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PubMed2001

An examination of the role and function of psychiatric nurses in clinical practice in Ireland.

AIM OF THE STUDY: The aim of the study was to describe the role and function of all grades of psychiatric nurse in clinical practice so as to clarify the nature and scope of psychiatric nursing services. BACKGROUND AND RATIONALE: The psychiatric nursing role in Ireland and the United Kingdom (UK) in recent years has undergone a period of great change. There is a new emphasis on health promotion, early intervention, community development, with nursing being provided closer to where people live and work as well as making access to services easier for vulnerable groups of the population. Role ambiguity and the difficulty with defining psychiatric nursing work is a constant theme in the psychiatric nursing literature and this leaves the profession of psychiatric nursing rather vulnerable during this period of intense change. DESIGN AND METHODS: A descriptive qualitative research design with a multimethods approach to data collection was utilized involving three disparate but complimentary methods. RESULTS AND FINDINGS: Following data analysis, nine categories of nursing role were identified; these included both independent and interdependent roles. Clearly psychiatric nursing occupied a pivotal role in all mental health care settings. A major proportion of psychiatric nursing related to caring interactions and this appears to be a central nursing element. The assessment and maintenance of patient's safety was also important as mental health problems may place the patient or others in a position where their physical safety is threatened. CONCLUSION: It is concluded that Irish psychiatric nurses have been innovative and initiated many new services in response to emerging needs. Our understanding of psychiatric nursing is far from complete and the immediate challenge is to determine the knowledge and skills base required for independent therapeutic roles in response to changing mental health care needs.

Documentation↗
PubMed2003

Doing practice differently: solution-focused nursing.

BACKGROUND: Critical thinking and reasoning take many forms; however, a problem-orientation remains the favoured approach in health care. PURPOSE: This paper considers the effects of a problem-orientation and argues that a solution-orientation fits nursing's interests more closely and represents an exciting way forward in both education and practice. DISCUSSION: Whilst a problem-focus is criticized by some, it remains largely unchallenged as the guiding light for nursing practice. A major reason is that the problem focused approach has strong cultural roots. It is deeply embedded in our thinking, and has become taken-for-granted and not often recognized or debated. Whilst problem-solving has an important place in helping to diagnose disorder and overcome difficulties, nursing needs to move beyond its borders because the role also concerns problem-free issues such as health and well-being. Creativity, imagination and focusing on strengths not problems are also important cognitive processes. CONCLUSION: A problem-orientated approach in nursing has had a constraining rather than enabling influence. By refocusing on a solution-focused approach, we could show how we are different from medicine, and how we aim to do nursing differently through using skills such as engagement, resilience-building, community development, primary health care and health education.

Education, Nursing↗
PubMed2002

Distribution of genotypes of F-specific RNA bacteriophages in human and non-human sources of faecal pollution in South Africa and Spain.

AIMS: To assess whether the distribution of genotypes of F-specific RNA bacteriophages reflects faecal pollution of human and animal origin in water environments. METHODS AND RESULTS: Stool samples, animal feedlot waste slurries and a wide variety of faecally polluted waters were studied in South Africa and Spain. Genotyping was performed by plaque and spot hybridization with genotype-specific probes. Only genotypes II and III were detected in human stool. Animal faeces contained predominantly, but not exclusively, genotypes I and IV. Raw hospital and municipal sewage contained mostly genotypes II and III, whereas genotypes I and II prevailed in settled sewage, secondary treated sewage and non-point diffuse effluents from developing communities. Abattoir wastewaters contained mostly genotypes I and IV. No differences were observed between the distribution of genotypes in Spain and South Africa. CONCLUSIONS: Although the association of genotypes II and III with human excreta and I and IV with animal excreta was statistically significant, the results suggest that the association cannot be used for absolute distinction between faecal pollution of human and animal origin. SIGNIFICANCE AND IMPACT OF THE STUDY: This study contributes greatly to understanding the usefulness of genotypes of F-specific RNA bacteriophages in source tracking of faecal wastes.

Animals↗
PubMed2000

Changes in community composition during dilution cultures of marine bacterioplankton as assessed by flow cytometric and molecular biological techniques.

Dilution cultures are a common technique for measuring the growth of bacterioplankton communities. In this study, the taxonomic composition of marine bacterioplankton dilution cultures was followed in water samples from Plymouth Sound and the English Channel (UK). Bacterial abundances as well as protein and DNA content were closely monitored by flow cytometry. Denaturing gradient gel electrophoresis (DGGE) of polymerase chain reaction (PCR)-amplified 16S rDNA fragments and fluorescence in situ hybridization (FISH) were applied directly to the water samples and to cells sorted from the dilution cultures based on their protein and DNA content. As expected, a rapid activation of bacteria occurred. However, molecular techniques showed that the community developed in the dilution culture within 1 day was significantly different from that in the original water samples. Whereas in the original samples, cells detectable by FISH were dominated by members of the Cytophagal Flavobacterium (CF) cluster, in dilution cultures, gamma-proteobacteria accounted for the majority of cells detected, followed by alpha-proteobacteria. An actively growing and an apparently non-growing population with average cellular protein contents of 24 and 4.5 fg respectively, were sorted by flow cytometry. FISH indicated mostly gamma- (64%) and alpha-proteobacteria (33%) in the first active fraction and 78% members of the CF cluster in the second fraction. Sequencing of DGGE bands confirmed the FISH assignments of the latter two groups. The data presented clearly show that even relatively short-term dilution experiments do not measure in situ growth, but rather growth patterns of an enrichment. Furthermore, it was demonstrated that the combination of flow cytometric analysis and sorting combined with FISH and DGGE analysis presented a fairly rapid method of analysing the taxonomic composition of marine bacterioplankton.

Animals↗
PubMed2000

Effects of O2 and CH4 on presence and activity of the indigenous methanotrophic community in rice field soil.

The activity and distribution of methanotrophs in soil depend on the availability of CH4 and O2. Therefore, we investigated the activity and structure of the methanotrophic community in rice field soil under four factorial combinations of high and low CH4 and O2 concentrations. The methanotrophic population structure was resolved by denaturant gradient gel electrophoresis (DGGE) with different PCR primer sets targeting the 16S rRNA gene, and two functional genes coding for key enzymes in methanotrophs, i.e. the particulate methane monooxygenase (pmoA) and the methanol dehydrogenase (mxaF). Changes in the biomass of type I and II methanotrophic bacteria in the rice soil were determined by analysis of phospholipid-ester-linked fatty acid (PLFA) biomarkers. The relative contribution of type I and II methanotrophs to the measured methane oxidation activity was determined by labelling of soil samples with 14CH4 followed by analysis of [14C]-PLFAs. CH4 oxidation was repressed by high O2 (20.5%), and enhanced by low O2 (1%). Depending on the CH4 and O2 mixing ratios, different methanotrophic communities developed with a higher diversity at low than at high CH4 concentration as revealed by PCR-DGGE. However, a prevalence of type I or II populations was not detected. The [14C]-PLFA fingerprints, on the other hand, revealed that CH4 oxidation activity was dominated by type I methanotrophs in incubations with low CH4 mixing ratios (1000 p.p.m.v.) and during initiation of CH4 consumption regardless of O2 or CH4 mixing ratio. At high methane mixing ratios (10 000 p.p.m.v.), type I and II methanotrophs contributed equally to the measured CH4 metabolism. Collectively, type I methanotrophs responded fast and with pronounced shifts in population structure and dominated the activity under all four gas mixtures. Type II methanotrophs, on the other hand, although apparently more abundant, always present and showing a largely stable population structure, became active later and contributed to CH4 oxidation activity mainly under high CH4 mixing ratios.

Alcohol Oxidoreductases↗
PubMed1999

Methodology of the VECAT study: vitamin E intervention in cataract and age-related maculopathy.

Cataract is the leading cause of blindness in the world today, while age-related macular degeneration is responsible for the majority of new cases of visual impairment in the Western world. There is a growing body of evidence suggesting a role for antioxidant therapy to prevent the progression of these conditions. A 4-year prospective, randomised, controlled trial of an antioxidant versus placebo in a population of healthy volunteers aged 55-80 years at enrolment is described. This paper outlines the primary aims of the Vitamin E, Cataract and Age-related Macular Degeneration (VECAT) Study, the methodology, and the recruitment rates. Additional data on the toxicity and non-ocular effects of vitamin E will also be collected. Standardised clinical grading of macular and lens features, and comparison of serial macular photographs and digital lens photographs will form the basis for assessment of primary study outcomes. Information collected in this study will assist in the assessment of the potential value of antioxidants in preventing the enormous burden imposed on developed communities by age-related eye disease. In addition, important data on prevalence and progression rates of cataract and macular degeneration will be collected.

Aged↗
PubMed2003

Control of endemic dracunculiasis in Ebonyi state, south-eastern Nigeria.

A field study was carried out in Ozibo and the Ebonyi local government area of Ebonyi state, south-eastern Nigeria to determine the effectiveness of several intervention strategies in the control of endemic dracunculiasis in that area. During the initial study prior to the application of such measures, 14,421 subjects were examined. A total of 8,688 (60.2%) persons had either Dracunculus ulcers or emergent worms. Sex-related prevalence rates were 56.1% and 63.9% for males and females respectively. Age specific prevalence rates increased with age in males, whereas highest infection rates were found in females younger than 20 years. Twenty-eight months after the introduction of intervention strategies the prevalence rate fell by 85.1% to 9% (males: by 88.2% to 6.6%, females: by 83.0% to 10.8%). Reduction rates of more than 90% were observed in males aged 10 to 19 and in females aged 0 to 9 years. Intervention measures included systematic pond treatment, distribution or replacement of filters, intensive health education, provision of hand-dug wells, regular bore-hole installation/rehabilitation as well as active case detection, containment, management, and prompt reporting. Active involvement of the endemic communities, governments and the Global 2000 staff regarding the control efforts is a necessity towards the final eradication of the disease in the near future. The relationship between some of these intervention strategies and community development are highlighted.

Adolescent↗
PubMed2006

Understanding the internet-based distance learning preferences of European respiratory specialists.

We studied the learning preferences of 160 respiratory specialists from four European countries who participated in ten internet-based learning modules and answered linked survey questions. Specialists were enthusiastic for internet learning amongst all national groups and particularly wanted to access material for teaching others. The value of social interactive learning was acknowledged but British and German subjects appeared more reluctant to participate. Internet delivered distance learning is well perceived amongst respiratory specialists. There is potential for both individual and group learning that could be realized by developing Europe-wide continuing professional development communities.

Choice Behavior↗
PubMed1998

Astrovirus infection in South Africa: a pilot study.

Astroviruses have been shown to be important aetiological agents associated with gastroenteritis in children, as have rotaviruses and the enteric adenoviruses. However, no inclusive studies have been conducted in South Africa to allow a comparison of the relative roles of these different viral agents. In this study, stool specimens were obtained between 1991 and 1993 from 225 young children with acute gastro-enteritis. These were examined for the presence of astroviruses using a monoclonal antibody-based ELISA, and for rotaviruses and enteric adenoviruses using commercially available kits. A control group of 56 infants and young children without symptoms of diarrhoeal illness was included in the study. Astroviruses were detected in 7% of the stools compared with 20% infected with rotaviruses and only 3% infected with enteric adenoviruses. In the control group, one specimen each had astrovirus or adenovirus and two shed rotaviruses. The astrovirus prevalence observed in this study is similar to that reported in other developing communities. Rotavirus and astrovirus infections were more prevalent in the autumn and early winter than in other seasons. Astrovirus and rotavirus infections predominated in children between 3 and 22 months of age.

Adenoviridae↗
PubMed2005

Biofilm formation by bacterial associations under various salinities and copper ion stress.

The study addresses the effect of abiotic (medium salinity and copper ions) and biotic (interactions between populations) factors on the formation of structured communities by binary associations consisting of halotolerant bacteria (Alcaligenes sp. 1-1 or Acinetobacter sp. 1-19) and a wild-type B. subtilis 2335 strain or a transgenic strain. The results showed that 250 mg l(-1) of copper ions inhibit formation of biofilms by monocultures of the tested strains. Binary associations of the strains were more resistant to high concentrations (250 mg l(-1)) of copper ions. At the lowest NaCl concentration (0.05% and 2.5%) and in the presence of copper ions, bacilli seemed to help halotolerant bacteria survive. Under increased salinity and in the presence of copper ions, structured communities developed due to halotolerant bacteria. Coexistence under stressful conditions was beneficial for the both groups of bacteria.

Acinetobacter↗
PubMed1991

Towards a model for the provision of comprehensive services for non-English speaking communities.

People from non-English speaking backgrounds (NESB) tend to utilize Australian health and welfare services less than those people born in Australia. There is also evidence that migrants to Australia tend to increase their consumption of alcohol and other drugs once they have settled. Therefore, NESB people should be a priority focus for the provision of comprehensive services for the prevention and treatment of alcohol and other drug-related problems. To date there has not been a co-ordinated approach to the provision of alcohol and other drug services to NESB communities. This paper proposes a model for the provision of such services, and uses the Sydney Arabic-speaking Lebanese community as an example. This model draws upon available literature and incorporates strategies of community development, namely networking and dissemination of information, and directs efforts at three levels of intervention.

Journal Article↗
PubMedDate not supplied

Antibiotic resistance: who is winning the war? Introductory remarks.

The evolutionary response of bacteria, fungi, viruses, and parasites to the selective pressure exerted by antimicrobial agents is the emergence of populations that resist the action of the antimicrobial. The emergence and dissemination of such resistance in a variety of these pathogens is a growing public health concern. In response, the scientific community developed an action plan to address this public health issue. Antimicrobial, antifungal, and antiviral drug development for the treatment of diseases caused by resistant pathogens is one component of this strategy. In addition, due to the targeting of specific drugs against resistant pathogens, we may more readily accept a given drugs toxicity profile for the added therapeutic benefit. This symposium provides a discussion of the modes of action and mechanisms of resistance to antimicrobial agents, and the use of surveillance systems to help understand the nature and magnitude of resistance. The goal is to help guide antimicrobial drug product development and use. Specific toxicity issues are presented that should be considered in phase 1 development of antimicrobial drug products for use in clinical medicine and veterinary medicine. Finally, the national and global strategies developed by federal agencies in the Public Health Action Plan to Combat Antimicrobial Resistance are outlined.

Animals↗
PubMed2001

Drug treatment services for ethnic communities in Victoria, Australia: an examination of cultural and institutional barriers.

Under-representation of ethnic minorities at drug treatment services represents under-utilisation rather than a lower need. To explore barriers to drug treatment among ethnic communities we undertook a comprehensive review of international and Australian literature to identify problems their members experience upon the discovery of illicit drug use in their community, how drug treatment is addressed and challenges for improved drug treatment outcomes. The concepts and themes derived from the literature were then compared with our research findings from key informant interviews and consultations with non-illicit drug-using spokespersons from eight ethnic communities in Victoria, Australia. Intense shame and loss of face linked to illicit drug use was common in ethnic communities and as a consequence seeking help for drug treatment was fraught with difficulties. Accessing drug treatment services often occurred following a crisis, but a sense of despair and confusion often prevailed owing to a lack of knowledge of available assistance. Even when treatment services were accessed most key informants and ethnic communities viewed them as culturally insensitive, inflexible and with language barriers that obstructed the flow of effective information. Understanding of the ethnic family ethos was of pivotal importance but frequently ignored by treatment services, contributing to the exclusion of ethnic communities from appropriate assistance. Ethnic communities need to be assisted to participate in drug issue discussions and community development strategies in order for their utilisation of drug treatment services to be improved.

Communication Barriers↗
PubMedDate not supplied

Mental health initiatives as peace initiatives in Sri Lankan schoolchildren affected by armed conflict.

The Health Reach Sri Lanka project (1993-96) is described. It was a school-based assessment of children's exposure to war-related events and the presence of psychological distress, undertaken in six communities in parts of Sri Lanka variously affected by armed conflict. Its objectives, methods and results are presented. The research project aimed to raise national awareness of the psychosocial effects of armed conflict on children, using a community-development approach to local capacity building, based on the 'health initiative as peace initiative' model. As a follow-up to the study, a locally run programme, based on creative play and trauma-healing, was established, initially for the children involved in the study. This was later extended to other children in the district affected by armed conflict.

Child↗
PubMed2005

The children's size-ordering task: a new measure of nonverbal working memory.

We present a new measure of nonverbal working memory for children, entitled the Children's Size-Ordering Task (CSOT). Two separate studies were conducted to test the utility of and partially validate this measure. Three specific hypotheses were investigated, namely that: (1) CSOT performance would correlate with age; (2) the CSOT would correlate with established measures of working memory; and (3) children with ADHD would exhibit weaker performance on the CSOT relative to typically developing community control children. Participants across both studies included 50 children with ADHD and 50 control children matched by age and gender. Collectively, the results of both studies supported all three hypotheses. These findings lend support to the CSOT as a valid and effective measure of nonverbal working memory.

Adolescent↗
PubMed2002

The development of acute exposure guideline levels for hazardous substances.

The National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances (NAC/AEGL) was created to develop guideline levels for short-term exposures to airborne concentrations for approximately 400-500 high priority, acutely hazardous substances. The program should be completed within the next 10 years. These Acute Exposure Guideline Levels (AEGLs) are being applied to a wide range of planning, response, and prevention applications both within the United States and abroad. The NAC/AEGL Committee seeks to develop the most scientifically credible, acute (short-term) exposure guideline levels possible within the constraints of data availability, resources and time. The program begins with comprehensive data gathering, data evaluation and data summarization. The resulting Technical Support Documents (TSD) are first reviewed by a small review committee; (chemical manager, two chemical reviewers and the author), then by the full AEGL committee. After that review, a summary is published in the Federal Register for Public comment. When these comments have been addressed, the TSDs are sent to the National Research Council's (NRC) Subcommittee on AEGLs for a peer review. Following acceptance by the NRC, they are published by the Academy. The NAC/AEGL Committee currently comprises representatives of federal, state, and local agencies and representatives from France, Germany, and the Netherlands, private industry, medicine, academia and other organizations in the private sector that will derive programmatic or operational benefits from the existence of the AEGL values. AEGL values are determined for three different health effect end-points. These values are intended for the general public where they are applicable to emergency (accidental) situations. Threshold exposure values are developed for five exposure periods (10 and 30 min, 1 h, 4 h, 8 h). Each threshold value is distinguished by varying degrees of severity of toxic effects, as initially conceived by the American Industrial Hygiene Association's Emergency Response Planning Committee, subsequently defined in the NAS' National Research Council publication of the Guideline for Developing Community Emergency Exposure Levels for Hazardous Substances and further categorized in the Standing Operating Procedures of the NAC/AEGL Committee. To date, the committee has reviewed almost 100 chemicals.

Air Pollutants↗
PubMed2004

Impact of supply-side ecology on consumer-mediated coexistence: evidence from a meta-analysis.

Studies of marine nearshore hard substrates have demonstrated that consumers and abiotic disturbances can remove biomass, clearing space for species that are competitively subordinate and subsequently increasing diversity. However, studies often examine the impact of these space-opening forces on diversity in isolation from other potentially interacting factors. In marine systems, space can be closed by recruitment decoupled from local populations. Therefore, we investigated how recruitment influences the impacts of consumers on diversity with a meta-analysis of 27 experiments of community development involving sessile species on marine hard substrates. These studies allowed quantification of recruitment rates, consumer pressure, and species richness of primary space occupants. This meta-analysis demonstrated that consumers generally increase diversity at high levels of recruitment but decrease diversity at low levels of recruitment. Therefore, species diversity of sessile species is controlled by the interaction between forces that open (predation and herbivory) and close (recruitment) space.

Animals↗