bluuebunny/crossref_metadata_2025 huggingface dataset:
Myocardial Protection by Glucose–Insulin–Potassium in Moderate- to High-Risk Patients Undergoing Elective On-Pump Cardiac Surgery: A Randomized Controlled Trial
Authors: Ellenberger Christoph , Sologashvili Tornike , Kreienbühl Lukas , Cikirikcioglu Mustafa , Diaper John , Licker Marc
Published: January 2018

BACKGROUND:

Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose–insulin–potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery.

METHODS:

A randomized controlled trial was performed in adult patients (Bernstein–Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction. The primary end point was postcardiotomy ventricular dysfunction (PCVD), defined as new/worsening left ventricular dysfunction requiring inotropic support (≥120 minutes). Secondary end points were the intraoperative changes in left ventricular function as assessed by transoesophageal echocardiography, postoperative troponin levels, cardiovascular and respiratory complications, and intensive care unit and hospital length of stay.

RESULTS:

From 224 randomized patients, 222 were analyzed (112 and 110 in the placebo and GIK groups, respectively). GIK pretreatment was associated with a reduced occurrence of PCVD (risk ratio [RR], 0.41; 95% confidence interval [CI], 0.25–0.66). In GIK-treated patients, the left systolic ventricular function was better preserved after weaning from bypass, plasma troponin levels were lower on the first postoperative day (2.9 ng·mL−1 [interquartile range {IQR}, 1.5–6.6] vs 4.3 ng·mL−1 [IQR, 2.4–8.2]), and cardiovascular (RR, 0.69; 95% CI, 0.50–0.89) and respiratory complications (RR, 0.5; 95% CI, 0.38–0.74) were reduced, along with a shorter length of stay in intensive care unit (3 days [IQR, 2–4] vs 3.5 days [IQR, 2–7]) and in hospital (14 days [IQR, 11–18.5] vs 16 days [IQR, 12.5–23.5]), compared with placebo-treated patients.

CONCLUSIONS:

GIK pretreatment was shown to attenuate PCVD and to improve clinical outcome in moderate- to high-risk patients undergoing on-pump cardiac surgery.
Mechanisms of erythrocyte development and regeneration: implications for regenerative medicine and beyond
Authors: Bresnick Emery H. , Hewitt Kyle J. , Mehta Charu , Keles Sunduz , Paulson Robert F. , Johnson Kirby D.
Published: January 2018

Hemoglobin-expressing erythrocytes (red blood cells) act as fundamental metabolic regulators by providing oxygen to cells and tissues throughout the body. Whereas the vital requirement for oxygen to support metabolically active cells and tissues is well established, almost nothing is known regarding how erythrocyte development and function impact regeneration. Furthermore, many questions remain unanswered relating to how insults to hematopoietic stem/progenitor cells and erythrocytes can trigger a massive regenerative process termed ‘stress erythropoiesis’ to produce billions of erythrocytes. Here, we review the cellular and molecular mechanisms governing erythrocyte development and regeneration, and discuss the potential links between these events and other regenerative processes.
Multiple Sclerosis and Exercise: A Literature Review
Authors: Reynolds Eric R. , Ashbaugh Andrew D. , Hockenberry Brandon J. , McGrew Christopher A.
Published: January 2018

Multiple sclerosis (MS) is the most common autoimmune disabling neurological conditions of young adults and affects more than 2.3 million people worldwide. Given the high likelihood for disability and decreased neurological function, there have been concerns about the role of exercise in MS patients with a fear of increased injury. This article looks at recent articles evaluating the role of exercise in MS and can hopefully be used by patients, caregivers, and health care providers to guide decision making about the role of exercise in patients with MS.
Genitourinary involvement of lymphomas on FDG-PET
Authors: Naik Nikita , Lin Michael , Lin Peter
Published: January 2018

Primary extranodal lymphomatous involvement of the genitourinary tract is rare and secondary extranodal involvement in disseminated disease occurs more frequently. Imaging of metabolic activity with 2-(fluorine-18) fluoro-2-deoxy-d-glucose (FDG) used in PET facilitates the identification of these extranodal sites of disease, particularly in the absence of structural lesions on conventional imaging modalities. Primary extranodal lymphoma affecting the genitourinary system is often caused by high-grade Non-Hodgkin’s Lymphoma (NHL) with the most common subtype being diffuse large B-cell lymphoma (DLBCL). Although rare, the incidence of extranodal lymphoproliferative disease is increasing and a delay in diagnosis holds a poor prognosis. Familiarity with benign and physiological causes of FDG uptake, particularly due to the urinary tracer excretion is crucial in identifying sites of lymphomatous involvement in the genitourinary system. Additionally, non-lymphomatous malignancies are usually treated surgically, whereas lymphoma is primarily treated with chemotherapy and/or radiotherapy. Therefore, accurate identification and staging together with histological confirmation significantly impacts management of these patients. This article serves to review and illustrate the imaging findings on FDG-PET/CT of primary extranodal lymphoma affecting the genitourinary system.
Insulin resistance indices and coronary risk in adults from Maracaibo city, Venezuela: A cross sectional study
Authors: Salazar Juan , Bermúdez Valmore , Olivar Luis Carlos , Torres Wheeler , Palmar Jim , Añez Roberto , Ordoñez Maria Gratzia , Rivas José Ramón , Martínez María Sofía , Hernández Juan Diego , Graterol Modesto , Rojas Joselyn
Published: January 2018

Background: Insulin resistance (IR) is a metabolic disorder related to atherosclerosis. Its measurement is of great importance not only as a marker of diabetes but also for cardiovascular disease. The aim of this research study was to evaluate the relationship between various IR indices and coronary risk in an adult population from Maracaibo city, Venezuela.

Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub study, 1272 individuals of both genders were selected with the measurement of basal insulin and coronary risk according to the Framingham-Wilson formula calibrated for our population. The insulin resistance indices evaluated were HOMA2-IR, triglycerides and glucose index (TyG) and triglycerides/HDL ratio (TG/HDL). The predictive capacity and association between each index and the coronary risk event in 10 years were determined.

Results: Of the evaluated population, 55.2% were female, 34.8% had a coronary risk ≥5% in 10 years, with the TG/HDL and TyG indices showing the highest AUC 0.712 (0.681-0.743) and 0.707 (0.675-0.739), respectively; compared to HOMA2-IR. Both were also the indices most associated with increased coronary risk, especially TG/HDL ≥3 with a higher association [OR = 2.83 (1.74-4.61); p<0.01] after multivariable adjustment.

Conclusions: TyG (≥4.5) and TG/HDL (≥3) indices showed a great predictive capacity of higher coronary risk, with being TG/HDL more associated even after adjusting for abdominal obesity and hs-CRP. Therefore, these represent useful tools for determining IR.
Social adaptation of convicted persons: the interaction of territorial bodies criminally-Executive system, bodies of state power of subjects of the Russian Federation and bodies of local self-government
Authors: Каляшин Андрей , Kalyashin Andrey
Published: January 2018

In the work the analysis of normative legal acts regulating the organization of social adaptation of convicted persons, the interaction of territorial bodies of Federal service of execution of punishments of the Russian Federation subjects and local authorities in its implementation and practice. Obtained in the course of the study helped to formulate specific proposals on the interaction of different levels of government.
The work is addressed to practitioners of criminal-Executive system, to persons engaged in social adaptation of convicts. Designed for use in educational process of educational institutions of Federal service of execution of punishments, as well as in research activities.
A step-by-step guide to the research process
Authors: Rees Colin
Published: January 2018

Where do you start with a research project? Research follows a logical series of stages and the aim of this article is to describe the steps involved. This will be of use both to those asked to carry out research and to those wishing to make use of published research.
Alternative therapies in pregnancy
Authors: Jones Kath
Published: January 2018

The use of alternative therapies in pregnancy and childbirth is becoming very popular. As women are being allowed more control over their childbirth experience, they are afforded the opportunity to use alternative therapies. This article describes some of the homoeopathic remedies used in pregnancy and presents a case study in which homoeopathic remedies were used in pregnancy and labour.
Student midwife selection — is it a lottery?
Authors: Alexander Jo
Published: January 2018

I have recently been involved, for the first time, in the selection of preregistration student midwives and this has led me to reflect on the basis on which we decide to accept one candidate while rejecting another. Presumably our first concern is to select someone who will make a ‘good’ midwife but we have little evidence as to what constitutes a good midwife, or even good midwifery. My personal portrait of a good midwife is one who is competent and calm, even in a crisis, able to form warm empathic relationships with women and their supporters, respectful of the rights and wishes of others, open-minded, flexible and tolerant, with well-developed counselling and health-promotion skills. Perhaps we should also include the ability to manage a caseload or the potential to carry the profession forward. However, should we be looking for candidates who already have these ‘virtues’ or for those who we feel have the potential to develop them?. Do we sometimes select what we consider to be good potential students rather than good practitioners, i.e. those likely to show some initative but not rock the boat too much?
Concern over demand forecasting of student midwives
Authors: Tucker Christina A
Published: January 2018

By this time of the year, midwifery educationalists have just received their contracted student midwife numbers for the following year. This exercise of manpower planning has no rational or scientific basis, but is more akin to crystal ball gazing and Russian roulette.
Effectiveness of antenatal education
Authors: Nolan Mary
Published: January 2018

Research into the effectiveness of antenatal eduation has considered both obstetric outcomes and the quality of the mother's childbirth experience without reaching any definite conclusions. There remains a need to identify more precisely both the clients' and the educators' agendas. A literature survey points to strategies for making classes more mother centred and a better source of health education.
Collaborative care planning in a maternity unit: 1
Authors: Mason Frances , Clark Jenny
Published: January 2018

The aim of all health care professionals should be to provide quality care and make the most effective use of resources. Collaborative care planning (CCP) is a means of achieving this, as it provides the opportunity to critically examine both the management and delivery of health care in hospital and in the community.
Maternity and child care in China: 1
Authors: Walton Irene , Turner Chani
Published: January 2018

A party of 25 midwives from all over the world went on a study tour of China organised by the British Journal of Midwifery. Part 1 of this article describes maternity and child care in China as a whole as well as focusing in particlular on the midwives' experiences in Beijing and Shanghai.
Huntleigh Fetal Dopplex II
Authors: Smithson Sue
Published: January 2018

This article describes the advantages and disadvantages of the Fetal Dopplex II as a means of monitoring the fetal heart rate electronically. It describes how the machine works and the implications it has for midwives.
Midwifery challenge to medical paradigm in maternity services
Authors: Davis Lorna
Published: January 2018

In recent years midwives have been disempowered by the emergence of a medical model as the dominant paradigm in maternity services. This article explores the potential for midwives to challenge this domination by the use of conceptual models, questioning common-sense practice, developing reflective skills and utilising action research.
How secure is your maternity ward?
Authors: Jackson Kate
Published: January 2018

At the beginning of the year, a stranger dressed as a nurse abducted a baby from her mother's room within a maternity unit. Since that time, not surprisingly, many new parents and the staff who care for their newborn babies have questioned arrangements for security in maternity care.
Midwifery team approach with the coffee morning network
Authors: Curran Val
Published: January 2018

In an attempt to provide mothers-tobe with better antenatal care, and to encourage greater interaction between midwives and patients, Southlands Hospital set up a coffee morning network. This article discusses how the scheme has fared.
What women want from midwives
Authors: Hutton Eileen
Published: January 2018

Consistent messages have come from women about the importance of the quality of the relationship with their midwife and how this can make or mar their experience of pregnancy, labour and early postnatal days. Good communication with a well-informed midwife committed to supporting the woman as an individual is highly valued.
Women's rights in relation to reproductive health
Authors: Chalker Baroness
Published: January 2018

The International Conference on Population and Development was held in Cairo in September 1994. Originally, the aim was to develop strategies to manage population issues around the world, but the emphasis quickly turned to meeting the needs of individuals. This article, written by Baroness Chalker, outlines the achievements of the conference.
Midwifery and childcare in China: 2
Authors: Walton Irene , Turner Chani
Published: January 2018

Part two of this article describes midwifery and childcare in the eastern part of China where care was more traditional than in the west of China and there was more opportunity to see Chinese medicine in use.
Is trust status changing the midwife manager's role at ward level
Authors: McCrea Hally
Published: January 2018

Trust status in NHS hospitals is influencing the role of midwife managers at ward level in a way that few management changes have done before. This seems to be the case throughout the UK irrespective of the title designated to midwives at this level. In Northern Ireland, for example, the traditional title of ‘ward sister’ still prevails, whereas in England it has been replaced by ‘team leader’.
Causes and treatment of infertility
Authors: Joels Lisa A , Wardle Peter G
Published: January 2018

Infertility requiring specialist help affects 1 in 6 couples at some time in their lives. This article examines the various causes of infertlity and concludes that assisted conception offers the most effective treatment for about 25% of infertile couples.
Reflections on a change in post
Authors: Warwick Cathy
Published: January 2018

A month ago I changed jobs. I moved, after a spell of 14 years in midwifery education, into the clinical management post of Director of Midwifery and Gynaecology Nursing Services at King's Health Care Trust, London. I gave 3 months notice in my old job and, inevitably, during this time, got involved in discussions about ‘why I was doing it’.
One-to-one midwifery practice
Authors: Page Lesley , Jones Barbara , Bentley Rosslyn , Cooke Pauline , Harding Maggie , Stevens Trudy , Wilkins Ruth
Published: January 2018

Changing Childbirth, the report of the Expert Maternity Group, published in August 1993, is to be put into action. The development of oneto-one midwifery practice serves as an example of how a changing childbirth service may be developed.
TAC-TIC: how do special care baby unit babies react to it?
Authors: de Róiste Áine , Bushnell Ian , Burns Joan
Published: January 2018

This study looks at the reactions shown by a group of premature and low-birthweight babies to a programme of sequenced stroking, called TAC-TIC. It also sets out to ascertain whether mothers, as compared to fathers, elicit different behavioural reactions while stroking their baby and whether they enjoy interacting with their babies using TAC-TIC.
Maternal and congenital toxoplasmosis
Authors: Thow Sally
Published: January 2018

Toxoplasmosis is an infection which can have a devastating effect on the fetus and pregnancy. This article discusses the issues that surround the infection and examines ways that it can be prevented.
Changing Childbirth: Encouraging debate
Authors: Jackson Kate
Published: January 2018

In the January edition of this journal Mary Stewart (‘Do you have to know your midwife’ Vol3, No 1, 1995: 19–20) challenged one of the basic concepts within Changing Childbirth (Department of Health, 1993): that services should be designed to try and ensure that 75% of women are looked after by a known carer while in labour. She argued that the recommendation was not based on sound evidence and questioned whether:

‘we could really justify a system that results in exhausted and disillusioned midwives?’
Coitus interruptus as a method of contraception
Authors: White Orla
Published: January 2018

The paucity of research on coitus interruptus is part of the reason why many health professionals who give contraception advice do not even recognise it as a method of contraception. This article examines the available evidence from a historical and sociological perspective and invites readers to draw their own conclusions based on informed choice.
Midwifery education betrayed
Authors: Rocb Sarah
Published: January 2018

The sorry truth that the English National Board (ENB) is increasingly impotent and no longer able to protect professional education standards against the economic demands of the government and higher education is made manifest in a recent letter entitled ‘Board decisions relating to staff:student ratios (SSRs) in nursing and midwifery education’ (DCL/24/RLV/ November 1994). At a stroke, the hard won SSRs for midwife teachers are abolished with no proper consultation and the specious rationale that this is a research-based decision by the ENB. A close look at the research (Murray et al, 1994) shows that this argument is invalid, although the research indicated, fairly predictably, that SSRs are not necessarily the most reliable indicator of quality education. This latter statement is not being challenged, and the ENB's suggested quality criteria are useful, but without the numerical ratio, the ability of midwifery education to retain an SSR as favourable as 1:10 for preregistration courses is vastly reduced.
Use of alternative therapies in childbirth
Authors: Silverman Ruth
Published: January 2018

Increasing interest in alternative therapies means that midwives are often asked by women either to advise on or use alternative therapies. However, midwives generally have a limited knowledge and are not able to do this. This article discusses acupuncture, hypnotherapy, aromatherapy and massage.
The National Board for Northern Ireland
Authors: McCausland Rhoda
Published: January 2018

The National Board for Nursing, Midwifery and Health Visiting for Northern Ireland is committed to the provision of high quality pre-and postregistration education in Nursing, Midwifery and Health Visiting. It makes a vital contribution to Midwifery Practice through the development and provision of Midwifery Education within the Northern Ireland College of Midwifery.
Introduction to ethnographic research in midwifery
Authors: Davies Ruth
Published: January 2018

This article introduces the basic principles underlying ethnographic research. It is suggested that greater use of the method may enable midwives to acquire cultural knowledge and an improved understanding of the process, within the unique culture of midwifery.
Providing midwifery care in a multi-cultural society
Authors: Bharj Kuldip
Published: January 2018

This article focuses on how the needs of women from black and minority ethnic communities can be incorporated by individuals and organisations to provide a more responsive, appropriate, sensitive and equitable maternity service.
A prominent role for local supervising authorities
Authors: Steene Jill
Published: January 2018

During the last year the profile of the supervision of midwives has been raised significantly. One of the main reasons for this is that the benefits which can be achieved for mothers, babies and midwives through good supervision have begun to be recognised and it is being used more positively than ever before to enable and encourage midwives working in the changing maternity services to develop and improve their practice. More recently, the role of the local supervising authority (LSA) has achieved a new prominence in England as proposals for changes to the regional health authorities (RHAs) have been suggested. There are no proposals for change at present in Scotland or Northern Ireland although in the future there will be changes in Wales which follow the same principles as those now taking place in England.
Ethics and obstetric ultrasound: 2
Authors: Proud Jean
Published: January 2018

Women who accept the offer of a scan have very often been persuaded to do so by well-meaning health professionals who feel that it is part of ‘safe practice’ to encourage women to enter screening programmes. However, they often minimise the possibility that anomalies may be discovered. This article discusses the professional status of those who perform ultrasound scans, ethical implications and safety issues involved in ultrasound screening programmes.
Behavioural iatrogenesis
Authors: Robinson Jean
Published: January 2018

It must be 15 years ago, but I have a vivid memory of the woman who appeared on my doorstep one summer afternoon. Susan was petite, pretty, smiling, and neatly dressed. Her GP had suggested that she come and see me. Could we have a chat?
Continuity of carer: miracle or mirage?
Authors: Walsh Denis
Published: January 2018

Setting up continuity of carer schemes in large maternity units in response to Changing Childbirth objectives is a complex and demanding task. This article, the first of three detailing one unit's experience of such a task, addresses the research basis of continuity of carer, particularly intrapartum, and raises questions about its meaning and application.
Tensions in the system
Authors: Warwick Cathy
Published: January 2018

Women's expectations of the maternity services following publication of the Changing Childbirth report in August (Department of Health, 1993) may be greater than can be achieved — particularly at a relatively early stage of the report's implementation — and beyond what would be considered an acceptable standard.
Midwifery in Sahiwal, Punjab, Pakistan
Authors: Brady Margaret , Shotton Eve
Published: January 2018

This article explores the system of midwifery care that is administered in Sahiwal in the Punjab, Pakistan, witnessed by the authors when they visited the area, and previously encountered by a separate group of midwives who live in Rochdale, Lancashire.
The Wistow project and intrapartum continuity of carer
Authors: Walsh Denis
Published: January 2018

Large caseloads, referral pattern anomalies, inappropriate grade mix and hospital core cover all complicate the setting up of intrapartum continuity of carer schemes. This second article on the Wistow Project in Leicester explores these issues and makes recommendations. The application of the concepts of named midwife and lead professional and the midwifery group practice model in practice are explained in detail.
Indicators of success
Authors: Jackson Kate
Published: January 2018

When the Expert Maternity Group (EMG) was near to completing its report, they — like many committee members before them — were keen to ensure that their recommendations would be implemented. They were equally keen to establish a mechanism to help assess whether the desired changes were being achieved.
Book reviews
Authors: Davis Sam , Greaves Julie , Rea JC , Sandall Jane
Published: January 2018

Improving Infant Health

Reactions to Motherhood

Special Care Babies and their Developing Relationships

Sexuality and Motherhood
Postnatal care cannot be ignored
Authors: Bick Debra
Published: January 2018

Changes to the maternity services in response to the recommendations of Changing Childbirth (Department of Health, 1993) are to be welcomed, particularly with regard to the commitment to a woman-centred approach. However, the need for evaluation and further research into the organisation of postnatal care should be addressed if women are to receive the most appropriate care after their delivery, as well as during pregnancy and labour. The House of Commons Select Committee Report on the Maternity Services (1992) highlighted the lack of information about postnatal care of the mother. The evidence submitted to the Committee from the Royal College of Midwives (1992) concluded that, ‘the lack of research reflected a lack of good practice in this important area.’
Ethics and obstetric ultrasound: 3
Authors: Proud Jean
Published: January 2018

All normal people make moral decisions. To a certain extent, morality is determined by culture, religious beliefs and social circumstances. Having considered ethical theories in the previous two articles, the cultural background, which is often based on religious beliefs, is discussed here in relation to ultrasound.
Drugs, the law and the midwife: 1
Authors: Simpson Doreen , Smith Ron
Published: January 2018

When acting in their professional capacity, midwives have the ability to sell, supply and administer certain drugs without recourse to a medical practitioner. This article — the first of two — aims to outline the midwife's responsibility regarding drugs in relation to current legislation and regulations.
The management of change
Authors: Walsh Denis
Published: January 2018

The management of change may be critical to the success or failure of new projects. This final paper on the Wistow Project describes this process using nine common impediments to change to illustrate helpful strategies for leading change.
The very pre-term baby and health service rationing
Authors: Rea Jackie
Published: January 2018

The purpose of this article is to discuss the concept of rationing in the NHS with particular reference to care of the very low birth-weight baby (those who are born weighing <1000g). It is intended to address this topic using a four ‘E’s' framework. The three ‘E’s': economic, effective and efficient are probably well known in many public and private sector domains. It is also intended that a further ‘E’, that of ethics, be introduced.
Matthew's story: an ethical dilemma
Authors: Miller Pam
Published: January 2018

This article discusses the plight of preterm babies and the ethics of whether or not they should be kept alive. A particular case is cited: that of a baby called Matthew who died after he was born at 26 weeks gestation.
The Safe Motherhood Initiative and VSO
Authors: Date Lara
Published: January 2018

This article discusses the role of the Safe Motherhood Initiative in overseas countries and the role that VSO (Voluntary Service Overseas) midwives play in implementing this programme.
Intrapartum emergencies: experience matters
Authors: Jackson Kate
Published: January 2018

In common with the Confidential Enquiries into Maternal Deaths Report (Department of Health, 1994), the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) (Department of Health, 1995) makes salutary reading.
Supervision of midwives: proposed changes to the Midwives' Rules
Authors: Steene Jill
Published: January 2018

The UKCC and in particular its Midwifery Committee have been concerned for some time about the difficulties experienced by some midwives and supervisors of midwives in relation to the statutory supervision of midwives. In response to this concern, during the past year the Midwifery Committee has undertaken work in order to assess the current situation in relation to the supervision of midwives. The purpose of this work has been twofold: To develop an up-to-date picture of the way that the supervision of midwives is being exercised across the UK To consider whether or not further standards should be developed to improve and strengthen the supervision of midwives for the future.
Should women prisoners be handcuffed during labour?
Authors: Todd Jane
Published: January 2018

Arecent instruction by the Director of The Prison Service regarding female prisoners caused much concern among midwives at the RCM Annual Conference in Belfast, in July 1995. This instruction makes it mandatory for all tenable prisoners to be handcuffed throughout their maternity care. Furthermore, the instruction states that women will be handcuffed throughout labour. The National Association of Prison Officers is justifiably concerned that the instruction will humiliate, embarrass and stress women, while midwives throughout the UK condemn this barbaric, insensitive and unnecessary policy.
Using diaries in qualitative research
Authors: Phillips Robyn , Davies Ruth
Published: January 2018

Research diaries can provide valuable insights into the world as perceived by another person. Used in conjunction with other means of data collection, research diaries are powerful tools in qualitative research.
When complications occur
Authors: Jackson Kate
Published: January 2018

In July the successful applicants for Changing Childbirth monies were announced by the Department of Health. The projects represent a range of initiatives all designed to promote the objectives outlined in Changing Childbirth.
Ventilator-associated pneumonia and suction: a review of the literature
Authors: Letchford Emma , Bench Suzanne
Published: January 2018

Aim:

to identify the most effective suctioning technique for the prevention of ventilator-associated pneumonia.

Background:

ventilator-associated pneumonia is an important hospital-acquired infection associated with increased mortality and morbidity.

Method:

a rapid review included an electronic database search of articles published between January 2009 and March 2016. The quality of the seven included studies was appraised and data were subjected to tabular and narrative syntheses.

Results:

closed suction systems have no clear advantage over open suction, but may better prevent late-onset ventilator-associated pneumonia. Subglottic secretion drainage reduces ventilator-associated pneumonia incidence.

Conclusion:

open versus closed suction combined with subglottic secretion drainage requires ongoing research. Alongside this, policy guidance, education, behavioural and managerial strategies must be implemented.
Nurses and global health: ‘at the table’ or ‘on the menu’?
Authors: Scammell Janet
Published: January 2018

Janet Scammell, Associate Professor (Nursing), Bournemouth University, looks at the role of the nursing workforce in shaping wider global health care, and the part nurse educators play in promoting international involvement
Accuracy of non-invasive blood pressure measurements in obese patients
Authors: Arnold Abigail , McNaughton Amanda
Published: January 2018

This article describes an evidence-based literature review, comparing upper arm and forearm blood pressure measurements using non-invasive devices on obese patients. The focus on blood pressure monitoring was in response to regularly witnessing inappropriately applied blood pressure cuffs on obese patient's upper arms in practice. An inaccurately obtained blood pressure measurement can result in the misdiagnosis and treatment of hypertension. As the prevalence of obesity grows worldwide, healthcare settings need to ensure they have the necessary equipment and trained staff to accurately measure obese patients' blood pressure. The aim of this review was to identify whether a forearm measurement provided a suitable alternative to upper arm measurements. The article discusses the development and execution of a search strategy, as well as the critical appraisal of a selected article. The results of the review demonstrated that forearm blood pressure measurements in obese patients do not replace upper arm blood pressure measurements taken with an appropriate cuff. It is recommended that further research is undertaken in order to identify suitable alternatives for obtaining an accurate non-invasive blood pressure measurement in obese patients.
Achilles paratendonitis: the relationship between predisposing factors and pathogenesis
Authors: Metcalfe Stuart A
Published: January 2018

Achilles paratendonitis is a common overuse injury, which frequently fails to respond to treatment given the high occurrence of chronic Achilles pathology. This article discusses the pathogenesis of Achilles paratendonitis in relation to the reported predisposing factors, to establish the need for a multidisciplinary approach to the diagnosis and treatment of this common condition.
Single-subject research in clinical practice
Authors: Parry Anne W
Published: January 2018

Simple, well-designed studies of a single person are an interesting and useful way of evaluating interventions and have the potential to make a significant contribution to knowledge about therapy and rehabilitation.
Multidisciplinary education in the health-care professions
Authors: Walker Alan
Published: January 2018

Multidisciplinary education in the health-care field has assumed an ever greater importance over the past few years. The reasons for this development are both professional and educational. Rapid changes in the service delivery of health care, particularly in the shift from acute to community services, place a greater premium on the collaborative working of health-care professionals. Educational changes have been equally rapid, involving the development of degree-level entry programmes, and the parallel absorption of single-discipline training schools by the university sector. In both cases, new opportunities for multidisciplinary activity have been created where few existed formerly.
Disability: a patient’s perspective on rehabilitation
Authors: Metcalfe Stuart A
Published: January 2018

In 1984, aged 18, I found myself lying on the hotel floor, covered in blood and amidst shards of glass, waiting for help from those around me. After just 2 hours of my holiday in Spain, I was waiting for an ambulance and thinking that my fall through a plate glass window would mean a few stitches and a day in hospital. Little did I know then that this accident was the beginning of a long road to recovery and rehabilitation which began with three popliteal grafts, gangrene and eventual amputation of my right leg above the knee.
Batteries Not Included: the campaign for state funding for indoor/outdoor powered wheelchairs
Authors: Kerridge Antony
Published: January 2018

Batteries Not Included is a national campaign, initiated by the Muscular Dystrophy Group and supported by 150 other organisations, with the single objective of securing guaranteed funding for indoor/outdoor powered wheelchairs, generally not available through the state system. This article outlines the background to the campaign and summarises the controversial findings of a recent comprehensive survey of UK wheelchair service providers.
Correspondence
Authors: Clelland Lorna , McPherson Kath , Muir Sheena , Norby Elizabeth , Fokke Chris , Alexander Caroline , Lenanne Anne-Marie , Marsland Fiona , Lloyd-Smith Walter
Published: January 2018

The nurse’s role in the rehabilitation of head injuries

I support the letter of Clelland et al regarding my article, and I feel that they highlight some important perspectives that I would like to address.

Encouragement of postgraduate physiotherapists

Benefits of shared learning
Aromatherapy and massage in palliative care
Authors: Wilkinson Susie
Published: January 2018

Aromatherapy and massage have gained wide popularity among nurses in clinical practice in recent years. Many nurses in palliative care settings are using these therapies with the assumption that they improve patients' quality of life, but no research has yet investigated their effectiveness. A study was set up to assess the effects of massage and aromatherapy massage on cancer patients receiving palliative care. Patients received three full body massages over a 3-week period, with or without the essential oil Roman Chamomile. The measurements used were the Rotterdam Symptom Checklist (RSCL) and State-Trait Anxiety Inventory. Post-test scores for all patients improved. These were statistically significant in the aromatherapy group on the RSCL physical symptom subscale, quality of life subscale and state anxiety scale. Responses to the post-therapy questionnaire indicate that patients consider the massage or aromatherapy to be beneficial in reducing anxiety, tension, pain and depression.
The development of an audit tool for Macmillan nurses
Authors: Luthbert Joanna , Webber Jeanette
Published: January 2018

Recent NHS reforms in the UK have stressed the importance of developing services that are in line with the preferences of patients. The desire to gauge the satisfaction of patients and carers with Macmillan nursing services led to the development of an audit tool for Macmillan nurses to use in hospitals or the community. This article describes the components of the audit tool and discusses its development. It concludes with a brief discussion of the issues arising from the pilot phase of the audit tool.
Comments welcoming the launch of the International Journal of Palliative Nursing.
Authors: Castledine George
Published: January 2018

Madam,

It was with great delight that I learnt of your new journal. I am sure that other nurses will be just as enthusiastic. Palliative nursing needs a scholarly vehicle to encourage research-based practice and to im prove care. Researchers also need a journal in which to publish the ever increasing number of studies in this area. May you be overwhelmed with manuscripts!
Book Reviews
Authors: Rogers Kim , Dunn Ginny
Published: January 2018

Facing Death: Patients, Families and Professionals (2nd edition)

Final Gifts: Understanding and Helping the Dying
Feasibility of education programmes in palliative care for nurses in Europe
Authors: Webber Jeanette
Published: January 2018

In September 1994, a group of nurses met for 3 days in London under the auspices of the European Oncology Nursing Society (EONS), supported by funds from the European Community Europe Against Cancer Programme (ECEACP) and the UK charity, the Cancer Relief Macmillan Fund (CRMF).
Role of complementary therapies in HIV/AIDS
Authors: Stevensen Caroline
Published: January 2018

Complementary is a commonly used term to describe therapies that were viewed as alternatives to conventional medicine. This change in thinking is important when considering their use for people with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). As orthodox medicine can offer support but not a cure for this condition, people with HIV/AIDS are seeking help from a variety of complementary therapies to enhance wellbeing and quality of life. This approach has also been adopted by many people living with other life-threatening illnesses such as cancer, where conventional medicine currently offers few guarantees of cure or remission. This article will focus on complementary therapies and the reasons for their use by people with HIV and AIDS, given the limits of current scientific research in this field. The qualities required by professionals offering complementary therapies and the close link of these therapies to the psychological and spiritual aspects of care for people with HIV/AIDS will be addressed.
Quality through partnership
Authors: Roch Jean , Baldwin Moyra A
Published: January 2018

Examination of the relationship between practice and education inspired the development of a model demonstrating that their partnership is essential in order to assure quality palliative care. The political, professional and personal influences that form the model's boundaries highlight the fact that palliative care is not only in a position to adopt change, but also to be proactive in influencing and effecting change. While the model was developed in the context of palliative care, it is equally applicable to other specialties.
Stress and staff support in hospice: a review of the literature
Authors: McKee Elizabeth
Published: January 2018

An extensive review of the literature was carried out which highlighted the causes and effects of stress, both generally and in palliative care, along with the coping strategies for stress. The literature emphasised the intense nature of palliative care and the importance of having effective support mechanisms in place for staff.
Staff support in hospices
Authors: McKee Elizabeth
Published: January 2018

This article reports on a descriptive study of staff support in 116 hospices in the UK. The study took the form of a postal questionnaire survey. Before the survey an extensive review of the literature was carried out which highlighted the causes and effects of stress, both generally and in palliative care, along with coping strategies. The literature emphasised the intense nature of palliative care and the importance of having effective support mechanisms in place for staff (McKee, 1995). The results of this survey showed that, in general, hospices are attempting to deal with staff stress by offering group and/or individual support.
A teacher's return to clinical nursing practice
Authors: Baldwin Moyra A
Published: January 2018

Having been employed as a nurse educationalist for many years, a return to clinical nursing care, while having been a big personal ambition, only became a reality in 1992.
Nurses' perceptions of palliative care nursing
Authors: Nebauer Monica , Prior Deborah , Berggren Lyn , Haberecht John , Ku Marie , Mitchell Ann , Davies Elizabeth
Published: January 2018

This exploratory study using a survey design sought to investigate nurses' perceptions of palliative care nursing before and after participating in a 60-hour continuing education programme. The 26 participants, from various nursing backgrounds, were enrolled on a joint university/hospital course which used a problem-based learning approach. During the course introduction, demographic data, together with descriptions of the students' perception/understanding of palliative care nursing, were obtained. Students' perceptions became the sole focus of the post-course study. Qualitative responses were analysed thematically and the remainder were analysed descriptively. The results suggest that those who undertook the course were beginning to move from a focus on carrying out nursing care to a deeper awareness of the possibilities of simply being with a patient. Other implications of the study were that palliative care educational programmes should be structured and taught in ways which help students reconceptualize the human person more holistically. Other factors emerged that were related to the physical environment of care and the wellbeing of staff in the practice setting.
Hospital nurses' bereavement support for relatives: study report
Authors: Lloyd-Richards Chris , Rees Colin
Published: January 2018

Health carers in the field of palliative care have developed skills in dealing not only with dying people but also with their relatives. The same, however, cannot be said for carers in other clinical areas. How do nursing staff in these other areas feel about the way they respond to the needs of relatives of the dead and dying? Do they feel adequately prepared? This article examines the issue of bereavement support provided by nurses to relatives in hospital. It is based on semi-structured interviews with 50 nurses in one large teaching hospital. It was found that bereavement support varied from ward to ward, and that there was a need for greater preparation of nursing staff to take account of the needs of relatives. These needs range from practical information to emotional support. More educational opportunities should be provided for nurses, and joint workshops for medical and nursing staff should be established to explore the issues and develop a sensitive approach to relatives in all clinical areas.
Helping children to grieve
Authors: Devlin Breige
Published: January 2018

The aim of this article is to address the needs of grieving children, who are often excluded from the grieving process. Many adults erroneously believe that children do not grieve or that their grief is milder and of a shorter duration than that of adults. The first section of the article examines the literature dealing with the problems of grieving children. Loss of someone close to a child can cause great distress and may have an adverse effect on development. Repression or denial of grief in childhood may lead to psychiatric illness in adulthood. It is therefore vitally important that adults understand children's grief and have some idea of how they can help them through the grieving process. The second part of the article draws on the published literature to present a number of strategies which may be of benefit in helping children through the grieving process.
Demonstrating the value of palliative care
Authors: Webber Jeanette
Published: January 2018

Recently, three issues have been covered in the UK nursing press which have highlighted some of the conflicting perspectives confronting nurses today. The first has arisen out of work established in 1995 when an Expert Advisory Group was set up by the Chief Medical Officers of England and Wales to advise on the organization of cancer services. Following wide consultation, the report was launched and is now being implemented (Department of Health, 1995). The framework identifies three contexts in which cancer treatment and care will be delivered — the cancer centre, the cancer unit and the primary care setting — and makes a strong case for the establishment of key specialist nursing posts in each of these settings.
Group cognitive behavioural therapy: an intervention for cancer patients
Authors: Bottomley Andrew
Published: January 2018

There is considerable evidence to suggest that cancer patients, including those with advanced disease, experience significant and long-term psychosocial problems. Work using group cognitive behavioural therapy with cancer patients has recently demonstrated a way in which it may be possible to treat emotionally distressed individuals effectively. This article reviews the literature on group cognitive behavioural psychotherapy and discusses for practitioners of all disciplines the important techniques, the value of time-limited interventions, the type of patients who may benefit, and where and how to facilitate successful interventions. Health workers with an interest in the emotional care of patients are thus provided with some understanding of the value that group cognitive behavioural psychotherapy may hold for them.