bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evaluation of a teaching intervention to improve the practice of endotracheal suctioning in intensive care units
Authors: Day Tina , Wainwright Steven P. , Wilson‐Barnett Jenifer 
Published: March 2003

• Endotracheal suctioning is a frequently performed procedure that has many associated risks and complications. It is imperative that nurses are aware of these risks and are able to practise according to current research recommendations.• This study was designed to examine to what extent intensive care nurses’ knowledge and practice of endotracheal suctioning is based on research evidence, to investigate the relationships between knowledge and practice, and to evaluate the effectiveness of a research‐based teaching programme.• This quasi‐experimental study was a randomized, controlled, single‐blinded comparison of two research‐based teaching programmes, with 16 intensive care nurses, using non‐participant observation and a self‐report questionnaire.• Initial baseline data revealed a low level of knowledge for many participants, which was also reflected in practice, as suctioning was performed against many of the research recommendations.• Following teaching, significant improvements were seen in both knowledge and practice. Four weeks later these differences were generally sustained, and provide evidence of the effectiveness of the educational intervention.• The study raised concern about all aspects of endotracheal suctioning and highlighted the need for changes in nursing practice, with clinical guidelines and focused practice‐based education.
Communication issues for the interdisciplinary community palliative care team
Authors: Street Annette , Blackford Jeanine 
Published: March 2003

• This paper discusses the findings of a critical study that examined the communication patterns between nurses and general practitioners (GPs) providing palliative care in Australia.• Interviews and focus groups involved 40 palliative care nurses who worked in the three settings of care: community, hospice and hospital.• Issues that impeded effective communication strategies between palliative care nurses and GPs were networking, case management, multiple service providers, lack of standardized documentation and formal tracking of clients, along with difficulties in transmission of relevant practice knowledge.• Supporting strategies for effective formal modes of communicating and reporting are described.
Communication skills: some problems in nursing education and practice
Authors: CHANT SIMON , JENKINSON TIM , RANDLE JACQUELINE , RUSSELL GRAHAM 
Published: March 2003

• This article is based on a literature review carried out as part of a study of communication skills training in pre‐registration nursing education in England in 2000.• A systematic literature search was conducted and 200 articles were found that were relevant to the study.• Definitional problems were found, with terms such as communication skills and interpersonal skills being used interchangeably.• The term communications strategies is suggested to overcome these problems, as it reflects the logical organization of a number of different communication skills within a theoretical or empirical framework.• Problems in current communication skills teaching and social barriers to using communication skills in practice are discussed.• It is concluded that problems continue to exist in these areas and that an emphasis on both aspects is needed if patient and staff satisfaction is to be improved.
Nurses' experience with vancomycin‐resistant enterococci (VRE)
Authors: MITCHELL ANN , CUMMINS TERESA , SPEARING NATALIE , ADAMS JUNE , GILROY LISA 
Published: March 2003

• The emergence and spread of resistant organisms, in particular vancomycin‐resistant enterococci (VRE), is an issue facing all staff in acute hospitals.• This study explored how nurses coped with the responsibility of halting further spread of this organism during an outbreak.• VRE‐positive patients were cohorted with nurses who cared for them in an endeavour to contain the spread of VRE.• The majority of nurses found the situation extremely stressful because of the need to act as `gatekeepers' responsible for educating and monitoring the practices of staff and visitors. The nurses reported that they felt they were inadequately supported, were blamed for the outbreak, and that they had an increased workload as they took on duties of other staff.• The results reinforce the need for a multidisciplinary team approach to education and control of VRE, more support for nursing staff cohorted with VRE‐positive patients, and stringent adherence to infection control measures by all hospital staff.
The quality of nursing care as perceived by individuals with chronic illnesses: the magical touch of nursing
Authors: THORSTEINSSON LAURA SCH 
Published: March 2003

• Providing high quality nursing care is the vision of nursing. The literature has revealed gaps between the perspectives of patients and nurses regarding the quality of nursing care.• The purpose of this study was to investigate how individuals with chronic illnesses perceive the quality of nursing care in order to enhance the quality of care.• The participants were 11 Icelandic individuals, aged 39–80 years with various chronic illnesses.• Phenomenology was the research approach and in‐depth dialogues were used.• Five themes emerged: nurses who provided high quality nursing care, the effects of high quality nursing care, the lack of good quality nursing care and its effects, ancillary factors, and the art of being a patient.• Based on the findings I conclude that professional caring is the most important part of quality of care as perceived by individuals with chronic illnesses.
Effects of sponge bathing on vagal tone and behavioural responses in premature infants
Authors: LEE HAE‐KYUNG 
Published: March 2003

• The purpose of this study was to evaluate the effects of sponge bathing on physiological (vagal tone, heart rate, heart period, oxygen saturation) and behavioural responses in newly born premature infants in the intensive care unit of a university hospital in South Korea.• A convenience sample was taken of 40 infants who were between 27 and 36 weeks gestational age at birth and free of congenital defects.• The infants' physiological parameters were recorded 10 min before, during and after bathing. To determine behavioural status, tools were modified from the instruments used in a previous study by Scafidi et al. (1990).• Analysis of the results showed that the premature infants reacted to sponge bathing with decreases in vagal tone and heart period and increases in heart rate. Oxygen saturation did not demonstrate any remarkable alteration during bathing. Also, there were no significant differences in behavioural signs, motor activity and behavioural distress.• Results of this study indicated that nurses in a neonatal intensive care unit should decide according to a premature infant's physiological state whether or not to give a sponge bath.
Parents' roles in using non‐pharmacological methods in their child's postoperative pain alleviation
Authors: PÖLKKI TARJA , VEHVILÄINEN‐JULKUNEN KATRI , PIETILÄ ANNA‐MAIJA 
Published: March 2003

• Increasingly nowadays, parents participate more fully in the care of their hospitalized children.• The purpose of this study was to describe parents' utilization of selected non‐pharmacological methods in relieving their hospitalized child's (aged 8–12 years) postoperative pain, and factors related to this function.• Data were collected by a questionnaire survey completed by parents (n=192) with a child hospitalized on a paediatric surgical ward in the five university hospitals of Finland. The response rate was 90%.• Results indicated that non‐pharmacological methods, such as emotional support and helping with daily activities, were well utilized whereas cognitive‐behavioural and physical methods were less frequently used strategies.• Certain background factors specific to the parents and their hospitalized children were significantly related to the non‐pharmacological methods used by the parents. The hospitalized child's gender, the time of the surgical procedure, and the parents' assessments of their child's pain intensity, were especially significantly related to many of these strategies.• The findings of this study could be used in clinical practice to improve guidance provided to parents regarding interventions for children's pain relief.
The role of community staff in care home placement in Sweden
Authors: SANDBERG J. , NOLAN M. R. , LUNDH U. 
Published: March 2003

• The role of community staff in placing a relative in a care home is a relatively unexplored area of practice.• Interviews with a variety of community staff in Sweden suggest that they play a significant role in helping family carers, particularly spouses, research the decision about the need for placement.• This role can include recognition that placement is required (seeing the need), initiating and sustaining discussions about placement (sowing the seed and nurturing the seed) and legitimating the decision.• However, once the decision has been made relatively little attention is given to the emotional consequences of the move and attention is focused largely on instrumental aspects.• Despite showing sensitivity in the decision‐making phase, community staff could do more to help carers deal with the guilt they experience and to initiate contact with the care home.
The transition of adolescents with diabetes from the children's health care service into the adult health care service: a review of the literature
Authors: FLEMING ELIZABETH , CARTER BERNIE , GILLIBRAND WARREN 
Published: March 2003

• Adolescents with diabetes have unique health needs, which impact upon their transition from children's health care services into adult health care services.• These health needs result from the precarious period in their lives, when they have to cope with the stresses of being a maturing person. This coincides with their move from the children's into the adult health care service. Whilst coping with these pressures they must also keep their diabetes under control.• The impact of emotional and physical demands upon the adolescent means that they are more susceptible to non‐adherence, which may result in reduced diabetic control.• This literature review identifies some of the many barriers erected to the transition into the adult health care system; these barriers may be constructed by any one of the parties involved: the children's health care team, adult health care team, the adolescent or their family.• Principles of a successful transition are explored, along with the prerequisite qualities required of health care providers and the health care service.
A pain workshop: an approach to eliciting the views of young people with chronic pain
Authors: CARTER BERNIE , LAMBRENOS KARINA , THURSFIELD JONATHAN 
Published: March 2003

•  Chronic pain is complex and there is still much to discover about the burden that it places on children and their families.•  The aim of this study was to explore the way in which the experience of chronic pain impacts on the lives of young people.•  Through the use of a pain workshop that involved a series of guided activities and a focus group, young people were able to share their experiences with each other and the facilitators/researchers.•  Data were analysed using a theoretical coding technique supported by Atlas.ti®.•  Five key interlinked themes emerged from the data and each theme is expressed in the words of the young people themselves: `no one's pain's the same', `getting on with it', `it's hard 'cos…', `keeping with the dream', and `it depends … some are OK'.•  The young people did experience significant disruption in their lives as a result of their pain.•  Pain was experienced as if it was both a separate entity as well as an intrinsic part of them and, to a degree, blighted their future.•  Based on the experiences shared by the young people, professionals need to develop insight and strategies into the challenges young people with chronic pain face on a daily basis.
E‐commerce: consumer protection issues and implications for research and education
Authors: Goldsmith Elizabeth , McGregor Sue L.T. 
Published: March 2003

AbstractThe impact of e‐commerce on consumers, public policy, business and education is examined. It behoves academics and students alike to keep abreast of new developments in this field and to contribute to the public debate on the widespread effects of e‐commerce. A discussion of public policy initiatives, research questions and ideas for future research are given.
Gender modification and resource allocation in subdioecious Wurmbea dioica (Colchicaceae)
Authors: Barrett Spencer C. H. , Case Andrea L. , Peters Gregory B. 
Published: March 2003

1 Populations of subdioecious species contain female, male and cosexual plants. Here we investigate factors influencing gender expression and patterns of resource allocation among the sex phenotypes in subdioecious populations of the diminutive geophyte Wurmbea dioica (Colchicaceae) from the Australian Capital Territory, south‐east Australia. 2 Demographic studies and population comparisons of the sex phenotypes were conducted to determine their distinguishing features, and whether sex expression was labile. Comparisons of biomass allocation were made to assess whether plants with hermaphrodite flowers were larger than unisexual plants. The seed fertilities of sex phenotypes were measured and related to the sex ratio of populations. 3 Female plants exhibited canalized gender producing only ovuliferous flowers, which were smaller and less showy compared to flowers of other plants. Some male plants displayed labile gender expression, producing varying numbers of male and hermaphrodite flowers (fruiting males). Maternal investment among male plants was size‐dependent. 4 Fruiting males were significantly larger and produced more flowers than unisexual plants. At flowering, we found no evidence for changes in proportional allocation with increases in size after controlling for total biomass. At fruiting, allocation patterns differed between females and fruiting males independently of size. 5 Total seed output by fruiting males was 70% of that produced by females. The number of seeds per fruit declined acropetally in both sexes, and males produced, on average, more seeds per fruit than females. Data on the relation between female frequency and the relative seed fertilities of males and females gave a poor fit to Lloyd's (1976) genetic model predicting equilibrium female frequency. The lack of congruence probably occurs because size‐dependent gender modification in males complicates the assumptions of the model.
The significance of assemblage‐level thinning for species richness
Authors: Stevens M. Henry H. , Carson Walter P. 
Published: March 2003

1 A unimodal relationship between species richness and primary productivity is commonly reported. To explain this pattern, the mechanisms proposed in the many hypotheses are generally complex and almost all are without a strong empirical foundation. Here we evaluate the role of self‐thinning in plant assemblages: assemblage‐level thinning. 2 We developed a simple two‐parameter model of species richness that predicts that plant species richness will be determined by a unimodal relationship between total plant density and above‐ground biomass. This model provides a very narrowly defined set of testable quantitative predictions, and thus is the first falsifiable model of assemblage‐level thinning. We fit this model to the species richness–above‐ground biomass data from 14 empirical studies that are often cited as evidence of a general diversity–productivity relationship. In addition, we compared our model to two other models, one more flexible and one more constrained than our own. 3 We found that our model of species richness explained a substantial and statistically significant portion of the species richness observed in 11 of the 14 empirical studies of species richness–biomass patterns. Therefore, given the conservative nature of our model, and the number of previously published data sets explained by this model, we argue that assemblage‐level thinning not only provides a viable and exceedingly parsimonious explanation, but may also be a widespread phenomenon.
Disturbance‐related heterogeneity in the seed banks of a marine angiosperm
Authors: Inglis Graeme J. 
Published: March 2003

Summary 1 Patterns in the distribution of seeds of the marine angiosperm Halodule uninervis were described over spatial scales ranging from a few centimetres to meadows separated by more than 120 km along the north‐eastern coast of Queensland, Australia. Separate surveys examined how seed bank densities were related to: (i) the distribution of male and female plants (primary dispersal) and (ii) disturbances caused by turbulent water movement and the foraging of large marine vertebrates. 2 The distribution of seeds was extremely heterogeneous at very small scales of sampling (centimetres to tens of centimetres). Variation in seed abundance within individual meadows (87% of total variation in seed densities) was at least an order of magnitude greater than that among separate intertidal populations (13%). Densities of seeds were greatest in micro‐topographic depressions where the overlying vegetation had been removed by directional water currents and the feeding activities of dugongs. Smaller disturbances that did not disrupt the cover of vegetation had no effect on seed abundance. Detailed mapping of the distributions of seeds and male and female reproductive shoots showed only a weak relationship between primary seed production and the seed bank, but revealed a pattern of seed distribution that was consistent with accumulation in linear depressions in the meadow. 3 The seed banks of intertidal sediments exhibit many similarities to those of physically dynamic desert sands. In these unstable environments, seeds are most abundant in sheltered micro‐habitats where sediment mobility is impeded. Plants that inhabit desert and marine sands appear to have responded similarly to strong selective pressures on seedling recruitment by developing mechanisms that restrict primary seed dispersal to take advantage of micro‐sites provided by established plants.
Restriction of the upper distribution of New England cobble beach plants by wave‐related disturbance
Authors: Kennedy Coleman W. , Bruno John F. 
Published: March 2003

Summary 1 The New England cobble beach plant community is an intertidal assemblage of halophytic forbs found exclusively behind fringing beds of the grass Spartina alterniflora. The purpose of this study was to determine the life stage and factors that limit the upper (landward) distribution of cobble beach plants in Narragansett Bay, Rhode Island, USA. 2 Seed traps and soil samples above the community border contained large numbers of seeds and buried seedlings of three cobble beach species, indicating that seed supply and germination do not limit vertical plant distribution. Experimentally added seeds of four species germinated above the community border, but seedlings did not emerge suggesting that seedling emergence is the proximate life stage limiting population and community distribution. 3 Measures of wave disturbance (cobble movement and change in cobble depth) indicated that substrate instability is substantially greater above than within the community, probably due to the lack of buffering by the S. alterniflora bed at higher tidal heights. 4 A second seed addition experiment demonstrated that seedlings of Suaeda linearis, a common cobble beach forb, are only able to emerge and grow into reproductive adults above the community border when the substrate there is artificially stabilized. Seedling transplants and glasshouse manipulations demonstrated that neither herbivores nor soil quality limited seedling emergence. 5 Overall, the vertical restriction of habitat modification by S. alterniflora appears to result in substrate instability at higher tidal elevations sufficient to prevent seedling emergence and limit the vertical distribution of cobble beach plants.
The effects of light quality, nitrate concentration and presence of bracteoles on germination of different fruit types in the heterocarpous Atriplex sagittata
Authors: Mandák Bohumil , Pyšek Petr 
Published: March 2003

Summary

We investigated the effect of light quality, nitrogen supply, fruit size and age on germination of the three types of fruit produced by Atriplex sagittata.
Regardless of fruit type, seed germination was significantly reduced in the dark. Light quality had no significant effect on germination of seeds from fruit types A and B, both of which are dormant, but seeds from fruit type C, which are non‐dormant, germinated better in green light (low photon flux and red : far‐red ratio, simulating conditions in the canopy) than in white light.
Optimum nitrate concentration differed between seed types but, for all, germination was reduced at the highest concentration used.
The effects of cold stratification and its interaction with light and nitrogen effects were also studied. Strong interactions between stratification and light were found in all seed types but other interactions were less frequent.
Three size classes of type C fruit showed similar final germination percentages but large seeds germinated more slowly.
The effect of seed age was highly significant: over a 3 year period, the germinability of dormant seeds (types A + B) increased while that of non‐dormant seeds (type C) fell.
The salt concentration in bracteoles of freshly ripened fruits was too low to mediate an inhibitory effect on germination. Moreover, the first autumn rain would be sufficient to remove all the salt from bracteoles.
Differences between fruit types in depth of dormancy, and in response to the quality of light and to nitrate concentration in the soil, allows A. sagittata to respond to the spatial and temporal variation in environmental conditions encountered by this annual of disturbed habitats.