The challenge of managing distinct "absence data".
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Absenteeism↗
Biomedical subjects
D Ward
Publications and source records attributed to D Ward.
Biochemical markers of sperm function: male fertility and sperm selection for ICSI.
The expression of a 70 kDa chaperone protein, HspA2 (formerly called CK-M), has been identified in mature human spermatozoa. The central role of HspA2 has been established, as the expression level of this protein is related to sperm cellular maturity, DNA integrity, chromatin maturity, chromosomal aneuploidy frequency and sperm function, including fertilizing potential. The spermiogenetic events of cytoplasmic extrusion and remodelling of the plasma membrane, which facilitate the formation of zona pellucida binding site(s) in human spermatozoa, are related. Finally, the presence of the hyaluronic acid (HA) receptor on the plasma membrane of mature sperm coupled with the HA-coated slide sperm-binding assay, facilitates the testing of infertile men and the selection of single mature spermatozoa for ICSI. Because mature spermatozoa have no residual cytoplasm, the HA-bound sperm fraction is also enriched in spermatozoa that are normal by the Kruger strict morphology method.
Aneuploidy↗
Regional subdivision in wild barley allozyme variation: adaptive or neutral?
We examined the adaptive importance of allozyme variation in wild barley (Hordeum spontaneum). The test involved a nested sampling design with four population groups, each representing a different environment, and a comparison of observed allozyme variation with that expected under the assumption that allozymes are not neutral. Measurements of plant fitness in indigenous and alien environments in reciprocal introductions of seeds and seedlings in the four environments provided a guideline for the expected pattern of allozyme variation. The results showed considerable variation in both the degree of regional and population subdivision and the pattern of the subdivision among loci. The observed pattern of variation was ambiguous. Although two alleles exhibited a pattern of distribution that cannot be explained by genetic drift as a function of geographic distance, we failed to detect either a significant relationship between genetic distance and environmental similarity or any favored epistatic allele combinations across the four environments. Our results suggest that interpretation of allozyme variation in wild barley as adaptive and directly related to local environment still needs justification. Although we could not reject the null hypothesis, a proposed methodology seeking a concordance between observed and "adaptive" (i.e., expected under hypothesis that allozymes are not neutral) allozyme variation may prove to be effective in resolving the neutralist-selectionist debate when applied to other species.
Adaptation, Biological↗
Intrinsic and extrinsic timing in stutterers' speech: data and implications.
This study examined interarticulator timing amongst stutterers and non-stutterers from the perspective of extrinsic and intrinsic timing models of speech motor control. Timing relationships were examined for an oral closure task across stress, rate, and vowel differences. Sequential aspects of extrinsic timing theories were analyzed by peak velocity sequence profiles of upper lip, lower lip, and jaw, and nonsequential aspects by sequence period (the time period covering all three of the articulator peak velocity onsets times irrespective of sequencing order). Intrinsic timing theory was modeled using phase portrait analyses of the same data. Consistently greater phase angle variability was seen amongst the stutterers, and variability was found to be significantly greater at a faster articulatory rate and when altered stress patterns were required. No group differences were found for peak velocity sequencing, but the (sequence independent) sequence period data somewhat mirrored the phase angle findings. This finding calls into question the notion that phase angle analyses reflect purely intrinsic timing phenomena.
Adult↗
Handwashing facilities in the clinical area: a literature review.
Handwashing is without doubt the most important intervention in the control of cross-infection. However, many healthcare staff do not comply with the procedure. One of the factors that contributes towards this is a lack of adequate and appropriate handwashing facilities. This article looks at the literature relating to handwashing and identifies what adequate and appropriate facilities actually are, with recommended standards for clinical areas. It concludes by highlighting that a greater commitment is needed from managers in this area in order to improve compliance with handwashing and therefore reduce infection rates.
Cross Infection↗
Infection control: reducing the psychological effects of isolation.
Although previous studies have shown that some patients, when nursed in isolation for infection control purposes, experience negative emotional effects, little research has been published which suggests what healthcare professionals can do to prevent or reduce these effects. A study was therefore carried out involving 21 patients being nursed in isolation who completed questionnaires. Five patients with negative experiences of isolation were then interviewed about the reasons for feeling the way they did and what they felt could be done to reduce or prevent negative emotions. Recommendations made from the research include the provision of written and individualized information, improved communication from medical staff, provision of a common room and better facilities to relieve boredom. Further large scale research is needed to investigate strategies to improve the isolation experience.
Adolescent↗
Implementing evidence-based practice in infection control.
Evidence-based practice is seen as a way of providing more effective health care and is considered to be vital in the current healthcare climate. However, in many areas of practice, and specifically in infection control, there is often little or no evidence to back or refute certain practices. This article looks at ritualistic practices, interventions with indirect evidence to support them and practices with overwhelming evidence in their favour which are not always followed. It is concluded that nurses need to integrate the best available evidence with clinical judgment and ensure that available evidence is disseminated appropriately.
Cross Infection↗
Ageism and the abuse of older people in health and social care.
Ageing is a natural process and yet ageism, ageist practice and abuse of older people occur among not only the general public but also in health and social care settings. Recent media reports have highlighted delays in meeting the needs of older people, physical and psychological abuse and that decisions are being made about whether or not to resuscitate an older patient without consultation with the patient and his/her family (e.g. British Journal of Nursing, 2000). This article looks at ageism and the abuse of older people and discusses what can be done to achieve quality care for older people while dealing with obstacles such as poor collaboration between agencies, a lack of support for carers and the belief that the needs of older people are less important than those of the young.
Aged↗
Expanded role of nursing in ambulatory managed care. Part I: Literature, role development, and justification.
New expanded roles in nursing are developing in response to the health system switch from private, episodic care of individuals to health maintenance organizations (HMO's) focusing on disease prevention and promotion of health for populations of persons with chronic illness. This evaluation project explored the role of the nurse clinician in population and case management at a large HMO in the Northwest United States. In Part I of this two-part series, a literature review, is presented on chronic illness, ambulatory nursing, expanded role nursing, and nursing in HMOs. The development of the expanded role nurse clinician at the managed care organization is also described. Results could be used by HMOs to attract and retain nurses, improve care processes, and decrease costs in ambulatory care.
Ambulatory Care↗
Expanded role of nursing in ambulatory managed care. Part II: Impact on outcomes of costs, quality, provider and patient satisfaction.
This evaluation project used a triangulation of methods and data sources to link the expanded role nurse clinician (NC) to outcomes of costs, quality, and satisfaction in managed care. Results of patient surveys, case studies, cost-benefit analyses, interviews, focus groups, and HMO documents suggest that the impact of the role has benefit far beyond its costs. This article builds on an earlier article (Nursing Economic$, Vol. 17, No. 1). Part I reviewed literature on expanded role nursing in population management, and described the development of the NC role. In Part II, the NC expanded role is linked to organizational outcomes of costs, quality, and satisfaction. Results here could be used by managers and planners to provide rationale for implementing expanded nursing roles in managed care in order to improve ambulatory care processes, recruit and retain nurses, reduce costs, and increase patient and provider satisfaction.
Ambulatory Care↗
Making policy decisions for insurance coverage: one nurse's role.
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Child↗
Nurses and the double duty standard.
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Economics, Nursing↗
National health insurance: where do nurses fit in?
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Health Care Rationing↗
Microkeratome lamellar corneal resection in the rabbit: a model for experimental study of the effects of Barraquer cryolathing techniques.
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Animals↗
Role of physical activity in the etiology and treatment of childhood obesity.
Children in the United States are getting fatter and less active. Some childhood obesity undoubtedly develops from overeating but underactivity contributes to this condition. Various studies document less movement and lower intensity of activity in obese youth. An increase in physical activity is desirable since the health-related fitness components of flexibility, muscular and cardiovascular endurance can be improved in addition to the primary goal of body fat reduction. Evidence from animal studies suggests that exercise may alter adipose cell proliferation as well as total fat mass if initiated during growth. Regaining the natural inclination of children to be physically active may require efforts by physicians, parents, schools and special clinics. An increase in physical activity during childhood may help prevent chronic adult diseases related to inactivity and obesity.
Activities of Daily Living↗
Gender differences in attitudes and use of condom availability programs among sexually active students in New York City public high schools.
In 1991, the New York City Board of Education expanded HIV/AIDS education to include condom availability in public high schools. A three-year study was initiated to assess the program's impact on student risk behavior, the schools' social environments, and patterns of communication about HIV/AIDS and condoms among students, their parents and teachers in 12 randomly selected New York City high schools. Findings on gender differences in both attitudes and use of the program among sexually active students are reported here. Sexually active girls' attitudes toward using condoms and the condom availability program were more positive than those of sexually active boys, yet boys were more likely to have used the program. Girls reported embarrassment and confidentiality concerns as the main deterrents to using the program. Data suggest that schools need to examine the address gender-specific attitudes that contribute to reluctance to use the program among sexually active girls.
Adolescent↗
Practical tips from clinical nurses: opinions about children visiting.
Children visiting parents in the ICU is still controversial. Here are six different opinions about children visiting from ICU nurses, an infection control practitioner, and even a parent. All view points are important to consider in providing access of children to their critically ill parents. Interestingly, even nurses who do not generally support child visitation have allowed children's visits in special circumstances and found the experience positive.
Child↗
Workers' compensation reform: 180 days in Massachusetts.
While not the usual Occupational Medicine review article, this description of the 1991 workers' compensation reforms in Massachusetts reveals some of the difficulties and possibilities inherent in such an undertaking.
Health Care Reform↗