bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiphospholipid (Hughes) syndrome
Authors: Woodward Sue
Published: May 2014

The antiphospholipid syndrome was first described in 1983 by Graham Hughes, from the Lupus Unit at St Thomas's Hospital in London (hence its alternative name ‘Hughes syndrome’). It is now considered a major neurological disease and one of the most significant syndromes to affect neurology practice in recent years (Hughes, 2003).
A case for change: Providing options for choice and dignity
Authors: Riley Ashley
Published: May 2014

Dignity in Dying campaigns for greater patient choice at the end of life. We believe that everyone should have what they consider to be a dignified death. Campaigning for terminally ill patients to have the option of a safe, legal, medically-assisted death is just one part of our work–we campaign on a range of issues to give patients greater choice and dignity at the end of life.
Sniffing out the sense of smell
Authors: Winter George
Published: May 2014

I have a clear childhood memory of the icy scent of eucalyptus and camphor piercing my twitching nostrils. ‘There's a Wagon Wheel there for you,’ booms my Aunt Gladys from the kitchen table. Her voice is rich and gracious, like a contralto's. She sits with a towel over her head, breathing in the fumes of a steaming decoction she has prepared to wage war on her mucus-clogged sinuses. Decades later, and I'm still unable to nibble on a Wagon Wheel without conjuring the scent of those familiar head-numbing vapours and thinking of good old Glad the Inhaler.
Book Review
Authors: Braine Mary
Published: May 2014

This book is Jackie Parker's first edited book and is volume 11 in the Good Practice in Health, Social Care and Criminal Justice series, which explores topics of current concern in social and health care and the probation services. Jackie is a Brain Injury Case manager working for a North of England private practice providing case management for brain injured people. As a qualified social worker and counsellor, Jackie's background includes working with adults with mental health difficulties and head injured patients from the acute stage through to the community care. The contributors are drawn from a variety of professional specialists including, social worker, neuropsychologist, occupational therapist and legal practitioner. Despite there being only one registered nurse contributor, Carol Varley, this does not detract from the value and relevance of the information and advice offered for neurosciences nurses in this complex area of neuroscience care.
Making headway after brain injury
Authors: Finch Elaine
Published: May 2014

Many people do not realize quite how devastating brain injury can be; the effects often stay with survivors for life. Brain injury challenges nearly every aspect of daily life–walking, talking, thinking and feeling. The losses can be multiple, severe and permanent. Not only does it mean loss of the life you once lived, but can also mean the loss of the person you once were.
Reviewing progress in improving standards in acute stroke care: Toward a national strategy
Authors: Sullivan Ben
Published: May 2014

Standard 5 of the National Service Framework for Older People, published in 2001, was framed to promote equal access to a high standard of health care for stroke patients. Stroke services are currently undergoing significant review as part of the development of a new national stroke strategy. Many changes in policy and guidance are expected, particularly in the areas of finance, treatments and access. This article investigates progress in achieving the goals set out in Standard 5 of the NSF and considers the impact of changes in finance, treatment and access on the future shape of stroke services and nurses' contribution to them.
Research Round-Up
Authors: Woodward Sue
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Research Round-Up
Authors: Eberhardie Christine
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail
Improvements in the acute management of head injuries sustained in the combat zone
Authors: Preece Anne
Published: May 2014

The acute management of head injuries sustained in combat has improved over the past 100 years as principles for effective treatment have been learned. These principles have now been enshrined within a system that enables prompt triage of the wounded and removal from the battlefield to a dedicated military centre in the Midlands attached to an NHS hospital where staff gain appropriate skills and expertise from the care of both military and civilian patients. As a result, limited resources are being used to treat head injuries sustained in combat more effectively.
The use of buccal midazolam in emergency seizure management in epilepsy
Authors: Queally Catherine
Published: May 2014

The oral liquid preparation of the benzodiazepine, midazolam, may be useful in situations of prolonged or serial seizure activity to avoid the development of status epilepticus. This article outlines recent research into the use of buccal midazolam and rectal diazepam. Discussion of the benefits and side effects are included as are recommendations for practice. Considerations for administration of buccal midazolam by carers are discussed and guidelines from the Joint Epilepsy Council are highlighted.
A case of musical colour
Authors: Winter George
Published: May 2014

Decades are defined by waiting staff. For example, in the present era of communication that is the 21st century, a waiter is considered loquacious if he says ‘yep’, whereas in the 1960s a waitress would announce, ‘Hi, how's your energy today? Our light-lunch special is the Gestalt lobster–we give you the live crustacean; you take the responsibility for killing it.’
Headstrong charity for neurological conditions
Authors: Walker Ken
Published: May 2014

The Brain and Spine Foundation is a UK based charity that aims to improve the quality of life for people with neurological conditions. It was founded in 1992 by neurosurgeon Peter Hamlyn to redress what he and other health professionals saw as a grave imbalance in the resources available for tackling neurological disorders, compared to the resources available for cancer and heart patients.
Botulinum waffles
Authors: Winter George
Published: May 2014

In Woody Allen's ‘Small-Time Crooks’ (2000), Ray presents Frenchy with a box of chocolates announcing that they are ‘Hand-made by Belgiumites’. Indeed, no pub quiz is complete without the challenge to name fi ve famous Belgians, and it can't be easy for any citizen from the land of the Brussels sprout to hear their country described in France as the gateway to Germany, and in Germany as the gateway to France.
New benchmark for thrombolysis proposed
Authors: Braine Mary
Published: May 2014

A business meeting of the Neuroscience Nursing Benchmarking Group was held in London on the 22 June. Representatives from four out of the five regional groups were present. This second meeting of the year was chaired by Mary Braine, current chair of the Neuroscience Nursing Benchmarking Group.
An integrated approach to dementia care
Authors: Hunt Neil
Published: May 2014

Neil Hunt argues that a multidisciplinary approach is needed to address the disparity in care received by people with dementia in care homes
RESEARCH ROUND-UP
Authors: Coggrave Maureen
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this roundup is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Admiral nurses respond to dementia strategy consultation
Authors: Weatherhead Ian
Published: May 2014

Ian Weatherhead reports on the hopes and concerns expressed by admiral nurses following the consultation over the national strategy for dementia care
Consider continence essential to quality of life
Authors: Thomas Sue
Published: May 2014

Sue Thomas looks at continence, how it can affect patients' lives and the importance of staying up-to-date with the most recent guidelines and treatments.
The uses and limitations of functional outcomes assessment instruments in stroke trials
Authors: Quinn Terence J
Published: May 2014

Quantification of patient recovery following a stroke requires an appropriate measure of functioning. A number of instruments have been developed for this purpose and are increasingly used as the endpoint in interventional stroke trials. A basic knowledge of the uses and limitations of assessment instruments is necessary to adequately interpret trial data. Thus, familiarity with the commonly used scales is important, not just for stroke trialists but for all members of the multidisciplinary team. In this article the application, limitations and future directions of popular post-stroke functional outcome assessments will be discussed. It is recognized that several of the tools discussed also have an important role in routine clinical practice, however, for this article the author will focus on functional assessment in the context of clinical trials only.
Neurology advocates needed to support Darzi review
Authors: Thomas Sue
Published: May 2014

Sue Thomas reflects on how nurses can get involved to ensure that improvements in services for neurology patients are part of the Darzi review
Time to end discrimination against brain injury survivors
Authors: Hassall Mandy
Published: May 2014

Mandy Hassall highlights the results of a survey that indicates that health services and other agencies are contributing to discrimination against survivors of brain injury
Professor Bryan Jennett (1926-2008)
Authors: Allan Douglas
Published: May 2014

A meticulous and caring clinician who made a major contribution to contemporary neurosurgery and neuro-nursing practice
Addressing the effects of ageing in persons who have had a spinal cord injury
Authors: Sarhan Firas
Published: May 2014

Spinal cord injury has a catastrophic effect on an individual′s life causing multisystem physiological dysfunctions that lead to a series of complications: medical, physical, psychological, social and financial. These physiological impairments and nonclinical changes remain in a dynamic state for the rest of a person′s life.

Owing to medical advances and early interventions the prognosis for a person following a spinal cord injury has improved markedly from nearly certain early death to a survivable disability for the majority who may lead active, productive lives into their 60s and 70s and beyond. Therefore it has become necessary to address the effects of normal ageing on the injuries and lifestyles of people with spinal cord injury. Ageing produces physiological and psychosocial changes in all people, but in people with a spinal cord injury ageing increases the wear and tear that living with such an injury imposes on cardiovascular, metabolic, respiratory, immune, musculoskeletal, gastrointestinal, genitourinary and nervous systems, as well as on skin health and psychosocial aspects of ageing. People with a spinal injury need lifelong follow-up, treatment and monitoring by multi- and interdisciplinary teams of health and social care professionals to minimize the complications of ageing with a spinal cord injury.
Health promotion for people with spinal cord injury: Improving quality of life
Authors: Sarhan Firas , Cummings Peter
Published: May 2014

Spinal cord injury (SCI) has devastating consequences on the individuals' bodily systems and activities of daily life: the influence of SCI extends beyond the individual to affect that person's family and relationships. Consideration of several secondary conditions associated with SCI is central to establishing and maintaining the biopsychosocial wellbeing of individuals with SCI. Consequently, health promotion becomes a major focus since empowerment of the individual optimizes the patient's control over his or her own life while reducing excessive and unnecessary demand on health resources. Physical disability resulting from SCI is associated with a reduction in muscle mass. The consequent incongruity between demand and ability further stresses already compromised body systems. Therefore, physical fitness plays an especially important role in enhancing functional ability and promoting a better quality of life for people with SCI (Lanig et al, 1996) and reduction or prevention of secondary complications remains a key feature in protracted care settings
Who am I? Survivor or new aunt?
Authors: McDonald Sheena
Published: May 2014

This month marks the 10th anniversary of my suffering a very severe head injury. Champagne all round? Not exactly—I see no reason to celebrate being knocked down by a police-van driving on the wrong side of the road. Of course, my recovery so far is a daily cause for rejoicing. ‘So far’? Surely after 10 years no further recovery is possible? The experts are guarded on how long it takes to recover from any brain injury. The Brain and Spine Foundation tells us:
Exploring the lived experience of palliative care for people with MS, 2: Therapeutic interventions
Authors: Embrey Nikki
Published: May 2014

This is the second article in a series exploring patients' experiences of palliative care services in long-term conditions such as multiple sclerosis. In the first article, a literature review of palliative care services for non-cancer patients supported an argument for palliative care services being rolled out for neurological conditions across the UK (Embrey, 2008). This article examines patients' views of therapeutic interventions encountered at a day-care service. Interviews were conducted with nine patients and analysed using a phenomenological approach. Findings on patients' views of therapeutic interventions are reported here. Subsequent articles will discuss patients' views of group support and information networking. Further evidence is needed to evaluate the effect of palliative day-care hospice programmes on quality of life for people with multiple sclerosis.
Tradition and tomorrow in neuroscience nursing
Authors: Eberhardie Christine
Published: May 2014

The changing face and worldwide development of neuroscience nursing were discussed at the 10th congress of the World Federation of Neuroscience Nurses in Toronto
Treating Parkinson's disease: Dopamine dysregulation syndrome and impulse control
Authors: Gallagher Steven
Published: May 2014

Dopamine dysregulation syndrome (DDS) has emerged as a recognized complication of dopamine replacement therapy (DRT) in the treatment of Parkinson's disease. This syndrome is characterized by increased addictive patterns of behaviour in relation to DRT use, and results in impulse control disorders (ICDs), including compulsive gambling, compulsive shopping, compulsive eating, hypersexuality and punding (repetitive and excessive, aimless behaviour). Such symptoms can have devastating social, occupational and financial effects on the patient and the carer. The clinical manifestation of DDS is often not straightforward: the patient may not have the insight to recognize symptoms, and the symptoms of the syndrome do not always occur in a recognized pattern of disease progression and may be expressed individually. Clinical staff may find the assessment of DDS in clinical practice very difficult. It is important to gain evidence from carers, but this may not always be easy due to a sense of loyalty or feelings of guilt and shame. This article aims to describe the syndrome and highlight the psychosocial issues related to DDS, and the medical and surgical management options available, as well as developments in psychological therapies.
Shedding greater light on the natural history and prevalence of multiple sclerosis
Authors: Burgess Megan
Published: May 2014

This is the first in a series of articles giving a comprehensive and up-to-date review of the theory and practice of multiple sclerosis (MS). This article examines the natural history of multiple sclerosis.

MS is an autoimmune, demyelinating disease of the central nervous system with a complex and uncertain aetiology. MS was first described clinically by Jean-Martin Charcot in 1863 although the first documented case is thought to date back to the 14th century with an account of the life of St Lidwina.

The cause of MS is unclear although it is known that genetic susceptibility in combination with exposure to certain environmental factors in childhood is required for someone to develop MS. The various studies exploring the epidemiology of MS and the possible environmental factors which have been implicated will be reviewed.
Health-care reform: a brief guide and implications for neuroscience
Authors: Thomas Sue
Published: May 2014

Major changes to the NHS have been announced in recent months, but what does the new Health and Social Care Bill and accompanying policy papers mean for the NHS?
Personal injury claims and rehabilitation
Authors: Horton Jane
Published: May 2014

Personal injury claims can provide the solution to the rehabilitation needs of a seriously injured person
The impact of welfare reforms on people affected by Parkinson's disease
Authors: Veall Anjuli
Published: May 2014

People with Parkinson's disease need extra support to live independently and maintain a good quality of life. Parkinson's UK has concerns that reforms to benefits may affect the support that these people receive.
A practical approach to spasticity management in patients with multiple sclerosis
Authors: Walton Krystyna
Published: May 2014

This article provides an overview of the assessment and management of spasticity in multiple sclerosis (MS) patients from a practical clinical perspective. Spasticity is a significant factor contributing to pain and disability in patients who have MS. It can cause impaired function, painful spasms, deformity, and adversely affect the provision of care. The assessment and management of spasticity requires expertise, and the involvement of a multidisciplinary team. Treatment is primarily physical, and supplemented by pharmacological treatments, which can be systemic or focal. Management strategies should be goal directed, and targeted to the needs of the individual. The range of treatments commonly used, and the rationale for choosing specific treatments, is described in this article.
Successful multidisciplinary team working: an evaluation of a Huntington's disease service
Authors: Kenny Rebecca , Wilson Eleanor
Published: May 2014

Background:

Huntington's disease (HD) is a neurodegenerative condition that affects motor, behavioural and cognitive functioning. This triad of complex symptoms often requires input from a number of different services.

Methods:

An evaluation of a multidisciplinary, nurse-led, community-based service was conducted by undertaking interviews with 11 health and social care professionals who had worked with or as part of the HD service.

Findings:

The participants identified two elements as being key to the successful working of the HD service: team working and the role of the clinical nurse specialist (CNS). Those working as part of the HD service recognised that they contributed to a ‘virtual’ team, often not physically in the same place but coordinated and led by the CNS.

Conclusion:

The success of the HD service was due to not only the multidisciplinary nature of the team but also the specific people in those roles.
Interdisciplinary management of dysphagia following stroke
Authors: McFarlane Mary , Miles Anna , Atwal Preetpal , Parmar Paresh
Published: May 2014

Dysphagia (difficulty swallowing) is common following stroke. It significantly affects quality of life and places patients at risk of pneumonia, malnutrition and death. An interdisciplinary approach is necessary to ensure patients with dysphagia remain safe. This paper provides a review of current practice in the UK and current evidence in the management of dysphagia following stroke. The roles of the dietitian, nurse, pharmacist and speech and language therapist in dysphagia management are discussed. The article focuses on the acute phase of stroke management and short-term management of swallow safety as well as nutrition, hydration and pharmaceutical needs.
Research Roundup
Authors: Kirkcaldy Andrew
Published: May 2014

Andrew Kirkcaldy provides a synopsis and brief review of a selection of recently published research articles of interest to neuroscience nurses, highlighting the key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.

[Figure: see text]
Antenatal education: failing to educate for parenthood
Authors: Nolan Mary L
Published: May 2014

This article asked parents attending various parenteral classes what they thought should comprise the content of the classes. Results showed that parents felt that classes should be driven more by the expressed needs of the consumer rather than the assumptions of the provider.
Different woman, different views
Authors: Summers Alison , McKeown Kevin , Lord Janet , Walton Liz
Published: May 2014

The publication of Changing Childbirth in August 1993, and its endorsement as policy by the Department of Health in 1994, meant that for the first time official guidance on developing maternity services was being shaped by the views of the women who experience the services as well as the professionals who provide them.
The development of evidence-based practice
Authors: Renfrew Mary J
Published: May 2014

This article is the first in a series which will review the Issues in evidence-based practice, and describe the relevant resources. This article describes the development of evidence-based practice, including the development of the Cochrane Collaboration, the NHS Centre for Reviews and Dissemination, and the NHS Research and Development Strategy. It will examine challenges to and criticisms of evidence-based practice in midwifery.
Therapeutic teaching and the education of student midwives
Authors: Crowley Jane
Published: May 2014

This article explains what therapeutic teaching is and outlines the rationale for its use in the education of student midwives using relevant literature. Some of the difficulties in facilitate therapeutic teachinf are explored. The article finishes with an account of therapeutic teaching from the author's personal experience as a midwife lecturer.
Midwifery is in need of more good spirit
Authors: Hunt Sheila
Published: May 2014

The tabloid press loves a crisis. It gives an opportunity to exaggerate problems and undermine hardworking individuals. However, there are rumblings in midwifery, and for many, genuine concerns. One of the main issues relates to midwifery managers. In many areas midwives find themselves with little real power.
Nappy rash: causes, considerations and preventive measures
Authors: Pacanowski Lynne
Published: May 2014

An important part of the midwives role is the daily examination and advice on the care of the baby during the first few days post-delivery (UKCC, 1994), and a common area of concern among mothers is the prevention and treatment of nappy rash. As with many other areas of baby care, there is a bewildering array of products on the market which are designed to deal with this problem. In this article, following a general discussion on various aspects of nappy rash, there will be a particular focus on the use of Johnson's Baby Nappy Rash Cream as a suitable preventive cream against this irritating and often distressing condition.
Resuscitation of the newborn: whose role?
Authors: Newton Carol
Published: May 2014

Within the rapidly changing health-care environment some areas of practice periodically need fresh consideration and debate from within the profession. One such area is resuscitation of the newborn infant.
Birthmarks, body image and their implications
Authors: Wheeler Heather MD
Published: May 2014

This article describes various types of birthmark or naevus, such as spider naevus, storkbite (naevus simplex), port-wine stain, strawberry naevus and pigmented naevus (mole). The characteristics of each type of birthmark are discussed, including origin of the name, aetiology, sites of occurrence, associated complications, whether they occur singly or in multiples, and whether they are permanent or temporary, small or extensive, conspicuous or concealed, and problematic or non-problematic. The effect of these disfiguring marks on those affected and their families is also examined.
Midwifery education: Part 4 The Trent region
Authors: Fraser Diane , Peat Anne
Published: May 2014

In April 1990, Trent Regional Health Authority reorganized nursing and midwifery education into four large colleges. In the north of the region the Sheffield and North Trent College took over five midwifery schools in South Yorkshire and North Derbyshire; in Mid Trent the college encompassed all of Lincolnshire (two midwifery schools), Nottingham and Central Nottinghamshire Schools of Midwifery; to the south, Leicester School of Midwifery became the Charles Frears College of Nursing and Midwifery; and in the west, Derby College comprised just one midwifery school.
Hyperbilirubinaemia in healthy breastfed infants
Authors: Smith Megan G
Published: May 2014

Hyperbilirubinaemia in normal full-term breastfed infants has previously been consider pathologic in origin. Recent evidence shows that breastfeeding jaundice and breastmilk jaundice are aetiologically different but possibly overlapping syndromes and an exaggeration of normal physiologic mechanisms. Infants with breastfeeding jaundice may be more vulnerable to the later onset breastmilk jaundice. Recent studies show that kernicterus or neurophysiological defects rarely occur in normal breastfed infants, and call for a review of management protocols regarding the use of diagnostic tests and phototherapy. Midwives need to discern more accurately the need for diagnostic tests and to challenge outdated management protocols that aim to ‘treat’ healthy infants with hyperbilirubina.
A photo opportunity for maternity units from Bounty Services
Authors: Linnane Elaine
Published: May 2014

The practice of photographing newborns has recently taken a step into the digital age. Baby Care: Photos from Bounty is a new photography service installed in various hospitals throughout the UK, that offers choice and security to mothers, and holds financial benefits for maternity units.
Primary care-led health services and midwifery
Authors: Silverton Louise
Published: May 2014

This article considers what the primary care-led health service could mean for midwifery and the maternity services. It examines the opportunities for midwives and the changes which will need to occur for midwives to capitalize on these.
Epidural analgesia in labour: recent developments
Authors: O'Sullivan Geraldine
Published: May 2014

The pain of labour is rarely surpassed and frequently exceeds the mother's prepartum expectations (Melzack, 1984). Although epidural analgesia is the only technique that can effectively relieve pain in labour its uptake has, at least in the past, been limited by its perceived side-effects, which include total motor and sensory block of the perineum and lower limbs, the abolition of the urge to bear down, a prolongation of the first and second stage of labour, an increased rate of instrumental delivery and more recently and more controversially, an increase in the caesarean section rate (Thorp et al, 1993). Mothers, midwives and obstetricians associate these side-effects with epidural analgesia and each group is influenced, albeit differently, by this association. The ideal regional block for labour should provide rapid onset of reliable analgesia (not anaesthesia) allowing the mother to perceive ‘painless contractions’ during the first and second stages of labour and the sensation of rectal pressure in the second stage with the retention of motor power, thereby maintaining mobility and the ability to void urine spontaneously throughout labour. This article examines recent developments in epidural analgesia.
Irish domiciliary midwife fights for her professional life
Authors: Tannam Anne
Published: May 2014

Are you a midwife, highly experienced and much loved by your clients? Have you delivered hundreds of babies and provided excellent ante- and postnatal care to as many mothers? Because if you have, then read on. Because what is happening to Anne Kelly, domiciliary midwife, could happen to you.
Critical incidences and the value of reflective thinking
Authors: Miller Stephanie
Published: May 2014

Self-reflection upon practice and ‘reflective feeling’ are of inestimable value for the necessary process of self-learning and the determining of future practice. Possible definitions as to what constitutes ‘experience’, drawn from established authorities in this field of enquiry, are presented, while three wholly different, unrelated critical incidences are reviewed. These incidences, drawn from the author's own experiences, demonstrate the unpredictable and often traumatic nature of midwifery care. The author's reaction to these incidences observed through a process of self-reflection illustrates the relevance of individual reflection upon responses to situations arising from the work environment. The undoubted value of self-reflection as a learning resource is clearly shown.
Congentital malformations: breaking the bad news
Authors: Robb Frith
Published: May 2014

Telling families that their infant has a congenital malformation is the first step in a series of potentially different interactions between parents and midwives. It challenges parental pride and puts at risk a network of established relationships. Skill and forethought are required from all professionals when breaking bad news. If midwives are to give families the consideration that they both expect and deserve, maternity services need to develop specialist counselling skills and protocols concerning the disclosure of birth defects.
HIV health and safety practice: considerations for midwives
Authors: Bott Jane
Published: May 2014

The increasing HIV prevalence rate among pregnant women (Unlinked Anonymous Surveys Steering Group, 1998) serves as a warning to midwives regarding the need to protect themselves against occupational infection. Midwives working in high prevalence areas such as London are particularly at risk. The Department of Health (DoH) has recently produced guidelines for health-care workers in relation to blood-borne viruses. These guidelines include recommendations which will enable midwives to reduce their risk of occupational infection to a minimum through the use of risk reduction strategies in practice and post-exposure prophylaxis (PEP). This article aims to inform midwives of current HIV health and safety issues, drawing from the DoH guidelines (DoH, 1997; DoH, 1998). Protection of clients from HIV infected healthcare workers will also be considered, with reference to relevant UKCC standards for practice.
How to cope with haemorrhoids during pregnancy
Authors: Turner Alfred
Published: May 2014

Haemorrhoids, also known as piles, occur in about one third of adults in the UK and are particularly prevalent in women during pregnancy (Singh, 1997). They occur when the haemorrhoidal veins around the anus and lower rectum become swollen in a similar fashion to varicose veins in the legs. Haemorrhoids are purple in colour and when outside the anus may resemble a bunch of grapes. The main symptoms are feelings of irritation and soreness around the anus, and pain and/or bleeding during defecation.
HIV risk reduction and the use of universal precautions
Authors: Bott Jane
Published: May 2014

Prevention of occupational infection is an important issue for midwives to consider when caring for women who may be unknowingly infected with human immuno-deficiency virus (HIV). Universal precaution (UP) is now a common concept and guidelines have been developed to enable all health-care workers to reduce their risk of occupational exposure to HIV and other body fluid and blood-borne infections. However, issues surrounding implementation of UP into midwifery practice are complex. Research undertaken by the author will be summarized in this article, which will highlight some of the key issues. The research findings highlight the need for effective education, well-publicized guidelines and a conducive work environment. Role models within the practice area appear to facilitate successful adoption of UP by midwives within the practice areas. In addition to providing equipment, managers need to review the effectiveness of the equipment, and introduce safer devices, as they become available. The findings suggest that a democratic management style, with an emphasis on team working, is more suited to the successful implementation of UP. Staff development needs may be identified during Individual Performance Review (IPR).
Conscientious objection to participation in abortion
Authors: Jones Shirley R
Published: May 2014

The law clearly states the right of health-care professionals to act according to their ethical beliefs, in order to prevent their personal moral compromise, yet it would appear that a variety of interpretations of this right exist. This paper seeks to clarify the situation regarding a midwife's conscientious objection to participation in the process of abortion.
Models of care and midwifery in the millennium
Authors: McFarland Noëleen
Published: May 2014

The aim of this article is to shatter the myth that all models of care are passé and to explore what health promotion models have to offer an evolving midwifery profession. Models are representative of something that facilitates understanding, explaining abstract concepts whilst clarifying the interrelations between its components. Midwives should use them to explain how they organise their thinking and how they transfer that thinking into practice with order and effectiveness asserting their position within the health service and Primary Care Groups/Trusts. Health promotion is a concept now in frequent use and of increasing importance and midwives must become more involved with (Department of Health, 1992; Department of Health, 1998b). Models can define a midwife's scope of practice proving to the Government that their role is paramount if its new NHS reforms are to be successfully implemented (Department of Health, 1999).
Perineal Care — following in Jennifer Sleep's footsteps
Authors: Kettle Christine
Published: May 2014

The pioneering clinical research carried out by Professor Jennifer Sleepover the past 20 years has made a significant contribution to perineal care during childbirth. Jennifer's work has helped health professionals to understand the effects of perineal trauma from the mother's perspective and has contributed to the mangement of both limiting and treating the injury. Most women experience some degree of genital tract trauma during vaginal birth and for some women the impact of such injury may be substantial, affecting her physical, psychological and social wellbeing both in the immediate and long-term postpartum period (Glazener et al, 1995). It can also disrupt breast-feeding, family life and sexual relations (Sleep and Grant, 1987; Glazener, 1997).
Adolescent sexual behaviour and knowledge
Authors: van den Akker OBA , Andre J , Lees S , Murphy T
Published: May 2014

This study aimed to determine whether sexual knowledge, feelings and behaviour differed between male and female adolescents. It was anticipated that there may be a culturally determined gender difference influencing adolescent boys' and girls' approaches to sex in the UK. This could have major implications for midwives in their roles as health promoters, sex educators, and for those providing contraceptive and pregnancy services. Two hundred and twelve, 11 to 19 year olds were recruited. Girls' empowerment in sexual matters was significantly more sophisticated than that found in boys. Differences between genders are important, and need to be considered when targeting sex education and interventions, in attempts to prevent unwanted teenage pregnancy. All health care providers, in touch with adolescents, would benefit from a gender specific tailored approach to advising, educating and supporting adolescents.
Consent, accountability and the rights of the fetus
Authors: Dimond Bridgit
Published: May 2014

Answers are given to some of the legal concerns held by midwives including the determination of capacity to make decisions, the form of giving consent, exempting the midwife from her duty of care and the rights of the fetus.
Part 2: human rights
Authors: Dimond Bridgit
Published: May 2014

In the first article on law, the sources of law: statute and common law were explained. This second step explains the significance of the Human Rights Act 1998.
Transition: Becoming a student midwife
Authors: Goldman Fiona
Published: May 2014

It interests me that time behaves strangely in unfamiliar situations. I have been a student midwife for ten weeks, and it is just beginning to feel like ten weeks. Four weeks ago, it felt like months, and eight weeks ago it felt like years. That says something of the nature of ‘transition’ and how it affects me. I remember years ago saying that I did not like change and that I was not very good at it. I think I just did not understand it very well — the confusion it caused left me off balance and out of control. I feel now that transition is an interesting place to be, because most of us are there, most of the time, in one way or another.
Part 3: Criminal and civil law
Authors: Dimond Bridgit
Published: May 2014

Law derives from two main sources: statute law and common law. Criminal and civil law derive from both statutes and common law. The terms criminal and civil apply to the nature of proceedings which follow and infringement of the law.
So what exactly is clinical governance?
Authors: Hunt Shella C
Published: May 2014

Clinical governance is an old concept with a new name. Like all new ideas, it is misinterpreted and often misunderstood. It is a matter for all midwives and likely to become one of the hottest issues of the new NHS. It simply means being accountable for professional practice and having individual responsibility for the quality of care being offered to childbearing women and their families.
Alternatives to litigation 2: no fault compensation
Authors: Symon Andrew
Published: May 2014

No-fault compensation has been suggested as a way of avoiding the unpredictability of litigation, and as a more efficient system of ensuring that those with serious handicap are financially compensated. However, difficulties with defining medical accidents, and concerns about the cost of such a scheme, have stalled moves to introduce this radical change.
Reproduction and contraception
Authors: Allen Rose , Burke Margaret
Published: May 2014

Hardly a day goes by without some reference being made to human reproduction by the media. While on one hand it is suggested that the world is overpopulated, indeed Roux (1995) suggests that uncontrolled population growth has made humans an endangered species. Yet on the other hand, women go to extremes to fulfil their right to reproduce.
Birth plans: how are they being used?
Authors: Kitzinger Sheila
Published: May 2014

Birth plans are often rejected, ignored, trivialized or ridiculed by care-givers. They may be appropriated by the medical system and used to obtain patient compliance. Birth plans can, however, be used constructively to inform, build positive relationships and increase self-confidence.
New developments in breastfeeding initiatives
Authors: Jamieson Lea
Published: May 2014

Midwifery has many areas where one can develop knowledge and skills. Breastfeeding is one such area and all study relating to it enhances midwifery practice. The advent of degrees and diploma courses in midwifery, though able to point in to the evidence which informs our breastfeeding practice, because of other priorities, cannot give sufficient time to explore breastfeeding at the depth possible.
Young people's views on breastfeeding
Authors: Ineichen Bernard , Pierce Mary , Lawrenson Ross
Published: May 2014

Breastfeeding rates appear to have levelled off in recent years, and variations by area, class and culture remain. In many cases, attitudes are formed in early life, and surveys of young people find their attitudes towards breastfeeding are often negative. Campaigns to reverse attitudes have been fairly successful. Further education of schoolchildren on the merits of breastfeeding is needed, taking into account existing variations in breastfeeding rates.
Part 5: the standard of care
Authors: Dimond Bridgit
Published: May 2014

In the last article it was explained that any person claiming compensation had to prove four elements of negligence: that a duty of care was owed; that there had been a breach of that duty; that harm had occurred; as a result of that breach of duty i.e. duty, breach, causation, and harm. The duty of care was explored last time. Here we consider the standard of care and whether there has been a breach of that standard.
Back pain: causes, symptoms and treatment
Authors: Lloyd Nicola
Published: May 2014

Back pain is a very common problem experienced by 60–80% of the population at some time in their lives (Clinical Standards Advisory Group (CSAG), 1994), with an increased prevalence in the 16–24 age group (National Back Pain Association, 1999). Back injury is the largest single recorded cause of long-term sick leave with 119.874 million days of certified incapacity recorded in 1996/7 and with annual costs to industry and the NHS of at least £6 billion and £480 million respectively (National Back Pain Association, 1999).
Delivering friends and relatives
Authors: Walsh Sandra
Published: May 2014

To know your midwife is said to increase the quality and satisfaction of the experience of childbirth, so what better than to have a midwife caring for you who is also a friend or relative?
A legal right to abortion: right or wrong?
Authors: Dimond Bridgit
Published: May 2014

In a recent cas a woman failed in her claim that her GP had wrongly refused to make arrangements for her to have a termination of pregnancy. The Abortion Act 1967 (as amended) is considered in relation to the rights of the woman and the extent of the right of a person to refuse to take part in a termination. Does this latter right extend to the evacuation of retained products? The implications of National Standard Frameworks and the National Institute for Clinical Excellence for termination of pregnancies are considered.
Communication: issues for change
Authors: Tennant Julie , Butler Margaret
Published: May 2014

This article examines midwives' communication practices when interacting with women, other midwives and health professionals. Derived from a retrospective study, discussion centres around communication priorities in relation to these interactions. An analysis of midwives' communication practices is framed within contemporary dialogue surrounding the complex nature of woman-centred care.
The attack on normal birth
Authors: Robinson Jean
Published: May 2014

It does get wearisome defending the same hard-fought territory over and over again. The UKCC hearing on Caroline Flint's case has unleashed an astonishing backlash in the press against those of us who support a woman's right to have a normal birth if that is what she wants. ‘Natural born fanatics’ wrote one woman in the Sunday Times (Knight, 1999). ‘Natural Born Backlash’ said another in The Guardian (Bennett, 1999). The funny thing is, in more than 20years of campaigning for better maternity care, I have never heard women who wanted a normal birth, at home or in hospital, insisting that every other woman should do likewise. They only wanted it for themselves and to preserve its existence for others. Yet somehow it is they, not the maternity services, who are responsible for bad experiences, or making other women feel guilty. It was left to Jean Murray in one of the tabloids to redress the balance and point out in what context the natural birth movement was born and how many women had benefitted from it (Murray, 1999).
Finding the evidence: using the internet
Authors: Sandall Jane
Published: May 2014

The aim of this article is to introduce the specific features of the internet, to introduce you to the variety of information types and sources available on the internet to find and evaluate information relevant to your work/interests.
Midwifery and healthcare in China
Authors: Vials Joyce M
Published: May 2014

This article begins with an insight into the culture and politics that have shaped, and are still shaping maternity, child and health care in China. It illustrates the wide variance in care according to where people live, work, and how affluent they are. We visited two top hospitals, clinics and kindergartens in the cities of Beijing and Shanghai, a provincial private hospital in Xi'an and a country clinic in Guillin. Most of the visits were to government run facilities, but included one company hospital.
Why aren't midwives feminists?
Authors: Stephens Lis
Published: May 2014

At the RCM Annual conference this year I found myself irritated once again by the use of the outdated and very obviously erroneous use of the phrase Madam Chairman. When I have commented to colleagues that I find this use of sexist language offensive at a gathering of midwives whose stated aim is to be with woman, and who are more than 99% women, I tend to get that exasperated look that leaves me thinking maybe I am a bit of an eccentric crank after all.
Can midwife-managed units improve continuity of care?
Authors: Reid Margaret , Young Denise , Gilmour W Harper
Published: May 2014

This study aimed to determine whether a midwife-managed programme could improve continuity of care over that achieved by shared care (i.e. care divided between hospital doctors, midwives and GPs). A randomized controlled trial (analysis by intention to treat) was conducted at the Glasgow Royal Maternity Hospital, which compared 648 women allocated to receive midwife-managed care and 651 allocated to receive shared care. The two main study outcomes were continuity of advice and continuity of carer. Data were collected via questions included in self-report questionnaires sent to women's homes at three time periods (response rates ranged from 63.1% to 85.3%) and a case record review. Women in the midwife-managed group reported receiving more consistent advice across all care periods. For example, during antenatal care, 51.0% of women in the midwife group reported receiving consistent advice all of the time, compared with 21.2% of women in the shared-care group (difference [diff] = 29.9%; 95% confidence interval [CI]; 24.1% to 35.6%). Overall, women in the midwife-managed group saw seven fewer care providers (midwife care mean = 10.0 [standard deviation [SD] = 6.3]; shared care mean = 17.1 [SD = 6.1], diff = -7.1; 95% CI; -8.4 to -5.8). At 7 months follow-up, 4.0% of women in the midwife group reported that they had seen too many or far too many staff during their care, compared with 28.3% of women in the shared care group (diff = -24.3%; 95% CI;-30.7% to -17.8%). These results suggest that midwife-managed care programmes can improve continuity of care.
Knowing your midwife during labour
Authors: Shields Noreen , Holmes Ann , Cheyne Helen , McGinley Mary , Young Denise , Gilmour W Harper , Turnbull Deborah , Reid Margaret
Published: May 2014

The paucity of research examining effects of a known carer during labour has been highlighted by a number of authors. This paper compares clinical and psycho-social outcomes of women cared for by a known midwife during labour with those cared for by an unknown associate midwife. Economic implications are also discussed.