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Biomedical subjects

C Webb

Publications and source records attributed to C Webb.

At least 73 records · Page 4Linked to original sources
PubMed1995

Predicting symptomatology and self-blame among child sex abuse victims.

Fifty-six sexually-abused girls and their nonoffending female caretakers from primarily low-income. African American families were comprehensively assessed in order to determine factors related to child symptomatology and self-blame. Girls whose overall relationships with their caretakers were somewhat negative exhibited more behavioral difficulties. Girls with disruptions in their relationship with a primary caretaker and who felt powerless as a result of the abuse were rated as functioning less well overall by clinicians. Child age, general attributional style, and caretaker blame of the child were related to child self-blame. Clinical implications of these findings include identification of clients at high risk for negative sequelae and development of interventions targeted at specific clinical issues.

Adaptation, Psychological↗
PubMed1995

The power of social judgement: struggle and negotiation in the nursing process.

In this paper we discuss an alternative view of the nursing process as it is experienced by both patients and nurses. The current conception of the nursing process is that it is a benevolent activity which aims to render care more individualized or person-centred. Its rhetoric usually includes notions of mutuality in goal setting, openness and collaboration between patients and nurses. We will suggest that such a view is idealized and has little basis in empirical reality as it is experienced by both nurses and patients. Rather, nurse-patient relations are beset by conflict and struggle, frequently resulting in the acquiescence of patients to the nursing and the medical goals of care. On the basis of an ethnography of a hospital medical ward, we will describe a process of social judgement and set it into a discussion of the social context where an unequal balance of power is integral to provider-recipient relations. Our account will focus upon four categories through which judgemental labelling may be analysed. These are assessing, negotiation, struggling and acquiescing. Of special interest to us are strategies which nurses used to maintain excellent care in the context of negative social judgements, and the place social judgement may play in moral decision-making. We emphasize the strengths which rich qualitative data have in relation to previous survey approaches of this phenomenon, whilst recognising the limitations of so focused a study.

Humans↗
PubMed1995

Parallels and contradictions in the theory and practice of action research and nursing.

This paper draws on the authors' experiences of nursing in general and of action research projects. Parallels will be drawn between, on the one hand, the relationship between the practice and theory of nursing and, on the other band, the relationship between the practice and theory of action research. Difficulties common to nursing and action research will be identified (e.g. between the implementation of the theory of nursing and of action research). Over- simplification, non-specificity of issues and gaps in theory are frequent but inevitable problems that hinder theoretical applications. Similarly, comparisons will be made between the problems associated with the translation of nursing practice into theory and the difficulties in transposing the experience of research into theory. The complexities of practice, whether nursing or research, and the evolutionary nature of experience inescapably give rise to dilemmas when analysing theory and practice. The concepts of theory and practice when conceived as a dichotomy present a useful overview of issues. We argue that, through a discussion of the core themes of action research, including 'knowledge in action' and 'self and group reflection', consideration should also be given to a symbiotic and complementary analysis of theory and practice. We observe that many contradictions exist within the theory and practice of action research and of nursing, and that these need to be addressed to promote theoretical and practical advances. Action research offers theoretical and practical insights that contribute to the current debate on the reciprocal relationship between theory and practice.

Diffusion of Innovation↗
PubMed1995

Rediscovering unpopular patients: the concept of social judgement.

Nurses have known about unpopular patients for over two decades. Influential studies such as Stockwell's in the UK have had considerable impact upon students of nursing. Stockwell's book, The Unpopular Patient, is widely cited and was reprinted in 1984. Further, a critical review of the wider literature by Kelly & May threw down a challenge to researchers to investigate the phenomenon using an interactionist perspective and ethnographic methods. This paper reports a study which should begin to reinforce doubt that evaluative labels, unpopular or otherwise, are in any way 'predictable', as Stockwell and a host of others have hoped and assumed. The process through which evaluative labels of people are socially constructed is explored and the context, explanations and some consequences of what we call social judgement are discussed.

Adult↗
PubMed1995

What kind of nurses do patients want?

This article discusses whether certain aspects of 'New Nursing' which involve changes in nurse-patient relationships and the emphasis of the nurse's role fit with patients' preferences for their care. It reports on a study investigating these issues, and concludes that patients in general want a warm and friendly style of nursing, but a substantial minority do not agree with the use of patients' first names. Patients' evaluations of the most important nursing activities focus on listening to patients' worries, teaching them about their conditions, and relieving pain.

Adult↗
PubMed1995

Assessing patient satisfaction. Part 1. The research process.

The research reported in this article formed part of a project evaluating nursing developments in four demonstration wards in one health authority, and the article focuses on evaluation of patient satisfaction. The evaluation of patient satisfaction is a topic surrounded by much methodological debate and therefore it was necessary to clarify the issues involved at the planning stage of the study. The 'process' aspects of evaluating patient satisfaction will be discussed here, while the content of patient interviews will be the subject of Part 2.

Humans↗
PubMed1995

Listening to the voices of older patients: an existential-phenomenological approach to quality assurance.

The motivation behind this study was a desire to gain access to the experiences of elderly people receiving nursing care in hospital. Previous experience with quantitative approaches to quality assurance had led to dissatisfaction with their neglect of the patient perspective or reliance on patient satisfaction questionnaires. An existential-phenomenological approach was used in an attempt to reconstruct patients' experiences as reported in their own words. Themes which emerged from the data and are reported here focus on 'routine geriatric care', 'care deprivation', 'depersonalization', and 'geriatric segregation'. The findings are discussed against the background of literature about nursing care of elderly people. It is suggested that in the setting studied, limitations posed by past management deficiencies, under-staffing and poor physical environment contributed to the situation reported. Trained nurses felt they worked hard to give the best care they could but, with a high ratio of untrained staff and lack of continuing education, they were aware that their levels of achievement were far from ideal. The study demonstrates that, with an appropriate methodology, it is possible to gain access to how patients' experience their care and in this sense the attempt to 'listen to the voices of patients' was successful and gives pointers to developing more patient-sensitive quality-assurance processes.

Aged↗
PubMed1995

Gynopia in nursing practice: the case of urethral catheterization.

A pilot study of catheterized women was designed to investigate their perceptions of pain and discomfort during the procedure. The study aimed to test the feasibility of conducting a larger randomized controlled trial. Problems were encountered during the execution of the study, due to the need to conform to established principles in clinical research. Restrictions on access to patients impinged upon the opportunity to 'cast the net wide' in order to generate meaningful data.

Attitude to Health↗
PubMed1995

Signal transduction pathways for B1 and B2 bradykinin receptors in bovine pulmonary artery endothelial cells.

Bovine pulmonary artery endothelial (CPAE) cells respond to bradykinin, and it has been suggested that the receptors on these cells do not fall into the normal B1/B2 classification of bradykinin receptors [J. Pharmacol. Exp. Ther. 244:646-649 (1988)]. The present study describes a detailed characterization of the subtypes of bradykinin receptors on CPAE cells. The B1-selective agonist des-Arg9-bradykinin and the B2-selective agonist bradykinin both activated polyphosphoinositide phospholipase C (PLC), caused an elevation in cytosolic Ca2+ concentration ([Ca2+]i), and increased the rate of 45Ca2+ efflux in CPAE cells. The pharmacology of these responses was consistent with interactions with B1 and B2 receptors. The effects of maximal concentrations of bradykinin and des-Arg9-bradykinin on the activity of PLC in populations of cells were not additive, suggesting that the two subtypes were expressed on the same cells. Indeed, des-Arg9-bradykinin and bradykinin both evoked increases in [Ca2+]i in 85% of single cells tested. The Ca2+ entry blocker NiCl2 inhibited bradykinin-induced increases in [Ca2+]i and 45Ca2+ efflux. In contrast, NiCl2 did not inhibit the increase in 45Ca2+ efflux evoked by des-Arg9-bradykinin and induced oscillatory increases in [Ca2+]i in response to the B1 agonist. NiCl2 had no effect on [3H]inositol trisphosphate generation by either agonist, indicating that its inhibitory effects on bradykinin-mediated Ca2+ responses were distal to B2 receptor-induced activation of PLC. LaCl3 did not differentiate between the 45Ca2+ efflux responses evoked by bradykinin and des-Arg9-bradykinin, attenuating both to a similar degree. Bradykinin-induced [3H]inositol trisphosphate formation was desensitized after pretreatment with bradykinin, but the response to des-Arg9-bradykinin was unchanged. Pretreatment with the B1 agonist did not inhibit responses evoked by subsequent challenges with either des-Arg9-bradykinin or bradykinin. These results provide pharmacological evidence for the existence of two distinct bradykinin receptor subtypes (B1 and B2) on CPAE cells, with no evidence for heterologous desensitization. Although both subtypes operated similar signal transduction pathways, the Ca2+ responses evoked by the two receptors could be differentiated by NiCl2.

Amino Acid Sequence↗
PubMed1994

The Delphi technique: a methodological discussion.

As in nursing, recent curriculum reform in radiographer education has resulted in the development of undergraduate programmes, and a study referred to in this paper investigated the activities of supervising radiographers in support of the undergraduate curriculum. Following on from 'ward learning environments' research in nursing, the most important activities which assist radiography students' clinical learning were investigated by means of the Delphi technique. At the design stage, a deficiency in previous work using the technique was identified, in that decisions relating to consensus among research respondents appeared to be based on arbitrary or post hoc rationales rather than predetermined or objective criteria. As the Delphi technique is being increasingly employed in nursing and similar research, it is important to explore issues of consensus, validity and reliability. The paper makes recommendations for improving these aspects in future studies.

Clinical Competence↗
PubMed1993

Feminist research: definitions, methodology, methods and evaluation.

The literature relating to feminist research both within and beyond nursing is reviewed in this paper. Feminist research is located within a post-positivist paradigm, and various definitions are considered. The distinctive methodological approach of feminist research is discussed, and interviewing and ethnography are evaluated as suitable methods for use in feminist research. Oakley's (1981) paper on interviewing women is subjected to criticism. A final section examines attempts by three sets of writers to propose evaluation criteria for feminist research. The review concludes that a number of paradoxes and dilemmas in feminist research have yet to be resolved.

Anthropology, Cultural↗
PubMed1992

Activated neutrophils impair rabbit heart recovery after hypothermic global ischemia.

Cardiopulmonary bypass is known to cause neutrophil activation, and activated neutrophils appear to be of importance in myocardial reperfusion injury. This study examined the effect of a preischemic infusion of activated neutrophils on the recovery of myocardial function after 40 minutes of hypothermic global ischemia. Studies were carried out in three groups of Langendorff-perfused rabbit hearts: control, control (unactivated) neutrophil infusion, and phorbol myristate acetate-activated neutrophil infusion. The activated neutrophil group showed significant deterioration in function during the activated neutrophil infusion. All three groups demonstrated significant depression of function initially after reperfusion, but the two control groups subsequently recovered to baseline levels. The activated neutrophil group, however, showed a persistent significant depression in ventricular force, rate of ventricular tension development, and rate of ventricular relaxation as well as a significant increase in coronary vascular resistance. It is concluded that activated neutrophils depress myocardial function and contribute to impaired recovery of function after global hypothermic ischemia.

Animals↗
PubMed1992

Spontaneous and inducible ventricular arrhythmias in a canine model of chronic heart failure: relation to haemodynamics and sympathoadrenergic activation.

The relationship between the incidence, frequency and complexity of spontaneous ventricular arrhythmias and the extent of haemodynamic compromise and sympathoadrenergic hyperactivity was evaluated in a canine model of chronic heart failure produced by multiple sequential intracoronary microembolizations. Ambulatory ECG Holter monitoring recorded during chronic heart failure in 18 dogs revealed spontaneous ventricular arrhythmias ranging from single ventricular premature beats (VPBs) to non-sustained episodes of ventricular tachycardia (VT). Single VPBs were present in 94% of dogs, couplets in 67%, triplets in 28% and spontaneous episodes of non-sustained VT in 33%. Dogs with > 28 VPBs.h-1 (n = 9) had a markedly higher plasma norepinephrine (PNE) concentration (1001 +/- 185 vs 561 +/- 31 pg.ml-1) (P < 0.03), and a higher pulmonary artery wedge pressure (PAWP) (18 +/- 2 vs 12 +/- 1 mmHg) (P < 0.03) than dogs with < or = 28 VPBs.h-1 (n = 9). Dogs that developed spontaneous episodes of VT also had significantly higher PNE levels (1119 +/- 247 pg.ml-1) compared to dogs that did not develop VT (612 +/- 64 pg.ml-1) (P < 0.02). Programmed ventricular stimulation performed in seven of 18 dogs resulted in the development of sustained monomorphic VT in three and ventricular fibrillation in three dogs each (43%, 43%). Dogs with inducible sustained monomorphic VT had a significantly higher number of ambient arrhythmias and higher PAWP compared to dogs that did not develop sustained VT. The observed complexity, frequency and incidence of spontaneous and inducible ventricular arrhythmias in this canine model are similar to those described in patients with chronic heart failure.

Animals↗
PubMed1992

Sulphasalazine therapy in rheumatoid arthritis: qualitative changes in lymphocytes and correlation with clinical response.

Clinical and immunological parameters in 14 patients with rheumatoid arthritis (RA) receiving sulphasalazine (SASP) were evaluated, to determine whether their clinical response was reflected by any quantitative changes in their peripheral blood lymphocytes after 12 weeks. Whilst disease activity markers fell significantly, no such changes were noted in the percentage or absolute numbers of lymphocytes or their subsets. The lymphocytes of a further 21 patients before and after receiving SASP for 12 weeks were then studied qualitatively. The suppression mediated by in vitro SASP on ex vivo PHA stimulated lymphocytes showed a decrease at 12 weeks. This change was more marked and reached statistical significance only in those patients who showed a good clinical response. It is postulated that this may in some way be related to expression of activation markers and concomitant SASP binding.

Arthritis, Rheumatoid↗
PubMed1992

Mothers and daughters: a powerful spell.

An unanticipated finding of a small exploratory study of the health of never-married women in old age is discussed. Focused conversational interviews yielded evidence of the potent effect the mother-daughter relationship had in a group of women who had lived for all their adult lives in the parental home. Usually mothers had outlived fathers, and when they finally died daughters lost someone to whom they had been very close and at the same time had to cope with living alone for the first time in their lives. Three case histories, illustrating both strong positive and negative aspects of mother-daughter relationships are reported, and the psychological and sociological literature is explored. Parallels are also drawn with biographical and autobiographical literature about this type of relationship, including that of Florence Nightingale and her mother. Finally, some implications for nurses are considered and the special support needs of these women at bereavement and in old age are highlighted.

Aged↗
PubMed1992

The use of the first person in academic writing: objectivity, language and gatekeeping.

Researchers have experienced difficulties in having papers which are based on qualitative research accepted for publication because the papers have been written in the first person. Arguments are presented to show why the use of the neutral, anonymous third person is deceptive when applied to quantitative research because it obliterates the social elements of the research process. With regard to research in the qualitative, critical and feminist paradigms, it is further argued that the use of the first person is required in keeping with the epistemologies of the research and in the pursuit of reflexivity. Links are made between these arguments and the process of reviewing for academic journals. Conclusions are drawn in favour of the use of the first person, where this is appropriate to the mode of research reported and where an author is giving a personal judgement arrived at on the basis of reasonable evidence. In keeping with this position, this paper is written in the first person.

Academic Dissertations as Topic↗