36834793
Experiences of a feasibility study of children with albinism in Zimbabwe: a discussion paper.
BACKGROUND
Feasibility studies are often a helpful prelude to constructing fundable research proposals. Where the intended research is in a foreign country, focuses on a vulnerable population, and is aggravated by political and pragmatic challenges, feasibility studies become essential. Albinism, a genetic condition of reduced melanin synthesis, is a major public health issue in southern Africa. Whilst much is known about the health needs of children with albinism, little is understood about how to address these effectively in low income countries. Further, the child care and protection needs of children with albinism are largely unexplored. Zimbabwe's current political and economic climate presents additional challenges to research on the topic.


METHOD
The technical, economic, legal, collaborative, operational, schedule and political feasibilities (acronym TELCOSP) to undertaking a study on children with albinism in Zimbabwe were explored over a six week period of fieldwork in the country.


RESULTS
Using the TELSCOSP framework allowed a deconstruction of each challenge to provide innovative solutions. The economic and legal feasibility aspects presented some difficulties that will require flexibility and perseverance to overcome.


CONCLUSION
With the assistance of the local communities and people with albinism in Zimbabwe, the obstacles appear surmountable. The feasibility study provided a productive framework for addressing potential challenges in studying the needs of Zimbabwe's children living with albinism.
32905395
On the precipice of great things: the current state of UK nurse education.
The significant policy changes in UK health care over the past decade have led to a consequent shift in the delivery of nurse education to ensure the development and sustainability of a knowledgeable nursing workforce. One of the most recent, radical and important initiatives is Modernising Nursing Careers, which outlined four key priority areas for nursing, all of which have implications for nurse education. In light of this initiative, we explore the extent to which the modernisation of nursing careers is rhetoric or reality for UK nurse education - we are on the precipice of great change. To facilitate this, we move chronologically through the issues of recruitment and access; pre-registration preparation; and post-qualification education and careers. In discussing these issues, we demonstrate that more changes are needed to produce nurses who are flexible, visionary and prepared to take risks. We suggest that vision, leadership and strong realignment with health priorities are needed to bring nurse education to a point where nurses are truly prepared for the demands of a 21st century health service.
18213491
The smacking controversy: what advice should we be giving parents?
BACKGROUND
Even among countries that have ratified the United Nations Convention on the Rights of the Child there is much disagreement about corporal punishment of children. Last year the Scottish Executive proposed a new law banning the smacking of children under the age of three, becoming the tenth European nation to do so. The proposal, currently abandoned whilst ostensibly still under debate, has raised a wave of controversy in child protection circles. In the nearest neighbouring country, England, a similar proposal was robustly rejected. PURPOSE OF THE PAPER: Given an increasing family and community focus in nursing, the implications of the debate for the profession cannot be ignored. What should we be telling 'ordinary' families about smacking? Thus this paper presents a positional statement on the smacking controversy and outlines some pointers for practice.


DISCUSSION
While for many the legislation proposed does not go far enough, others decry it as a breach of parental rights and, thus, the issue has become hugely controversial. Media opinion and various opposing campaigns dominate both public and professional spheres. Rights, responsibilities, examples from other countries, culture and gender are all used as fodder in the debate. Extreme examples are cited by both sides and used as grist for what are at times tenuous arguments. As there is even a division within child protection arenas, practising professionals may struggle to find a way through the maze of seemingly contradictory findings from research, policy and opinion.


CONCLUSIONS
A wide range of literature suggests that both public and professional opinion is divided on the use of smacking as a form of discipline of young children. Opinion is also divided on the ability of legislation to bring about change in social attitudes and behaviour. Health care professionals need to be in a position to recommend best practice and to do so consistently.
205326823
Practitioner assessments of 'good enough' parenting: factorial survey.
AIM
The aim of this study was to measure health visitors' professional judgements on 'good enough' parenting and identify what factors and combinations of these are important when making such judgements.


BACKGROUND
The relationship between parenting and child health is unclear. Whilst agreement exists that 'good enough' parenting requires boundary setting, consistency and putting the child's needs first, attempting to define 'good enough' parenting in precise terms is complex. When faced with a complex situation, practitioners rely on relatively few factors to form judgements.


DESIGN
Factorial survey methods were employed using vignette techniques.


METHODS
Vignettes were constructed using previous research on those variables, which may influence nurses' judgements, for example, accommodation and child dentition. The level of factors was randomly varied. Two thousand vignettes were administered to a sample of 200 health visitors in two Health Boards who then made a judgement about this scenario.


ANALYSIS
Data were analysed through multiple regression with dummy variables and one-way analysis of variance. Regression equations for both good enough mothering and good enough parenting are reported.


RESULTS
The models used are significant predictors of parenting and mothering. Significant predictors on health visitor judgements' were boundary setting in sleep behaviours, type of housing inhabited and health behaviours. Although parenting and mothering are often conflated, health visitors appear to separate these aspects when making judgements based on type of housing.


CONCLUSIONS
Most professionals can articulate what makes a 'good' parent, equally they may have strong views regarding what constitutes 'poor' parenting. The difficulty is in determining when parenting is 'good enough' to provide a child with a nurturing environment.


RELEVANCE TO CLINICAL PRACTICE
This study suggests that practitioners move their thresholds of what is 'good enough' depending on a narrow range of factors. Awareness of the factors, which influence individuals' judgements is important in safeguarding children.
39760502
Commentary on Kong S and Bernstein K (2009) Childhood trauma as a predictor of eating psychopathology and its mediating variables in patients with eating disorders Journal of Clinical Nursing 18, 1897-1907.
46164621
The rhetoric vs. the reality in child care and protection: ideology and practice in working with fathers.
Within child care and protection, practitioners can be paralysed by a fundamental gap between the rhetoric and the reality in engaging fathers in their children's care. In an earlier paper we argued that there is a lack of an effective framework to guide practice with fathers in child care and protection work. We examined how health visitors and social workers could begin to assess how fathers could be categorized as either (or both) a risk or an asset to the child. Based on a review of the literature we now explore the limitations of current models of practice and trace the theoretical strands that influence them, drawing from the legal framework, attachment theory and models for anti-oppressive practice. We then highlight messages for practice with fathers for health care professionals involved in child protection. The working context for this paper is Scotland, although we believe that the ideas may be extrapolated to other geographical areas.
25216421
Discontinuities in the DNA synthesized by an avian retrovirus.
The unintegrated linear DNA synthesized in cells infected by Rous sarcoma virus is a predominantly double-stranded structure in which most of the minus-strand DNA, complementary to the viral RNA genome, is genome sized, whereas the plus-strand DNA is present as subgenomic fragments. We previously reported the application of benzoylated naphthoylated DEAE-cellulose chromatography to demonstrate that of the linear viral DNA species synthesized in quail embryo fibroblasts infected with Rous sarcoma virus greater than 99.5% contain single-stranded regions and these regions are predominantly composed of plus-strand DNA sequences (T. W. Hsu and J. M. Taylor, J. Virol. 44:47-53, 1982). We now present the following additional findings. (i) There were on the average 3.5 single-stranded regions per linear viral DNA, and these single-stranded regions could occur at many locations. (ii) With a probe to the long terminal repeat, we detected, in addition to a heterogeneous size distribution of subgenomic plus-strand DNA species, at least three prominent discrete size classes. Each of these discrete species had its own specific initiation site, but all had the same termination site. Such species were analogous to those reported by Kung et al. (J. Virol. 37: 127-138, 1981). (iii) These discrete size classes of plus-strand DNA were present not only on the major size class of linear DNA but also on a heterogeneous of slower-sedimenting species, which we have called immature linears. Our interpretation is that we have thus detected several additional sites for the initiation of plus-strand DNA. (iv) The 340-base plus-strand strong-stop DNA was only found associated with the immature linears. (v) From a size and hybridization comparison of these discrete size classes of plus-strand DNA with minus-strand DNA species, as synthesized in the endogenous reaction of melittin-disrupted virions, it was found that the putative additional initiation sites for plus-strand DNA synthesis corresponded to many of the pause sites in the synthesis of minus-strand DNA.
31260021
Improving transfer of mental health care for rural and remote consumers in South Australia.
In Australia, it is commonplace for tertiary mental health care to be provided in large regional centres or metropolitan cities. Rural and remote consumers must be transferred long distances, and this inevitably results in difficulties with the integration of their care between primary and tertiary settings. Because of the need to address these issues, and improve the transfer process, a research project was commissioned by a national government department to be conducted in South Australia. The aim of the project was to document the experiences of mental health consumers travelling from the country to the city for acute care and to make policy recommendations to improve transitions of care. Six purposively sampled case studies were conducted collecting data through semistructured interviews with consumers, country professional and occupational groups and tertiary providers. Data were analysed to produce themes for consumers, and country and tertiary mental healthcare providers. The study found that consumers saw transfer to the city for mental health care as beneficial in spite of the challenges of being transferred over long distances, while being very unwell, and of being separated from family and friends. Country care providers noted that the disjointed nature of the mental health system caused problems with key aspects of transfer of care including transport and information flow, and achieving integration between the primary and tertiary settings. Improving transfer of care involves overcoming the systemic barriers to integration and moving to a primary care-led model of care. The distance consultation and liaison model provided by the Rural and Remote Mental Health Services, the major tertiary provider of services for country consumers, uses a primary care-led approach and was highly regarded by research participants. Extending the use of this model to other primary mental healthcare providers and tertiary facilities will improve transfer of care.
44475655
Replication of human hepatitis delta virus: recent developments.
In a natural setting, hepatitis delta virus (HDV) is only found in patients that are also infected with hepatitis B virus (HBV). In hepatocytes infected with these two viruses, HDV RNA genomes are assembled using the envelope proteins of HBV. Since 1986, we have known that HDV has a small single-stranded RNA genome with a unique circular conformation that is replicated using a host RNA polymerase. These and other features make HDV and its replication unique, at least among agents that infect animals. This mini-review focuses on advances gained over the last 2-3 years, together with an evaluation of HDV questions that are either unsolved or not yet solved satisfactorily.
27724235
Avian RNA tumor virus DNA before and after integration into the host genome.
3459683
Quality improvements in resident mobility care: using person- and relationship-centered frameworks.
PURPOSE OF THE STUDY
Research is needed to demonstrate the application of person- and relationship-centered care to nursing home practice. This article aimed to find a suitable person/relationship-centered framework to assist with mobility care practice improvements in nursing homes.


DESIGN AND METHOD
The authors discuss the task of mobility care, the nature of person- and relationship-centered care, and the significance of such approaches to mobility care. The Senses Framework (Nolan, Davies, Ryan, & Keady, 2008) is employed to develop mobility care practice improvement objectives.


RESULTS
The objectives are used to evaluate outcomes from 2 hypothetical scenarios to illustrate the possible value of the Senses Framework.


IMPLICATIONS
The Senses Framework facilitated development of objectives for mobility care practice improvement that considers the needs of all stakeholders.