bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender differences and fears in patients awaiting coronary artery bypass grafting
Authors: Koivula Meeri , Paunonen‐Ilmonen Marita , Tarkka Marja‐Terttu , Tarkka Matti , Laippala Pekka 
Published: March 2003

• The study aimed at ascertaining the gender differences and fears among patients awaiting coronary artery bypass grafting.• Data were collected using a mailed questionnaire from patients (n=207) scheduled for coronary artery bypass grafting at one hospital. Intensity of fear was measured on a 10‐point scale including 12 objects of fear.• The results showed that demographic data, lifestyle and functional capacity differed between the sexes. Patients’ fears differed with respect to their objects and intensity, with women reporting more intense fears. Men also had fears, but the objects of fear differed from those in women. Apart from gender, the intensity of fear was associated with physical exercise, emotional problems and depression.• Nursing interventions could be developed to meet the different needs for information and support, especially among women but also among men, to relieve their fears during the wait for coronary artery bypass grafting.
Sleep quality and responses to insufficient sleep in women on different work shifts
Authors: EDÉLL‐GUSTAFSSON ULLA M. 
Published: March 2003

• The aim of this study was to examine degrees of cognitive behavioural effects of fatigue, mood changes and somatic responses to sleep loss in women with and without sufficient sleep, and to explore possible links between effects of sleep loss and specific sleep disturbances in selected groups.• A total 156 women working in a casualty department on different work shifts responded to a questionnaire which measured sleep quality, strain and symptoms related to working conditions, as well as effects of sleep loss.• About 40% of the women had perceived insufficient sleep during the last 6 months. They perceived significantly worse sleep quality and a higher degree of strain according to working conditions than the others. Palpitation and dysphoria as effects of sleep loss were independently predicted by sleep quality. Dysphoria was also predicted by difficulty in falling asleep. Cognitive behavioural effects of fatigue was predicted by disturbed sleep. Palpitation effects led to a 10‐fold increase in the probability of cognitive behavioural effects of fatigue. The effects were most prominent among women suffering from gastrointestinal problems of long duration and chronic pain.• Responses to reduced sleep quality in women constitute a form of stress, with sympathetic activation, increased susceptibility to infection, moderate cognitive impairment, mood changes and somatic distress.
The relationship between organizational climate and the content of daily life for people with dementia living in a group‐dwelling
Authors: NORBERGH KARL‐GUSTAF , HELLZÉN OVE , SANDMAN PER‐OLOF , ASPLUN KENNETH 
Published: March 2003

• One factor influencing the outcome of care may be nursing staff's experience of the organizational work climate. The aim of the study was to investigate how people with dementia spend their time in group‐dwelling units (GD) with either a creative or less creative organizational climate.• For the study, two GD units assessed as having a creative organizational climate and two units assessed as having a less creative climate were selected. Eighteen residents living in the units assessed as creative and 20 residents living in the units assessed as less creative participated in the study.• For measuring the organizational climate the Creative Climate Questionnaire was used. Observations of residents' activities were classified according to the Patient Activity Classification. For measuring residents' functional ability the Multi‐Dimensional Dementia Assessment Scale was used. Their cognitive capacity was measured with the Mini Mental State Examination.• Residents living in the units assessed as having a creative organizational climate spent 45.2% of the time with nursing staff, while those in the less creative climate spent 25.6% (P < 0.001). Time spent with fellow residents in the creative climate was 13.9% and in the less creative climate 31.3% (P < 0.001). There was no significant difference between the units according time spent with relatives and time spent alone.• Since the purpose of GD is to offer care adapted to the abilities and psychosocial needs of people suffering from dementia, a less creative climate can be a threat to the aims of GD. In order to maintain these, it is important for managers to be aware of the work climate and its impact on care for people with dementia.
An exploration of the occurrence of pressure ulcers in a British spinal injuries unit
Authors: ASH DAVID 
Published: March 2003

• Spinal cord injury (SCI) is associated with increased risk of pressure ulcers, but there are few published data about this in the United Kingdom (UK). This article represents a quantitative exploration of the occurrence of pressure ulcers in a UK spinal injuries unit (SIU).• The technique used is a retrospective review of records: details of 144 completed first admissions for SCI between 1998 and 2000 were entered on to a database (SPSS) for analysis.• Thirty‐two per cent of patients already had pressure ulcers on admission to the SIU, while a total of 56% experienced an ulcer at some stage between injury and discharge from the SIU.• Four pressure ulcer risk assessment scales were used (Waterlow, Braden, Norton and SCIPUS‐A). These appeared to have moderate predictive power in this population.• Pressure ulcers were found to be associated with increased length of hospital stay, density of lesion, surgical stabilization of neck injury before transfer to the SIU, tracheostomy on admission to the SIU and delayed transfer to the SIU after injury.• Implications for practice are discussed.
Pain and quality of life among older people with rheumatoid arthritis and/or osteoarthritis: a literature review
Authors: JAKOBSSON ULF , HALLBERG INGALILL RAHM 
Published: March 2003

• The aim of this study was to review the research literature on pain and quality of life (QoL) and the relationship between these variables among people aged 75 years and above with rheumatoid arthritis and/or osteoarthritis.• A Medline and CINAHL search was carried out using MeSH terms rheumatoid arthritis, osteoarthritis, QoL and pain in various combinations.• Seventeen articles were identified that met the requirements for methodological quality and inclusion criteria. No study focused only on respondents aged 75 years or over. The studies had varying representation of this age group. Pain was common in both groups and was found to increase with age and disease duration among those with rheumatoid arthritis but not among those with osteoarthritis. Increased pain could lead to depression. Pain, functional limitation and increased age were found to decrease QoL among those with rheumatoid arthritis and osteoarthritis alike. Social support was found to buffer against negative effects on QoL among those with osteoarthritis while no moderating effects were found in rheumatoid arthritis.• Increased age was found to relate to pain (rheumatoid arthritis) and decrease QoL (both rheumatoid arthritis and osteoarthritis). It is, however, hard to draw any firm conclusions about older people's pain and QoL because of the lack of studies including respondents aged 75 years or over. Thus, research about pain and QoL, especially focusing on the old and the very elderly with rheumatoid arthritis/osteoarthritis, is needed. It also seems justified to say that nursing care should especially focus on older people and that these people should be assessed for their level of pain, functional limitations and QoL especially in the case of having rheumatoid arthritis and/or osteoarthritis.
Observation of pain assessment and management − the complexities of clinical practice
Authors: Manias Elizabeth , Botti Mari , Bucknall Tracey 
Published: March 2003

Summary? Pain assessment and management are complex issues that embrace physiological, emotional, cognitive, and social dimensions.? This observational study sought to investigate nurse–patient interactions associated with pain assessment and management in hospitalized postsurgical patients in clinical practice settings.? Twelve field observations were carried out on Registered Nurses' activities relating to pain with their assigned patients. All nurses were involved in direct patient care in one surgical unit of a metropolitan teaching hospital in Melbourne, Australia. Six observation times were identified as key periods for activities relating to pain, which included change of shift and high activity periods. Each observation period lasted 2 hours and was examined on two occasions.? Four major themes were identified as barriers to effective pain management: nurses' responses to interruptions of activities relating to pain, nurses' attentiveness to patient cues of pain, nurses' varying interpretations of pain, and nurses' attempts to address competing demands of nurses, doctors and patients.? These findings provide some understanding of the complexities impacting on nurses' assessment and management of postoperative pain. Further research using this observational methodology is indicated to examine these influences in more depth. This knowledge may form the basis for developing and evaluating strategic intervention programmes that analyse nurses' management of postoperative pain and, in particular, their administration of opioid analgesics.
Uncertain terms of sedation in ICU. How nurses and physicians manage and describe sedation for mechanically ventilated patients
Authors: Egerod Ingrid 
Published: March 2003

Summary? Sedation which is used for intubated patients may prolong mechanical ventilation by increasing the risk of complications. The aim of the study was to illuminate the specific terminology and unrecognized contextual factors which may influence nurses' and physicians' sedation practices.? The main research questions were: How do nurses and physicians describe sedation? and How does the level of nursing skill relate to the level of sedation? The hypotheses were that sedation practices are inconsistent and that experienced nurses provide a better quality of sedation than less experienced nurses. The hypotheses were supported by the study.? The research strategy was case study research with triangulation of sources and methods and a multicentre multiple‐case design. Four university hospitals in Copenhagen, Denmark, and 14 cases were included in the study. The findings were based on secondary analysis of observation, interviews and chart review.? The theoretical framework for the study was the problem‐solving model, in which sedation was assumed to be provided according to indication (clinical problem), intervention (clinical decision) and expected outcome (clinical end‐point). Indications could be patient‐related, ventilator‐related, or patient–ventilator related. Interventions could be related to the choice of agent, dose or administration method and the outcome was the level of sedation.? Sedative therapy was prescribed by physicians and administered by nurses. The four sites in the study did not use guidelines for sedation and did not use sedation level assessment tools. The study shows that when the terminology is unclear, the indications, interventions and outcomes become unclear.
Quality of life as a concept for developing learning disability nursing practice?
Authors: Northway Ruth , Jenkins Robert 
Published: March 2003

Summary• This paper offers a critical examination of how the concept of Quality of Life might be used to enhance learning disability nursing practice.• Quality of Life will increasingly influence the provision and evaluation of services and practice in the field of learning disability. Attempting to define and assess Quality of Life is, however, problematic because of the complexity and multidimensional nature of the concept.• The use of domains to measure Quality of Life is advocated by many researchers for both objective and subjective measures and use of Quality of Life as an evaluation tool is seen as a way of improving the life quality of people with learning disabilities. However, there are concerns that the use of such an approach could perpetuate professional agendas rather than empower people with learning disabilities themselves.• To date, Quality of Life approaches have not had a major impact on learning disability nursing. However, it is suggested that they can be helpful as sensitizing concepts, a basis for collaborative care planning and a framework for evaluation.• Recommendations are made for education, practice and research.
Combination of clomipramine and nortriptyline in the treatment of obsessive‐compulsive disorder: a double‐blind, placebo‐controlled trial
Authors: Noorbala  , Hosseini  , Mohammadi  , Akhondzadeh  
Published: March 2003

Objective:
There is growing interest in investigating noradrenergic functions in obsessive‐compulsive disorder (OCD) because some antidepressants with strong effects on serotonin reuptake blockade fail to relieve obsessive‐compulsive symptoms. We undertook a trial to investigate whether the combination of clomipramine with nortriptyline was more effective than clomipramine alone
Method:
Thirty patients who met the DSM‐IV criteria for OCD completed the study. Patients were allocated in a random fashion, 15 each to clomipramine 150 mg/day plus nortriptyline 50 mg/day and clomipramine 150 mg/day plus placebo
Results:
Although both protocols significantly decreased the scores of the Yale‐Brown obsessive‐compulsive scale over the trial period, the combination of clomipramine and nortriptyline showed a significant superiority over clomipramine alone in the treatment of OCD
Conclusion:
As this study indicates, a rapid onset of action is one of the advantages of this combination. This study supports further investigation of the noradrenergic‐serotonergic hypothesis in OCD
Altitudinal gradients in tropical forest composition, structure, and diversity in the Sierra de Manantlán
Authors: G. J. Antonio Vázquez , Givnish Thomas J. 
Published: March 2003

1 Data on the composition, structure and diversity of plant communities were gathered along a 1000‐m altitudinal transect from tropical seasonal dry forest to cloud forest on calcareous Cerro Grande in Jalisco, México. 2 A total of 470 species, 292 genera and 103 families of vascular plants occurred in 43 samples of 0.1 ha, stratified at 100‐m elevational intervals between 1500 and 2500 m a.s.1. There were 97 tree species, 76 shrubs, 70 vines, 181 terrestrial herbs, 39 epiphytes, 3 hemiparasites, 3 succulent rosette shrubs and 1 saprophyte. 3 Forest composition varied continuously with altitude, based on the Shipley & Keddy (1987) test, ordination via reciprocal averaging, and elevational trends in the Sorenson similarities of samples at adjacent altitudes. supporting the individualistic hypothesis of plant community organization. 4 Understorey herbs, shrubs and vines showed the greatest decline in species number with increasing altitude. This pattern is hypothesized to result from the more open, more frequently disturbed, and more completely deciduous canopies at lower, drier elevations. The proportion of evergreen woody plants was greater at higher altitudes, reflecting less seasonal aridity and greater soil leaching. The proportion of endozoochorous species increased with altitude, while the proportion of pterochorous and ectozoochorous species decreased, reflecting trends in the hypothesized efficacy of these mechanisms of seed dispersal. 5 Total basal area of woody plants > 2.5 cm d.b.h. and basal area per tree both increased roughly fourfold between 1500 and 2500 m. 6 Species richness decreased sharply with altitude, due mainly to decreases in terrestrial herbs, and (to a lesser extent) shrubs and vines. The average number of species per 0.1 ha declined from 134 at 1500 m to 43 at 2500 m. The numbers of species, genera and families per sample declined linearly with elevation. Species composition of samples within an altitudinal band showed greater horizontal turnover (β diversity) at lower elevations, showing that low‐elevation forests are not only locally more diverse, but spatially more patchy. Community composition varies roughly six times as rapidly with elevation as with the same distance horizontally. 7 A cascading series of effects of elevation on soil fertility, anti‐herbivore defences, and the level of density‐dependent mortality may account for the observed drop in diversity with elevation, and would be consistent with lower β diversity and greater basal area at higher elevations.
Designs for greenhouse studies of interactions between plants
Authors: Gibson David. J. , Connolly John , Hartnett David. C. , Weidenhamer Jeffrey. D. 
Published: March 2003

1 Designs for greenhouse studies of interactions between plants are reviewed and recommendations for their use are provided. 2 Papers published over a 10‐year period showed the replacement series design to be the most popular, especially in studying crop–weed interactions. Fifty per cent of the studies involved only two species, although studies testing the interaction between different genotypes of only a few species were also popular. 3 Limitations imposed by the choice of design, the variables measured, and the analysis used on the range of inferences that may be validly drawn from the experiment are frequently not well understood or appropriate for the questions that appear to be addressed. One example is the failure to distinguish the outcome of competition (the long‐term outcome of interaction) and the effects of species on each other. 4 Studies in which only final yield is measured are severely limited as to the inferences which may be drawn. Effects due to interspecific interaction during the course of the experiment cannot then be separated from pre‐existing differences, and interpretation may be biased towards species whose individuals were initially larger. In addition, measurements at several times are necessary to understand the changing dynamics of species interaction. 5 Simple pair‐wise mixtures can assess the effect of treatment factors on the outcome of competition. Replacement series and related diallel designs generally produce results that may be size‐biased even when initial interspecific differences are known. Additive designs (including target–neighbour designs), despite confounding density with species proportions, offer considerable scope for addressing mechanistic questions about interspecific interactions. Designs that allow response surface analysis can avoid many of the problems inherent in the other methods, but all need to be adjusted for initial interspecific differences. Designs for multiple species experiments are still largely untested, although several designs have been used. At the level of the individual plant, hexagonal fan designs permit study of the effects of varying the spatial pattern, and the densities and the relative proportions of interacting species, but suffer from lack of independence and lack of randomization.
Habitat associations of trees and seedlings in a Bornean rain forest
Authors: Webb Campbell O. , Peart David R. 
Published: March 2003

Summary 1 In species‐rich mixed dipterocarp rain forest in Indonesian Borneo, we evaluated evidence for tree species associations with physical habitat variables (physiography for adults and seedlings, and light for seedlings). A total of 325 species were included in the analysis. 2 A stratified random sample of 28 tree and seedling plots (0.16 ha and 36 m2, respectively) was taken from a 150‐ha study area on homogeneous parent rock (granite) between 110 and 270 m a.s.l. 3 In a principal component analysis (PCA), based on an abundance index of all tree species, plots segregated into three groups. These corresponded closely with the three physiographically defined habitat types assigned in the field: (i) plateaux with a deep humus layer, (ii) sharp ridges and upper slopes, and (iii) gullies and lower slopes near permanent streams. Segregation of plots by habitat was weaker when seedling (rather than tree) species abundance was used in the PCA. 4 In single species analyses, using Monte Carlo randomization tests, we found significant associations with the three physiographic habitat types in 17 out of 49 abundant species for trees, and in 5 out of 22 abundant species for seedlings. In PCA and single species analyses, weaker associations with habitat for seedlings than for trees suggest higher mortality of seedlings in ‘suboptimal’ habitats. 5 Seedlings of 8 out of 45 abundant species were also significantly and positively associated with high light availability (measured in 2 × 2 m subplots, using hemispherical photographs). 6 Combining light and physiographic habitat associations, 20 out of the 45 abundant species were associated with at least one habitat factor as either adults or seedlings. 7 Thus, the distributions and abundances of many species are influenced by local heterogeneity in physical habitat variables. However, about half of the abundant species (25 of 45) showed no significant habitat association as adults or seedlings, and in no case did the relative abundance of any species exceed 5% in its ‘preferred’ habitat.
Reduced growth and seed set following chemical induction of pathogen defence: does systemic acquired resistance (SAR) incur allocation costs?
Authors: Heil Martin , Hilpert Andrea , Kaiser Werner , Linsenmair K. Eduard 
Published: March 2003

Summary 1  Although most theories on plant defence assume that costs will result from the production and maintenance of defensive traits, studies on the costs of induced defence against pathogens are comparatively rare. 2  We focus on fitness costs resulting from the chemical induction of systemic acquired resistance (SAR), a rather unspecific form of defence, which can be induced by and is effective against a broad spectrum of bacteria, fungi and viruses. 3  We used a model system in which we treated wheat plants that were protected against fungi by ‘traditional’ fungicides with BION® (a benzothiadiazole which induces pathogen resistance). Treated plants were therefore compelled to invest in defence without gaining any profit from the induction. 4  Treated plants achieved lower biomass than untreated controls, and developed fewer shoots and ears and therefore produced fewer seeds. The effects were most pronounced in plants that suffered from a shortage of nitrogen, and were observed only when pathogen resistance was induced during lateral shoot production. Later treatment revealed no significant effects. 5  We discuss whether the differences between treated and control plants can be interpreted as a consequence of allocation costs. Such costs could result from metabolic competition between processes involved in plant growth and the synthesis of defence‐related compounds.