurements. We observe that the orientational order in phosphatidylcholine multilammellar vesicles increases significantly upon addition of small amounts (≤ 15 mol%) of cholesterol and is significantly reduced for unsaturated lipids. Based on these measurements and using the quantitative nature of multiplex CARS microscopy the exact local concentration of lipid molecules within the vesicles can be measured in terms of the number of lipid bilayers present in the microscopic probing volume.
AB‐plot assisted determination of fluorophore mixtures in a fluorescence lifetime microscope using spectra or quenchers
Authors: HANLEY Q. S. , CLAYTON A. H. A. 
Published: March 2005

SummaryMost treatments of frequency domain lifetime measurements indicate that a set of measurements must be made at multiple frequencies in order to determine the lifetimes of the components in a mixture. Although this is the case in general, under special conditions, single‐frequency data can resolve multiple lifetimes. Here, data are presented showing several approaches to determining fluorescence lifetimes in two‐component mixtures using single‐frequency data. Common to all of the procedures presented is exploitation of variations in the relative contributions of a particular fluorophore to the total fluorescence from a mixture of fluorophores. This variation can be produced intentionally by observing a number of samples which contain different relative amounts of the fluorophores. It can be produced fortuitously by observing spatial variations in a mixture of fluorophores in a specimen or set of specimens observed with a lifetime imaging system. It can also be produced by examination of the lifetime spectrum obtained from a fluorophore mixture or by varying the concentration of a quencher in a fluorophore mixture, in which the two fluorophores have different rate constants for quenching. In many instances, the set of approaches presented here will be unsuitable for examination of arbitrary samples of unknown composition for which the multifrequency approach should be used. However, measurements produced using single‐frequency methods may be applied to good effect for controlled experiments having defined fluorophores or sets of fluorophores, particularly in the case of biological lifetime imaging studies.
Comments on the shortcomings of predicting the precision of Cavalieri volume estimates based upon assumed measurement functions
Authors: GLASER E. 
Published: March 2005

SummaryIt is well known that the estimation of an object's volume by means of serial cross‐sections, the so‐called Cavalieri method, yields an unbiased estimate. But by itself it provides no means by which to estimate how precise this estimate is unless the shape of the volume is fully known beforehand. This knowledge can only be partially determined from the serial section information that is collected. Methods have been developed that claim to surmount this difficulty by using the serial section data to create a mathematical model of the volume's shape properties. The model then is used to estimate (predict) the precision of the volume estimate (its CE) from the single set of data available. Unfortunately, the theory underlying the model is flawed and so the model itself amounts to no more than an unsubstantiated guess about the shape of the volume. Therefore, the precision of the volume estimates that one obtains from the method is only as good as the model and this cannot be ascertained from the single set of acquired data. In this letter I explain the inadequacies of the modelling method. I suggest that it be used only with caution, if at all. Instead I suggest two alternative ways to predict the CE, one that is based upon a rule‐of‐thumb approach to the object's shape, and another that is based upon spectral analysis of the measurement function and that is easy to implement with available computer software.
Sedimentation on a wave‐dominated, open‐coast tidal flat, south‐western Korea: summer tidal flat – winter shoreface
Authors: YANG B. C. , DALRYMPLE R. W. , CHUN S. S. 
Published: March 2005

AbstractSedimentation on the open‐coast tidal flats of south‐western Korea is controlled by seasonal variation in the intensity of onshore‐directed winds and waves. As a result, an environmental oscillation takes place between tide‐dominated conditions in summer and wave‐dominated conditions in winter. In summer, thick muddy deposits, including sporadic storm deposits, accumulate in response to low wave energy, weak currents, and intense solar insolation that promotes consolidation of the mud at low tide. Bioturbation is minimal because of rapid sedimentation and soft substrate. During the autumn, the summer mud deposits experience erosion due to increasingly strong onshore winds and waves, until only small mud patches and mud pebbles remain. The concentration of ebb runoff between the mud patches produces small, ephemeral tidal creeks. In winter, storm waves occur frequently (ca 10 days a month) and dominate sedimentation in the intertidal zone, producing extensive wave‐generated parallel lamination and short‐wavelength (0·3–2 m) hummocky cross‐stratification. The prevalence of strong onshore winds decreases in spring, allowing longer and more frequent intervals of calm weather, during which time muddy sediments are deposited by tidal processes. Over the long term, winter storm waves dominate sedimentation and the preserved deposits consist of amalgamated storm beds that resemble those generally associated with shorefaces. This raises the question of how many ancient ‘shorefaces’ are, in fact, open‐coast tidal flats.
Grain‐size sorting in grainflows at the lee side of deltas
Authors: KLEINHANS MAARTEN G. 
Published: March 2005

AbstractThe sorting of sediment mixtures at the lee slope of deltas (at the angle of repose) is studied with experiments in a narrow, deep flume with subaqueous Gilbert‐type deltas using varied flow conditions and different sediment mixtures. Sediment deposition and sorting on the lee slope of the delta is the result of (i) grains falling from suspension that is initiated at the top of the delta, (ii) kinematic sieving on the lee slope, (iii) grainflows, in which protruding large grains are dragged downslope by subsequent grainflows. The result is a fining upward vertical sorting in the delta. Systematic variations in the trend depend on the delta height, the migration celerity of the delta front and the flow conditions above the delta top. The dependence on delta height and migration celerity is explained by the sorting processes in the grainflows, and the dependence on flow conditions above the delta top is explained by suspension of fine sediment and settling on the lee side and toe of the delta. Large differences in sorting trends were found between various sediment mixtures. The relevance of these results with respect to sorting in dunes and bars in rivers and laboratory flumes is discussed and the elements for a future vertical sorting model are suggested.