bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moving from institutional dependence to entrepreneurialism. Creating and funding a collaborative research and practice development position
Authors: Darbyshire Philip , Downes Maeve , Collins Carmel , Dyer Susan 
Published: August 2005

Aims of the paper.  The paper describes the creation of, the rationale behind and the external funding of a collaborative research‐clinical practice development position. The paper also demonstrates the benefits of nursing's collaboration with external funding bodies and the value of moving from our traditional position of assuming that ‘the hospital’ will always provide.Background.  There is a constant refrain that nursing must become more ‘research‐based’ and develop an active research culture. In harsh financial times however, funding for research development is scarce. Nurses can respond to this by bemoaning the lack of money or by taking an entrepreneurial approach, creating innovative project proposals that develop new partnerships and attract external funding.Discussion.  Institutional support for clinical research is often more verbal than financial as most health care systems are experiencing extreme financial stringencies. Nurses need to reconsider the notion that every initiative must automatically be funded by the institution. In this paper we show how in a busy major hospital, clinicians and researchers collaborated to create and fund the kind of innovative research and practice development position that may be impossible to fund through existing budgets.Conclusion.  With creativity and determination, nurses can challenge the orthodoxy that they are solely dependent on institutional funding. If there is a clear project vision, a convincing rationale, a strongly argued ‘business case’ and a passionate and persistent team, then innovative new projects and positions can be realized.Relevance to clinical practice.  Developing clinical focused, practice based research is now a worldwide policy and practice imperative for nurses. Unfortunately, current levels of institutional funding are unlikely to support research promotion positions and initiatives. This paper outlines an approach to securing funding for research initiatives that can create exciting new positions and develop productive partnerships between researchers, clinicians and external agencies.
Exploring district nursing competencies in health promotion: the use of the Delphi technique
Authors: Irvine Fiona 
Published: August 2005

Aims and objectives.  The research outlined in this paper aimed to establish a consensus view amongst primary healthcare professionals about the competencies that district nurses need in order to fulfil an effective role in health promotion.Background.  In recent years there has been a growing emphasis on health promotion in primary care in the United Kingdom and health promotion is becoming increasingly important to nurses who work in the community. However, consideration of the role of the district nurse in health promotion is rather restricted and consequently district nurses have limited access to empirical evidence, from which they can develop their work in health promotion.Design and methods.  The Delphi technique was used for this study. Seventy‐two primary healthcare professionals were mailed a series of three questionnaires, which achieved response rates of 86, 87.5 and 78.9%.Results.  There was a consensus amongst the panellists that district nurses require a range of competencies to engage effectively in health promotion. These were categorized to produce a definitive list of eight knowledge‐, seven attitude‐ and eight skill‐related competencies.Conclusions.  For the first time, this study achieves a consensus on the competencies needed by district nurses to engage in health promotion.Relevance to clinical practice.  District nurses should feel encouraged to develop their health promotion role in light of the fact that many of the competencies that they require for this activity have been identified as essential for their day‐to‐day nursing practice. The research highlights the fact that new paradigm health promotion is a concept that has moved beyond the academic arena and is recognized as significant by practising health professionals.
How graduate nurses use protocols to manage patients’ medications
Authors: Manias Elizabeth , Aitken Robyn , Dunning Trisha 
Published: August 2005

Aims and objectives.  The aim of the study was to determine how graduate nurses use protocols in their medication management activities. The objectives were to: examine the extent of adherence to various protocols in relation to medication activities and determine how the ward environment impacts on graduate nurses’ use of protocols to manage patients’ medications.Background.  Protocols help newly qualified nurses integrate new knowledge into practice and promote effective decision‐makingDesign.  A descriptive prospective qualitative design was used.Methods.  Twelve graduate nurses involved in direct patient care in medical, surgical and specialty wards of a metropolitan teaching hospital participated in the study. Participant observations were conducted with the graduate nurses during a two‐hour period when medications were being administered to patients. In‐depth interviews were conducted with each nurse immediately after observations and demographic data were collected on participating nurses and patients in their care, including all medications prescribed. Protocols associated with medication management activities for the clinical settings were also transcribed.Results.  Six themes were evident from the data: availability and use of protocols, scrutinizing patients’ identity before medication administration, double‐checking certain medications before administration, writing incident reports, following specific policies and timing the administration of medications.Conclusion.  Graduate nurses adhered to protocols if they were perceived not to impede with other nursing activities. Participants were also more likely to follow protocols if they felt encouraged to make their own decisions and if there was a decreased likelihood that disciplinary action would be involved.Relevance to clinical practice.  Experienced health professionals should encourage graduate nurses to comply with medication protocols and to make clinically reasoned decisions about medication activities. By providing peer support and acting as role models, experienced health professionals can also demonstrate to graduate nurses how effective protocol use is an important component of quality patient care.
Supporting learners in clinical practice: capacity issues
Authors: Hutchings Andy , Williamson Graham R , Humphreys Ann 
Published: August 2005

Aim.  The aim of this paper is to report a study exploring, from the perspective of key stakeholders (mentors of nurses, managers of nurses, and modern matrons) in one English acute sector hospital, how decisions are made on how many learner nurses can be supported in clinical practice. The objective was to identify what factors are taken into consideration in making these decisions.Background.  Supporting increasing numbers of students is a demand of current service provision in the English National Health Service, as part of an expansion in the numbers of all healthcare professionals. This is particularly the case in nursing, where the government announced a required increase in numbers of qualified nurses of 20 000. This expansion of numbers has implications for the quality of placement learning in clinical placements.Methods.  Data were collected using three focus group interviews with a total of 12 participants in 2003/04. Recruitment was on a purposive basis. Subsequent analysis identified themes, which were compared across groups. A short questionnaire was also used to establish participants’ biographical details prior to the focus groups.Findings.  Three key themes were identified: ‘capacity issues’, ‘enhancing support in practice’ and ‘issues impacting on learning in practice’. ‘Capacity issues’ identified factors that impact on the capacity of placements to support learners. ‘Enhancing support in practice’ identified necessary roles and strategies to enhance learning in practice. Finally, ‘issues impacting on learning in practice’ identified learner groups where support could be enhanced through structured management of the placement experience.Conclusions.  Decisions on learner numbers to be supported at any one time are complex, with a multitude of dimensions. These include identification of types of learners and numbers of mentors available to support them and other operational issues. ‘Educational staff’ are needed at operational and strategic levels to support learning in practice. Timely and appropriate audit information to support allocation decisions and identify strategies to enhance the quality and support of learning in practice, are also required.Relevance to clinical practice.  Increases in learner numbers and National Health Service modernization have had an impact on clinical placements’ capacity to support learning, and potentially, on learners’ achievements in practice. Findings from this study are thus important in evaluating the impact of these policy initiatives.
The clinical learning portfolio: a practice development experience in gerontological nursing
Authors: Coffey Alice 
Published: August 2005

Background.  Assessment of clinical practice in post registration programmes can require a different focus to capture the essence of learning at a higher level. There are differences of opinion in the literature on the potential use of the portfolio as an assessment method.Aims.  The aims of this paper are to describe the use of a portfolio of evidence‐based practice and reflection to assess clinical learning in a Higher Diploma in Gerontological Nursing Programme and to present the findings of a pilot evaluation of this assessment.Design and method.  The evaluation was conducted by postal questionnaire distributed to the first cohort of students following graduation from the programme in 2002.Results and conclusions.  Arising from this exploration of the student experience, it appears that the use of a portfolio in addition to formative assessment, can promote a link between theory and the advancement of gerontological nursing practice.
Gamma irradiation does not affect 7‐day storage of platelet concentrates
Authors: Van Der Meer P. F. , Pietersz R. N. I. 
Published: August 2005

Background and Objectives  Extension of storage of leucocyte‐reduced platelet concentrates (LR‐PCs) to 7 days has recently been introduced, but the effect of gamma irradiation on in vitro parameters was unknown.Materials and Methods  A paired experiment was carried out, with gamma irradiation on day 1 or day 5 with 25 Gy, and no irradiation served as a reference.Results  Measurements during storage up to 8 days after blood collection showed no significant differences of irradiated LR‐PCs vs. the control.Conclusions  Irradiation, either on day 1 or day 5, had no effect on platelet quality during a 7‐day storage period.
Separation of whole blood into plasma and red cells by using a hollow‐fibre filtration system
Authors: Hornsey V. S. , McColl K. , Drummond O. , Prowse C. V. 
Published: August 2005

Background and Objectives  The aim of this study was to assess the separation of whole blood into red cells and plasma by using the Sangofer® device, which is a gravity‐fed, hollow‐fibre system. The components would then be compared with those produced by the use of more elaborate technical equipment.Materials and Methods  Ten whole‐blood units were leucoreduced by using a WBF2 filter and immediately separated into red cells and plasma by using the Sangofer® blood‐separation device. Red cells were stored in additive solution and tested on days 1 and 42. The plasma was assayed for levels of various coagulation factors and for markers of both coagulation and complement activation.Results  The red‐cell parameters were similar to those obtained when routine centrifugation methods were used. The filter did not cause haemolysis. Levels of plasma factor VIII and factor XI were lower than those seen in routinely produced leucoreduced plasma units but there was no evidence of activation of the coagulation and complement systems.Conclusions  The Sangofer® device is simple and straightforward to use and eliminates the need for both centrifugation and automated separation steps during the processing of whole blood into red cells and plasma components. Minor changes are required to make the procedure easier to incorporate into routine use.
Collaborative study to establish the first international standard for quantitation of anti‐HPA‐1a
Authors: Allen D. , Rigsby P. , Bessos H. , Berry J. , Wilson D. , Ouwehand W. H. , Urbaniak S. , Metcalfe P. 
Published: August 2005

Background and Objectives  This report describes the production of a freeze‐dried preparation of pooled human plasma, containing immunoglobulin G (IgG) antibodies against the human platelet antigen 1a (HPA‐1a). The material, coded 03/152, is proposed as an International Standard containing 100 arbitrary units of anti‐HPA‐1a for use in quantitative assays to determine the anti‐HPA‐1a activity in clinical samples.Materials and Methods  Plasma samples containing potent anti‐HPA‐1a were pooled and freeze dried in 1‐ml ampoules. In addition, three individual plasma samples were selected which had varying levels of anti‐HPA‐1a activity. The anti‐HPA‐1a activity of these three samples was determined by using a variety of quantitative assays with the proposed standard as a reference.Results  An international collaborative study, which was part of the 2004 ISBT Platelet Immunology Workshop, involved 39 laboratories in 24 countries and showed that the anti‐HPA‐1a activity in three test samples could be reliably determined by using the proposed standard.Conclusions  Laboratories can use this standard to measure the anti‐HPA‐1a activity in patient's samples. Further studies are required to determine the relationship between anti‐HPA‐1a activity and clinical outcome in patients with neonatal alloimmune thrombocytopenia (NAIT).
Does Counting Count for 3‐ to 4‐year‐olds? Parental Assumptions about Preschool Children's Understanding of Counting and Cardinality
Authors: Fluck Michael , Linnell Maggie , Holgate Melanie 
Published: August 2005

AbstractResearch indicates that children do not typically understand the connection between counting and cardinality for several months after learning to count, yet parents speak to 3‐year‐olds as though they already understood the significance of counting. The present research was designed to investigate mothers’ awareness of the discrepancy between children's procedural and conceptual mastery of counting. In Study 1 mothers of a hundred 3‐ to 41/2‐year‐olds completed an anonymous questionnaire asking them to anticipate how their child would respond to a series of real‐life vignettes based on widely used experimental measures of cardinal understanding. Most anticipated that their child, irrespective of age, would (1) understand the significance of the last word of a count, and (2) be able accurately to give a specified non‐subitizable number of objects. Comparison with the performance of 54 children from the same local population supported the hypothesis that parents overestimate children's understanding of the cardinal significance of counting. Mothers reported a range of impromptu number‐related activities in which their child had recently participated at home; most of these involved simple procedural counting. In Study 2, 35 mothers of 3‐ to 41/2‐year‐olds completed a modified questionnaire concerning procedural aspects of counting as well as cardinality; their responses were then compared with the performance of their own children. Again, mothers overestimated their children's cardinal understanding, but this was shown not to be a result of a general tendency to overestimate their counting abilities. It is suggested that preschoolers’ counting generally occurs during joint activities in which caregivers may be unaware of the support that they provide, and, provided that the jointly executed count procedures are error‐free, parents implicitly assume a ‘common knowledge’ regarding the cardinal significance of counting.
FISH: A New Computer Program for Friendly Introductory Statistics Help
Authors: Brooks Gordon P. , Raffle Holly 
Published: August 2005

SummaryAll introductory statistics students must master certain basic descriptive statistics, including means, standard deviations and correlations. Students must also gain insight into such complex concepts as the central limit theorem and standard error. This article introduces and describes the Friendly Introductory Statistics Help (FISH) computer program, which is free and easy‐to‐use software designed to help students learn such introductory statistical concepts.
Awareness of number in children with severe and profound learning difficulties: three exploratory case studies
Authors: Porter Jill 
Published: August 2005

SummaryThis paper reports on exploratory work investigating how children with severe and profound learning difficulties register an awareness of small quantities and how they might use this information to inform their understanding. It draws on studies of typically developing children and investigates their application to pupils whose response to conventional mathematical tasks are often limited because they lack relevance and interest. The responses of the three pupils to individualized learning contexts mirror the progression suggested in the literature, namely from awareness of number to simple actions using number cues to problem‐solving behaviour.
An investigation of students’ with mild learning disabilities reactions to participating in sexuality research
Authors: Thomas Gail , Kroese Biza Stenfert 
Published: August 2005

SummaryThis study investigates 35 students’ with mild learning disabilities reactions to participating in a research project exploring their sexual knowledge, attitudes and behaviour. Students completed an informed consent procedure prior to their participation in the sexuality research and all were interviewed using a confidential interview procedure. During the research interviews, each student's reaction to participation was observed and recorded by their interviewer. Following the interviews, each student's reaction to participation was observed and recorded by their college tutor. Researchers observed that although some students were embarrassed discussing certain sexual topics, none chose to stop their interviews when invited. Ten students requested additional information from their interviewers about the issues discussed. Tutors reported that no students appeared anxious or distressed following their interviews and that no inappropriate sexualized behaviour, or talk, were observed. Tutors also reported that several students appeared to have been positively affected by their participation. No tutors expressed concern about their students participating in similar research in the future. It is concluded that a number of methodological and participant factors may have accounted for the positive outcomes reported. The implications of these findings and recommendations for future research are discussed.
The magnitude of abortion complications in Kenya
Authors: Gebreselassie Hailemichael , Gallo Maria F. , Monyo Anthony , Johnson Brooke R. 
Published: August 2005

Objective  To estimate and describe the magnitude of abortion complications presenting at public hospitals in Kenya.Design  Cross‐sectional descriptive study.Setting  Hospital‐based.Population  Records of all women presenting prior to 22 weeks of gestation with abortion‐related complications at selected hospitals during a three‐week study period. All public tertiary and provincial hospitals were included; stratified random sampling was employed to select a subset of 54 district hospitals nationwide.Methods  Data collectors identified 809 patients with abortion complications on all hospital wards and completed a standardised questionnaire for each by extracting information from the patient's hospital record.Main outcome measures  Incidence, aetiology, morbidity and mortality of abortion complications.Results  Most women (80%) presented with incomplete abortion. Approximately 34% of the women had reached the second trimester of pregnancy. Adolescents (14–19 years old) accounted for approximately 16% of the study sample. Manual vacuum aspiration was used to manage 80% of first trimester cases. The projected annual number of women with abortion complications admitted to public hospitals in Kenya is 20,893. The case fatality rate was estimated to be 0.87% (95% CI 0.71–1.02%), so an estimated 182 (95% CI 148–213) of these women die annually. The annual incidence of incomplete abortion and other abortion‐related complications per 1000 women aged 15 to 49 years is projected to be 3.03.Conclusions  The high rate of abortion‐related morbidity and mortality documented in the study highlights the critical need to address the issue of unsafe abortion in Kenya.
A 50‐year audit of maternal mortality in the Peninsula Maternal and Neonatal Service, Cape Town (1953–2002)
Authors: Fawcus S.R. , van Coeverden de Groot H.A. , Isaacs S. 
Published: August 2005

Objective  To audit trends in maternal mortality in the Peninsula Maternal and Neonatal Service (PMNS) over a 50‐year period, with respect to rates and patterns of causation.Design  Retrospective and prospective audit.Setting  The PMNS, an integrated perinatal service composed of primary, secondary and tertiary facilities in Cape Town.Population All women giving birth in the area of the Cape Peninsula served by the PMNS over the 50‐year period.Methods  Data on maternal deaths were collected for 1953–2002 inclusive, from annual obstetric and gynaecological reports. Three triennia (1954–1956, 1981–1983 and 1999–2001) were selected for a detailed comparison of trends in rates and causes of death.Main outcome measures  Maternal mortality rates (MMRs). Causes of maternal deaths.Results  Total deliveries increased from 7315 in 1953 to 27,575 in 2002. The MMR declined from 301 deaths per 100,000 deliveries in 1953 to 31.2 in the triennium, 1987–1989. From 1999, the MMR increased, reaching 112 in 2002. Comparing 1954–1956 (MMR of 253.9) with 1981–1983 (MMR of 43.8), there was a marked decline in the MMR related to hypertension (80.4 to 11.3), haemorrhage (50.8 to 4.2), abortion (55 to 4.2), suspected pulmonary embolism (25.4 to 2.8), pregnancy‐related sepsis (8.5 to 4.2) and cardiac disease (21.2 to 2.8). Comparing 1981–1983 (MMR of 43.8) with 1999–2001 (MMR of 59.4), there was a decline in the MMR associated with abortion (4.2 to 0). The MMR for haemorrhage, suspected pulmonary embolism and cardiac disease remained the same. There was a slight increase in the MMR attributed to hypertension (11.3 to 14.5) and pregnancy‐related sepsis (4.2 to 7.3). There was a marked increase in the MMR associated with non‐pregnancy‐related infections/AIDS (4.2 to 18.2).Conclusions  The MMR for all causes of maternal death declined significantly from 1953 to 1981 as a result of several interventions. From 1999, there has been a non‐significant increase in MMR, predominantly due to the burden of HIV/AIDS‐related mortality.