Sourcing the ore from the Drierivier copper smelting site in central Namibia, using lead isotope fingerprinting

Copper smelting residues from C. AD 1650 found at the Drierivier site near Rehoboth in central Namibia have 207Pb/206Pb isotope ratios that match a particular deposit at Swartmodder, but are markedly different from other known occurrences in the Rehoboth–Windhoek areas. For this reason, precise lead isotope determination is not necessary to source the ore, and raw peak height ratios obtained by inductively coupled plasma mass spectrometry are sufficient. This characteristic signature is present in all samples of malachite ore, slag, and copper prills collected on the site. Significantly, it is absent from a sample of local native copper, as well as from seven copper beads found elsewhere in central Namibia. This not only identifies the probable source of malachite ore but also provides a powerful tool for provenancing copper artefacts made at the Drierivier site, distinguishing them from those made elsewhere in the Namibian highlands

A qualitative study of GP, nurse and practice manager views on using targeted case-finding to identify patients with COPD in primary care

‘Finding the missing millions’ with chronic obstructive pulmonary disease became part of the Department of Health strategy for England in 2010. Targeted case-finding within primary care is one potential pro-active strategy, but currently little is known about the views of healthcare professionals on this approach. In this study, 36 healthcare professionals (12 GPs, 14 nurses, and 10 practice managers) from 34 UK practices participated in semi-structured telephone interviews about targeted case-finding. Interviews followed an interview guide, were audio-recorded, transcribed verbatim, coded and analysed using ‘Framework Approach’. Most of those interviewed practiced opportunistic case-finding. The main perceived barriers to wider case-finding programmes were the resource implications associated with running such programmes and identifying more chronic obstructive pulmonary disease patients. Financial incentives, support from specialist clinicians, and comprehensive guidance were viewed as facilitators. While targeted case-finding is conceptually accepted by primary care staff, scepticism surrounding (1) the value of identifying those with mild disease and (2) the availability of effective targeted case-finding methods, may lead some to favour an opportunistic approach. Key concerns were a lack of unequivocal evidence for the relative benefits vs. disadvantages of diagnosing patients earlier, and resource constraints in an already over-burdened system. Barriers to practical implementation of case-finding studies may be addressed with financial, human and educational resources, such as additional staff to undertake searches and perform spirometry tests, and practical and educational support from specialist teams

Understanding the meaning of medications for patients: The medication experience

Objective: To understand and describe the meaning of medications for patients. Methods: A metasynthesis of three different, yet complementary qualitative research studies, was conducted by two researchers. The first study was a phenomenological study of patients’ medication experiences that used unstructured interviews. The second study was an ethnographic study of pharmaceutical care practice, which included participant observation, in-depth interviews and focus groups with patients of pharmaceutical care. The third was a phenomenological study of the chronic illness experience of medically uninsured individuals in the United States and included an explicit aim to understand the medication experience within that context. The two researchers who conducted these three qualitative studies that examined the medication experience performed the meta-synthesis. The process began with the researchers reviewing the themes of the medication experience for each study. The researchers then aggregated the themes to identify the overlapping and similar themes of the medication experience and which themes are sub-themes within another theme versus a unique theme of the medication experience. The researchers then used the analytic technique, “free imaginative variation” to determine the essential, structural themes of the medication experience. Results: The meaning of medications for patients was captured as four themes of the medication experience: a meaningful encounter; bodily effects; unremitting nature; and exerting control. The medication experience is an individual’s subjective experience of taking a medication in his daily life. It begins as an encounter with a medication. It is an encounter that is given meaning before it occurs. The experience may include positive or negative bodily effects. The unremitting nature of a chronic medication often causes an individual to question the need for the medication. Subsequently, the individual may exert control by altering the way he takes the medication and often in part because of the gained expertise with the medication in his own body. Conclusion: The medication experience is a practice concept that serves to understand patients’ experiences and to understand an individual patient’s medication experience and medication-taking behaviors in order to meet his or her medication-related needs

A qualitative review of migrant women's perceptions of their needs and experiences related to pregnancy and childbirth

Aim: A synthesis of the evidence of migrant women's perceptions of their needs and experiences in relation to pregnancy and childbirth. Background: Despite the fact that all European Union member states have ratified human rights-based resolutions aimed at non-discrimination, there is a relationship between social inequality and access to pre-, intra-, and postpartum care. Design: A qualitative systematic review of studies from European countries. Data sources: A search was made for relevant articles published between January 1996–June 2010. Review methods: Data were analysed by means of thematic synthesis. Results: Sixteen articles were selected, analysed, and synthesized. One overall theme; ‘Preserving one's integrity in the new country’ revealed two key aspects; ‘Struggling to find meaning’ and ‘Caring relationships’. ‘Struggling to find meaning’ comprised four sub-themes; ‘Communication and connection’, ‘Striving to cope and manage’, ‘Struggling to achieve a safe pregnancy and childbirth’, and ‘Maintaining bodily integrity’. ‘Caring relationships’ was based on the following three sub-themes: ‘Sources of strength’, ‘Organizational barriers to maternity care’, and ‘The nature and quality of caring relationships’. Conclusion: The results of this review demonstrate that migrant women are in a vulnerable situation when pregnant and giving birth and that their access to health services must be improved to better meet their needs. Research is required to develop continuity of care and improve integrated maternal care

Análise de títulos de artigos de pesquisas publicadas em um periódico brasileiro de enfermagem Análisis de títulos de artículos de investigaciones publicadas en una revista brasileña de enfermería Analysis of titles of research articles published in a Brazilian nursing journal

O estudo analisa títulos de pesquisas publicadas em um periódico de enfermagem nos anos de 1997 e 1998. Os dados foram coletados através de formulário e organizados mediante a utilização do sistema computacional EPI-INFO 6, sendo que a análise fundamentou-se em literatura nacional e internacional recente relativa a análise de relatórios de pesquisa. Os resultados, dispostos em tabelas, mostraram que a maioria dos artigos analisados apresenta uma captação parcialmente adequada dos títulos, em relação às variáveis, populações estudadas e/ou palavras-chave. Conclui-se que a avaliação dos títulos de pesquisas em enfermagem ainda necessita de uma maior atenção, tendo em vista que grande parte das bases de dados, acessadas por pesquisadores, trabalha com a divulgação das pesquisas somente por meio de seus títulos.<br>El estudio analiza los títulos de investigaciones publicadas en una revista de enfermería en los años de 1997 y 1998. Los datos fueron recolectados a través de formulario y organizados por medio del uso del programa EPI-INFO 6.0. El análisis se fundamentó en la literatura nacional e internacional reciente, relacionada con el análisis de informes de investigación. Los resultados, presentados en tablas, mostraron que la mayoría de los artículos analizados presenta una captación parcialmente adecuada de los títulos, en relación con las variables, poblaciones estudiadas y/o palabras claves. Se concluye que la evaluación los títulos de investigaciones en enfermería necesita una atención mejor ya que gran parte de las bases de datos buscadas por los investigadores, trabaja con la divulgación de las investigaciones solamente por medio de sus títulos.<br>This study analyzes titles of research works published in a nursing journal in 1997 and 1998. Data were collected through forms and organized by using the EPI-INFO 6.0 computer program. The analysis was based on recent national and international literature concerning the analysis of research reports. Results, which have been disposed in tables, showed that most of the analyzed articles presented a partly adequate titles in relation to variables, studied populations and/or key words It was concluded that the evaluation of titles in nursing research still requires more attention since a large number of databases aused by researchers only publicize research work means of its titles