bluuebunny/crossref_metadata_2025 huggingface dataset:
Paediatric inpatient setting: an evaluation of parental perspectives
Authors: Williams Geraint , Nizamoglu Metin , Williams Elisabeth
Published: May 2014

The Nursing and Midwifery Council (2008) define the standards of conduct, ethics and performance for nurses and midwives of nursing currently practicing in the UK. The Code places emphasis on the core nursing principles of kindness, respect, dignity and support for patients and relatives while under nursing care. A prospective study was conducted using a validated questionnaire to assess adherence to these core nursing principles on the basis of parental assessment in an orthopaedic paediatric inpatient unit at University Hospital Coventry and Warwickshire (UHCW). Core nursing standards were highest in respect to ‘kindness’ and ‘respect’ shown for patients (96% and 98% positive scores) and lowest for ‘support’ offered to their parents (89% positive scores). Lower ‘support’ scores possibly relate to information provision or emotional support. Improvement may be achieved via provision of additional time to identify parental concerns, which may be non-medical. The results demonstrate that parents perceive core nursing principles to be strongly adhered to on the orthopaedic paediatric unit at UHCW.
‘What I want clinicians to know’— experiences of people with arthritis
Authors: Ryan Sarah , Lillie Kate , Thwaites Cath , Adams Jo
Published: May 2014

Aim: To explore the perceptions and experiences of people with osteoarthrits (OA) and rheumatoid arthritis (RA) regarding the knowledge and skills they want nurses and allied health professionals (AHPs) to have to manage their care needs. Method: Two condition-specific focus groups were conducted in London with five people with OA and eight people with RA in January 2011. A semistructured interview guide was used. The focus groups were audiotaped and the transcripts analysed using content analysis. Results: Shared and condition-specific themes were identified. The shared themes were: living with pain; the need for self-management; and meaningful consultation. The condition-specific themes were: no experts in OA; and wanting to talk in the RA participants. Conclusion: People with OA and RA wanted nurses and AHPs to listen, empathise and help them to manage their condition, especially the pain. Participants with RA would value psychological support. We need to ensure that nurses and AHPs have the knowledge and skills to address these needs.
We need primary care services fit for our changed society
Authors: Tingle John
Published: May 2014

John Tingle discusses a report from the Patients Association on provision of and access to primary care services.
How first experiences influence newly qualified nurses
Authors: Tapping Jen , Muir Jenny , Marks-Maran Di
Published: May 2014

The beginning of a nurse's career can be a challenging time and first experiences can influence the retention of newly qualified nurses and their career progression. Nurses experience anxiety and lack of confidence as they make the transition from student to newly qualified nurse. St George's Healthcare NHS Trust, in collaboration with the Faculty of Health and Social Care Sciences at Kingston University/St George's University of London, embarked on an innovative programme of role and career development for newly qualified nurses that included a Signal Post Development Scheme. The scheme integrated preceptorship, clinical supervision, role development and leadership development together with a set of four periodic review points. At each review point the individual nurse had the opportunity to self-assess her or his own development and then meet with a senior member of nursing staff to receive feedback on development, progress and action planning. The self-assessment and signal post review was undertaken using the role description for band 5 nurses and the role description for band 6 nurses. Each signal post review enables progress, development and feedback to take place against progression along continua from the band 5 to the band 6 role description. An evaluative study of the scheme was undertaken, which demonstrated that band 5 nurses were largely positive about the scheme and the impact it had on their role and career development.
Extending the scope of wilful neglect will result in paternalistic nursing care
Authors: Griffith Richard
Published: May 2014

The recommendation that the criminal offence of wilful neglect be extended to protect all patient groups may seem a proactive way for the Government to begin to restore public confidence in nursing following the Mid Staffordshire NHS Trust Inquiry. However, the experience of the courts hearing cases of wilful neglect in relation to adults who lack capacity show that they are complex trials and, despite several appeals, still lack clear guidance that nurses can apply in practice to avoid prosecution while still promoting the autonomy of patients. In this article the author reviews recent cases of wilful neglect to come before the Court of Appeal and argues that rather than offering protection to patients, criminalising a failure to act is more likely to result in paternalistic interventions, with nurses insisting on providing care because they fear prosecution if they fail to do so.
Optimising wound care in a child with an infected gastrostomy exit site
Authors: Rollins Hazel , Nathwani Nisha , Morrison Denise
Published: May 2014

The percutaneous endoscopic gastrostomy (PEG) tube has become a widely used feeding tube for long-term delivery of fluids, liquid feed and medicines. PEG tube insertion can be considered a minimally invasive technique, associated with rapid recovery and early discharge from hospital but is not without risk ( Vervloessem et al 2009 ; Naiditch et al 2010 ). A lack of nationally agreed, evidence-based clinical practice guidelines makes PEG exit site care a matter of local clinical practice and clinical judgement. In paediatric practice, children experience care shared across several healthcare settings, meeting clinical teams with varying levels of knowledge and experience of PEG care. This can lead to conflicting advice, which can have a negative effect on patient safety and experience. The case history in this article demonstrates how PEG tube insertion is never a minor procedure for a child and family ( Vervloessem et al 2009 ; Khattak et al 1998 ). It highlights areas of potential conflict in clinical management of PEG exit sites, and it shows how application of wound care principles, along with a range of modern products can have a positive outcome.
Encouraging healthy ageing: a vital element of NHS reform
Authors: Hughes Lloyd , Pearson Andrew
Published: May 2014

The implications of an ageing population are all around us, with issues such as increasing healthcare and social care costs, and a perceived pensions crisis, for example. However, too often the focus remains on how to manage the challenges of an ageing population rather than investing in research and implementing social reform to promote healthy ageing. This article reviews the major areas of medical, social/political and scientific research that together offer an opportunity to allow people to age in a healthy way.
The setting of healthcare priorities through public engagement
Authors: Meetoo Danny
Published: May 2014

Global fiscal constraints mean that the UK healthcare system of the 21st century can no longer provide all possible services and treatment for all the people it serves. Currently, more than ever, there is a need to set priorities in terms of resources. The allocation of scarce healthcare resources will result in some care programmes being supported while others are not. Decision makers are increasingly engaging the public in policy making and priority-setting processes. Advocates of increased public engagement argue that public services are paid for by the people and, therefore, should be shaped more extensively by them, preferably by a fully representative sample. Central to the concept of public engagement is a desire for open dialogue and debate between groups that might not ordinarily have the channels to understand or speak to one another. Public engagement activities aim to link the healthcare community with the general public, community groups, civil society organisations and any other groups or communities in the outside world where healthcare decision-making gains its relevance. This article, therefore, aims to discuss the importance of promoting public engagement.
Hand burn management: minimising pain and trauma at dressing change
Authors: Edwards Jacky , Mason Sally
Published: May 2014

The aim of wound management in hand burn injuries is to restore function and prevent problem scars, so a key consideration in wound healing is the removal of dressings without causing pain and further trauma as well as preserving function. Conventionally, wound dressings such as paraffin gauze were used for burn injuries, but this led to pain and trauma on removal, as well as drying out. This study looks at the use of Mepitel® One on hand burns; this dressing incorporates all the benefits of Mepitel, however, it only has Safetac technology on the wound contact side, allowing easy handling and application.
Wound bed preparation: ultrasonic-assisted debridement
Authors: Butcher Gillian , Pinnuck Loreto
Published: May 2014

Wound bed preparation is essential for the healing of wounds. The TIME framework (tissue, infection/inflammation, moisture balance, edge of wound) for wound bed preparation shows the importance of debridement in the treatment of chronic wounds. Debridement involves the removal of devitalised tissue from the wound bed. It also facilitates the removal of biofilms—complex microbial communities that are known to contribute to delayed wound healing and chronicity of wounds. Ultrasonic-assisted wound debridement (UAWD) is a lesser known debridement method that uses low-frequency ultrasound waves. There is evidence to show that the three clinical effects of atraumatic selective tissue debridement, wound stimulatory effects and antibacterial activity facilitate early healing of wounds, reducing the cost to the healthcare system and improving the patient’s quality of life.
Ankle brachial pressure index of normal, healthy, younger adults
Authors: Niblo Jane , Coull Alison
Published: May 2014

Doppler ultrasound and ankle brachial pressure index (ABPI) calculations are used in the assessment of lower limb vascularity, specifically to determine arterial deficiency. ABPI is important as it is used as an indicator when deciding management options for the treatment of leg ulceration. This study aimed to investigate the range of ABPI measurement, using Doppler ultrasound and sphygmomanometry in 36 young healthy adults aged 18–55 years. The findings show a mean ABPI in the left leg of 1.19 and a mean ABPI of 1.17 in the right leg which, while within the normal range, are consistently in the upper range and significantly higher than the acknowledged ‘normal’ midpoint of 1.0. It would appear that younger people will have ABPIs within the upper aspect of the normal range and well above the established norm of 1.0.
Dipping a toe into the specialist nursing pool
Authors: Reyes Selina
Published: May 2014

Selina Reyes is a second-year nursing student in Gibraltar. Here she reflects on her first-year experiences of being introduced to various specialist nursing areas.
Adult-trained perioperative nurses' practice of family-centered care
Authors: Hamilton Grainne , Corlett Jo , Dowling Maura
Published: May 2014

Aim

The aim of this study was to explore adult-trained perioperative nurses' practice of family-centered care (FCC).

Method

A qualitative research design with a hermeneutic phenomenological approach was used. In-depth interviews were conducted with six adult-trained perioperative nurses. Data analysis was guided by Colaizzi's seven-step framework, resulting in a composite description of perioperative nurses' practice of FCC.

Findings

While participants supported the principle of family involvement in care, they found its implementation in practice difficult and stressful. They reported that families often appeared inadequately prepared for the surgical experience, and subsequent poor experiences for families caused feelings of upset and inadequacy for nurses.

Conclusion

While some of these findings are similar to those in previous studies of paediatric nurses' practice of FCC, this is the first known study to examine adult-trained perioperative nurses' practice of FCC. Participants articulated an awareness of what constitutes effective FCC and showed the motivation to accomplish the task of improving family-centered practice in their practice area.
Prevention and managament of pressure ulcers: support surfaces
Authors: Moore Zena , Haynes Jackie Stephen , Callaghan Rosie
Published: May 2014

Pressure ulcers are a common and debilitating problem in health care, impacting negatively on health-related quality of life and compounding challenges in achieving patient safety targets. Pressure ulcer prevention is a multidisciplinary team effort, involving a myriad of interventions, such as nutrition, skin care and repositioning. This article discusses the factors influencing pressure ulcer development, and then elaborates on the principles of prevention. This is followed by a focused discussion on the use of redistribution devices and the importance of the cover of such equipment in contributing to achieving good standards in prevention.
Nurse-led line insertion and management in renal access
Authors: Manuel Wilfredo
Published: May 2014

Wilfredo Manuel is this year's BJN IV Therapy Nurse of the Year. Here, he shares his award-winning implementation of a nurse-led CVC line insertion and management service in renal access
Recovery and wellbeing: the new paradigms for mental health services
Authors: Carson Jerome , Gordon Lorraine
Published: May 2014

Mental health services are being urged to embrace new approaches. Jerome Carson and Lorraine Gordon ask whether enough is being done to help staff understand the implications for practice.
Integrating a spirited dimension into health and social care
Authors: Gilbert Peter
Published: May 2014

Peter Gilbert argues that the place of individual spirituality and religious faith is increasingly being recognised by the NHS and other organisations
A human rights based approach to involving service users and carers
Authors: Dyer Lindsey
Published: May 2014

Mersey Care NHS Trust takes a human rights based approach to the involvement of service users and carers. Lindsey Dyer, below, suggests this approach can help trusts to deliver their obligation to promote human rights among service users
Continuing Professional Development: Therapeutic use of self
Authors: Currid Thomas , Pennington Jenni
Published: May 2014

The therapeutic use of self is perhaps the most fundamental of all skills that mental health workers have at their disposal. While understanding the theory underpinning the approach is important, regular practice is necessary to master this skill. This article draws on the literature from a number of disciplines involved in delivering mental health services. It also includes some self-assessment tasks to test the reader’s knowledge
Portraits: Patients and Psychiatrists
Authors: Anderson Gemma
Published: May 2014

Artist Gemma Anderson’s series of 16 life-sized copper etchings depict psychiatric patients and psychiatrists, blurring the distinction between the two. Here she describes how she produced them, and how she uses portraits to empower the individual.
What have we learnt from Szasz?
Authors: Beichman Jay , Rogers Paul
Published: May 2014

50 years after Thomas Szasz challenged the concepts of modern psychiatry in ‘The Myth of Mental Illness’, Jay Beichman and Paul Rogers ask whether Szasz’s ideas are still relevant
Singing for health: a musical remedy
Authors: Clift Stephen
Published: May 2014

Stephen Clift examines findings from the Sidney De Haan Research Centre which suggest that the arts—such as music—can have a positive influence on mental and physical wellbeing
Correspondence
Authors: Rogers Paul
Published: May 2014

In the same week that the Government announced a draconian comprehensive spending review (CSR), the National Patient Safety Agency published a list of ‘never events’ which should never happen in health care. These included, a surgical intervention performed on the wrong site and the placing of naso or orogastric tubes in the respiratory tract, rather than the gastrointestinal tract.
Living with HIV: mental health and wellbeing
Authors: Peate Ian
Published: May 2014

When an individual has been diagnosed with an illness such as the human immunodeficiency virus (HIV) it is likely to have an immense emotional impact on that person’s wellbeing. People with HIV have higher rates of mental health problems than those seen in the general population. This article provides an overview of the emotional and mental health issues that people with HIV may experience. Living with any long-term condition can have a negative impact on a person’s wellbeing; this can be multiplied further if a person is living with HIV. Some people may experience mental health problems such as depression or anxiety as well as low mood or a feeling of helplessness or hopelessness. It is important that the person understands and deals with these feelings to cope effectively.
Retreating from public service
Authors: Conlon Karen
Published: May 2014

Karen Conlon discusses her experience of a staff retreat programme and the positive influence it had on her attitudes to both patient and staff wellbeing
Fighting off stigma through a countywide Tae Kwon Do project
Authors: Coss Katie
Published: May 2014

A Norwich-based martial arts project for people with mental health problems has been met with enthusiasm, says Katie Coss
Promoting mental health needs in people with physical conditions
Authors: Walsh Lynne
Published: May 2014

There are clear links between physical and mental health and there is a need to improve knowledge, skills and attitudes towards mental health in general. This article recognises the importance of promoting mental health and wellbeing in people who also have physical conditions. Nurses can be supported to become more confident in caring for patients with poor mental health and as a result become more confident in practice.
First check the blood pressure
Authors: Beary Michael
Published: May 2014

Michael Beary shares the reasons why it is important to check a patient’s blood pressure
Libya remembered
Authors: Nolan Peter
Published: May 2014

Peter Nolan reflects on his time spent working as a general nurse in Libya in the late 1960s
Improving the physical wellbeing of people with mental health problems
Authors: Harper William , Abraha Nazareth
Published: May 2014

People with mental health problems are much more likely than the general population to suffer poor physical health. There is an urgent need for health professionals to actively promote the physical health of this group. This article reports on an audit that was carried out in the Camden & Islington NHS Foundation Trust. The outcome reinforces the view that, with appropriate training and support, all health and social care professionals can deliver personalised health promotion interventions. In addition, it underlines that in response to complex needs, health and social care professionals will increasingly have to develop a set of common generic skills that enable them to provide a consistent level of care for patients in line with the Quality, Innovation, Productivity and Prevention agenda ( DH, 2010 )
Cigarette smoking in adolescents with asthma
Authors: Croghan Emma
Published: May 2014

Adolescents, particularly those with a chronic illness, often engage in risk-taking behaviour including cigarette smoking. Active cigarette smoking increases asthma severity, but are adolescents with asthma actually at an increased risk of smoking compared to their non-asthmatic peers?
Meningitis: Everyone’s concern
Authors: Blewitt Jane
Published: May 2014

Meningitis is a dangerous disease that can affect people in a very serious way, in extreme cases leading to disbility or even death. The school nurse has an important role to play in supporting the health protection team, co-ordinating the care of a disabled child and raising disease awareness.
A specialist nurse for looked after children
Authors: Park Jane
Published: May 2014

Jane Park, a specialist nurse, talks about the hectic week she has in her role working with looked after children and also discusses the challenges she faces as a sexual health nurse. However, she still manages to find a bit of time for fun at the end of the week.
Involving young people in decisions about medicines
Authors: Letts Melinda
Published: May 2014

Ask About Medicines Week is 5–9 November 2007 and a campaign called ‘asking about medicines as we grow up’ is being aimed at children and young people. The school nurse has an important role to play in aiding young people to take responsibility for their own medicines.
Tackling obesity in children: What can schools do?
Authors: Horridge Dean
Published: May 2014

Dean Horridge is a former PE teacher who founded Fit For Sport in 1991. Fit for Sport is an OFSTED registered organization catering for over 10 000 children per week, and a healthy lifestyle activities provider, committed to promoting good health and fitness among children.
An overview of allergic diseases in school children
Authors: Collard John
Published: May 2014

Allergy affects the lives of thousands of children every year and for some it is a potentially life threatening disease. This article looks at the substances that cause the allergies, the symptoms they produce and makes suggestions how to manage them.
Breaking the threadworm cycle: Key to management
Authors: White Sharon
Published: May 2014

At least 40% of children under the age of 10 years will be affected by threadworms, so it is likely that school nurses will come into contact with an infected child in the course of the job. School nurses have a vital role to play in managing this infection.
Can teach, will teach? Sex education in schools
Authors: Whitehead Elizabeth
Published: May 2014

The different experiences of sex education by pregnant and non-pregnant teenagers indicate that school nurses may have a unique role to play in the teaching of personal, social, health and sex education
Smoking cessation in young people
Authors: Quinlivan Marie
Published: May 2014

Many young people start smoking at a young age, increasing the chances of adult smoking. This article looks at the issue of smoking cessation in young people aged 11–18 years, in a mixed boarding school environment.
Use of solution focused brief therapy in bullying
Authors: Kvarme Lisbeth , Eboh Winifred , van der Teijlingen Edwin , Love John
Published: May 2014

Bullying in schools is still a major concern globally and raises great health problems for children affected. There is evidence that using peer support groups based on solution focused brief therapy can help pupils with a range of difficulties caused by the bullying.
Domestic violence: Impact on children and young people
Authors: Obadina Seye
Published: May 2014

Domestic violence is a form of power control and intimidation used by one partner over the other and in 90% of domestic violence cases, children and young people are in the same room or nearby. This can impact on their lives, disrupting their health, schooling, family life and community networks.
Preventing unintentional injury in children
Authors: Prentice Pam
Published: May 2014

Many unintentional injuries can be prevented through simple steps. School nurses are in an ideal position to address risks and run educational activities on safety for children.
Interprofessional working is key to delivering quality PSHE
Authors: Sherwin Sarah
Published: May 2014

Sarah Sherwin reports on an interprofessional learning project, and on its positive outcomes for those who took part and the children and young people who are, or will be, in their care.
School nursing: On the move again
Authors: Richardson-Todd Barbara
Published: May 2014

Barbara Richardson-Todd provides us with an overview of presentations at the Royal College of Nursing school nursing conference which took place on March 14, in London.
MMR vaccination: Consent, controversies and challenges
Authors: Cotton Richard
Published: May 2014

After the safety of the MMR vaccine was questioned, its uptake substantially dropped. As a result more children are being affected by mumps and measles. Richard Cotton provides an overview of the consent issues, the controversies and the challenges.
Cutaneous larva migrans: Diagnosis and management
Authors: Watkins Jean
Published: May 2014

Jean Watkins discusses the life cycle, symptoms and treatment of cutaneous larva migrans, and provides practical advice on prevention.
Putting the pieces together to support mental health
Authors: Stockman Tina R , Murray Louise
Published: May 2014

A school nurse and teacher in Aberdeen have collaborated to develop a school-based mental health programme using methods drawn from cognitive behavioural therapy, arts education and peer-group counselling techniques.
School nurses are under-recognized and under-resourced
Authors: Day Patricia
Published: May 2014

Patricia Day examines the state of school nursing and argues that school nurses need more resources to achieve their potential
The importance of working to achieve bowel continence
Authors: Yaz Gill
Published: May 2014

Gill Yaz explains the impact faecal incontinence can have on children and young people’s wellbeing and the importance for school nurses to be well informed on bowel management to work effectively with parents in helping implement an adequate bowel care regime.
Improving attainment for pupils with an autism spectrum disorder
Authors: Charman Tony
Published: May 2014

The heterogeneity of abilities in children with an autism spectrum disorder often presents a challenge to educationalists. Tony Charman provides an insight into research that will contribute to a better understanding of these differences and may therefore help adapt teaching to make it more accessible.
Case study: Treating eating disorders in the community
Authors: Coombs Anita
Published: May 2014

Given that eating disorders develop most frequently in mid-to-late adolescence, school nurses are likely to encounter them in the course of their practice. Eating disorders can be attributed to a number of external and internal causes and typically present in late adolescence, though they are becoming more diverse. Early intervention, delivered in accordance with best practice guidelines, can have a significant impact on patient outcomes. This article uses a case study to examine the causes, treatment and legal issues surrounding the treatment of an eating disorder in a primary care setting, including the role of the school nurse in the multi-disciplinary team. School nurses are able to provide support in the community, helping to prevent teenagers from being unnecessarily hospitalized. They can make referrals if concerned, help all members of the team to present a consistent message, and ensure that family members are involved wherever appropriate. Nurses working with adolescents should be alert to the signs of eating disorders and familiarize themselves with local and national policy on consent and mental capacity.
Helping students to build and develop their self-esteem
Authors: Deacon Nichola
Published: May 2014

In this series of articles aimed at school nurses with little experience in teaching, Nichola Deacon provides some suggestions for activities that can be used to help students develop their self-esteem.
Tackling homophobic language: The responsibility of all staff
Authors: Tallon Alastair
Published: May 2014

Schools have a responsibility to address use of homophobic language among their pupils. Here, Alastair Tallon outlines the nature of the problem and the action that can be taken.
Returning to school after a kidney transplant
Authors: Walsh Grainne , Gamston Fiona , Roberts Denise
Published: May 2014

Going back to school after a kidney transplant can present many challenges for the children, their parents, teachers and friends. School days missed may be difficult to make up, infections can pose threats to the new kidney, and anti-rejection medication may change the child's body. Grainne Walsh, Fiona Gamston and Denise Roberts outline how to support children re-integrating into normal life.
Supporting young people with epilepsy in school
Authors: Solomon Nina
Published: May 2014

The role of the school nurse is vital in ensuring that teaching staff members are appropriately trained in how to recognise and deal with seizures and the child is supported in every way possible. This article gives a brief overview of epilepsy including the various seizure types and treatments, and outlines the possible psychosocial, educational and behavioural issues that may arise. By understanding and recognising some of the potential problems that may be associated with the child's epilepsy, support systems can be put in place to improve the child's overall quality of life and learning potential.
School nursing strategy
Authors: Nicholson Wendy
Published: May 2014

Wendy Nicholson, Professional Officer for Nursing at the Department of Health and lead on the School Nurse Development Programme (SNDP), answers questions from BJSN.
Introducing the new vision and model for school nursing
Authors: Nicholson Wendy
Published: May 2014

The Department of Health has recently published its new vision. Wendy Nicholson, lead on the School Nurse Development Programme, looks at how the model aims to strengthen the foundations for school nursing.
Anaphylaxis: Managing emergencies in school
Authors: Fitzsimons Roisin , Kane Patricia , Fox Adam
Published: May 2014

Anaphylaxis, a severe, life-threatening allergic reaction, has become an increasingly common occurrence in the UK and a significant proportion of such reactions in children occur in the school environment. Early recognition and prompt treatment are essential components of the successful management of anaphylaxis.
Knowing how to use formative assessment strategies
Authors: Faber Krista
Published: May 2014

In this series of articles aimed at school nurses new to teaching, Krista Faber provides some advice on teaching effective PSHE lessons. This article focuses on assessing pupil's learning.
Protecting young people from the risk of sexual exploitation
Authors: Eastwell Catherine
Published: May 2014

Recent events may have increased the awareness of sexual exploitation in young people; however, the number of young people being groomed for sexual exploitation is largely underestimated. This article discusses the role of the school nurse in reducing sexual exploitation in young people of secondary school age, and explores how those most at risk can be identified and supported at universal service level. It will clarify how school nurses can use their unique role to raise awareness of sexual exploitation and be comfortable in referring to other agencies as appropriate.
Effective partnership working between school nurses and health visitors in safeguarding
Authors: Obadina Seye
Published: May 2014

Safeguarding is an important part of the work carried out by both health visitors and school nurses. To ensure that children and families’ needs are met, it is essential that both professions are able to work together effectively.

This article looks at the main characteristics of the school nursing and health visiting roles in safeguarding with the aim of helping increase the understanding of each other's roles, as well as ways in which they can work together effectively.
A vital resource in reducing mental health problems
Authors: Bhardwa Seeta
Published: May 2014

Seeta Bhardwa explains why school nurses are a vital resource in reducing mental health problems in young people and presents some recent innovations that can help support them.
Generic or specialist: a model for contracting the professions
Authors: Wheeler Neil , Grice Diana
Published: May 2014

The professions allied to medicine (PAMs) make up the second largest workforce in the NHS, but with clinical directorates and GP fundholders wanting ‘their own’ PAMs, deployment is difficult to manage, and all too easy to fragment. This article distills the discussions and recommendations from a number of national and international fora to suggest an unusual model for future service delivery.
Craniofacial pain
Authors: O'Geary Sean
Published: May 2014

Pain in the head, neck and face is common and debilitating. Indeed, headache is probably the most common pain affecting mankind. Patients treated for pain in this region are often misdiagnosed and are still in pain following treatment, with subsequent frustration to both patient and practitioner. This article provides an overview of this problem and indicates how dentistry can take its place in the multidisciplinary management of these conditions.
The physical restraint minefield: a professional's guide
Authors: McDonnell Andrew A
Published: May 2014

The physical management of challenging behaviours is a contentious area. This article reviews the issues surrounding the use of these procedures in health-care settings. The safety, effectiveness, and social acceptability of physical restraint methods are discussed, as well as the utility of guidelines and the implications for training in the area.
Purchasing services based on client need: dilemma in gaining information and making decisions
Authors: Turner Ronald
Published: May 2014

This article considers the problems faced by purchasers in developing services in the absence of quality information and research, with regard to health needs assessment. It focuses principally on the dilemmas and complexities faced by district health authorities when having to make decisions about resource investment in rehabilitation services. It also explores contemporary issues such as evidence-based purchasing, user involvement and service specifications.
A new challenge to bring therapy home
Authors: Lambert Pat , Round Janet
Published: May 2014

In a move to provide the highest level of specialist care for older people in their home environment, the Cambridge-based Lifespan Healthcare NHS Trust is creating challenging new roles for therapists. Lifespan Healthcare NHS Trust provides local and specialist services for the people of Cambridge, Ely and East and South Cambridge and is a recognized innovator in providing challenging roles for therapists. In October it opened the Oliver Zangwill Centre for brain injury rehabilitation, the only one of its kind in the UK.
Reflexivity in qualitative and quantitative research
Authors: Aspinall Gill
Published: May 2014

In introducing her address, Linda Finlay, an Occupational Therapy Consultant, underlined the topical nature of the conference theme, both in terms of improving practice and the pressures of demonstrating validity for interventions. She posed the question: ‘What constitutes research and evaluation?’ Arguing that so-called ‘hard research’ often does not reflect the complex nature of human behaviour and experience she described her own ethnographic participant research of occupational therapists work using qualitative methods that were self-consciously critical.
The qualitative research paradigm: an introductory workshop
Authors: Stewart Sandra
Published: May 2014

This workshop explored the basic tenets of the qualitative paradigm, initially by asking group members to put forward terms which they would associate with this methodological approach. This was followed by the use of a number of qualitative research papers from which members were asked to identify language, processes and research problems indicative of the method. A relevant research problem was identified by the group and a lively discussion centred on how this issue could be investigated by the qualitative paradigm. Using this research question as a focus for further debate, the workshop leader then addressed the key principles of deciding on the most appropriate methodological approach, process and methods of data collection and analysis, and the issue of trustworthiness in qualitative research. The concluding discussion centred on the place of both the qualitative and quantitative paradigms in health-care research.
Bridging a painful gap
Authors: Lageard Peter
Published: May 2014

The therapist seeks to manage patients' problems by progressing along two pathways which do not necessarily run in parallel: painful to painless and functionless to ‘functionful’. This means joining the pathway at one of an infinite number of points, which may be determined by well reasoned assessment. This presupposes the availability of reliable and valid examination procedures which, when applied, will lead to appropriate evaluated therapeutic techniques. In practice this is rarely the case, clinical decision-making processes being tempered perhaps too often with past experience and patient mileage analyses which, as Sim (1995) points out, may often be of value but may also perpetuate our own biases and misconceptions.
Plants as medicine: possible benefits and potential risks
Authors: Ernst E
Published: May 2014

Both the media and public believe that natural medicines are harmless, a myth that has been perpetuated for so long and with such a degree of stubbornness that it borders on dogmatism. This opinion is clearly not true and can be dangerously misleading.
Patient compliance: a desirable goal of patient education?
Authors: Jerosch-Herold Christina
Published: May 2014

This article reviews the concept of compliance and its compatibility with the goals of patient education. Issues such as health beliefs and locus of control and how these impact on compliance are considered.
Jerry's story: a music therapy case study
Authors: Sutton Julie P
Published: May 2014

This case study describes how a 9-year-old boy used his individual music therapy sessions to explore aspects of living with the threat of terrorist violence as well as the stress of coping with speech and language impairment.
Attitudes of physiotherapists towards mandatory HIV testing
Authors: Mandy Anne , Wingate Kitty M
Published: May 2014

Increasing numbers of health-care workers are being infected with human immunodeficiency virus (HIV) which has resulted in the American Senate enforcing health professionals to disclose their serostatus. This study surveyed attitudes of physiotherapists within the South East Thames region towards mandatory HIV testing of health-care professionals. Results indicated that mandatory testing is currently not considered necessary, but fears of contagion are expressed.
The diagnosis of osteoporosis depends on clinical measurement
Authors: Robertson J
Published: May 2014

Osteoporotic fractures kill 1500 women annually, disable survivors, and cost £750 million. Prevention depends on early diagnosis which in turn depends on a bone densitometry strategy utilizing the right equipment.
Achieving effective patient records: the Yorkshire Regional Chiropody Notes Audit Tool
Authors: Calam Melanie , Speak Katharine
Published: May 2014

Patient records exist in abundance in health departments everywhere. The quality of these records varies tremendously and the value of patient documentation as an aid to good practice is often underestimated. This article details the development of a region-wide audit tool for patient records.
Evaluating primary care occupational therapy: results from a London primary health-care centre
Authors: Tyrrell Jeanne , Burn Annabel
Published: May 2014

Increasing numbers of occupational therapists are working in primary care settings in the UK. Although the College of Occupational Therapists has published guidelines for occupational therapy in primary care, as well as an information leaflet for GPs, there has been little research into the health outcomes of this new area of practice. This article presents some results from a recent evaluation of primary care occupational therapy in a London health centre.
Delegation to assistants: a management problem
Authors: Saunders Liz
Published: May 2014

This article addresses the need for a systematic method for delegation of tasks to assistants. Factors involved in delegation to assistants are considered and the issues necessary to manage delegation are presented to produce a system of work that is cost-beneficial without loss of quality.
Health-care education and training: out of the hospital and into higher education
Authors: Pittilo R Michael
Published: May 2014

On 21 December 1995, Kingston University (a new University) and St George's Hospital Medical School (a traditional medical school that is part of the University of London) together signed a contract with the NHS for nursing and midwifery education and training. This contract has, along with existing programmes in diagnostic and therapeutic radiography that resulted from earlier contracts, led to the creation of a new Faculty of Healthcare Sciences. In this editorial, the key issues associated with the transfer of health-care education and training into higher education (HE) and the way the NHS has influenced the development of HE in this part of the country are reviewed.
The role of the occupational therapist in primary health care
Authors: McGuinness Olivia
Published: May 2014

Over the last 2 years there has been an increasing emphasis on moving health care into the community which has resulted in the development of some primary health-care posts for occupational therapists. This article will describe the role of an occupational therapist in a Dundee fundholding practice and look at how the service has developed in the absence of local role models or literature on national initiatives.
Defining irritability: the measure of easily aggravated symptoms
Authors: Sayres Lucy R
Published: May 2014

Irritability is a term commonly used by physiotherapists to describe symptom behaviour in musculoskeletal disorders. Despite its crucial role in clinical reasoning, irritability is poorly defined and widely misused. In order to redress this situation, the current understanding of the physiological mechanisms responsible for symptom behaviour are reviewed and a definition for irritability is founded in the light of this knowledge.
Decline in balance with age in asymptomatic subjects using the single leg stance test
Authors: Cahalane Eibhlís , Finn Ann
Published: May 2014

Balance is essential for safe and efficient functioning in our daily lives. A decline in balance with advancing age has been demonstrated by many investigators. This article describes how the single leg stance test is effective in demonstrating this decline in asymptomatic subjects.
Loneliness, loss and grief: an experience of old age
Authors: Stewart SE
Published: May 2014

Elderly people needing occupational therapy often experience multiple losses, the sequelae of which may be misunderstood by therapists. Recognition of those losses and an understanding of the attribution of meaning to those losses by the elderly person is an important task for the therapist. Control-enhancing programmes should be introduced to encourage greater self-efficacy and autonomy.
Persistent vegetative state: the gap between law and medicine
Authors: Taylor Lisa
Published: May 2014

This paper discusses the medical, ethical and legal aspects of persistent vegetative state. In doing so, it considers the case of Airedale NHS Trust v Bland [1993], and subsequent developments in medicine and law. This paper argues that there is a need for a greater awareness of medical advancements by the legal system.
Occupational therapy and case management in mental health rehabilitation
Authors: Lloyd Chris , Samra Pam
Published: May 2014

Little has been written in the literature about the role of occupational therapists as case managers. Occupational therapists, with their focus on performance of essential daily living skills, have the opportunity to develop a significant role in case managing mentally ill clients. It is suggested that a rehabilitation focus would be an effective framework for occupational therapists to work within as case managers.
Introducing aromatherapy into clinical practice
Authors: Hall Gillian
Published: May 2014

This article describes the therapeutic potential and clinical application of aromatherapy and discusses the challenges of establishing this form of intervention within the current health-care system.
Bereavement and the elderly
Authors: Thomas CM , Winter G
Published: May 2014

No theoretical model adequately addresses the specific problems facing the elderly with regard to bereavement. If more weight is given to the findings of research we may improve our understanding of the process of bereavement, and be more able to intervene effectively when necessary.
Writing for publication: a guide for health-care professionals
Authors: Jerosch-Herold Christina
Published: May 2014

This paper is intended for those with little or no experience in writing for publication and provides some pointers for the novice on how to prepare a paper for publication. The process of writing, editing and reviewing is outlined with the aim of encouraging readers to submit papers for publication. It neither aims to be prescriptive nor is it exhaustive on the topic but is intended as a simple guide to writing and publishing. References for further reading on the subject are given at the end of the article.
An overview of seating for use by people with a disability
Authors: Jones Liz
Published: May 2014

There is an extensive choice of chairs available for use by people with a disability with a wide variety of seat heights, depths, widths, varying back angles and a host of optional extras. This article is a reminder to the reader of the essential requirements to be considered when choosing suitable seating — it takes time and the chair should fit the individual rather than the individual fit the chair.
The place of the family in the contemporary care of older people
Authors: Wade Siân
Published: May 2014

This article aims to explore features of contemporary family life and the implications of this for social policies. The place of families in supporting and caring for older relatives is examined. The view that contemporary families no longer care for their older relatives is challenged, while the pressures and conflicts that may be experienced by them are acknowledged. In the light of this the question is raised; what may or should we as health and social care professionals expect of families in supporting older people when they wish to continue living independently?
The need for standards in pressure care
Authors: Haar Barend ter
Published: May 2014

There are many changes occuring in the pressure care industry, relating to the increasing likelihood of the introduction and establishment of agreed standards which will ensure a higher quality of pressure care.
Developing collaboration: interprofessional education
Authors: Vanclay Lonica
Published: May 2014

The provision of coordinated, ‘seamless’ care requires different professionals to work effectively together. Patients and their carers want the different professionals involved in their care to work together harmoniously. They do not want to be given conflicting advice, to be asked the same questions over and over, or to be inappropriately referred.
Examining delegation in outpatient physiotherapy
Authors: Saunders Liz
Published: May 2014

A functional model of delegation was used as a tool to measure the extent to which delegation was organized in five outpatient physiotherapy departments. The ratio of physiotherapists to assistants was found to vary, but this and the amount of training the assistants received did not affect the level of clinical tasks carried out by assistants. Managers and some physiotherapists said that they would like to see an increase in assistant involvement in clinical tasks, but there was no structured system to support an increased level of delegation. Former decisions made by groups of physiotherapy staff on delegation deterred individual physiotherapists from delegating in an ad hoc manner.