bluuebunny/crossref_metadata_2025_split huggingface dataset:
Men living with fibromyalgia‐type pain: experiences as patients in the Swedish health care system
Authors: Paulson Margareta , Norberg Astrid , Danielson Ella 
Published: March 2003

Background. Individuals with fibromyalgia (FM) frequently use health care services and experience only short‐term improvements. They often feel that health care staff do not take them seriously. This increases the burden of living with the illness.Aim. To describe how men living with fibromyalgia‐type pain experienced being patients in the Swedish health care system.Method. Narrative interviews with 14 men who fulfilled the American College of Rheumatology criteria for classification of fibromyalgia. Content analysis was used when analysing the data.Results. The results are described using five themes. Theme I ‘Feeling afraid of being looked upon as being a whiner’ highlights how the men endured a lot of pain before they sought health care, and how difficult it was to find a receptive listener. Theme 2 ‘Feeling like a guinea pig’ shows that the men's feelings were twofold; they wanted examinations, even if these made them feel that they were being exposed to numerous treatments without any cure. Theme 3 ‘Feeling hopeful’ describes the hope for a cure after having been referred to a specialist clinic. Theme 4 ‘Feeling neglected’ illustrates being looked upon as an uninteresting patient and theme 5 ‘Feeling no recovery’ illustrates the pain relief they gained, but not the actual cure.Conclusion. Men with FM type pain experienced a long wait before treatment at a specialist clinic as well as no continuity and follow‐ups in primary care and general hospitals. Encounters with engaged and skilful staff promoted the men's well‐being despite the fact that no cure was available. Not being respected led to a feeling of being neglected despite the care received. Thus, the men had to accept the fact that they would never recover.
Living with newly diagnosed breast cancer: a qualitative study of 10 women with newly diagnosed breast cancer
Authors: Landmark Bjorg T. , Wahl Astrid 
Published: March 2003

Aim. The aim of this qualitative study was to describe from the perspective of 10 women (aged 39–69 years), their experience of living with breast cancer.Background. Although there is increasing research into a variety of aspects associated with breast cancer, there is a continuing need for research to increase nurses' understanding of how women experience living with newly diagnosed breast cancer.Design/methods. Following ethical approval, open‐ended interviews were analysed, using methods influenced by Grounded Theory. Verifiability and empirical grounding of the theory was established through use of the constant comparative method.Findings. Existential issues arose as an important aspect of living with newly diagnosed breast cancer. The will to live emerged as the central theme. All energy was channelled into a tenacious fight for life. Furthermore, results revealed other aspects in the women's awareness of living with breast cancer, such as their experiences in relation to emotional reactions, bodily physical changes, their female identity, meaningful activities and their social network.Conclusions. An understanding of how women experience their new and changed life situation is important to the support nurses give in the process of healing. Nurses need this knowledge to be better able to assist women and their families in their development of coping strategies.
Pain management problems in patients' terminal phase as assessed by nurses in Finland
Authors: Kuuppelomäki Merja 
Published: March 2003

Background.  This study is part of a larger questionnaire survey concerned with the views of nursing staff on physical, emotional and spiritual support for terminally ill patients and decision making on the transition to the terminal phase of treatment. Aim.  This article discusses the results concerning the prevalence of physical pain in patients and with problems in pain management. Methods.  A total of 328 nurses working on the inpatient wards of 32 municipal health centres in finland took part. Data were collected with multiple‐choice items and one open‐ended question, which were part of a larger structured questionnaire. The data were analysed by means of the SPSS statistical software and content analysis. Findings.  Dying patients often suffered from pain, which was most commonly because of cancer. Intractable pain was common. The problems of pain management concerned attitudes and qualifications related to treating pain, the assessment of the pain, pain management per se and the organization of pain management. Conclusion.  The study highlights the need to increase pain education, discussion and agreement on the principles of pain management in municipal health centres in Finland.
Exploring childhood immunization uptake with First Nations mothers in north‐western Ontario, Canada
Authors: Tarrant Marie , Gregory David 
Published: March 2003

Background. Childhood immunization is an important component of preventive health care for young children. Successful control of vaccine‐preventable diseases depends on high levels of immunization coverage. Immunization statistics show that on‐reserve First Nations (Native Indian) children have lower vaccination coverage than children in the general Canadian population. There has been little research, however, conducted with First Nations populations on this topic.Aim of the study. This study explored First Nations parents' beliefs about childhood immunizations and examined factors influencing immunization uptake.Methods. This study used a qualitative descriptive design to explore the issue of childhood immunization uptake. Twenty‐eight mothers from two First Nations communities in north‐western Ontario, Canada, were interviewed about their perceptions of childhood immunizations and vaccine‐preventable diseases. The interviews were transcribed and content analysis was used to examine the data.Findings. Data analysis revealed the following six themes: (1) the fear of disease; (2) the efficacy of immunizations; (3) the immunization experience; (4) the consequences of immunization; (5) interactions with health professionals; and (6) barriers to immunizations. Participants were motivated to seek immunizations for their children by a fear of vaccine preventable diseases. A small proportion of mothers, however, questioned the effectiveness of vaccines in preventing disease. Traumatic immunization experiences, vaccine side‐effects and sequelae, negative interactions with health professionals, and barriers such as time constraints and childhood illnesses all served as deterrents to immunization.Conclusions. The research outcomes highlight the varied beliefs of First Nations parents about childhood immunizations and the numerous factors that both positively and negatively influence immunization uptake. Further research is needed to explore the issue of childhood immunizations in First Nations communities and to determine strategies to improve uptake.
Personal improvement project in nursing education: learning methods and tools for continuous quality improvement in nursing practice
Authors: Kyrkjebø Jane Mikkelsen , Hanestad Berit Rokne 
Published: March 2003

Background.  All health care providers, including nurses, need to learn how to improve the care they give. Continuous quality improvement (CQI) is a theory and method used in health care to guide improvement. The question is how best to teach it, particularly to nursing students. It was conjectured that a systematic approach to improve study habits and lifestyle would increase nursing students' awareness of how they handled their studies and, at the same time, became acquainted with improvement knowledge methodology. Using the starting point that ‘quality is personal’, students worked on personal change and improvement. The purpose was to learn methods and tools for improvement in their personal life and enable them to transfer and use this knowledge in their professional work. Aims.  To describe the use of a personal improvement project (PIP) by nursing students and the resulting increased knowledge, skills, and enthusiasm to continue working with CQI. Methods.  Forty‐four nursing students worked on a PIP, which they felt was important, and presented their projects to fellow students. The students answered a questionnaire, and their presentations documented the results of their work. Results.  All 44 students followed the instructions in a workbook describing PIPs over an 8‐week period and answered a questionnaire. Forty‐five per cent felt they had made an improvement in their study habits or lifestyle. Eighty‐nine per cent reported that this project helped them to start learning CQI, and 75% reported that they could see the benefit of this kind of knowledge in their future clinical practice. Conclusions.  Personal improvement projects seem to be an effective way of introducing CQI knowledge to nursing students. Even those who did not succeed in achieving personal improvement felt they had a positive learning outcome from the project.
Relationships with undergraduate nursing exchange students – a tutor perspective
Authors: Koskinen Liisa , Tossavainen Kerttu 
Published: March 2003

koskinen l. &tossavainen k. (2003) Journal of Advanced Nursing 41(5), 499–508

Relationships with undergraduate nursing exchange students – a tutor perspective Background. Student exchange has been used increasingly in nursing education throughout Europe as a method of learning intercultural sensitivity. In the host country, each foreign student is assigned a personal tutor to enhance learning. Aim. The aim of this study was to describe tutor–student relationships between Finnish nurse teachers and British exchange students from the tutors' perspective. Ethical issues. The researcher's close relationship with the study context and participants caused some ethical concerns, which will be discussed. Methods. The data consisted of tutorial session observations, research diary notes, group interviews and background questionnaires. They were analysed using Spradley's developmental research sequence method for ethnographic data. Findings. The tutoring relationship was pastoral and clinical rather than academic. The pastoral aspect of the relationship was essential in assisting the students to adjust to the stress of studying in a foreign country. On the other hand, tutors were unable to support all the students to overcome their culture shock. Tutors were uncertain about their role and did not integrate Finnish culture or practice into theory, but found their role pleasant. Conclusions. A dialogic tutor–student relationship is important for learning intercultural sensitivity. Tutoring strategies should be developed to assist students' adjustment to the differences in the host culture and to encourage their reflection on personal, experiential and scientific cultural knowledge during their study abroad.
The response of wild Atlantic salmon parr to acute reductions in water flow
Authors: Armstrong John D. , Braithwaite Victoria A. , Fox Mark 
Published: March 2003

1.  A seasonal reduction in water flow, due both to prevailing weather conditions and anthropogenic disturbance, is a prominent feature of the habitat in many riverine systems, yet the response of many aquatic vertebrates, such as juvenile Atlantic salmon, to low flows is not well understood. However, in accordance with general fitness optimization theory, it might be predicted that salmon will emigrate from shallow areas to seek refuge in pools as water levels decrease to critically low levels (fitness approaches zero). To test this prediction, we directly measured the movement response of individual Atlantic salmon (Salmo salar L.) (74–109  mm) to drought in near‐natural mesocosms. 2.  In five separate trials during summer, groups of salmon were introduced into enclosed 30‐m long sections of stream, each comprising a central 10‐m long region of shallow riffle habitat bordered upstream and downstream by 10‐m long regions of deeper water. After fish had settled into home ranges, those fish inhabiting deep areas were removed and the water flow was later decreased to zero over 2 days, so that the riffles were nearly dry. The movements of each individual fish within the enclosures were monitored remotely and continuously using a passive integrated transponder (PIT) tracking system. 3.  Of the total of 33 fish with home ranges that included only riffle habitat, 14 moved into deep water at some point during drought, but only seven of these fish (0–50% between trials) established new home ranges that included deep areas. The others returned to regions of riffle during the drought. None of the eight fish that definitely had not sampled in pool habitat prior to settling on riffle emigrated during drought. 4.  The optimal response of salmon parr to moderate natural drought appears not to be fixed, but for many individual fish it may be to stay in shallow riffle areas. The optimal response of salmon parr to extreme natural drought and anthropogenic de‐watering will, in many cases, be to move. An increase within the population of traits that promote an ideal response to natural drought will therefore make it more vulnerable to severe drought and anthropogenic de‐watering and vice versa. 5.  The absence of emigration by salmon from shallow areas during acute drought can be reconciled with fitness optimization theory if, when natural drought progresses, fish become stranded in shallow areas some considerable time before the point at which they die.
Spatial dynamics of two competing specialist parasitoids in a host metapopulation
Authors: LEI GUANGCHUN , HANSKI ILKKA 
Published: March 2003

1.  We investigated spatial dynamics in two specialist larval parasitoids, Cotesia melitaearum and Hyposoter horticola, attacking the Glanville fritillary butterfly, Melitaea cinxia, in Finland. 2.  Presence of C. melitaearum in a host larval group significantly reduced the rate of parasitism by H. horticola (18 vs. 33% in groups with and without C. melitaearum), but there was no significant reverse effect. The parasitism rates at the level of local populations showed a similar trend. 3  Hyposoter horticola females moved frequently among larval groups, whereas C. melitaearum females often spent several days at a single larval group. In agreement with these behavioural observations about movements within populations, H. horticola was found to have a higher colonization rate of host populations than C. melitaearum. 4.  At the within‐population level, C. melitaearum tended to occupy large larval groups in the centre of the host population, whereas H. horticola parasitized also small and more isolated (peripheral) larval groups, especially in the presence of C. melitaearum. At the metapopulation level, host population size had a significant positive effect on the presence of local populations of both parasitoid species, but isolation had a significant negative effect on the presence of C. melitaearum only. 5.  These results suggest that C. melitaearum is a superior competitor, but an inferior disperser to H. horticola, which facilitates the co‐existence of the two species both at the level of local populations and at the level of a metapopulation. 6.  Data from a 50‐patch network showed a decline in the number of host populations from 34 to 13 in 4 years. This decline caused a near‐extinction of the superior competitor, but inferior disperser, C. melitaearum, whereas the abundance of the inferior competitor, but superior disperser, H. horticola, remained relatively constant, in agreement with the prediction of a theoretical model.
Testing the relative influence of instrinsic and extrinsic variation in food availability on feral pig populations in Australia's rangelands
Authors: CHOQUENOT DAVID 
Published: March 2003

Summary

Instrinsic variation in the availability of food to animal populations reflects the influence of foraging by the animals themselves. Instrinsic variation in food availability provides a link between population density, subsequent food availability and variation in the rate of population increase (r), operating through density‐dependent food shortage. In contrast, extrinsic variation in food availability is caused by environmental influences on food or animal abundance, which are independent of animal foraging. Extrinsic variation in food availability is random relative to that arising through intrinsic shortage. Intrinsic and extrinsic variation in food availability can influence animal populations simultaneously. Intrinsic variation will impart a tendency towards an equilibrium between animal and food abundance. which will be progressively obscured by density‐independent variation as the influence of extrinsic factors increases.
This study used a large‐scale field experiment, in which the density of food‐limited feral pig (Sus Scrofa L.) populations was manipulated on six sites, to assess the relative influence of intrinsic and extrinsic variation in food availability. The experiment evaluated the influence of pig population density on r and the abundance of food resources measured as pasture biomass. It was predicted that if intrinsic shortages dominated variation in food availability, pasture biomass and r would decline with increasing pig density. If extrinsic factors dominated variation in food availability, pig density would have no systematic effect on either pasture biomass or r. If intrinsic and extrinsic sources simultaneously affected variation in food availability, higher pig densities would have no systematic effect on r, but would reduce pasture biomass. The simultaneous model predicts reduced pasture biomass because, in the absence of compensatory changes in other sources of variation, the effects of intrinsic and extrinsic factors will be additive.
To examine further the degree of interdependence in pig and pasture abundance, a series of stochastic models of the grazing system were estimate and the feedback loop comprising the functional and numerical responses of feral pigs to variation in pasture biomass was manipulated.
In the large‐scale experiment, neither pasture biomass nor r declined with increasing pig density, suggesting that food availability was dominated by extrinsic factors. However, limitations of the experiment meant that a minor decline in pasture biomass may have gone undetected. Comparison of simulation models, which included and omitted pasture offtake by pigs, indicated that because they were less efficient grazers and persisted at lower average densities relative to other large herbivores, pigs had little influence on variation in pasture biomass.
Using local–regional richness plots to test for species saturation: pitfalls and potentials
Authors: Srivastava Diane S. 
Published: March 2003

1. Plots of local versus regional species richness are an exciting new tool for testing for species saturation in ecological communities. In this method, the local richness of a community is plotted as a function of its regional richness for different biogeographical regions. A proportional relationship between local and regional richness is interpreted as evidence for an unsaturated community, that is, a community with strong evolutionary limits to local richness. There will be no correlation between local and regional richness in a saturated community, that is, a community whose local species richness is limited largely by ecological processes. 2. Although at least 36 data sets have now been analysed using local–regional richness plots, there has not been much critical evaluation of the method. This paper provides such a critique, focusing on the selection of communities for comparison, the prevalence of pseudoreplication and multiple null models, and the effects of differing region size. 3. Local–regional richness plots are best suited for comparing similar habitats between different regions, not different habitats in a single region. In the latter, taxa effects and species pool effects are confounded. 4. Four very different types of local–regional richness plots have been published. Each type of plot has important underlying assumptions which are often not addressed by ecologists. 5. Of the 36 data sets reviewed in this paper, 13 were spatially pseudoreplicated, and 2 were temporally pseudoreplicated. Furthermore, ecologists differ in their choice of null model, with the result that the same local–regional plot could be interpreted as evidence for saturation by one ecologist, and for lack of saturation by another. 6. Differences in region size can result in pseudosaturation, the appearance of saturation by an unsaturated community. A simple model demonstrates this phenomenon. Other sources of error in estimating the regional species pool are also of concern. 7. In conclusion, local–regional richness plots are a potentially useful tool for distinguishing saturated from unsaturated communities, but should be used cautiously, and in conjunction with other supporting evidence (such as the presence or absence of competitive exclusion, resource limitation, density compensation and the effects of species invasions).
Cyclic dynamics in field vole populations and generalist predation
Authors: Lambin Xavier , Petty Steve J. , Mackinnon James L. 
Published: March 2003

Summary1. A geographical gradient in the relative impact of generalist and specialist predators on small rodent populations has been hypothesized to be responsible for the gradient in cyclicity found in Fennoscandia. Population oscillations resulting from weasel–vole interactions are said to be dampened by the increasing stabilizing impact of generalist predators in southern Fennoscandia resulting from: (i) a greater abundance and diversity of predators sustained by alternative prey; (ii) the absence of significant snow cover leading to constant exposure of voles to generalist predators; and (iii) a heterogeneous habitat that makes dispersing voles more vulnerable to predators.2. Changes in the abundance of field voles (Microtus agrestisL.) in a man‐made spruce forest in northern England were recorded during 1984–98 using sign indices at 14–18 sites calibrated with capture–recapture estimates of vole density.3. Field vole populations exhibited cyclic dynamics which were in many ways similar to those reported from Fennoscandia, including population declines taking place during the breeding season and long periods with no recovery in numbers following population crashes.4. The density dependence structure of the time series was explored by means of partial autocorrelation functions, which suggested second‐order density dependence. Analyses based on two density estimates per year (spring and autumn) reveal significant negative values for lags of 1, 1·5 and 2 years, suggesting that the time‐lag might be somewhat shorter than 2 years.5. Estimates of predation on field voles by red foxes and tawny owls at high vole density were above the value predicted for this site and for the whole generalist predator community by a published model assuming that predation by generalist predators stabilizes vole populations. However, empirical estimates of the parameter used both for designing and testing the model are inherently imprecise.6. A qualitative evaluation of the three variables (see1) correlated to the Fennoscandian gradient and assumed to contribute to variations in generalist predation pressure did not support the hypothesis that low predation rates by generalist predators are necessary for vole dynamics to be dominated by the destabilizing impact of weasel–vole interactions. The specialist/generalist predation hypothesis must therefore be modified to account for the regular population cycles occurring in northern Britain.