bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spirituality and sexual orientation: relationship to mental well‐being and functional health status
Authors: Coleman Christopher L. 
Published: August 2003

Background. Research has shown that spirituality has a positive effect on physical and mental health; however, few studies have explored the influence of spirituality and sexuality on mental well‐being and functional health status in people with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).Aim. This descriptive cross‐sectional study was designed to examine the relationships among spirituality, sexual orientation, mental well‐being and aspects of functional health status (physical, role, social and cognitive functioning) in a sample of 117 African‐American men and women living with HIV/AIDS.Methods. Spirituality was measured using the Spiritual Well‐Being Scale. A demographic questionnaire gathered data on sexual orientation, age and gender. The Medical Outcomes Study Questionnaire‐30 assessed aspects of functional health status and mental well‐being. The HIV Symptom Checklist for Persons With HIV disease was used to collect data on HIV symptoms. The data were collected in 1996.Findings. The findings indicate that spirituality had a direct relationship with cognitive and social functioning and was inversely related to HIV symptoms. Sexual orientation had direct relationships with mental well‐being, cognitive, physical, social and role functioning. t‐Tests showed that heterosexual participants reported poorer mental well‐being and functional health status compared with homosexual participants. Regression analysis showed that spirituality, sexual orientation, age and HIV symptoms contributed significantly to mental well‐being and functional health status.Conclusions. The regression analysis showed that spirituality, sexual orientation, age and HIV symptoms contributed significantly to mental well‐being and functional health status. Further research is needed to explore the various ways that sexual orientation influences health status findings in those with HIV disease in certain segments of the population. The findings support the inclusion of spirituality as a variable when examining mental well‐being and physical health. Finally, given the limitations of the design, more rigorous methods should be employed to understand further the contribution of spirituality to the health status of African‐Americans living with HIV, because of its social importance to this particular community.
Effects of multi‐sensory stimulation for people with dementia
Authors: Baker Roger , Holloway Jane , Holtkamp Chantal C.M. , Larsson Anita , Hartman Lindy C. , Pearce Rebecca , Scherman Birgitta , Johansson Seija , Thomas Peter W. , Wareing Lesley Ann , Owens Matthew 
Published: August 2003

Background. Over recent years multi‐sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS.Aim. To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.).Methods. A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30‐minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre‐, mid‐, post‐trial and follow‐up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital.Results. There were limited short‐term improvements for both the MSS and activity groups immediately after sessions, and limited short‐term improvements between the groups during sessions. There were no significant differences between the groups when assessing change in behaviour, mood or cognition at home/on the ward or at the day hospital. In the UK, however, behaviour at the day hospital for both groups remained stable during the trial but deteriorated once the sessions had stopped, and active/disturbed behaviour at home improved but likewise deteriorated once sessions had stopped.Conclusions. Overall, MSS was found to be no more effective than an activity in changing the behaviour, mood or cognition of patients with dementia in the short‐ or long‐term.
Living with the Ilizarov frame: adolescent perceptions
Authors: Martin Linda , Farrell Michael , Lambrenos Karina , Nayagam Duria 
Published: August 2003

Introduction. The Ilizarov technique has become an established method in the treatment of children with serious skeletal disorders. Whilst the technique is acknowledged for solving difficult conditions, the application of the external fixator marks the beginning of an arduous treatment programme. Research has suggested that undergoing such treatment can negatively impact upon the physical and psychological well‐being of the young person. Yet limitations in research design reduce the usefulness of the findings, given in that most of the previous studies have used retrospective, quantitative data collection approaches, often with a heterogeneous sample population. We wished to gain a richer insight into the experiences of adolescents living with the frame by drawing on both qualitative and quantitative approaches.Aims. To explore adolescents’ perceptions of the anticipated and actual impact of the Ilizarov frame on aspects of daily activity.Design. A mixed‐method approach, using a prospective and longitudinal study design.Method. Fifteen adolescents undergoing the Ilizarov treatment were contacted at several predetermined time‐points during the course of their treatment to share their perceptions of living with the frame. At several of these points semi‐structured interviews were used to ascertain their perceptions, whilst quantitative data were gained at all time‐points by adolescents completing a range of psychometric measures.Findings. Adolescents found that life with the frame was not as bad as anticipated, and they adopted a pragmatic approach, appreciating that this was something they ‘just had to get through’. Peers had a substantial role in supporting their friend to adjust and cope with the frame. Psychometric scores were largely within normal limits.Conclusion. This study suggests that, while the Ilizarov treatment is demanding for adolescents, it is one that they can tolerate without sustained adverse psychological impact.
Baby walkers – health visitors’ current practice, attitudes and knowledge
Authors: Kendrick Denise , Illingworth Rachel , Hapgood Rhydian , Woods Amanda J. , Collier Jacqueline 
Published: August 2003

Background. Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker‐related injury. Health visitors’ knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far.Aim. The aim of the study was to describe health visitors’ knowledge of walkers and walker‐related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice.Method. A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use.Results. The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6–9 month check. Most did not usually discuss the frequency of walker‐related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker‐related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0·03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0·29, P = 0·023) and believed parents to have more positive attitudes towards walkers (rs = −0·49, P < 0·001). Few health visitors had resources to discuss walkers.Conclusions. Health visitor advice regarding walkers needs to be given earlier in the postnatal period than is currently common practice, and they need more knowledge about walker use and related injuries. Education about baby walkers needs to be incorporated into undergraduate and in‐service education, which may need to include the development of skills in exploring reasons why parents use walkers and in negotiating alternatives to their use. The provision of audio‐visual aids for discussing walkers might also be helpful.
Approaches to learning: psychometric testing of a study process questionnaire
Authors: Snelgrove Sherrill , Slater Julie 
Published: August 2003

Background. One method of evaluating students’ learning is to measure surface, deep and achieving approaches to learning using a questionnaire. In comparison with research on student nurses’ learning styles, there has been little examination of their ‘approaches to learning’. Much of the ‘approaches to learning’ research has been conducted with higher education students in Australia and Hong Kong and this kind of measurement is viewed as a valid and reliable way to assess learning.Aim. The aim of study reported here was to establish the validity of an ‘approaches to learning’ questionnaire, the study process questionnaire, for use with student nurses by undertaking psychometrical testing, including exploratory factor analysis.Method. The study process questionnaire is a 42‐item questionnaire measuring surface, deep and achieving approaches to learning. It was distributed to 300 student nurses attending a common foundation programme in a higher education establishment in the United Kingdom (UK) in July 2000. Principal components analysis was conducted to determine the validity of the deep, surface and achievement scales in the questionnaire.Results. A new factor structure was identified comprising three main scales which were similar in content but not identical to the original questionnaire. The deep factor correlated positively and significantly with grade performance average and sociology examination results.Conclusion. The study process questionnaire is a valid and useful tool for nurse teachers to gain knowledge about student nurses’ approaches to learning. Deep learning appears to influence academic performance. More work is required to elucidate the complex nature of deep learning.
Individual determinants of research utilization: a systematic review
Authors: Estabrooks Carole A. , Floyd Judith A. , Scott‐Findlay Shannon , O'Leary Katherine A. , Gushta Matthew 
Published: August 2003

Context. In order to design interventions that increase research use in nursing, it is necessary to have an understanding of what influences research use.Objective. To report findings on a systematic review of studies that examine individual characteristics of nurses and how they influence the utilization of research.Search strategy. A survey of published articles in English that examine the influence of individual factors on the research utilization behaviour of nurses, without restriction of the study design, from selected computerized databases and hand searches.Inclusion criteria. Articles had to measure one or more individual determinants of research utilization, measure the dependent variable (research utilization), and evaluate the relationship between the dependent and independent variables. The studies also had to indicate the direction of the relationship between the independent and dependent variables, report a P‐value and the statistic used, and indicate the magnitude of the relationship.Results. Six categories of potential individual determinants were identified: beliefs and attitudes, involvement in research activities, information seeking, professional characteristics, education and other socio‐economic factors. Research design, sampling, measurement, and statistical analysis were examined to evaluate methodological quality. Methodological problems surfaced in all of the studies and, apart from attitude to research, there was little to suggest that any potential individual determinant influences research use.Conclusion. Important conceptual and measurement issues with regard to research utilization could be better addressed if research in the area were undertaken longitudinally by multi‐disciplinary teams of researchers.
Emotional support and the role of Clinical Nurse Specialists in palliative care
Authors: Skilbeck Julie , Payne Sheila 
Published: August 2003

Background. Clinical Nurse Specialists (CNS) play a major role in the delivery of specialist palliative care services to patients with advanced cancer, in hospital, hospice and community settings across the United Kingdom. A major component of their work focuses on the delivery of emotional care and support to patients and their families.Aim. This paper critically examines the literature on emotional care and support for patients with advanced cancer requiring palliative care. The aim is to increase understanding of how CNSs and patients interact and work together to produce emotionally supportive relationships.Methods. A literature search was performed using the CINAHL, MEDLINE and ASSIA CD‐ROM databases and combinations of the key words: ‘emotional support’, ‘emotional care’, ‘end of life’, ‘palliative’, ‘terminal illness’, ‘advanced cancer’, ‘Clinical Nurse Specialist’, ‘emotional labour’. Additional relevant articles were identified from the reference lists of papers identified by the literature search.Findings. The literature revealed a lack of clarity about the terms used to describe emotional care and support. However, at the same time, there is a taken for granted assumption that a shared understanding of these terms exists. Developing supportive nurse–patient relationships involves a complex process, one that consists of getting to ‘know the patient’ through the effective use of communication skills, in a variety of health care contexts. The costs of engaging in ‘emotion work’ are highlighted.Conclusions. Existing research fails to recognize that emotional care and support as a concept is not a fixed, stable entity learnt through experience and socialization, but is moulded by the process of social interaction and by specific contexts and theoretical perspectives. Further methodologically sound research is needed to explore what happens when emotional care and support are delivered in different care settings, obtaining the views of both parties involved. Implications for the practice of CNSs are discussed.
Image‐guided spinal injection for diagnosis and therapy
Authors: Galloway Howard R 
Published: August 2003

SummaryOver the past decade, major advances have been made in our ability to identify a putative cause of patients’ spinal pain using image‐guided injection techniques. These techniques might also provide a means of temporarily relieving patients’ pain and facilitating increased mobility. This article aims to review the rationale for and the techniques of the more commonly used spinal injection techniques.
Emergency embolization of spontaneous ruptured hepatocellular carcinoma: Correlation between survival and Child−Pugh classification
Authors: Lau KY , Wong TP , Wong WWC , Tan LTH , Chan JKW , Lee ASL 
Published: August 2003

SummaryFrom February 1994 to April 2000, 29 emergency gelfoam embolizations for spontaneous ruptured hepatocellular carcinoma (HCC) performed in 28 patients were retrospectively reviewed. There were 11 patients in Child's A , 11 in Child's B and six in Child's C classification of cirrhosis. The duration of the procedure, artery embolized and complications were reviewed, and the Child−Pugh classification of each patient was correlated with their mean survival period. Embolization was done in 12 right hepatic arteries, two left hepatic arteries and 15 proper hepatic arteries. In one patient, the left hepatic artery was embolized initially but the proper hepatic artery was also embolized because another subcapsular liver tumour was found after reviewing the preangiogram CT scan. The entire procedure took 40−170 min (mean = 86 min) with no periprocedural complication. Following embolization, the mean survival period for Child's A class was 218.3 days, Child's B class was 83.4 days and Child's C class was 11.0 days. Transcatheter embolization is an effective treatment to arrest bleeding in spontaneous ruptured HCC. Patients with Child's A class cirrhosis have the longest survival. Selective embolization of either the right or the left hepatic artery alone carries the potential risk of missing multifocal HCC that might not be easily appreciated during angiography.
Precision of bone densitometry measurements: When is change true change and does it vary across bone density values?
Authors: Wong Joseph CH , Griffiths Matthew R 
Published: August 2003

SummaryThe precision error of the bone densitometer is used to interpret significant change in bone mineral density (BMD) in serial studies. The precision error can be expressed as standard deviation (SD) or coefficient of variation (CV). The aims of this study are to determine the precision error over a range of BMD values and to demonstrate the application of the precision error in clinical practice. A bone phantom was used consisting of a perspex block with eight compartments containing varying amounts of hydroxyapatite powder to simulate a range of bone densities. The block was scanned 21 times and manual regions placed over each compartment to measure the BMD in each compartment. There were no significant differences in the variances or SD for all eight compartments, that is, over the range of BMD normally encountered in clinical practice. However, the calculated CV show a progressive fall in values as the BMD rises. Therefore, the SD should be used to calculate significant BMD change. In a practise with quality control procedures in place to detect calibration drift and with appropriately trained personnel, a change of approximately 0.05 g/cm2 is generally regarded as being a significant change at a 95% confidence level.
Hydrodilatation in the management of shoulder capsulitis
Authors: Bell Simon , Coghlan Jennifer , Richardson Martin 
Published: August 2003

SummaryThe aim of this study was to research the benefit of hydraulic arthrographic capsular distension (hydrodilatation) in the management of adhesive capsulitis of the shoulder. One hundred and nine shoulders with primary adhesive capsulitis were treated with hydrodilatation. Prior to the procedure, 93 shoulders were painful. Two months following the procedure, 31 continued to have some pain. In the 109 shoulders, the measured range of passive glenohumeral movement improved by approximately 30° in all directions. The procedure was of similar benefit if carried out early or late in the disease process. The absolute improvement in movement range was similar in severe and mild cases. The severe cases in the long term, although improved, still had more restriction in movement and tended to have more pain than the other cases. There was considerable improvement in all the non‐diabetic patients. The patients with diabetes responded less well in the long term to hydrodilatation and had an increased requirement for arthroscopic surgery. Effective treatment of adhesive capsulitis can be achieved in the majority of cases with an immediate hydrodilatation of the shoulder. Technically, it is important to achieve maximum distension, preferably with capsular rupture, and to utilize cortisone in the fluid injected.
Triangular cord sign and ultrasound features of the gall bladder in infants with biliary atresia
Authors: Visrutaratna Pannee , Wongsawasdi Lumduan , Lerttumnongtum Pailin , Singhavejsakul Jesda , Kattipattanapong Vinaisak , Ukarapol Nuthapong 
Published: August 2003

SummaryThe aim of this study was to reassess the accuracy of the triangular cord sign, the triangular cord sign coupled with abnormal gall‐bladder length, and an irregular gall‐bladder wall in the diagnosis of biliary atresia. The ultrasonograms of 46 infants with cholestatic jaundice were reviewed for the triangular cord sign, gall‐bladder length and gall‐bladder wall without knowledge of the clinical data. Of the 23 infants with biliary atresia, 22 had the triangular cord sign whereas 17 infants with other causes of cholestatic jaundice did not have the triangular cord sign. The sensitivity, specificity, accuracy and positive predictive value of the triangular cord sign in the diagnosis of biliary atresia were 95.7, 73.9, 84.8 and 78.6%, respectively. The sensitivity, specificity, accuracy and positive predictive value of the triangular cord sign coupled with abnormal gall‐bladder length in the diagnosis of biliary atresia were all 95.7%. Gall‐bladder wall irregularity was seen in seven of 14 infants (50%) with biliary atresia whose gall bladders contained bile on ultrasound and in two of 22 infants (9.1%) without biliary atresia whose gall bladders contained bile on ultrasound. At the medical centre where this study was performed and where infants present with cholestatic jaundice at an advanced stage, the ultrasonographic triangular cord sign coupled with abnormal gall‐bladder length is more reliable than the ultrasonographic triangular cord sign alone or gall‐bladder wall irregularity in the diagnosis of biliary atresia.
Radiologists’ detection of mammographic abnormalities with and without a computer‐aided detection system
Authors: Quek ST , Thng CH , Khoo JBK , Koh WL 
Published: August 2003

SummaryThe aim of this study was to to evaluate the role of a computer‐aided program (CAD) in assisting detection of mammographic lesions by radiologists not specifically trained in mammography and its potential utility in breast screening. Mammograms were evaluated by radiologists not specifically trained in mammography first without, and then with, the CAD. Finally, the mammograms were evaluated by experienced mammographers who formed the reference standard. Two hundred and ninety four breasts were studied. In 257 breasts (87.4%), the CAD system did not help with the detection of abnormalities. It assisted radiologists in detecting abnormalities in 21 breasts (7.1%) with potential for detecting abnormalities in a further 13 breasts (4.4%). Only in three cases (1%) did it cause confusion in interpretation. There is overall increased sensitivity in detecting mammographic abnormalities with the aid of the CAD system from 74.4 to 87.2%, which is statistically significant. However, it failed to detect suspicious abnormalities in 71 breasts (24.1%). The CAD system improved detection of suspicious mammographic abnormalities by radiologists who are not specifically trained in mammography. However, there is also a substantial failure to detect suspicious mam­mographic features that cautions against over‐reliance on the system, emphasizing its role as a second reader at best.