Occupational stress in nursing. International Journal of Nursing Studies (1989), 26, 359-368.
Explore the source record for details and available documents.
Attitude of Health Personnel↗
Biomedical subjects
N Reid
Publications and source records attributed to N Reid.
Do we understand trends in atmospheric sulfur species?
Anomalies appear to exist in our understanding of atmospheric sulfur compounds, specifically as evidenced in the time trends of the different chemical forms of these compounds. Trends determined at a number of locations by several different groups seem to indicate that, responding to emission reductions across North America, the concentration of SO2 in the atmosphere is declining more rapidly than that of aerosol SO4(2-). A number of possible reasons for this discrepancy are examined, but it is not possible to provide a definitive answer at this stage. The intent is to stimulate debate, because shortcomings in our understanding of the processes involved could have profound implications for the credibility of abatement strategies and policies for both acid deposition and fine particulate matter (PM).
Acid Rain↗
Clinical and microbiological epidemiology of Streptococcus pneumoniae bacteraemia.
A survey of Streptococcus pneumoniae bacteraemia in the Grampian region of Scotland was carried out over a 2-year period. One hundred and four bacteraemic episodes were identified in 103 patients, an incidence of 9.8/100,000 population/year, and the mortality was 24%. Clinical information was abstracted from 92 sets of patient notes and 98 isolates of S. pneumoniae were available for further study. The incidence of S. pneumoniae bacteraemia was highest at the extremes of age and peaked at 78 cases/100,000 population/year in those over 80 years old. Many patients had predisposing conditions, of which chronic lung disease (23%), chronic alcohol abuse (10%) and malignant disease (10%) were the commonest. Age was the highest risk factor for mortality, with 20 of the 22 deaths in those over 65 years old. The commonest serotype of S. pneumoniae isolated was serotype 14 (23.5%). Only one isolate (serotype 6A) showed intermediate resistance to penicillin, but 12 isolates (12.2%) were resistant to erythromycin. Nine of these 12 isolates were of serotype 14 and had MICs clustered in the range 12-24 mg/L. Examination of all serotype 14 isolates by pulsed-field gel electrophoresis (PFGE) showed the presence of two distinct genetic clusters, with all the erythromycin-resistant isolates in the same cluster. These isolates had similar PFGE profiles to erythromycin-resistant serotype 14 strains isolated elsewhere in the UK and they were positive for the mefE gene by PCR, confirming that resistance was of the M phenotype. The recent increase in erythromycin resistance in S. pneumoniae may be due, at least in part, to the spread of a serotype 14 clone of the M phenotype which appears to be an important cause of invasive disease.
Adolescent↗
Statistical inference by confidence intervals: issues of interpretation and utilization.
This article examines the role of the confidence interval (CI) in statistical inference and its advantages over conventional hypothesis testing, particularly when data are applied in the context of clinical practice. A CI provides a range of population values with which a sample statistic is consistent at a given level of confidence (usually 95%). Conventional hypothesis testing serves to either reject or retain a null hypothesis. A CI, while also functioning as a hypothesis test, provides additional information on the variability of an observed sample statistic (ie, its precision) and on its probable relationship to the value of this statistic in the population from which the sample was drawn (ie, its accuracy). Thus, the CI focuses attention on the magnitude and the probability of a treatment or other effect. It thereby assists in determining the clinical usefulness and importance of, as well as the statistical significance of, findings. The CI is appropriate for both parametric and nonparametric analyses and for both individual studies and aggregated data in meta-analyses. It is recommended that, when inferential statistical analysis is performed, CIs should accompany point estimates and conventional hypothesis tests wherever possible.
Bias↗
Globular clusters, Hipparcos, and the age of the galaxy.
We discuss the impact of the results from the recent Hipparcos astrometric satellite on distance estimates of galactic globular clusters. Recalibrating the clusters not only implies a relatively small change in the distance to the Large Magellanic Cloud, and hence a rescaling of several estimates of the Hubble constant, but also leads to significantly younger cluster ages. Although the data are not yet conclusive, the results so far point to a likely resolution of the apparent paradox of a universe younger than its constituents, without requiring significant modifications to simple cosmological models.
Journal Article↗
Precise microdissection of human prostate cancers reveals genotypic heterogeneity.
To determine the incidence of genetic heterogeneity in primary prostate cancer, we have microdissected 125 tumor and mesenchymal foci from 18 patient biopsies and analyzed the DNA for loss of heterozygosity using PCR microsatellite markers. In 100% of patients with genetic lesions on chromosome 8p, there was evidence for intratumoral genetic heterogeneity. There was also a low but significant incidence of loss of heterozygosity in mesenchymal tissue. Our results show that phenotypically similar tumor foci can have different genotypes and provide evidence for the multifocality of tumor development in the prostate.
Chromosomes, Human, Pair 8↗
Co-ordinated changes in expression of cell adhesion molecules in prostate cancer.
The expressions of E-cadherin, the integrin subunits beta 1, beta 2, beta 3, CD44 and alpha-catenin were studied in parallel by immunohistochemistry in a series of 40 prostate biopsies comprising one normal, 11 benign prostatic hyperplasia (BPH), and 28 prostatic adenocarcinomas. As reported by others, there was a consistent loss of E-cadherin expression with increasing tumour grade and de-differentiation. However, a significant proportion of losses occurred at earlier grades than previously reported. The parallel nature of this study showed, for the first time in human prostate carcinoma, a reciprocal expression pattern of E-cadherin and beta 1 integrin in the higher grades of prostate cancer. A reciprocal expression pattern was also found for E-cadherin and CD44 between moderately and poorly differentiated tumours. alpha-Catenin expression was downregulated only in those cells which had previously lost E-cadherin expression, and beta 2 and beta 3 integrin were rarely expressed in prostate tumours. A loss of expression of the luminal epithelial specific keratins CK8 and CK18 was also observed in advanced stage, poorly differentiated carcinomas.
Adenocarcinoma↗
Attitudes and beliefs within the Sikh community regarding organ donation: a pilot study.
The current shortage of organs for transplantation is a matter of considerable concern in the United Kingdom (U.K.). Whilst issues of histocompatibility create particular problems in this respect for the Asian population in the U.K., it is sometimes suggested that there is also a resistance to the idea of organ transplantation among this community. To explore this issue, a small-scale interview study was conducted in Coventry among members of the Sikh community. A judgemental sample of 22 individuals, from different strata of the local Sikh community, were interviewed either in one-to-one interviews or in a focus group. These interviews had two broad aims: to determine the prevailing attitudes towards organ transplantation, and to gauge the impact and acceptability of the current Department of Health campaign literature. It was found that, whilst there were a number of misgivings to do with notions of mutilation and reincarnation, and anxieties as to technical or clinical aspects of the transplantation process, the prevailing view was supportive of transplantation, and organ donation was seen as a highly appropriate means of exhibiting the altruistic tradition within Sikhism. Such barriers that exist to the idea of transplantation seem to have more to do with knowledge and understanding than with cultural or religious factors. Concerning the campaign literature, informants identified a number of shortcomings, and indicated ways in which the impact of the leaflets and posters might be enhanced. Although the generalizability of these findings is limited, and despite possible threats to the validity of the data collected, this study has produced findings with significant implications for future policy in this area.
Ethnicity↗
Customer complaints in the National Health Service.
This paper addresses the role of consumer complaints in the flourishing quality assurance industry within the National Health Service (NHS), and considers the traditional ethos of complaints within the service. The advent of the internal market is considered as one of a range of factors which may change attitudes of NHS staff to complaints. In evaluating how complaints services might develop relevant literature is reviewed and recent national data on complaints procedures are cited.
Attitude of Health Personnel↗
The 12-hour shift: the views of nurse educators and students.
Interest in 12-hour nursing shifts has been renewed in response to demands for improved cost-effectiveness in the UK National Health Service. But the effects of the shift on nursing education are unclear. We report surveys of the attitudes of student nurses and nurse educators towards 12-hour shifts. Learners are reasonably positive about 12-hour shifts, but this preference is based on social rather than professional benefits. A reported effect of fatigue on home study is evident. Very negative views about the 12-hour shift are held by the group of educators. Their criticisms appear to be primarily organizational, but they are unequivocal that learning is detrimentally affected. Thus, even if students appear to like this shift pattern, serious concerns are raised by these findings about the impact of the shift on nursing education.
Adult↗
The quantity of nursing care on wards working 8- and 12-hour shifts.
Interest in 12-hour nursing shifts has been renewed in response to demands for improved cost-effectiveness in the NHS, but the effects of this shift on the delivery of patient care have been unclear. This paper describes the results of a repeated-measures study of 10 wards, using activity analysis to describe patterns of care under an 8-hour compared to a 12-hour shift system. Significant reductions in the amount of direct patient care were found under the 12-hour shift, with corresponding increases in unofficial work-breaks. It is suggested that these findings, which were consistent over all study wards and throughout the whole 12-hour day, demonstrate a "pacing" effect by nurses who face 12 hours on duty. Such a detrimental effect should be a major consideration when coming to any decision to implement a 12-hour shift.
Hospital Units↗
Nurse manpower demand: a review of United Kingdom methodologies.
Forecasting the demand for nurses is a complex and difficult problem. However, in a climate of economic cutbacks and disadvantageous demographic trends, it is essential that adequate methods are developed to predict both the supply and demand for nurse manpower. To this end a number of methods have been constructed, particularly in the last decade. In this paper we survey the work that has been done to provide an effective way of forecasting nurse manpower demand. The two most common approaches are from the 'top-down' or 'bottom-up'. However, an evolutionary method which allows for modification and detailed refinement is more likely to provide a means of taking into account the complexities of the system. Finally, we focus on the nursing hours per patient (NHPP) ratio as a possible tool for demand forecasting. This index is easily calculated and is readily adaptable to the bottom-up approach.
Bed Occupancy↗
12-hour shifts: job satisfaction of nurses.
A before and after study was carried out amongst staff of 10 wards of a county hospital before and after the introduction of a 12-hour shift system for nurses. The purpose was to investigate the impact of the shift system on job satisfaction. Some 320 nurses covering all qualified and unqualified grades were surveyed using a standard job satisfaction attitude scale. It was found that under the 12-hour shift both intrinsic and extrinsic factors of job satisfaction had been detrimentally affected. Considerable dissatisfaction was expressed about hours of work, conditions of work and the impact of the shift on domestic and social arrangements. The vast majority (83%) reported that they did not want to go on working the shift and there was support for the view that recruitment to nursing would be adversely affected by the shift.
Adult↗
Using a manpower database to analyse the nurse limbo stock.
A manpower database for nurses employed by the Department of Health and Social Services (DHSS) in Northern Ireland is used to identify the qualified nurses not currently employed by the DHSS, i.e. the limbo stock, and describe this stock in terms of age, sex, length of previous service, grade and location. This information is invaluable for manpower planners who must decide on how many vacancies can be filled by recruitment from the limbo stock, as opposed to training new nurses. Such a methodology provides a valuable tool for the nurse manpower planner.
Adult↗
Educational activities on wards under 12 hour shifts.
Interest in 12 hour nursing shifts has renewed in response to demands for improved cost effectiveness in the NHS. But the effects of the shift on nursing education are unclear. A repeated measures study was conducted, using activity analysis to record patterns of nursing and educational behaviour under a 12 hour as compared to an 8 hour shift. Lower levels of ward based education occur under the 12 hour shift. Students pair up with trained staff less. Rather they work alone or with other students more. They also have less contact with patients than under an 8 hour shift.
Attitude of Health Personnel↗
Using a manpower database to model nurse turnaround and return to service.
A manpower database for nurses employed by the Department of Health and Social Services in Northern Ireland has been developed. This database contains information on all nurses employed between March 1977 and July 1988 and consists of data on all posts held in this period, including breaks in service. The authors show how these data may be used to analyse the durations of spells in post and spells out of service prior to departure to a number of destinations for the sister and staff nurse grades. The results are presented in a graphical format which enables us to evaluate the relative proportion of departures to each destination and at what stage in service these departures are likely to occur. Such a methodology provides a valuable tool for the nurse manpower planner, and utilizes personnel data which are routinely collected by most health authorities.
Career Mobility↗
Purification and polypeptide composition of corpora amylacea from aged human brain.
Corpora amylacea (CA) accumulation in the brain is a normal correlate of ageing. The presence of a small amount of protein in these polyglucosan bodies is a consistent finding, although the nature of this protein material remains unknown. Using sucrose gradient fractionation and density centrifugation on Percoll, a method was developed to obtain highly pure preparations of CA from human brain. The protein content of isolated CA was estimated to be approx. 4% of the total fraction by weight. SDS-PAGE analysis of CA fractions showed several polypeptide bands with molecular weights ranging from 24 to 133 kDa. Four of these bands with molecular weights of 133, 94, 42 and 24 kDa are more abundant. Thus, pure preparations of CA can be obtained that are suitable for protein analysis.
Aged↗