PubMed Health⌕ Search

Biomedical subjects

C Hicks

Publications and source records attributed to C Hicks.

At least 19 recordsLinked to original sources
PubMed1998

A triangulation approach to the identification of acute sector nurses' training needs for formal nurse practitioner status.

The current confusion surrounding the definition and role function of the nurse practitioner (NP) has created a situation in which advanced clinical practice is delivered in a variety of ways and at many levels. Not surprisingly, this has led to difficulties in regulating educational provision for NPs. This study reports a survey of the perceptions of the role definitions and training needs of all nurses working at advanced clinical levels within an acute sector Trust. Although this concept is not a novel one in advanced nursing practice, the procedure adopted differed from previous studies in two fundamental ways: firstly, a unique training needs assessment instrument was used, which because of its validity and opacity, was capable of yielding a highly reliable data-base, comprising a prioritized profile of real training needs as opposed to the standard wish-list typically elicited. Secondly, it did not rely simply on the self-reported needs of the nurse sample, but also included the perceptions of the sample's immediate medical and managerial colleagues. In this way, a triangulation paradigm was adopted. The results indicated that overall, there was high agreement between the nurses and their managers, regarding both the definition of the NP role and the essential training requirements, with somewhat different opinions being offered by the medical staff. When the raw scores were standardized to correct for response bias, the data provided an operational definition of the role of the NP and a prioritized profile of training needs for nurses who wished to train to this level.

Clinical Competence↗
PubMed1998

Selection index updating for maximizing rate of annual genetic gain in laying hens.

Four selection strategies aimed at maximizing egg production in laying hens were compared with respect to expected annual genetic gain (GA). The selection strategies were: 1) (S1P) Traditional single-stage selection based on a single-house production system using partial records for both the individual and its ancestors, 2) Single-stage selection based on a single-house production system using full records for both the individual and its ancestors (S1F), 3) Single-stage selection based on a two-house production system using partial records for the individual and full records for its ancestors (S2P), and 4) Multistage selection based on a two-house production system using partial records for the individual and all available ancestral records (M2P). Strategy M2P resulted in the shortest generation interval (0.538 yr) and was the most efficient (deltaGA4 = 3.620 eggs per year), whereas strategy S1F generated the longest generation interval (2 yr) and was the least efficient (deltaGA2 = 1.334 eggs per year). Strategies S1P and S2P resulted in generation intervals of 1 yr, and were intermediate in efficiency (deltaGA1 = 2.232 eggs per year, deltaGA3 = 2.593 eggs per year). It was concluded that a two-house production system utilizing multistage selection was the most effective selection methodology. Further, selection based on M2P is expected to improve persistency of lay, whereas selection on S1P will not.

Animals↗
PubMed1997

Neuroprotective effects of the antioxidant LY231617 and NO synthase inhibitors in global cerebral ischaemia.

Recent studies have shown that the novel antioxidant LY231617 protects against ischaemia-induced neuronal damage in rat models of global cerebral ischaemia. In the present studies we have examined the effects of LY231617 in the gerbil model of global cerebral ischaemia. We also examined the effects of four nitric oxide synthase inhibitors (3-bromo-7-nitroindazole, N(G)-nitro-L-arginine methyl ester, aminoguanidine and S-methylisothiourea sulphate) in this model. LY231617 (50 mg/kg p.o. or 30 mg/kg i.p.) was administered either 30 min prior to occlusion or immediately post-occlusion followed by three further doses at 4, 24 and 48 h after the initial dose. 3-Bromo-7-nitroindazole was administered at 40 mg/kg i.p. immediately after occlusion followed by 20 mg/kg i.p. at 3, 6, 24 and 48 h, N(G)-nitro-L-arginine methyl ester was administered at 10 mg/kg i.p. immediately after occlusion followed by 5 mg/kg i.p. at 3, 6, 24 and 48 h. Aminoguanidine was administered at 80 mg/kg i.p. immediately after occlusion followed by 40 mg/kg i.p. at 3, 6, 24 and 48 h and S-methylisothiourea sulphate was administered at 10 mg/kg i.p. immediately, 3, 6, 24 and 48 h after occlusion. We also examined the effects of aminoguanidine administered at 80 mg/kg i.p. immediately after occlusion followed by 40 mg/kg i.p. at 3, 6, 24, 48, 72 and 96 h and S-methylisothiourea sulphate administered at 10 mg/kg i.p. immediately, 3, 6, 24, 48, 72 and 96 h after occlusion. Control animals were either sham operated or subjected to 5 min bilateral carotid occlusion. Extensive neuronal death was observed in the CA1 layer of the hippocampus in 5-min bilateral carotid artery occluded animals 5 days after surgery. LY231617 provided significant neuroprotection against the ischaemia-induced brain damage when administration was initiated before or after occlusion (P < 0.05). The neuronal NO synthase inhibitors, 3-bromo-7-nitroindazole and a general NO synthase inhibitor, N(G)-nitro-L-arginine methyl ester also provided significant neuroprotection (P < 0.05). In contrast aminoguanidine and S-methylisothiourea sulphate (two inducible NO synthase inhibitors) failed to protect against the ischaemia-induced brain damage. These results indicate that free radicals and nitric oxide are involved in ischaemia-induced brain damage following global cerebral ischaemia. Antioxidants such as LY231617 or neuronal NO synthase inhibitors can prevent the ischaemia-induced neurodegeneration and may be useful as anti-ischaemic agents.

Animals↗
PubMed1997

Aims, processes and problems of antenatal education as identified by three groups of childbirth teachers.

OBJECTIVE: To establish whether variations exist in the philosophy and approach of three groups of childbirth teachers working in different organisations in the UK. PARTICIPANTS: Two midwifery Parentcraft Sisters working in the UK maternity services, three National Childbirth Trust Antenatal Teachers and two Active Birth Teachers working in the voluntary sector, and two Midwife Teachers. METHOD: Semi-structured interviews were tape-recorded, transcribed and analysed using a grounded theory approach to identify common categories. FINDINGS: All three groups of teachers identified similar aims for antenatal education, with the need to build clients' confidence in their ability to give birth and care for their babies as the most important. However, the process by which the various teachers attempted to realise their aims appeared to be very different. IMPLICATIONS FOR PRACTICE: In order to ensure the prioritization of antenatal education with purchasers and providers, childbirth teachers need to define more clearly the criteria by which it can be audited.

Attitude of Health Personnel↗
PubMed1997

Mixed messages in nursing research: their contribution to the persisting hiatus between evidence and practice.

The current emphasis in the United Kingdom on evidence-based health care requires that medical and non-medical professionals ensure that their clinical practice is founded on scientifically derived findings rather than on intuition and ritual. To this end, many initiatives have been introduced which are intended to increase both the corpus of available research evidence and the extent to which it informs practice. To date, however, there has been a disappointing shortfall in published research in the paramedical domain, which has been largely attributed to a number of structural and organizational issues. This paper suggests that confusion about what constitutes valid and useful research may be an additional significant contributory factor in the documented research/practice hiatus. Moreover, the emphasis on experimentation and Randomized Controlled Trials (RCTs), with the relative marginalization of alternative, more qualitative forms of research may seriously limit the nursing research data-base because of its inappropriateness for many nursing investigations. It is suggested that a more eclectic approach to evidence-based care is considered, with more attention being diverted to qualitative methodologies at the funding and dissemination stages. In this way, a comprehensive and balanced overview of relevant information can be obtained which has the potential to influence some of the less quantifiable aspects of care delivery.

Attitude of Health Personnel↗
PubMed1997

The use of a customized training needs analysis tool for nurse practitioner development.

The role and professional boundaries of the nurse practitioner (NP) in the UK have not yet been unequivocally defined. This confusion has served to limit the expansion of the NP in both the acute and primary care sectors, despite a mounting body of evidence that attests to their value. This lack of coherence has necessarily impacted upon the educational provision currently available for NP development, with a range of courses of variable nature and standards being provided. The lack of nationally agreed educational criteria and the importance of taking account of local needs, together suggest that a formal training needs analysis might be valuable in systematizing and unifying the present position. Such a survey would have the function of informing both the definition and regional training requirements of NPs, provided the data were obtained through the use of a reliable assessment instrument. To this end a total population survey of all nurses employed in general practice within a large regional health authority was undertaken, using a psychometrically valid and reliable training needs analysis questionnaire. The information obtained provided a preliminary definition of the NP role and a clear index of the content and level of prospective educational provision. In addition, the survey offered an estimate of the numbers of potential participants on NP courses, by FHSA and preferred educational institution. In this way, the use of a scientifically constructed and specifically customized training needs analysis tool may have the potential to inform precise educational commissioning, thereby rationalizing resources and enhancing the quality of both training and ultimate care provision.

Adult↗
PubMed1997

Identifying training objectives: the role of negotiation.

Current training initiatives for health care professionals tend to be based on management assumptions of need or on the wish-list demands of potential course attenders. Each approach has major disadvantages, in that neither has the capacity to simultaneously satisfy the organization's objectives, whilst maintaining the motivation and commitment of the participants. This short report discusses an alternative approach that used a valid and reliable training needs analysis instrument with nurses and managers to inform Nurse Practitioner development. The results facilitated the commissioning of relevant education courses, clarified new role boundaries and acted as an agent for negotiation and change between the two groups.

Curriculum↗
PubMed1997

Morbidity in the preterm infant with mature lung indices.

This study was designed to evaluate neonatal morbidity and mortality following preterm delivery in the setting of mature amniotic fluid pulmonary studies. We performed a retrospective analysis of all pregnancies resulting in preterm deliveries (< 37 weeks) from 1/1/88 to 5/31/92 in which there was a "mature" phospholipid profile, defined as positive phosphatidylglycerol (PG) or lecithin/sphyngomyelin (L/S) ratio > or = 2 determined within 1 week of delivery. Excluded were multiple gestations, diabetic pregnancies, and fetal or neonatal abnormalities involving the cardiovascular, renal, or pulmonary tract. Main outcome measures were incidence of significant neonatal morbidity, including respiratory distress requiring respiratory support, sepsis, patent ductus arteriosus, grade 3-4 intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, meningitis, and pneumonia. A total of 153 patients fulfilled the inclusion criteria. Mean (SD) gestational age at delivery and birth weight were 33.8 (2.1) weeks and 2298 (561) g, respectively. There were no neonatal deaths, but significant morbidity was present in 20% (31/153) of cases. The most common major neonatal complications were respiratory distress (12%) and suspected or documented sepsis (16%). Univariate analysis showed that frequency of major neonatal morbidity was related to gestational age at delivery (p < 0.001), birth weight (p < 0.001), Apgar score at 5 minutes < 7 (p = 0.008) and method of lung maturity assessment (complications were ore frequent when lung maturity was defined by L/S > or = 2 than by PG positivity) (p = 0.02). Multivariate analysis demonstrated a significant association between the presence of a neonatal complication and method of lung maturity assessment after adjustment for gestational age at delivery (p = 0.04). The incidence of major neonatal complications among preterm infants is high even in the presence of mature fetal lung studies; this incidence is related primarily to the gestational age at birth, and secondarily to the method of lung maturity testing (complications are less common in the presence of PG positivity than of L/S > or = 2).

Amniotic Fluid↗
PubMed1997

Validation of a vignette simulation of assault on nurses by patients.

PURPOSE: To determine the degree to which causal attribution ("blame") scores obtained from written vignettes of assault incidents, simulations of reality, reflect results that would be obtained from victims of actual assaults. DESIGN: Correlational study. Data were collected, 1990-1993, from a convenience sample of 59 RNs who had been assaulted verbally or physically at one neuropsychiatric hospital in the United States. METHODS: Victims used the Causal Attribution Scale to assign blame for their assault. Three judges then used the same scale to attribute cause for the assault based on a written description of the assault by the victim. FINDINGS: No significant differences in mean causal attribution levels were found between victims and the average ratings for the three judges for mild or severe assaults, nor between victims, judges, and the response levels obtained in two previous vignette studies. CONCLUSIONS: Mean causal attribution ("blame") scores observed in simulations that are carefully constructed assault vignettes are nearly the same as those observed in actual assaults. Vignettes appear promising as a simulation to study actual or hypothetical responses to assault.

Adult↗
PubMed1997

Identification of PDGF receptors on human megakaryocytes and megakaryocytic cell lines.

Platelet-derived growth factor (PDGF) is a potent chemotactic and mitogenic factor implicated to play important roles in a variety of normal and pathophysiologic settings. We investigated PDGF receptor expression on human megakaryocytes and several megakaryocytic cell lines (CHRF, DAMI, Meg-01, M-07e) using enzyme-linked immunosorbent assay (ELISA), flow cytometry and immunocytochemical staining. Both PDGF receptor subtypes were identified on CHRF, DAMI, and Meg-01 cells by ELISA; PDGF beta-receptor levels exceeded alpha-receptor levels. Flow cytometry revealed that beta-receptor levels on CHRF and DAMI cells exceeded those on Meg-01 cells, and that M-07e expressed neither receptor. Immunocytochemical staining confirmed these findings and determined that bone marrow megakaryocytes also expressed PDGF receptors. Exposure of megakaryocytes to PDGF-BB dramatically induced the expression of the immediate-early gene, c-fos, within 30 min. Moreover, PDGF-BB significantly stimulated CHRF proliferation and colony formation. The present study demonstrates the presence of functional PDGF receptors on human megakaryocytes and their ability to mediate a mitogenic response.

Cell Line↗
PubMed1996

Neuroprotective effects of 7-nitroindazole in the gerbil model of global cerebral ischaemia.

To evaluate the role played by nitric oxide in global cerebral ischaemia we examined the effects of 7-nitroindazole and a sodium salt of 7-nitroindazole (inhibitors of neuronal nitric oxide (NO) synthase) and NG-nitro-L-arginine methyl ester (a more general inhibitor of NO synthase) in the gerbil model of cerebral ischaemia. Four experiments were carried out. In the first experiment, animals were either sham-operated, subjected to 5 min bilateral carotid occlusion (BCAO) or administered 7-nitroindazole or NG-nitro-L-arginine methyl ester immediately after occlusion followed by three further doses at 3, 6 and 24 h post-occlusion. In the second experiment, we examined the effects of a sodium salt of 7-nitroindazole, which is more soluble than 7-nitroindazole, using the same protocol. In the third experiment, the effects of the sodium salt of 7-nitroindazole administered at 10 mg/kg at 0, 3, 6, 24, 27, 30, 33, 52, 55, 72, 75 and 78 h post-occlusion or at 0.05 mg/h for 72 h via mini-pumps were evaluated. In separate experiments, we examined the effects of three reference compounds dizocilpine (MK-801), 2, 3-dihydroxy-6-nitro-7-sulphamoyl-benz(F)-quinoxaline (NBQX) and eliprodil using the same model. Extensive neuronal death was observed in the CA1 layer of the hippocampus in 5 min bilateral carotid occluded animals 5 days after surgery. Both 7-nitroindazole and NG-nitro-L-arginine methyl ester provided significant neuroprotection (P < 0.01) against this neuronal death. The sodium salt of 7-nitroindazole showed no protection when administered up to 12 times post-occlusion, but did provide significant (P < 0.01) neuroprotection when administered via mini-pump. The neuroprotection was similar to that provided by MK-801 and eliprodil, but not as good as that observed with NBQX. These results indicate that nitric oxide plays a role in ischaemic cell death and that selective neuronal nitric oxide synthase inhibitors can protect against ischaemic brain damage.

Animals↗
PubMed1996

Nurse researcher: a study of a contradiction in terms?

Despite considerable top-down pressure and numerous professional body initiatives, a persistent shortfall in published nursing research has been noted. Numerous explanations have been put forward to account for this which implicate issues at both the individual/psychological and the structural/ organizational levels. However, one area which has not yet been properly addressed is that of role appropriateness, in that research skills and activities may be construed as being incompatible with the traditional role expectations and values of nursing. To test this proposition, two groups of qualifed nurses were each required to consider six descriptors of an imaginary nurse following the paradigm of Asch's (1946) seminal Central Trait Theory study. Of these, five adjectives were identical for both groups, but the sixth descriptor was manipulated, such that one group received "good clinician' and the other "good researcher'. The subjects then had to rate this imaginary nurse along each of 15 bipolar traits. The groups' ratings were compared using a series of unrelated t-tests. The results indicated that if a nurse was described as a good researcher she or he was also assumed to be more ambitious, a poorer communicator, less kind, stronger, more logical, more controlled, more confident, less popular, more ruthless, more rational and more analytical than if she or he was described as a good clinician. These findings suggest that the qualities attributed to a good nurse are dissonant with those attributed to a good researcher and, in this way, the mutual incompatibility of each role's requirements may serve as an obstacle to the development of research with nursing.

Clinical Competence↗
PubMed1996

A study of nurses' attitudes towards research: a factor analytic approach.

Despite considerable top-down pressure on nurses to undertake research, the available evidence suggests that relatively few nursing studies are submitted for publication. Given the need to increase the degree to which research informs practice, this shortfall in output must of necessity constitute a cause for concern. Therefore, it seems timely that a full-scale investigation into the possible reasons for non-submission is conducted. This study, therefore, in an attempt to meet this aim, used factor analysis on the scores from an attitude-to-research scale completed by 230 nurses. The results suggested that five coherent factors underpinned the sample's general attitudes to research. These were labelled 'nurses' subjective barriers to research', 'organizational/structural barriers to research', 'doctors' reactions to nursing research', 'health care professionals' reactions to research' and 'impact of nursing research'. The variables clustering on two of these factors suggested a predictive relationship with two relevant outcome behaviours relating to research. When this was tested, the predictions were supported, indicating that these factors could be used as a quick and simple screening tool to highlight individuals or groups of nurses who might benefit maximally from specific attitude change programmes. In this way, it might be possible to increase nursing research activities and output.

Attitude of Health Personnel↗
PubMed1996

The potential impact of gender stereotypes for nursing research.

The move towards evidence-based health care has meant an increasing pressure on paramedical professionals to become more research aware and research active. However, despite various initiatives designed to encourage research, there remains within nursing a notable paucity of relevant published research. While numerous explanations have been put forward in an attempt to account for this shortfall, they have tended to focus on structural/organizational barriers rather than difficulties located at the individual level. However, Hicks, in studies of midwives and nurse managers suggests that one critical perspective may be the stereotypes and assumptions associated with the nursing profession, these being so diametrically opposed to the core skills required of researchers that they operate as a natural deterrent to research activities of any sort. Embedded within this theory is the notion of gender roles, which are archetypally feminine for nursing yet archetypally masculine for research. However, Hicks' studies, which were both variants of Asch's Central Trait Theory, focused on women both as the hypothetical subject of the exercise involved and as participants. If research is bound up with gender attributions in the way she suggests, it would be necessary to ask if this is still relevant when the gender of the hypothetical figure at the centre of the study is changed. To this end, the present study was conducted which, apart from the modification just highlighted, was a replication of Hicks' earlier studies. In brief, two groups of participants rated a hypothetical male candidate for a nursing post along 15 bipolar dimensions. The candidate had been described by his referee using six adjectives, of which five were identical for each group. However, the final phrase used to describe the first group's candidate was "good clinician' while for the second group it was "good researcher'. The ratings given by the two groups along the 15 dimensions were then compared. It was found that the male applicant described as a good researcher was assumed to be more successful, more ambitious, more confident and more ruthless than one described as a good clinician. The implications of these results are discussed in relation to gender theories and nursing research.

Adult↗
PubMed1996

Investigating attitudes to research in primary health care teams.

Despite top-down professional body and government agency pressure to increase the research base of clinical practice, there remains a considerable body of evidence which suggests that many ineffective, and even dangerous, health care interventions continue to be practised in areas where there are significant contradictory findings. While numerous explanations have been put forward which implicate the role of structural, organizational and informational barriers to integrating research with practice, less attention has been focused on the individual and psychological contributions. The study reported here forms part of a larger scale project aimed at developing a diagnostic instrument for identifying research training needs, in the widest sense, within primary health care groups. To provide the instrument with content validity, following formal psychometric guidelines, opaque and transparent techniques of data collection were employed at the development stage. This yielded some interesting and unexpected results from the respondents, which suggested that despite overt statements to the contrary, the majority of the primary health care professionals studied perceived research as being unimportant and peripheral to their jobs, and the responsibility of other health care professionals. Moreover, the subjects' understanding of research and its methodologies was discordant both within and across professional groups. The implications of these results from this pilot phase suggest that fundamental and deep-seated attitudes which are resistant to research may be a contributory factor to the persistence of ritualistic, non-evidence-based care.

Attitude of Health Personnel↗
PubMed1996

The relationship of behavioral cues to assaultive behavior.

The purpose of this 2-year, case control study was to determine whether differentiation between assaultive and nonassaultive patients can be made based on behavioral assessments and/or sociodemographic variables. For each assault incident, the chart of the patient who assaulted and a randomly chosen patient who did not assault on that day were reviewed (N = 72 subjects or 26 pairs). Various scales were used to evaluate the subjects retrospectively (the day prior to the assault), and patients who assaulted staff were interviewed when possible. An analysis found no differences between patients who assaulted and controls on sociodemographic variables. Those who assaulted had significantly more prior assaults (p = .04) and more difficulty verbalizing angry feelings appropriately on their units (p < .01). Prior to the assault, assaultive patients were more verbally hostile (p = .037) and showed more increased motor activity (p = .001) than controls.

Cues↗
PubMed1996

Effects of gentle human touch on preterm infants: pilot study results.

A pilot study was conducted to evaluate the effects of gentle human touch (GHT) provided for 15 minutes a day to preterm infants from day 7 to day 12 of life. The study suggested that GHT has no adverse effects on the oxygen saturation or heart rate levels of small preterm infants and that GHT has a soothing effect as evidenced by decreased levels of active sleep, motor activity, and behavioral distress. These results can provide NICU nurses with a basis for guiding parents in their early interactions with preterm infants in the NICU.

Female↗