Biopsy forceps as a source of bacterial contamination leading to overgrowth of Helicobacter pylori culture medium with Pseudomonas aeruginosa.
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Bacteriological Techniques↗
Biomedical subjects
C L Cooper
Publications and source records attributed to C L Cooper.
Change in stress outcomes following an industrial dispute in the ambulance service: a longitudinal study.
A longitudinal study to assess change in the symptoms of strain following an industrial dispute was carried out in a North of England ambulance service. A cohort of ambulance staff was surveyed over three stages: during the dispute; during the process of reorganizing the service; and during the implementation of a new operating structure. Dependent variables included measure of job satisfaction and mental and physical health. Independent variables included measures of the type A behaviour pattern, locus of control, source of perceived pressure and coping techniques. The results failed to support the main hypothesis as the symptoms of strain measured did not show any reduction after the dispute. Job dissatisfaction increased in the aftermath of the dispute and remained poor during the implementation of change. Symptoms of mental and physical ill-health showed no reduction following the dispute but symptoms of mental ill-health increased as organizational change was implemented. The high level of 'externality' shown by ambulance staff partially accounted for both these increases. It is proposed that the manner in which the aftermath of the dispute and ensuing organizational change were managed gave an increasingly limited scope for influence.
Adaptation, Psychological↗
Research priorities for nephrology nursing: American Nephrology Nurses' Association's Delphi Study.
The purpose of this study was to identify and prioritize research topics of importance for nephrology nursing and the American Nephrology Nurses' Association (ANNA). This was an explorative survey design using the Delphi technique. Nephrology nurses who are members of ANNA participated in the study. In Round 1 participants included 90 members of the Advanced Practice Special Interest Group. Round 2 participants were 537 nephrology nurses who attended the 28th ANNA National Symposium. Participants in Round 3 were 491 ANNA members who had at least a master's degree in nursing or another field. A three-round Delphi technique was used to solicit, identify, and prioritize problems for nephrology nursing research. In Round 1, 90 nurses identified problems in response to an open-ended question. These responses were analyzed and categorized into a 21-item research survey that was used for subsequent rounds. Round 2 participants rated each research question/topic on the survey on a 1 to 5 scale for level of importance. In addition, they were asked to identify the top-ranked research priorities from the 21 questions. In Round 3, the participants were asked to do the same as in Round 2. In addition, they indicated whether the research priority was primarily a nursing responsibility or a collaborative effort with other health care personnel. Based on 3 rounds of the Delphi study and analysis of both level of importance and rated-research priority, the five areas that were identified as research priorities are (a) nursing interventions to prevent vascular access infections, (b) nursing interventions to maintain vascular access patency, (c) educational needs of patients and families, (d) levels of nursing competence and the effect on patient outcomes, and (e) validation of nursing interventions to achieve patient outcomes. These research priorities provide direction for nephrology nursing research and the ANNA. This Delphi study represents a significant step for ANNA in its commitment to research.
Adult↗
Differential expression of Id genes in multipotent myeloid progenitor cells: Id-1 is induced by early-and late-acting cytokines while Id-2 is selectively induced by cytokines that drive terminal granulocytic differentiation.
Hematopoietic development is regulated by a complex mixture of cytokine growth factors that guide growth and differentiation of progenitor cell populations at different stages in their development. The genetic programs that drive this process are controlled at the molecular level by the type and number of transcriptional regulators coexpressed in the cell. Both positive- and negative-acting helix-loop-helix transcription factors are expressed during hematopoietic development, with the Id-type transdominant negative regulators controlling the net helix-loop-helix activation potential in the cell at any given time. It has been demonstrated that some of these Id factors are involved in the checkpoint at which undifferentiated progenitor cells make the commitment to terminal maturation. Therefore, we sought to determine whether these Id family factors are selectively induced or extinguished by cytokines that act at different points during hematopoiesis. NFS-60, a myeloid progenitor line that proliferates in response to multiple cytokines, was stimulated by treatment with SCF, IL-3, IL-6, G-CSF, and erythropoietin. Id-1 expression correlated tightly with cellular proliferation: it declined when growth factor stimulation was withdrawn and was quickly induced whenever the cell began to proliferate. The regulation of Id-2 was more complex: its expression was slightly upregulated in factor-deprived cells but only strongly reinduced after extended exposure to cytokines that drive granulocytic differentiation (IL-6, G-CSF, and TGFbeta). These data support a cell-cycle regulatory role for Id-1 in multipotent myeloid progenitor cells and a role for Id-2 during terminal granulocytic differentiation.
Cell Differentiation↗
New stressors for GDPs in the past ten years: a qualitative study.
OBJECTIVE: To identify new stressors that general dental practitioners have experienced from those reported in the UK national surveys of 1986 and 1996. DESIGN: Series of interviews. SETTING: General dental practices from suburban and inner city areas in two health authorities of the North West of England. SUBJECTS: A random sample of ten general dental practitioners participated; there were no refusals. METHOD: In-depth interviews employing a research psychologist were conducted to invite comment on the areas of work pressure they had experienced during the past ten years. Interviews were audio-taped, transcribed and content analysed. RESULTS: More than 130 statements categorised into 29 topics referred to pressures related to work. There was good agreement (93%) between authors and an independent assessor when a sort of the statements into the defined categories was completed. The most referred area of stress was the system changes of running a practice and the possibility of further changes. Patient expectations were considered to be rising. Aggression exhibited by some patients in the practice, the risk of cross-infection, litigation and the dentist working as a team member were newly identified stressors not included in original classifications of dental work pressure. CONCLUSIONS: Dental practitioners from this small study identified uncertainty in the future of the organisation of dental care provision as the most important new pressure of work.
Adult↗
Measuring occupational stress: development of the pressure management indicator.
The study of occupational stress is hindered by the lack of compact and comprehensive standardized measurement tools. The Pressure Management Indicator (PMI) is a 120-item self-report questionnaire developed from the Occupational Stress Indicator (OSI). The PMI is more reliable, more comprehensive, and shorter than the OSI. It provides an integrated measure of the major dimensions of occupational stress. The outcome scales measure job satisfaction, organizational satisfaction, organizational security, organizational commitment, anxiety--depression, resilience, worry, physical symptoms, and exhaustion. The stressor scales cover pressure from workload, relationships, career development, managerial responsibility, personal responsibility, home demands, and daily hassles. The moderator variables measure drive, impatience, control, decision latitude, and the coping strategies of problem focus, life work balance, and social support.
Adaptation, Psychological↗
Photo quiz II. Leukocytoclastic vasculitis secondary to parvovirus B19 infection.
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Female↗
Nephrology nurses' perceptions of barriers and facilitators to using research in practice.
OBJECTIVE: The purpose of this study was to determine nephrology nurses' perceptions of barriers to research utilization and to identify effective ways to facilitate integration of research findings in nephrology nurses' practice. DESIGN: This was an explorative, descriptive study. SAMPLE/SETTING: Four hundred ninety-eight nephrology nurses participated in the study. The primary areas of clinical practice were hemodialysis (36%), peritoneal dialysis (29%), transplantation (15%), pediatric nephrology (3%), or various combinations (18%). METHODS: Participants completed a demographic data form and the previously validated instrument, Barriers and Facilitators to Using Research in Practice. Descriptive statistics were used to analyze the data. RESULTS: The majority of respondents (52%) were staff nurses. The other respondents included 30% in management, 12% in advanced practice roles, and 6% in education. The barriers to research utilization most frequently identified were insufficient time on the job to implement new ideas and not enough time to read research. The most effective facilitators identified were increased administrative support and encouragement, increased time available for reviewing and implementing research findings, and improved understandability of research reports. CONCLUSIONS: Additional nursing and nonnursing administrative support for research activities and designated time to read research and implement research-based clinical practices may facilitate the development of research-based nephrology nursing practice.
Adult↗
Expression of the Id family helix-loop-helix regulators during growth and development in the hematopoietic system.
To better understand the molecular mechanism(s) by which growth and differentiation of the primitive hematopoietic stem cell is initiated, as well as the means by which the maturing cell can commit to development along a specific cell lineage, we elected to study the Id family of helix-loop-helix (HLH) transcriptional regulators. Some members of the HLH family are expressed in a stage-specific manner during hematopoietic development and can regulate the ability of immature hematopoietic cells to terminally differentiate. None of the four Id family genes were detected in the most primitive progenitors. Id-1 was widely expressed in proliferating bi- and unipotential progenitors, but its expression was downregulated in cells of increasing maturity; conversely, Id-2 and, to a limited extent, Id-3 gene expression increased as cells matured and lost proliferative capacity. Id-2 expression ran counter to that of Id-1 not only during maturation, but during periods of cell growth and arrest as well. This is quite distinct from the nonhematopoietic tissues, in which these two factors are coordinately expressed and suggests that Id-1 and Id-2 might be regulating very different events during hematopoiesis than they regulate in other cell types.
Animals↗
An intervention strategy for workplace stress.
This article explores a range of sources of workplace stress and a three-prong intervention strategy for managing pressures at work. The three approaches highlighted are primary, secondary, and tertiary prevention interventions. Primary is concerned with stressor reduction, secondary with stress management and tertiary with remedial support. In addition, a number of wider policy issues are suggested, such as risk assessment, economic incentives, and specific measures to help small- and medium-sized workplaces in managing workplace stress.
Humans↗
'Are life events related to the onset of breast cancer?'.
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Breast Neoplasms↗
Do resources bolster coping and does coping buffer stress? An organizational study with longitudinal aspect and control for negative affectivity.
Psychiatric workers facing redeployment completed questionnaire measures of stressors, resources (locus of control and perceived social support), coping, well-being, and negative affectivity, at baseline (N = 109) and 1 year later (loss of 7 participants). Regression analyses of the baseline data suggested that as stressors increased, so did avoidance coping, but less so for those high in internality or perceived social support. Problem-focused coping was bolstered by internality and emotion-focused coping by perceived social support. Other regression analyses, with a longitudinal aspect, suggested that stressors had a deleterious effect on well-being. Problem- and emotion-focused coping had beneficial effects, whereas avoidance coping had a (delayed) deleterious effect. These effects of coping were predominantly main and not buffering effects.
Adaptation, Psychological↗
The impact of trust status on health care workers.
Reports the findings of a study which was undertaken to examine the effects of radical organizational changes, the move towards NHS trust status, on the health and wellbeing of health care workers within a large district hospital and community service. A prospective longitudinal design was adopted incorporating pre- and post-trust measures. A shortened version of the Occupational Stress Indicator (OSI) was supplemented by questions specific to the health care sector. The findings suggest that the transition towards trust status has not resulted in negative outcomes for the organization as a whole, as measured by levels of sickness absence. However, certain employees may be particularly vulnerable during the early stages of organizational change.
Absenteeism↗
Occupational stress in the ambulance service: a diagnostic study.
The Occupational Stress Indicator (OSI) was used to investigate job stress in an ambulance service in the northwest of England. Seven different aspects of the stress-strain relationship were assessed and the findings compared with those from the fire service. Ambulance service employees were found to be experiencing major stress outcomes of low job satisfaction and poor mental and physical health. Fire service employees revealed significantly poorer physical health. Assesses the sources of job stress, type A behaviour, locus of control and coping styles and discusses them in the light of change in the public services.
Adaptation, Psychological↗
Health and safety problems associated with long working hours: a review of the current position.
The European Community Directive on Working Time, which should have been implemented in member states of the European Community by November 1996, contains several requirements related to working hours, including the right of employees to refuse to work more than 48 hours a week. The United Kingdom government attempted to oppose the Directive, arguing that there is no convincing evidence that hours of work should be limited on health and safety grounds. Much of the research in this area has focused on the problems of shiftworking and previous reviews have therefore tended to emphasise this aspect of working hours. However, there is much less information about the effects of overtime work, which is a central element of the terms of the Directive. This paper reviews the current evidence relating to the potential effects on health and performance of extensions to the normal working day. Several gaps in the literature are identified. Research to date has been restricted to a limited range of health outcomes--namely, mental health and cardiovascular disorders. Other potential effects which are normally associated with stress--for example, gastrointestinal disorders, musculoskeletal disorders, and problems associated with depression of the immune system, have received little attention. Also, there have been few systematic investigations of performance effects, and little consideration of the implications for occupational exposure limits of extensions to the working day. Existing data relate largely to situations where working hours exceed 50 a week and there is a lack of information on hours below this level, which is of direct relevance to the European Community proposal. Finally, it is clear from investigations relating to shiftwork that a range of modifying factors are likely to influence the level and nature of health and performance outcomes. These include the attitudes and motivation of the people concerned, the job requirements, and other aspects of the organisational and cultural climate. It is concluded that there is currently sufficient evidence to raise concerns about the risks to health and safety of long working hours. However, much more work is required to define the level and nature of those risks.
Adaptation, Psychological↗
Viewpoint: the information age and the changing nature of work.
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Employment↗
Stress in mental health professionals: a theoretical overview.
Clearly, mental health professionals are subjected to similar organizational stressors as other workers. They also face additional emotional strain by the very nature of their professions in dealing with troubled persons often over extended periods of time. Further understanding of these problems and development strategies, such as insight-oriented training, requires a greater appreciation of the interactions between home-work and the individual. This broader-based ongoing research is imperative not just to protect the health of the carers and their patients/clients but is, we believe, an ethical requirement. Best care can only be provided to others by carers who are themselves well.
Burnout, Professional↗
Nursing practice related to peritoneal catheter exit site care and infections.
OBJECTIVE: The purpose of the study was to obtain information from nephrology nurses on existing policies and protocols related to peritoneal catheter exit site care and treatment of exit site infections. DESIGN: This was an explorative, descriptive study. SAMPLE/SETTING: Fifty-four nurses who attended the 1995 Consensus Conference on Peritoneal Dialysis at the 26th Annual American Nephrology Nurses' Association National Symposium completed a survey questionnaire on exit site care and management of exit site infections. METHODS: A survey was mailed to nephrology nurses preregistered to attend the 1995 ANNA Consensus Conference related to peritoneal dialysis at the 26th National Symposium. Surveys were also collected at the meeting. RESULTS: Hydrogen peroxide and povidone iodine are frequently used in the nursing care of both healing and chronic exit sites. Almost all of the dialysis units require patients to stabilize or secure the catheter. The majority of respondents had a standardized method of assessing exit sites. Risk factors for exit site infections are presented for both the immediate post-catheter insertion period and the well-healed exit site. There were many different combinations of cleansing agents used to treat inflamed and infected exit sites. CONCLUSIONS: Procedures for exit site care vary widely. Prospective, randomized studies of exit site care protocols and cleansing agents are necessary to determine the most effective procedures to promote healthy exit sites.
Catheters, Indwelling↗