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Biomedical subjects

Roger Watson

Publications and source records attributed to Roger Watson.

At least 19 recordsLinked to original sources

Is there a role for higher education in preparing nurses?

Nurse education is now almost wholly situated within universities internationally. However, issues such as the necessity of higher education for what is seen as a practical occupation and the question of whether or not nursing is a profession arise. Newman viewed universities as places where training was given but character was also formed and self-awareness was developed through exposure to a wide range of disciplines and this type of education has helped to shape other professions. If nursing fulfills the criteria for a profession then it requires nurses to be properly educated in higher education. Poor media images of nursing, opposition from within and outside of the profession and poor funding for research, especially in the UK, where most nurses still do not enter the register with a degree, mean that the place of nursing in higher education remains on the periphery. Nurses must be competent to practice and higher education is not incompatible with the development of competent practitioners. However, higher education should take competent practitioners to a higher level whereby they become capable: able to respond appropriately in unfamiliar situations and to unfamiliar events. This paper argues for the role of higher education for nurses in terms of developing capability.

Attitude of Health Personnel↗

Primary emotions in patients after myocardial infarction.

AIMS: This paper reports a study testing the reliability and validity of the Emotion and Health Scale and to check convergent and discriminant validity against the Hospital Anxiety and Depression Scale. BACKGROUND: Reactions to illness are often measured in the narrow terms of anxiety and depression. Primary emotions are claimed by the functionalist school of psychology to be adaptive and to produce specific behaviours for survival. The functionalist theory requires testing in the context of health threat and adaptation. This paper is concerned with the development of a 24-item self-assessment scale of eight primary emotions. METHODS: A healthy cohort of 150 university students was enrolled to complete the Health and Emotion Scale. A cohort of 80 first-time myocardial infarction patients was enrolled to complete the Emotion and Health Scale and the Hospital Anxiety and Depression Scale four days after the onset of myocardial infarction or when symptoms were controlled. The data were collected in 2002. RESULTS: The Emotion and Health Scale was shown to have acceptable internal consistency. Significant differences were observed between the healthy and myocardial infarction cohorts in illness attributed sadness, anger, disgust and surprise. Healthy men had significantly more health fear than women. CONCLUSIONS: The Emotion and Health Scale is a valid and reliable instrument that could be used to study emotion and illness. This line of enquiry may improve understanding of illness reactions and the role primary emotions exert on adaptation to health change.

Adult↗

Feeding and dementia: a systematic literature review.

AIM: This paper reports a systematic review of the literature on interventions to promote oral nutritional intake of older people with dementia and feeding difficulty between 1993 and 2003. BACKGROUND: Older people with dementia commonly experience difficulty with feeding, especially in the later stages of the condition. This topic and related nursing care was reviewed in 1993 and the conclusion was that there was little research into interventions that nurses could use to alleviate feeding difficulty. METHOD: A systematic review of the literature was carried out using the CINAHL, Medline, EMBASE and Cochrane databases and the search terms 'feeding', 'eating' and 'dementia' combined as follows: '(feeding or eating) and (dementia)'. A second search was carried out combining the search terms 'mealtimes' and 'dementia' as follows: 'mealtimes and dementia'. The literature search was carried out on 1 December 2003 and papers were included in the review if retrieved by 31 December 2003. English language papers only were retrieved. RESULTS: Sixty-seven papers were retrieved, of which 13 addressed interventions aimed at helping older people with dementia to feed. All studies reported positive outcomes but only one randomized controlled trial was reported. Music was the most common intervention but there were no standardized interventions or outcomes across the studies and none reported the use of power analysis to decide on sample size. There were problems in some studies with confounding variables. CONCLUSIONS: Further research is needed into interventions aimed at how nurses can help older people with dementia to feed. There are some promising lines of enquiry, with music being one of these, but future studies need to use adequate samples and to use power calculations and account adequately for confounding variables. There is also a need to standardize interventions and outcomes across such studies to facilitate meta-analysis.

Aged↗

Nutritional screening and assessment tools for older adults: literature review.

AIM: This paper reports a literature review to examine the range of published tools available for use by nurses to screen or assess nutritional status of older adults, and the extent to which validity, reliability, sensitivity, specificity and acceptability of the tools has been addressed. BACKGROUND: The incidence of malnutrition in older adults is high. One method by which malnutrition or risk of malnutrition can be detected is by the use of nutritional screening or assessment tools. METHODS: A comprehensive literature review methodology was employed. A variety of electronic databases were searched for the period 1982-2002. Search terms incorporating nutrition, screening, validity, reliability and sensitivity and specificity were combined to retrieve relevant literature. In addition, manual searches were conducted and articles retrieved from those listed in key papers. In this paper, nutritional screening or assessment tools are described as tools which use a questionnaire-type format containing more than one risk factor for malnutrition, and give a quantitative or categorical assessment of risk. RESULTS: Seventy-one nutritional tools were located, 21 of which were identified as designated for use with an older population. A wide variety of risk factors for malnutrition are used with the tools, ranging from objective measurements to subjective assessment. Some tools identify an action plan based on the score obtained. Many tools appear not to have been subjected to validity and/or reliability testing but are used clinically. CONCLUSIONS: As malnutrition is present in the older adult population, nutritional assessment and screening tools can be useful to highlight those in need of a nutritional care plan. However, many have not been subjected to evaluation and consequently may not demonstrate sensitivity and/or specificity in clinical use. The decision to use a particular tool should therefore be considered carefully.

Aged↗

Use of factor analysis in Journal of Advanced Nursing: literature review.

AIM: This paper reports a review analysing the use of factor analysis in papers in Journal of Advanced Nursing. BACKGROUND: Factor analysis is a multivariate statistical method for reducing large numbers of variables to fewer underlying dimensions. There are several methods of factor analysis with principal components analysis being the most commonly applied. Factor analysis has been used by researchers in nursing for many years but the standards for use and reporting are variable. METHOD: Papers using factor analysis in Journal of Advanced Nursing were retrieved from 1982 to the end of 2004. The search term 'factor analysis' was used in the CINAHL database and applied specifically to Journal of Advanced Nursing in December 2004. Retrieved papers were included in the review if they came from Journal of Advanced Nursing and used factor analysis as part of the method of the reported study. RESULTS: One hundred and twenty-four papers were retrieved as a result of the initial search criteria of which 116 were from Journal of Advanced Nursing. Screening of papers for the use of factor analysis left 100 papers for review. Principal components analysis was the most commonly used method of factor analysis; Eigenvalues greater than one was the most commonly applied criterion for selecting the number of factors followed by orthogonal rotation to achieve simple structure. The majority of papers did not report the whole factor solution and there were papers that did not specify anything beyond the fact that they carried out factor analysis. Confirmatory factor analysis was rarely used and exploratory methods other than principal components analysis were also rarely used. CONCLUSIONS: Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.

Bibliometrics↗

The placebo effect.

Explore the source record for details and available documents.

Complementary Therapies↗

Improving research supervision in nursing.

In this paper, four experienced researchers from the UK, China and Australia offer guidance in research supervision based on their experiences and the recent document, Improving standards in postgraduate research degree programmes [Higher Education Funding Council for England, 2003. Improving standards in postgraduate research degree programmes. Formal consultation. Department for Employment and Learning, Northern Ireland, Higher Education Funding Council for England, Higher Education Funding Council for Wales, Scottish Higher Education Funding Council, HEFCE, London]. Supervision is an important aspect of not only the development of the neophyte researcher, but of academic staff and research activity in general. With increased academic accountability, good supervision should be an integral component of a quality research governance framework and resourced as such. Recommendations include: adoption of these standards; rigorous selection of research students and supervisors and development of projects; development of departmental procedures for monitoring, feedback and intellectual property; and transparency, rigour and fairness in examination procedures.

Attitude of Health Personnel↗

Generation of a conditional allele of the B-myb gene.

B-Myb is an essential transcription factor involved in control of the cell cycle and the regulation of tissue-specific gene expression in a wide range of cell types. Loss of both alleles results in early embryonic lethality at E4.5-6.5. To address the function of B-Myb in later stages of embryogenesis and in specific adult tissues, a floxed B-myb allele (B-mybF) was generated. Cre-mediated deletion in vivo was demonstrated by breeding with a transgenic GATA-Cre mouse line. An intermediate allele produced in the creation of the floxed allele, in which the PGK-neo(R) cassette is present in intron 3 (B-myb(loxneo)), was deduced to be a weak hypomorph based on the later embryonic death of homozygotes compared to B-myb(-/-) embryos. To demonstrate the efficiency and possible consequences of B-myb inactivation, we performed conditional deletion in cultured MEFs and observed decreased growth that correlated with aberrant nuclear DNA replication.

Alleles↗

Quality assurance in UK nursing education: public protection in the era of streamlined assessment.

This paper describes recent reforms of quality assurance (QA) for the education of nurses, midwives and health visitors and reports qualitative findings from a study of how they are working out in practice. This study reported whether the stakeholders consider the system to be adequate for the principal aim of public protection. Using a postal survey and interviews, QA in nursing, midwifery and health visiting is compared and contrasted in the four countries of the United Kingdom. Issues of subjectivity versus objectivity in decision making over QA of nursing, midwifery and health visiting education and the extent to which these processes are rigorous arose. There is an inverse relationship between the number of higher education institutions in a country and the extent to which nursing, midwifery and health visiting QA personnel, responsible for conducting QA events, become involved with those institutions in offering advice and support. Generally speaking, where the changes have been greatest, satisfaction with the QA processes is lowest. Dissatisfaction was only expressed with processes and most likely arose from resistance to change but these are early days in the operation of the new QA procedures.

Consumer Behavior↗

High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder.

We sought to review the definition, diagnosis, prognosis, and treatment of high-grade Ta urothelioma carcinoma and carcinomas in situ (CIS) in order to provide evidence-based guidelines for their diagnosis and treatment. The English-language literature on high-grade Ta urothelial carcinoma and CIS was identified and critically reviewed by a panel of 9 international experts. The panel then met at a consensus conference to present their conclusions. Levels of evidence and grades of recommendation were assessed. Findings from approximately 100 publications appearing prior to February 2005 were reviewed and summarized. High-grade Ta urothelial carcinoma and CIS are relatively rare tumors; thus results are often based on small nonrandomized studies. Their assessment is made more difficult owing to inaccuracies in staging and grading. Although there were similar numbers of level 1, level 2, and level 3 evidence citations, guidelines have been developed based only on levels of evidence supporting grade A and grade B recommendations. These evidence-based guidelines have been developed to aid clinicians in the diagnosis and treatment of patients with high-grade Ta urothelial carcinoma and CIS.

Algorithms↗

NHS cadet schemes: do they widen access to professional healthcare education?

AIM: The aim of this paper is to report a study investigating the extent to which National Health Service cadet schemes widen access to professional health care education. BACKGROUND: Cadet schemes have been reintroduced in the United Kingdom to increase recruitment of nurses and other health care staff to the National Health Service and also to widen access and increase participation in professional health care education by groups poorly represented in such education, including minority ethnic groups. METHODS: A questionnaire survey of all cadet schemes (n = 62) in England at the time of the study was carried out, and the respondents were cadet scheme leaders (n = 62) and cadet students (n = 411). The questionnaires to scheme leaders enquired about when the schemes were established, what the schemes were preparing cadets for, modes of delivery and entry qualifications. The questionnaires to cadets enquired about age, gender, family circumstances, prior experience and ethnic background. FINDINGS: The majority of schemes had been established since the health service reforms of 1999 and most were preparing cadets to enter professional nurse education programmes. Very few provided opportunities for part-time study and some asked for entry qualifications. Cadets were younger on entry than a comparator group of student nurses, fewer were married, fewer had previous employment or health-related employment and a lower percentage of cadets were white. CONCLUSION: Cadet schemes have the potential to widen access to professional health care study, but there is only limited evidence that they are doing so. In particular there was a lack of mature entrants to health care professional education via the schemes. However, the majority of schemes offered a route into professional education for students who did not hold sufficient educational qualifications for direct entry to professional health care education. It is encouraging that cadet schemes appear to be attracting a significantly greater proportion of students from Black and minority ethnic groups than preregistration nursing programmes overall.

Adult↗

Nutritional screening and assessment tools for use by nurses: literature review.

AIM: This paper reports a literature review describing the range of published tools available for use by nurses to screen or assess nutritional status of patients/clients, and to examine whether the validity, reliability, sensitivity, specificity and acceptability of the tool have been investigated. Tools developed specifically for use with older adults are not considered in this review. A screening/assessment tool is described as a tool that uses a questionnaire-type format, contains more than one risk factor for malnutrition and gives an assessment of risk. BACKGROUND: The incidence of malnutrition in people cared for by nurses is high and screening or assessment tools are often used to identify those with, or at risk of, malnutrition. METHODS: A comprehensive literature review methodology was employed. A range of electronic databases was searched from 1982 to 2002. Search terms incorporating "nutrition", "screening", assessment, feeding, instrument, tool, validity, reliability, sensitivity and specificity were combined. Manual searches were also conducted. RESULTS: Seventy-one nutritional screening/assessment tools were identified of which 35 were reviewed. Tools not reviewed included those which incorporated significant use of biochemical measures (8), included complex anthropometric measures (3), were concerned specifically with ingestion (4) or were designated for use with an older population (21). The tools reviewed use a wide variety of risk factors for malnutrition, varying from anthropometric measurements to socio-cultural aspects of eating behaviour. Some identify an action plan based on the score obtained. Many have not been subjected to validity and/or reliability testing and yet appear to be in use in clinical practice. The sensitivity, specificity and acceptability of the tools are often not investigated. CONCLUSION: There are many published nutritional screening/assessment tools available for use by nurses to screen or assess the nutritional status of patients/clients. Many have not been subject to rigorous testing. Future work should consider a more standardized approach to the use of these tools.

Humans↗