bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventing hypothermia during continuous veno‐venous haemodiafiltration: a randomized controlled trial
Authors: Rickard Claire M. , Couchman Bronwyn A. , Hughes Marissa , McGrail Matthew R. 
Published: July 2004

Background.  Continuous veno‐venous haemodiafiltration is a common form of dialysis used in intensive care units. Unfortunately, patients often experience hypothermia as a side‐effect of the therapy because of the necessity for extracorporeal blood flow. Intensive care nurses aim to prevent hypothermia developing. Intravenous fluid warmers are sometimes added to the dialysis circuit in an attempt to maintain patient temperature. However, the efficacy of this method has not been previously studied.Aim.  This paper reports a study to investigate whether intravenous fluid warmers prevent hypothermia during continuous veno‐venous haemodiafiltration.Method.  A prospective randomized controlled trial was carried out in the intensive care unit of a metropolitan, tertiary‐referral, teaching hospital. After Ethics Committee approval, 60 circuits in continuous veno‐venous haemodiafiltration mode (200 mL/minute blood flow, 1 L/hour countercurrent dialysate, 3 L/hour pump‐controlled ultrafiltration and prefilter fluid replacement of 1·7–2·0 L/hour) were studied. Circuits were randomized to have either an intravenous fluid warmer set at 38·5°C on the dialysate and 1 L/hour of replacement fluid lines or no fluid warmer. Patient core temperature was recorded at baseline and then hourly. Hypothermia was defined as a core temperature <36·0°C.Results.  Mean core temperature loss did not vary between circuits with or without a fluid warmer (0·92°C vs. 1·11°C, P = 0·339). Survival analysis found no difference in hypothermia incidence between groups (log rank = 0·47, d.f. = 1, P = 0·491). Lower baseline temperature (RR 0·142, 95% CI 0·044, 0·459, P = 0·001) and female gender (RR 0·185, 95% CI 0·060, 0·573, P = 0·003) were significant risks for hypothermia.Conclusions.  Intravenous fluid warmers used as described do not prevent hypothermia during continuous veno‐venous haemodiafiltration. Female patients and those with a low–normal baseline temperature are most likely to become hypothermic during this form of dialysis. Further research is needed to address effective ways of preventing hypothermia in critically ill patients receiving continuous renal replacement therapies.
Health issues of aboriginal female adolescents in Taiwan
Authors: Chen Mei‐Yen , James Kathy , Liao Jenny 
Published: July 2004

Background.  The mortality rate and prevalence for some chronic diseases are higher for aborigines compared with the rest of the Taiwanese population. Health professionals in many countries have been concerned with the health of aborigines, but specific health policies for native adolescents have been neglected.Aims.  This paper reports a study comparing the general health status of aborigines and non‐aborigine female adolescents, based on school enrolment health examinations.Methods.  A cross‐sectional prevalence study with between group comparison was conducted. School enrolment health files were accessed between September 2000 and June 2001. A total of 320 selected female aboriginal students were compared with 237 non‐aborigines.Results.  With the exception of eye problems, general health status was inferior for the aboriginal female adolescent students. They had lower mean red blood cell volumes, lower haemoglobin concentrations, more oral decay, a greater prevalence of hepatitis B virus carriers and were more likely to be overweight.Conclusions.  It seems reasonable to suggest that health intervention strategies specific for indigenous adolescents should be provided. The design of these strategies should target lifestyle modification and provision of more accessible health information. Health professionals, and particularly nurses, are in a prime position to offer advice and support to this group.
Interpretations of stillbirth
Authors: Hsu Min‐Tao , Tseng Ying‐Fen , Banks Janet M. , Kuo Ling‐Lih 
Published: July 2004

Background.  Continuity is a major concept in the father–son domain of the Han Chinese value system in Taiwan. Aspects of continuity may include structure, interactions and other facets of family; however, providing descendants is the keystone of women's reality in these families. In a culture in which death is seen as a taboo subject and the unborn child has not been recognized as a real baby, losing a long‐expected child at the end of pregnancy becomes a great challenge to women who have experienced stillbirth.Aim.  The aim of this paper is to report a study exploring Taiwanese mothers’ interpretations of stillbirth, and their unique sociocultural context.Method.  An interpretive ethnographic approach was used. Over a two and a half‐year period, 20 women who had experienced such losses after at least 20 weeks of pregnancy were interviewed to find out how they interpreted their babies’ deaths. Interview data were analysed thematically.Findings.  The four major themes identified were: ‘loss of control’, ‘broken dream’, ‘shattered self’ and ‘something wrong with me’. Interpretations of stillbirth among Taiwanese women indicate a strong sense of incompleteness and personal failure, triggering reactions in terms of not only maternal identity, but also female cultural roles. Many interviewees blamed themselves for the deaths of their unborn children, a viewpoint resulting in excessive guilt feelings.Conclusion.  Culturally bound taboos against talking about death, participating in death‐related events, and expressing grief in public affect the adaptation and grieving processes of Taiwanese women who have had a stillbirth. Nurses should, therefore, make an effort to listen to the perspectives of such patients in order to assist them with coming to terms with their loss. As part of their education, nurses require information on cultural beliefs so that they can provide appropriate care to grieving mothers.
Priority setting in clinical nursing practice: literature review
Authors: Hendry Charles , Walker Anne 
Published: July 2004

Background.  Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then ‘rationing’ must occur. In clinical practice such rationing requires practitioners to set priorities for care.Aims.  The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this.Method.  CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982–2002 were searched, using the terms (clinical decision‐making or problem‐solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review.Findings.  Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse–patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area.Conclusions.  Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.
Emancipation in decision‐making in women's health care
Authors: Wittmann‐Price Ruth A. 
Published: July 2004

Background.  Emancipation as a nursing concept is derived from a long‐standing history of social oppression and is easily addressed by both critical social theory and feminist theory. It is the apparent concept to describe a phenomenon witnessed in nursing when caring for women in the decision‐making process about health care issues. Emancipation has been recognized by expert clinical observation.Aim.  The aim of this paper is to define the concept of emancipation for possible future application to nursing practice for the promotion of humanistic nursing care in women's health, specifically applied to the decision‐making process.Method.  A literature search was carried out using the CINAHL database and the keywords nursing and emancipation, and covering the period 1985–2003. The Rodgers and Knafl (2000) method of concept analysis was then used to derive a conceptual meaning of emancipation that benefits patient care as well as professional nursing development. Emancipation is broken down into antecedents, attributes and consequences. Related concepts are also explored, compared and discussed to synthesize relevant characteristics.Findings.  This concept analysis identifies emancipation in decision‐making as a nursing phenomenon by discussing the antecedent of oppression and exploring the identified attributes: (a) empowerment, (b) personal knowledge, (c) social norms, (d) reflection and (e) flexible environment. The consequence of emancipation is free choice. It is a futuristic concept with strong historical ties in need of exploration and development within the context of women's health care in relation to decision‐making.Conclusions.  The concept model illustrates emancipated decision‐making, with its five attributes in relation to oppression as a non‐linear phenomenon. Areas for further study include the exploration of the contribution of each critical attribute and its relationship to emancipated decision‐making, and the decision‐making process in relation to patient satisfaction and how long the person continues to adhere to the decision. Also the professional nursing role in promotion of emancipated decision‐making is virtually unexplored, but is an important concept in the paradigm of shared decision‐making about health care alternatives.
Attitudes towards hospitalized older adults
Authors: McLafferty Isabella , Morrison Frederic 
Published: July 2004

Background. A number of studies have explored nurses’ attitudes toward older people. However many of those have produced inconclusive results. Moreover dated attitudinal measures have been used to answer a broad range of questions relating to older people.Aim. The aim of this paper is to report a study examining whether negative attitudes and beliefs toward older adults persist.Methods. Focus group interviews were used identifying factors which may influence attitudes and beliefs both negatively and positively. Nine Registered Nurses from care of older adult areas, four from acute areas, six nurse teachers, and 17 nursing students participated in the study. Ten themes were identified from the findings.Findings. The findings show that the student nurses had varying experiences in older adult settings. Some of which had the effect of turning them away from the specialty. However, nurses who worked with older adults were very positive about their work and the nursing opportunities they had to offer student nurses. They were rather critical of the content of the pre‐registration curriculum, which they perceived to over‐rely teaching the negative aspects of ageing, and there was also criticism of the currency of teachers’ knowledge. Nurses who worked in acute settings also did not escape criticism, in that they were identified as attributing a lack of sense of humour to older adults. The limitations include the small sample size although it is congruent with qualitative research.Conclusions. All nursing staff need to be more aware of their influence on the attitudes of student nurses toward older people. Good practice includes the ability to demonstrate that older people in hospital settings are valued. Nurse teachers need to review the way they prepare students for this specialist work in order to avoid inadvertently conveying negative attitudes.
Anxiety and self‐consciousness in patients with minor facial lacerations
Authors: Tebble Nicola J. , Thomas David W. , Price Patricia 
Published: July 2004

Background.  Although minor facial injuries are relatively common, their psychological impact is an area neglected in the literature. For physiologically major injuries (such as facial cancers, burns and fractures), the face has been suggested to be a psychologically significant area of the body and disfigurement has been found to have numerous potential social consequences for patients.Aims.  This paper reports the findings of an inquiry that explored the psychological impact of minor facial injuries and the influence of patient and scar characteristics in relation to self‐consciousness and anxiety levels.Method.  Data were collected in 2001 in an accident and emergency unit from patients with a visible laceration over 1·5 cm that was treatable in an outpatient setting. The Derriford Appearance Scale (with general and social self‐consciousness subscales) and the State‐Trait Anxiety Inventory were administered to 63 patients 1 week later; data on 50 patients were also available 6 months after the injury.Results.  Larger scar size, living alone and aetiology of injury were significantly related to self‐consciousness and anxiety levels, although gender, age, socio‐economic group, location of scar, satisfaction with appearance and number of scars were not. General self‐consciousness improved at 6 months but social self‐consciousness and anxiety remained the same. Patient factors were not related to changes in general self‐consciousness over time.Conclusions.  Minor facial scars can have significant psychological impact for some people. Awareness training for health professionals, social skills training for affected patients and a patient information leaflet are recommended.
The Euribor Futures Market: Efficiency and the Impact of ECB Policy Announcements
Authors: Bernoth Kerstin , Hagen Jürgen von 
Published: July 2004

AbstractFor an effective and smooth monetary policy, it is important that interest rate expectations are in line with central bank policy intentions. The predictability of money market interest rates is, therefore, an indicator of transparency and clarity in the communication of monetary policy and of the effectiveness of monetary policy implementation.In this paper, we analyse three aspects of the predictability of money market rates in the European Monetary Union (EMU). The first is the efficiency of the three‐month Euribor interest rate futures markets. The second aspect is the effect of ECB policy announcements on the volatility of Euribor futures rates, and the third aspect is the effect of ECB policy announcements on the prediction error contained in Euribor futures rates. We find that the new Euro money markets were able to predict short‐term rates well. Our results suggest that the ECB communication of monetary policy has worked well during the first years of EMU and that the predictability of ECB policy decisions seems to have improved over time. ECB Council decisions still cause some surprises, but their effect on volatility is small.
Identifying the Role of Moral Hazard in International Financial Markets
Authors: Kamin Steven B. 
Published: July 2004

AbstractConsiderable attention has been paid to the possibility that large‐scale IMF‐led financing packages may have distorted incentives in international financial markets, leading private investors to provide more credit to emerging market countries, and at lower interest rates, than might otherwise have been the case. Yet, prior attempts to identify such distortions have yielded mixed evidence, at best. This paper makes three contributions to our ability to assess the empirical importance of moral hazard in international financial markets. First, it is argued that, because large international ‘bail‐outs’ did not commence until the 1995 Mexican crisis, financial indicators prior to that time could not have reflected a significant degree of this type of moral hazard. Therefore, one test for the existence of moral hazard is that the access of emerging markets to international credit is significantly easier than it was prior to 1995. Second, the paper argues that because private investors expect large‐scale IMF‐led packages to be extended primarily to economically or geo‐politically important countries, moral hazard, if it exists, should lead these countries to have easier terms of access to credit than smaller, non‐systemically important countries. Finally, in addition to looking at bond spreads, the focus of earlier empirical analyses of moral hazard, the paper also examines trends in capital flows to gauge the access of emerging market countries to external finance. Looking at the evidence in light of these considerations, the paper concludes that there is little support for the view that moral hazard is significantly distorting international capital markets at the present time.
An Empirical Analysis of Inflation in OECD Countries
Authors: Ihrig Jane , Marquez Jaime 
Published: July 2004

AbstractDuring the 1990s, many OECD countries had declining rates of inflation while their unemployment rates were also falling, something that on the surface seemed at odds with the Phillips curve relationship between inflation and unemployment. For the USA, these seemingly contradictory developments have been reconciled in terms of two factors: (1) an acceleration in productivity and (2) structural changes in labour markets that lowered the natural unemployment rate (NAIRU). Here we ask whether comparable forces were at work in 19 other industrial countries. We find that productivity advancements were the main structural factor reducing inflation only in the USA. In other industrial countries, persistent labour‐market slack was the main factor exerting downward pressure on inflation. This persistence stemmed, in part, from structural reforms that lowered the NAIRU while the unemployment rate was declining. Ireland, New Zealand and Norway were three countries where labour‐market reforms helped to push inflation down dramatically.
Structural Traps, Politics and Monetary Policy
Authors: Dugger Robert H. , Ubide Angel 
Published: July 2004

AbstractStructural conditions pose a challenge to monetary policy, as the example of Japan shows. In this paper we develop the concept of structural trap, where the interplay of long‐term economic development incentives, politics, and demographics results in economies being unable to efficiently reallocate capital from low‐ to high‐return uses. The resulting macroeconomic picture looks like a liquidity trap – low GDP growth and deflation despite extreme monetary easing. But the optimal policy responses are very different and mistaking them could lead to perverse results. The key difference between a liquidity trap and a structural one is the role of politics. We show how, in the Japanese case, longstanding economic incentives and protections and demographic trends have resulted in a political leadership that resists capital reallocation from older protected low‐return sectors to higher‐return newer ones. If the Japanese case is instructive, in a structural trap, extremely loose monetary policy perpetuates deflation and low GDP growth, because unproductive but politically important firms are allowed to survive and capital reallocation is prevented. By preventing the needed reduction in excess capacity, a structural trap condemns reflationary policies to failure by making the creation of credible inflation expectations impossible. Faced with a structural trap, an independent central bank with a price stability mandate should adopt a monetary policy stance consistent with restructuring. If political resistance is high, monetary policy decision makers will need to keep nominal rates high enough to ensure that capital reallocation takes place at an acceptable pace.
Glomerular albumin permeability as an in vitro model for characterizing the mechanism of focal glomerulosclerosis and predicting post‐transplant recurrence
Authors: Ghiggeri Gian Marco , Artero Mary , Carraro Michele , Candiano Giovanni , Musante Luca , Bruschi Maurizio , Zennaro Cristina , Ginevri Fabrizio , Caridi Gianluca , Faccini Luigi , Perfumo Francesco , Gusmano Rosanna 
Published: July 2004

Abstract:  The putative mechanisms of proteinuria in idiopathic focal glomerulosclerosis and of its post‐transplant recurrence are discussed. It is proposed that a balance between circulating factors with permeability activity on glomeruli and putative inhibitors play a key role. The characterization of inductors is currently in progress; most inhibitors appear to be apolipoproteins (mainly apoJ and apo E) but we cannot exclude other substances. The goal is now to evaluate the concentration of both inducers and inhibitors of glomerular permeability in vivo. Permeability activity in plasma of patients with FSGS with and without recurrence of the disease may be evaluated by an in vitro functional essay with isolated glomeruli. Published data on permeability activity evaluated with this method in different proteinuric states gave, however, controversial results and this test cannot be readily considered of clear clinical utility.Only the definitive characterization and quantification in vivo of the different molecules that play a role in FSGS may furnish adequate answer.
Effects of various densities of Ophiostoma ips inoculations on Pinus sylvestris in north‐western Spain
Authors: Fernández M. M. F. , García A. E. , Lieutier F. 
Published: July 2004

SummaryThe aim was to determine the inoculation density above which Scots pine (Pinus sylvestris) is overcome by the blue‐stain fungus Ophiostoma ips that is associated with the bark beetle Ips sexdentatus. In north‐western Spain, stems of 16 Scots pines were inoculated at various densities (0, 400, 800 or 1600 inoculi/m2) along circumferential 100 or 150 cm wide inoculation belts. Each inoculum consisted of a 5 mm diameter cylinder of malt extract agar colonized by the fungus. Three months later, all trees were harvested and trunk resinosis and foliage colour were visually assessed. The percentage of healthy, desiccated, resin soaked, and blue‐stained sapwood, as well as growth productivity indices, were calculated from stem disks cut from within the inoculated zone of each tree. Sapwood‐specific hydraulic conductivity (Ks) of each tree was measured in the middle of the inoculated zone. All parameters of tree vigour changed dramatically to the worse when inoculation densities were above 400 inoculi/m2, and foliage changed from green to yellow‐green or yellow when an inoculation density of 800 instead of 400 was used. The percentage loss of sapwood‐specific conductivity (PLC) increased from 30 to 90% and the percentage of healthy, conductive sapwood dropped from 85 to 35% at 800 inoculi/m2. No effect of the width of the inoculation belt was observed, and there was no relationship between tree productivity indices and the level of resistance. A non‐linear negative relationship was found between PLC and the percentage of healthy sapwood. It is concluded that tree resistance was overcome and that trees were going to die when the inoculation density was ≥800 inoculi/m2.