bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dental health of dentists’ children in Mongolia
Authors: Tseveenjav B. , Vehkalahti M. , Murtomaa H. 
Published: December 2004

Summary. Objectives. To describe the dental health of dentists’ children, to evaluate its association with their dentist‐parents’ background and work‐related characteristics and to compare it with that of children in the general population in Mongolia.Design. Cross‐sectional survey, questionnaire‐based data.Subjects. Dentists’ children, aged 3–13 years.Sample. All dentists (n = 250) actively practising in the capital city of Mongolia.Results. The dentists’ children's dmft ranged from 0 to 12, and DMFT from 0 to 8; 50% were caries‐free. The younger the children, the higher was their total caries experience expressed as the sum of DMFT + dmft scores (r = −0·22; P = 0·001). Dentist‐parents’ background and work‐related factors were not associated with their children's caries status (P > 0·05). When dentists’ children were compared with their counterparts at the population level, mean dmft for 6‐year‐olds was 2·6 for (urban) dentists’ children, 6·5 for children in the urban population and 0·9 for those in rural population of equivalent age. Mean DMFT for 12‐year‐olds were 1·0, 1·8 and 1·2, respectively, in the same three groups. In general, (urban) dentists’ children in all age groups had better dental health than did their urban counterparts at the population level. Among 5–7‐year‐olds, dentists’ children had worse dental health than did their counterparts in the rural population.Conclusions. Despite the dentists’ knowledge and awareness, their children demonstrated higher rates of dental caries than expected. This suggests that Mongolian dentists may have insufficient preventive orientation. In particular, the primary dentition of younger children seems to be poorly valued. In Mongolia, dentists should have better training and education in modern methods of caries prevention and their advantages. Appreciation and care of the primary dentition need to be improved at all levels of oral health promotion in Mongolia.
Werna Naloo –‘We Us Together’: the birth of a midwifery education consortium
Authors: Cutts Diane , David Patricia M. , McIntyre Meredith , Seibold Carmel , Hopkins Finbar , Miller Maria 
Published: December 2004

Aim.  The metaphor of a journey will be used to describe the process covering 2 years of development of a Bachelor of Midwifery curriculum shared between a consortium of three universities in Victoria, Australia. Background.  The landscape or background against which this journey took place is described, providing a context for understanding the political and pragmatic steps necessary to achieve common vision and processes. This journey has necessitated a convergence of our thinking about what constitutes the living theory and philosophy of the new midwifery in the Australian context, and how this fits with international trends. Process.  The journey took midwife academics from one paradigm to another, forging partnerships between universities to develop an innovative undergraduate midwifery curriculum that shares academic expertise and resources. Consultation between a multitude of competing interests and voices became one of our biggest challenges, but this process itself has helped to change the very landscape in which we travel. In the end, we had to examine our baggage, and much that was excess had to be abandoned. In particular, our emphasis on language and the politics of the midwifery partnership with women became the subject of much debate and contention, and reflects the competing philosophies developing in the midwifery profession. Despite this, there were many who suggested that we had left behind too much, and others who would have us pack even more. Compromises were inevitable if we were to proceed and set up the next stage of a journey that would open a new and challenging frontier to working with Australian childbearing women.
Occupational health and school health: a natural alliance?
Authors: Croghan Emma , Johnson Carol 
Published: December 2004

Background.  The United Kingdom National Health Service aims to provide a holistic ‘cradle to grave’ service. In order to achieve this, systems are in place for effective communication between providers of services for babies and children. However, when children leave school, communication between the school health services and workplace health services to protect and promote the health of the new workforce is rare. Working together is a commonly‐stated rhetoric of contemporary nursing theory, but often this is not applied in practice. School health and occupational health have similar aims and objectives and, by working together, may be able to improve the health of large populations for a lifetime.Aim.  This paper aims to examine the similarities in principles and practices between school health and occupational health nurses, and to identify areas of overlap in which collaboration could improve care for clients of both services.Discussion.  The paper examines the nature of nursing in occupational and school settings, and similarities and differences in policy, law and principles. It also examines these two areas of practice within a public health framework, looking for areas of overlap. A basis is suggested for collaborative working between the two areas, and barriers, facilitators and benefits of this practice are examined.Conclusion.  We conclude that there does exist a natural alliance between occupational and school health nursing, and that the two should work together to provide continuity of care for clients on leaving school, and to prepare children and young people for the workplace and any special health issues in their chosen careers.
Barriers to evidence‐based practice in primary care
Authors: McKenna Hugh P. , Ashton Sue , Keeney Sinead 
Published: December 2004

Background.  Evidence‐based practice is one of the most important underlying principles in modern health care. In the United Kingdom, successive governments have highlighted the fact that a quality health service is built upon the use of best evidence. Health professionals are becoming more accountable within clinical governance structures for the care they provide. The need to use robust research findings effectively is a critical component of their role. However, studies show that a number of barriers prevent the effective use of best available evidence.Aim.  This study aimed to identify barriers to evidence‐based practice in primary care.Method.  A specially designed questionnaire was used to gather respondents’ perceptions of the barriers to evidence‐based practice. Data were collected in 2000/2001.Findings.  Findings show that general practitioners (GPs) ranked barriers differently to community nurses. GPs believed that the most significant barriers to using evidence in practice were: the limited relevance of research to practice, keeping up with all the current changes in primary care, and the ability to search for evidence‐based information. In contrast, the most significant barriers to the identified by community nurses were poor computer facilities, poor patient compliance and difficulties in influencing changes within primary care. This suggests that these two groups may require different strategies for barrier removal.Conclusions.  Identifying barriers is just the first step to addressing issues surrounding the use of evidence‐based practice. Extra resources will be needed if these barriers are to be tackled. However, if the resultant change improves the health and wellbeing of people and communities, then the extra costs would be offset by more efficient use of services.
Assessment of malnutrition in mental health clients: nurses’ judgement vs. a nutrition risk tool
Authors: Abayomi Julie , Hackett Allan 
Published: December 2004

Background.  The existence of malnutrition in general hospitals is well documented. Psychiatric patients are known to have increased risk of malnutrition, yet physical examinations and nutritional assessments rarely take place in psychiatric hospitals.Aim.  The purpose of this study was to adapt an established nutrition risk score for use with psychiatric patients, using criteria previously agreed by the care team, and to assess whether the clinical judgement of ward staff alone identified a similar group of patients to be at risk.Method.  The risk score assessment was compared with a subjective risk assessment made by nursing staff as patients were admitted to the unit. Data were collected for 112 patients.Results.  The comparison revealed that nurses did not identify malnutrition in the same patients as the risk score, overlooking 27 (29%) at risk patients. Nurses associated malnutrition with psychotic illness, suggesting that depressed patients are more likely to be overlooked.Study limitations.  Although the risk score was based on a validated tool and its content and face validity were established, it has not itself been validated against criteria of nutritional status (malnutrition).Conclusions.  Implementing routine nutritional screening on such units would assist in identifying at risk patients, enabling referral for dietetic intervention to be made. Providing nutrition education for staff might help to improve knowledge and awareness of malnutrition for this patient group.
Benefits and challenges of nurse prescribing
Authors: While Alison E. , Biggs Kathryn S.M. 
Published: December 2004

Background.  Since 1999, all health visitors and district nurses in the United Kingdom (UK) have received additional education to permit their registration as independent prescribers from a limited list of medicinal products. Little research has investigated how more than 20 000 health visitor and district nurse prescribers have implemented their new role since the evaluation of the pilot sites.Aims.  The aims of the study were to describe prescribing practices of healthvisitors and district nurses, the factors (contextual and professional) which enable and facilitate nurse prescribing, and views about the Nurse Prescribers’ Formulary.Method.  A mail survey was conducted of all health visitors and district nurses working in three trusts in southern England. A 74% response rate was achieved (n = 91).Findings.  Most respondents prescribed less than three times a week, with district nurses prescribing significantly more than health visitors (P ≤ 0·001). Over two‐thirds of the sample found nurse prescribing at least moderately helpful to their professional role and over four‐fifths reported that they were more than moderately confident nurse prescribers. A range of information sources was identified as helpful, regarding both new products and for continuing educational needs. Over two‐thirds reported that the current Nurse Prescribers’ Formulary did not cover their prescribing needs, and a number of factors were identified as hindering prescribing. Most respondents said that their general practitioner/primary care team was at least moderately supportive of their prescribing role.Limitations.  The survey was conducted in three primary care trusts in southern England, which may be unrepresentative of trusts elsewhere in UK.Conclusions.  The level of reported prescribing by health visitors and district nurses in this study indicates that they are not acting as substitute prescribers for general practitioners of the products in the limited formulary. Implementation of a major role change such as nurse prescribing requires a number of conditions, including adequate education/preparation, a formulary that meets practitioners’ needs, and acceptance by the practitioners themselves.
Involvement of the L‐arginine/nitric oxide neural pathway in non‐adrenergic, non‐cholinergic relaxation of the bovine oesophageal groove
Authors: Barahona M. V. , Sánchez‐Fortún S. , San Andrés M. D. , Ballesteros E. , Contreras J. , San Andrés M. 
Published: December 2004

Summary

The distribution and localization of nitric oxide synthase (NOS) immunoreactivity and nicotinamide adenine dinucleotide phosphate diaphorase (NADPH‐d) activity in the bovine oesophageal groove were investigated by immnunohistochemical and histochemical staining techniques. Functional in vitro studies were performed to correlate the presence of NOS‐ immunoreactivity (IR) and NADPH‐d staining with smooth muscle relaxations involving the L‐arginine/nitric oxide neural pathway in the bovine oesophageal groove activity.
NOS‐IR and NADPH‐d were expressed in nerve cell bodies of the myenteric, submucosal and intramuscular ganglia, and in nerve fibres distributed around blood vessels and throughout the different muscular layers of the bovine oesophageal groove.
In oesophageal groove strips treated with guanethidine (10−5 M) and atropine (10−7 M) to block noradrenergic neurotransmission and muscarinic receptors, respectively, electrical field stimulation (EFS, 0.5–32 Hz, 1 ms duration, 20‐s trains) induced relaxations which were practically abolished by tetrodotoxin (TTX, 10−6 M).
Incubation with an inhibitor of nitric oxide synthesis, NG‐nitro‐L‐arginine (L‐NOARG, 3 × 10−5 M), significantly inhibited relaxations induced by EFS. This inhibition was partially reversed by L‐arginine (L‐arg, 5 × 10−3 M). D‐NOARG (3 × 10−5 M) had no effect on EFS‐induced relaxations.
NO added as an acidified solution of NaNO2 (10−6–10−3 M) and S‐nitroso‐L‐cysteine (10−7–10−4 M) caused concentration‐dependent relaxations of the bovine oesophageal groove. These relaxations were unaffected by L‐NOARG (3 × 10−5 M).
The presence of NO‐synthesizing enzyme in nerves and ganglia, and the pharmacological evidence for NO‐mediated smooth muscle relaxation suggested that the L‐arg/NO neuronal pathway is involved in the inhibitory neurotransmission of the bovine oesophageal groove.
The role of MAO‐A and MAO‐B in the metabolic degradation of noradrenaline in human arteries
Authors: Figueiredo I. V. , Caramona M. , Paiva M. Q. , Guimarães S. 
Published: December 2004

Summary

Segements of human cystic, gastric and ileocolic arteries were obtained from patients undergoing surgery.
Segments of arterial tissues, the noradrenaline content of which ranged between 0.27 and 0.52 μg g−1, were incubated with 0.1 μmol l−1 [3H]‐noradrenaline for 30 min and the accumulation of the amine as well as the formation of metabolites was measured.
In all the arteries, oxidative deamination predominated over O‐methylation; the mean values of the deaminated and O‐methlated metabolites formed for the three arteries were 247.6 and 82.4 pmol g−1 tissue, respectively. Dihydroxymandelic acid (DOMA) was the most abundant metabolite.
Both clorgyline (a selective MAO‐A inhibitor) and selegiline (a selective MAO‐B inhibitor) reduced the formation of dihydroxyphenylglycol (DOPEG), DOMA and O‐methylated‐deaminated metabolites (OMDA), and increased that of normetanephrine (NMN). However, clorgyline depressed the formation of DOPEG more than that of DOMA, while selegiline depressed the formation of DOMA more than that of DOPEG.
In conclusion, three major differences distinguish the metabolism of noradrenaline by human arteries from that observed in other species: (1) the large predominance of deamination over O‐methylation; (2) the extremely high formation of DOMA; and (3) the relative lack of selectivity of clorgyline and selegiline for MAO‐A and B, respectively. Since the arterial vessels used were collected from patients older than 60 years, the morphological changes depending on age may explain the increase in DOMA formation.
Electromechanical coupling in human vas deferens: effects of agents that modulate intracellular release of calcium
Authors: Amobi N. I. B. , Smith I. C. H. 
Published: December 2004

Summary

The effects of ryanodine, cyclopiazonic acid (CPA) and caffeine on electromechanical coupling in human vas deferens were investigated.
High [K+]o (120 mM) evoked nifedipine‐sensitive contractions of longitudinal and circular muscle which consisted of initial and secondary components.
Exposures to ryanodine (≤10 μM) or CPA (≤ 3 μM) induced a change of basal tension, and higher doses (30 μM) induced intermittent rhythmic contractions of both muscle types in the quiescent tissue. In the presence of the drugs, contraction to high [K+]o was preceded by marked rhythmic activity.
In circular muscle, ryanodine (1–30 μM) or CPA (1–30 μM) reduced both components of contractions to high [K+]o. In longitudinal muscle, the drugs enhanced the initial component and prolonged the secondary component. High doses (≥ 10 μM) produced variable effects on the initial component.
Caffeine (20 mM) reliably contracted longitudinal, but not circular muscle. Pre‐exposures to caffeine enhanced both components in the post‐caffeine contractions of circular muscle to high [K+]o. In longitudinal muscle, only the initial component (post‐caffeine) was enhanced.
Contractions evoked in longitudinal muscle by caffeine were not blocked by ryanodine (30 μM) or CPA (30 μM). However, the enhancement of post‐caffeine contractions to high [K+]o was inhibited.
These results show that ryanodine and CPA produced comparable effects on the excitability of longitudinal and circular muscle in the quiescent tissue, but electromechanical coupling was affected differently. The findings suggest that the muscle types utilize different mechanisms to regulate elevations in cytosolic Ca2+ during stimulation.
Electromechanical coupling in both muscle types involves Ca2+ influx via nifedipine‐sensitive voltage‐operated calcium channels and activation of ryanodine‐sensitive calcium‐induced calcium release from the sacroplasmic reticulum (SR). In longitudinal muscle, the SR also buffers increases in cytosolic Ca2+ via a pharmacologically distinct Ca2+ compartment (caffeine releasable but ryanodine/CPA‐insensitive). In circular muscle, the SR (ryanodine/CPA‐sensitive) serves mainly in the regulation of excitability of the quiescent tissue.
Enhanced bradycardia induced by β‐adrenoceptor antagonists in rats pretreated with isoniazid
Authors: Vidrio H. , Sánchez‐Salvatori M. A. , Medina M. 
Published: December 2004

Summary

High doses of isoniazid increase hypotension induced by vasodilators and change the accompanying reflex tachycardia to bradycardia, an interaction attributed to decreased synthesis of brain γ‐aminobutyric acid (GABA). In the present study, the possible enhancement by isoniazid of bradycardia induced by β‐adrenoceptor antagonists was determined in rats anaesthetised with chloralose‐urethane.
Isoniazid significantly increased bradycardia after propranolol, pindolol, labetalol and atenolol, as well as after clonidine, but not after hexamethonium or carbachol.
Enhancement was not observed in rats pretreated with methylatropine or previously vagotomised.
These results are compatible with interference by isoniazid with GABAergic inhibition of cardiac parasympathetic tone. Such interference could be exerted centrally, possibly at the nucleus ambiguus, or peripherally at the sinus node.
Cardiac rehabilitation: the importance of patient expectations – a practitioner survey
Authors: Lau‐Walker Margaret 
Published: December 2004

Background.  Numerous cardiac rehabilitation national guidelines consistently endorse the need for psychological support to create effective individualized care. Recent surveys suggest that the psychological factors remain poorly assessed and the measurement of psychological parameters remains patchy.Aim.  To examine cardiac rehabilitation practitioners’ perception and understanding of the importance of patient expectations and their capacity to assess and utilize these expectations to develop individualized care.Methods.  A survey of cardiac rehabilitation professionals from 10 hospitals in the south‐east of England. The questionnaire used in the survey was developed from content analyses of the current cardiac rehabilitation literature and expectancy theory articulated in Bandura's writings.Results.  The results of the study show that cardiac rehabilitation practitioners are very aware of the general importance of patient expectations but have little structured support in the development of techniques to either assess these expectations or to utilize them in a therapeutic context. This leaves them unsure about the extent to which patients do receive individualized care and how best to develop their own practice in this regard.Relevance to clinical practice.  This study suggests that there is a need for the development of a structured assessment tool, which has a sound theoretical basis to assess patients’ expectation if good practice is to be established in providing individualized car in cardiac rehabilitation.
Day surgery: patients’ perceptions of a nurse‐led preadmission clinic
Authors: Gilmartin Jo 
Published: December 2004

Background.  Previous research studies have demonstrated that nursing intervention is often lacking in the provision of adequate information and psychological support, and fails to meet the holistic needs of patients in the preassessment for day surgery.Aim.  The aim of this study was to elicit patients’ perceptions of the preassessment preparation they received prior to day surgery.Method.  A hermeneutic phenomenological research approach was utilized to elucidate the participants’ experiences of the preassessment process and to collect data. Qualitative data were collected using face‐to‐face interviews and analysed thematically following procedures expounded by Colaizzi and van Manen.Sample.  The sample included 30 patients undergoing day surgery in a large teaching hospital in the north of England. The day unit built for this purpose consisted of a preassessment unit, a seated preoperative area, three theatres, a six space first stage recovery area, a 24 space second stage recovery area and a separate seated recovery area. The patient groups focused on individuals scheduled for general surgery, gynaecology and urology procedures.Results.  Findings suggest that the nurse‐led clinic appeared to function effectively; most patients felt they were adequately assessed and prepared for day surgery. The majority reported receiving comprehensive information about procedures, appreciated health education interventions and had opportunity to ask questions. A few patients pointed to deficits in information giving, indicating that their individual needs were not met, leaving them feeling anxious. Others alluded to problems associated with unexpected cancellation of procedures, which threw them into states of disequilibrium.Relevance for clinical practice.  The findings indicate that information giving, psychological support and person‐centred care could be strengthened in the preassessment preparation of patients undergoing day surgery.