bluuebunny/crossref_metadata_2025 huggingface dataset:
An evaluation of patients’ and staff members’ satisfaction with, and knowledge of, a volunteer service
Authors: Stiller Kathy , Benger Kathy , Oatey Anthea
Published: May 2014

Kathy Stiller, Kathy Benger, Anthea Oatey

Aims: Volunteers provide valuable services across the community, including healthcare organisations. The purpose of this prospective study was to determine patients’ and staff members’ level of satisfaction with, and knowledge of, a volunteer service at a rehabilitation centre. The volunteer services provided to patients included coordinating television hire, doing laundry, ward visiting, escorting patients to appointments outside the rehabilitation centre, and running a kiosk for patients, staff and visitors.

Methods: Purpose-designed surveys were used to investigate the level of satisfaction and knowledge. Patients who had received services from the volunteers, nursing and social work staff who referred patients to the service, and senior management, medical and therapy staff were eligible for participation. Ninety-seven patients and 54 nursing, 6 social work, 23 senior managerial, 5 medical and 20 therapy staff participated in the study.

Findings: Overall, patients were highly satisfied with the volunteers’ services they received in terms of the helpfulness of the services, and the personal qualities of the volunteers. Staff members were also highly satisfied with the volunteers’ services in terms of the types of services they provided to patients, the referral process, response times and personal qualities of the volunteers. The level of knowledge of patients and staff members regarding the range of services available was variable.

Conclusions: A volunteer service provided at a rehabilitation centre was highly rated by both patients and staff members. However, the level of knowledge about the range of services was not always high, providing an opportunity for the volunteers to raise their profile across the rehabilitation centre in the future.
Geographic differences in traumatic brain injury and spinal cord injury rehabilitation
Authors: Mazurek Micah , Johnstone Brick , Hagglund Kristofer , Yamato Yuko
Published: May 2014

Background/aims: To examine potential geographic differences among individuals with traumatic brain injury (TBI) and spinal cord injury (SCI) in demographics, rehabilitation services/costs, and outcomes at one year follow-up.

Methods: 152 participants with TBI from the Missouri Model Brain Injury System and 149 participants with SCI from the Missouri Model Spinal Cord Injury System were enrolled at initial acute or rehabilitation hospitalization and followed for one year. Measures included demographics, rehabilitative services/costs, functional independence measure, residency at discharge, and substance use.

Findings: Few differences in demographics or rehabilitation services were found when comparing rural and urban groups, and there were no differences in one year outcomes measured.

Conclusions: The results suggest that, contrary to expectations, individuals with severe disabilities in rural areas do not necessarily experience worse outcomes than those in urban areas, indicating potential improvements in access to services in rural areas.
Is higher education ready for the information revolution?
Authors: Bartholomew Nicola
Published: May 2014

Background: The management of chronic conditions has evolved to include tele-rehabilitation systems but are these changes being realised in practice and is the increasing adoption of networked environments refected in pre-registration health education? This paper outlines a scoping exercise which explores current health informatics education in regional higher education institutions for medical, nursing, and allied health professions pre-registration curricula in England.

Aims: to establish whether health informatics (HI) competencies are integral to regional higher education (HE) health care programmes and whether graduates would be equipped to work safely and effectively within networked primary care, secondary care and rehabilitation centres.

Methods: a mixed research model was adopted; generating data from a regional sample of education providers offering pre-registration medical, nursing, and/or allied health professional programmes. Data collection was by way of online survey and interviews. From 27 identified regional programmes, academics (n=14) representing nine different medical and health professions responded via interview and online questionnaire; a response rate of 51%. Students representing eight health professions (n=186) responded to online questionnaires.

Findings: Basic information communications technology (ICT) skills, information literacy, and knowledge management are well supported within the identified programmes of study. However, several endorsed informatics standards are not fully integrated. Time constraints and a shortage of expertise were identified as barriers to integration. Sixty-one percent of students would value more access to, and training on clinical information systems.

Conclusions: The report revealed limitations in the provision of informatics education; within HE health care curricula and offers recommendations to improve practice.
Effects of ‘The Listening Program’ on Children with Profound and Multiple Learning Difficulties
Authors: Francis Helen
Published: May 2014

Background: ‘The Listening Program’ (TLP), a commercially available music-based auditory stimulation technique, claims to positively affect behaviour and learning in people with autism and dyslexia through targeting auditory processing difficulties. The author investigated changes in mood (calm vs anxious), attention to task, and person engagement in young people with profound and multiple learning difficulties (including auditory processing deficit) who participated in TLP. These behaviours were also examined following exposure to regular classical music.

Methods: In a multiple single case study twelve participants aged 9-19 years completed TLP plus a shorter placebo regular classical music cycle. Assessment procedures included video recording, observational checklists, the school's ‘Profound Education’ Curriculum, and a post-study questionnaire for carers.

Results: Greater indications of positive change were seen in attention to task and person engagement after TLP than with regular music. These positive changes were more apparent in participants with sensory processing difficulties, particularly those with Rett Syndrome. Participants with predominantly motor impairment (cerebral palsy) did not show measurable change. Some improvement in mood was observed following both regular classical music and TLP for those with sensory processing difficulty.

Conclusions: The challenge posed by carrying out studies with this client group is addressed and decision making for subsequent clinical practice is examined.
Reliability and validity of an electronic dynamometer for measuring grip strength
Authors: Allen Deborah , Barnett Fiona
Published: May 2014

Aims:

This article describes a study aiming to establish the concurrent validity and test-retest reliability of the Biometrics E-LINK EP9 electronic dynamometer.

Methods:

Grip strength testing was performed on 49 healthy participants. Three trials were completed for the right and left hands on the Biometrics and Jamar dynamometers, using a repeated measures design. Data was compared and used to establish concurrent validity of the Biometrics dynamometer. Fifteen participants repeated the testing a week later, for test-retest reliability of the Biometrics dynamometer.

Findings:

The Biometrics E-LINK EP9 evaluation system was found to have excellent validity (ICC 0.983-0.986). However, a small but statistically significant difference between the right hand grip strength scores of the Biometrics (31.65 ± 8.89) and Jamar (30.44 ± 9.49) dynamometer was revealed (p ≤ 0.05). Test-retest reliability of the Biometrics system proved excellent, with ICC scores of 0.986 for the left hand and 0.996 for the right hand.

Conclusions:

The results indicate that the Biometrics E-LINK EP9 evaluation system is valid, reliable and comparable to the Jamar hydraulic dynamometer, when used for measuring grip strength with the second handle position. However, due to the statistically significant differences found for the right hand grip strength scores, therapists should exercise caution when interchanging instruments.
Impact of Visual Impairment Assessment on Functional Recovery in Stroke Patients: a Pilot Randomized Controlled Trial
Authors: Jarvis Kathryn , Grant Emily , Rowe Fiona , Evans Janet , Cristino-Amenos Meritxell
Published: May 2014

Aim: To determine whether providing therapy staff with objective information regarding the nature of visual impairment enhances functional recovery of stroke survivors.

Methods: A mixed methodology incorporated a pilot randomized controlled trial (RCT) and qualitative study. Patients presenting acutely with functional disability and suspected visual deficit, underwent visual assessment. Patients with visual impairment were recruited; all subjects received rehabilitation. The sample was randomized to group A (control) where details of visual assessment were withheld from therapy staff and group B (experimental) where details of visual assessment were disclosed. Functional measures (Functional Independent Measure, timed walk) were recorded at baseline and 6-week follow-up. Health professionals participated in a focus group to discuss the perceived influence of the additional visual assessment service on functional outcome.

Findings: 64 patients were recruited over 18 months (group A=31; group B=33). Drop out resulted in 19 subjects in group A and 20 in group B for full analysis. Significant functional improvement was noted in both groups, no significant difference was found between groups. Health professionals reported a perceived positive impact from the vision assessment service.

Conclusions: Provision of visual assessment information did not influence functional recovery. Qualitative findings indicated perceived benefits from the provision of the vision assessment service.
A case of dressing apraxia? A case study
Authors: Haughey Fiona , Morgan Jacinta M , Stapleton Tadhg
Published: May 2014

Dressing apraxia is defined as the condition in which automatic, spontaneous capacity for dressing is lost ( Brain, 1941 ). This case report details the rehabilitation of a 58-year-old man who required protracted ITU care for endocarditis complicated by bilateral hemispheric embolic infarcts. At presentation to the rehabilitation unit he exhibited significant visuo-perceptual changes and difficulties with dressing, domestic and community-based tasks. He developed insight into his spatial impairments and, following a period of intervention, compensated for these difficulties. However the dressing difficulties remained despite intervention. This is an unusual presentation and one that might typically be considered dressing apraxia.

This case report aims to highlight the importance of considering apraxia related to dressing within a differential diagnosis of visuo-perceptual impairments. Our report suggests that there may be justification in the classification of dressing apraxia as an impairment outside the broader terms of ideomotor and ideational apraxia. It also highlights the difficulty in treating apraxia related to dressing particularly when the affected person has minimal insight into their difficulties.
Using head posture assessment to inform the management of neck pain: a pilot focus group study
Authors: Silva Anabela , Punt David , Johnson Mark
Published: May 2014

Background/Aim: There is limited evidence about the procedures and rationale for head posture assessment in clinical practice for patients with neck pain. The aim of this study was to gather information from physiotherapists about the rationale and protocols they use when assessing head posture for these patients.

Methods: This is a qualitative research study employing focus group interviews. Twenty-one physiotherapists with at least 3 years experience of working with patients with neck pain were asked to comment on their use of head posture assessment, including the procedures of assessment and the rationale for these. Interviews were audiotaped, transcribed and analysed using thematic analysis.

Findings: Physiotherapists reported that they routinely assess head posture for patients with neck pain. Head posture was assessed by observing ‘deviations from the norm’ against an imaginary line of reference. Outcome was recorded using simple 2- and 4-point severity category scales. Participants claimed that the information provided was used in conjunction with the outcomes of other clinical tests to inform neck pain pathophysiology and treatment strategies, although discussions suggested that clinical experience and intuition was playing a major role in decision making.

Conclusions: The procedures reported and rationale provided for assessing head posture are in line with recommendations found in physiotherapy textbooks, but are challenged by the available research.
Exploring Impact of Independent Living Programme on Activity Participation Of Elderly People with Chronic Conditions
Authors: Dugow Hassan , Connolly Deirdre
Published: May 2014

Background:

The Independent Living Programme (ILP) is an eight-week community-based rehabilitation programme, consisting of group and individual interventions for older adults with chronic conditions. This research is an exploratory study to examine the potential impact of the programme on attendees' participation in daily activities and self-perceptions of performance and satisfaction with their performance of activities of daily living.

Methods:

Study participants were over 70 years of age, with physician-confirmed diagnoss of chronic conditions. 4 single-group, pre-test, post-test design ( Shadish et al, 2002 ) was used with a qualitative component. Evaluation measures included the Model of Human Occupation Screening Tool (MOHOST), the Canadian Occupational Performance Measure (COPM) and qualitative interviews. Ethical approval was obtained from Trinity College Dublin and Health Service Executive ethics committees.

Findings:

Ten people participated in the study. There was significant improvement in participants' overall activity participation (P<0.011), self-perceptions of performance (P<0.001) and satisfaction (P<0.001). Motor skills and motivation to engage in activity also improved significantly (P<0.001 and P<0.035). Interviewees reported increased self-efficacy and reflection on how they performed their daily activities. There was no significant difference in scores on process skills, communication/ interactions skills, and environmental influences on performance pre and post participation in the programme.

Conclusion:

This 8-week ILP significantly increased participants' overall activity participation, their self-perceptions of their activity performance and satisfaction with same. Due to the non-experimental nature of the study however, the results must be interpreted with caution. On the other hand, this study has clinical significance as it appears that the combination of group-education sessions, and individual tailored interventions, improves people's confidence, their motivation and motor skills to participate in activities. Further experimental research is required to confirm these findings.
Effect of carer education on functional abilities of patients with stroke
Authors: Mudzi Witness , Stewart Aimee , Musenge Eustasius
Published: May 2014

Background/Aim:

Stroke is a well-documented public health problem in low, middle, and high-income countries. Post stroke, patients are discharged home quite early and usually need help with activities of daily living. This help is usually provided by informal carers. The purpose of this study was to establish the effect of carer education on functional abilities of patients with stroke in a low resource setting where access to rehabilitation post discharge was limited.

Methods:

A randomised controlled trial consisting of two groups (control and experimental) each with 100 patients and their carers was used. The carers in the control group received individualised training as was needed to help look after the person with stroke. The patient's functional abilities were measured using the Barthel Index and the Rivermead Mobility Index. Measurements were taken at discharge, 3, 6 and 12 months post discharge from hospital.

Results:

Patients were discharged home with low functional abilities and though they improved over time, they did not do so to satisfactory levels. Carer education alone did not result in significant improvements in patients’ functional abilities.

Implications and conclusion:

There is a need to devise new ways of providing rehabilitation to patients post discharge from hospital e.g. strengthen domiciliary visits. Carers require more support to enable them to positively influence patient outcomes post stroke.
Depression and chronic physical illness: its prevalence and diagnosis, and implications for therapeutic practice
Authors: Spearing Rachel , Bailey Jill
Published: May 2014

Background:

This article explores the prevalence of depression comorbid with physical illness, issues in recognition of depression, and the implications for health professionals’ practice. The authors are British physiotherapists, but the issues raised will be relevant to other clinicians in other countries too.

Content:

Prevalence of depression in the UK and worldwide is examined and the implications for this on health policy are considered. Prevalence rates for depression in people with chronic physical illnesses are explored, and some of the possible reasons for the wide range in these figures are discussed, including difficulties that arise in the recognition and diagnosis of depression in this group. Implications for therapeutic practice are considered including some suggestions for practice.

Conclusion:

The prevalence of depression in people with chronic physical conditions is high, so clinicians working in diverse settings will be involved in the management of people with this condition. It is vital therefore that health professionals are alert to the possible presence and impact of depression, so that appropriate monitoring, management, and referral can be undertaken.
Impairment and function: the difficulty with definition and measurement of outcome in clinical practice
Authors: Bailey Toni , Doherty Patrick , Rouse Simon
Published: May 2014

Background:

The term function is used in rehabilitation both as an expression of patient status (e.g. low functional capacity) and also as a term to capture the extent of change following rehabilitation interventions (e.g. improved walking efficiency); however there is a lack of consensus as to the possible terms used to encompass the term function. There is uncertainty about the primary focus of interventions within rehabilitation in the sense that some clinicians work on reducing impairment whereas others believe they are working at a functional level. This suggests that the terms are used interchangeably in clinical practice and that an assumed link exists between altering the impairment and improving function.

Aim:

This analysis paper investigates the distinctiveness and commonality between function and impairment in rehabilitation within a conceptual framework and encourages clinicians to discuss and debate the potential for a universally recognised definition of function.

Conclusion:

Function and impairment are not always considered as being distinct, resulting in attributing observed changes in impairment to a change in functional status without the evidence to support the process.
A pilot study exploring head and shoulder movement in visual field deficits following stroke
Authors: Taylor Lisa , Poland Fiona , Stephenson Richard
Published: May 2014

Objective:

This study investigated the effects of a systematic treatment programme on head and shoulder movement for individuals with visual field deficits following stroke, providing evidence in a clinical area that is reportedly poorly understood and has received little attention ( Thumser et al, 2010 ).

Design:

The study used a single case method based on an ABC design—incorporating a pre-treatment baseline phase (A), treatment phase of 4 weeks (B), and post-treatment baseline phase (C) at week 5 and week 17. The subjects received 30 minute sessions twice weekly for 4 weeks.

Results:

An initial autocorrelation co-efficient calculation with a non-significant result is necessary to enable further analysis of the data—which was achieved with the current study data. Subsequent visual analysis indicated a reduction in the angle between the head and shoulder for both subjects when turning to the left but only for Subject 1 when turning to the right; celeration lines were applied to the data to indicate the significance of the results. The celeration lines were statistically significant for Subject 1 turning to the left and for Subject 2 turning to the right in addition two standard deviation band was statistically significant for Subject 2 turning to the right.

Conclusions:

The data from this study provide preliminary support for a theory of head and shoulder movement change following visual field deficit as a result of stroke. The change of movement measured following the introduction of the systematic treatment programme suggests that use of the systematic treatment programme may influence the head and shoulder movement of individuals with visual field deficits as measured during this study.
Specifics in running kinematics developed by Pose Method in disabled sprinters with cerebral palsy
Authors: Pyanzin Andrey , Romanov Nicholas , Vasilyev Valeriy , Fletcher Graham
Published: May 2014

Background:

The absence of a commonly accepted theory of running technique and teaching methods creates certain practical and theoretical difficulties in the training of athletes of all levels. This particularly concerns disabled athletes who specialise in running. The absence of an established standard in running technique makes it difficult for runners diagnosed with cerebral palsy to learn an effective and reliable running technique in order to build up a foundation for developing sport performance skill and to reduce injuries.

Hypothesis:

Disabled runners affected by cerebral palsy can experience changes in running technique similar to those of healthy runners by learning to run with the Pose Method.

Objective:

The purpose of this study was to find specifics in kinematics of disabled runners learning the Pose Method, and to compare them to the specifics in kinematics of healthy runners learning the Pose Method.

Data sources:

To conduct the comparative analysis of kinematics, data of healthy runners were gathered from two Pose Method studies published in International Journal of Sports Science & Coaching, and International Quarterly of Sport Science. Data of runners with cerebral palsy were obtained by conducting a new study with parameters and criteria similar to the published studies.

Results:

Six out of eight characteristics in changes in kinematics of disabled runners learning the Pose Method were similar to the changes in kinematics of healthy runners learning the Pose Method.

Conclusions:

The data indicates that teaching the runners with cerebral palsy symptoms to run using the Pose Method leads to less deviations from the optimal parameters of running technique, making it a better controlled process. Further research is required to find out the effect of these changes in running kinematics on speed, performance, and injury reduction in runners with disabilities.

Clinical relevance:

These data provide an insight into the potential of development of better sensory structure of movement of individuals diagnosed with cerebral palsy.
Types of disability in children and maternal depressive symptoms: Is there any relationship?
Authors: Rashedi Vahid , Rezaei Mohammad , Morasae Esmaeil Khedmati , Weisi Farzad
Published: May 2014

Objective:

To investigate the level of depressive symptoms in mothers of children with intellectual developmental disabilities (IDD) and the variations of these symptoms between mothers of children with different categories of IDD.

Methods:

This descriptive, cross-sectional study was conducted among 162 mothers of children with IDD in Tehran, Iran. The Beck Depression Inventory-II (BDI-II) and a demographic questionnaire were used to gather the required data.

Results:

Mothers of children with IDD experienced depressive symptoms of varying degrees of severity. BDI-II scores of the mothers who had children with IDD were high (18.15 ± 10.62) but depressive symptoms were not significantly associated with the children's type of disability.

Conclusion:

Mothers of children with IDD, in general, reported a mild level of depressive symptoms. As a result, one can suggest that they should be provided with regular psychological support.
Postural sway and EMG analysis of hip and ankle muscles during balance tasks
Authors: Florence Tse Yuen Yi , Petrofsky Jerrold , Berk Lee , Daher Noha , Lohman Everett , Cavalcanti Paula , Laymon Michael , Rodrigues Sophia , Lodha Riya , Potnis Pooja A
Published: May 2014

Aims:

This study examined how vision, base of support (BOS) and surface compliance affected postural sway and electromyography (EMG) activity of hip and ankle muscles during eight balance training tasks in young adults.

Methods:

Postural sway and EMG activity of gluteus maximus (GMAX), gluteus medius (GMED), tibialis anterior (TA), and medial gastrocnemius (GAST) were measured during eight balance tasks with eyes open or closed, feet in tandem or apart, and on foam or a firm surface.

Results:

Postural sway and EMG activity of hip and ankle muscles were significantly affected by the alteration of vision, surface compliance or BOS during eight balance tasks (P<0.05). There was more postural sway when the number of sensory factors altered in the balance tasks increased. GMED and TA EMG activity increased significantly in tasks with tandem standing; GMAX was recruited significantly only when vision was excluded in tasks with tandem standing; and GAST EMG activity was significantly higher in tasks on the foam and in tandem standing.

Conclusions:

Balance exercises may be progressed according to the rank of the task’s difficulty by increasing the number of sensory factors altered in a balance task. There was significant recruitment of hip and ankle muscles in the balance tasks indicating the importance of these muscles in postural control.
Quality of life in persons with voice disorders: A review of patient-reported outcome measures
Authors: Slavych Bonnie , Engelhoven Amy , Zraick Richard
Published: May 2014

This article provides concise reviews of widely-used quality of life (QOL) instruments for use with persons with voice disorders. Designed primarily for English-speaking persons, the reviewed instruments are delineated by title and population served, i.e. adult or paediatric. Each review reports the purpose of the QOL instrument as well as its psychometric soundness. Future voice-related QOL instruments are briefly considered. Finally, the appendices include tables with currently-available translations and known readability information. This article will serve as a reference for physicians and speech-language pathologists seeking to assess the voice-related QOL of their patients.
Emergency department primary contact physiotherapists improve patient flow for musculoskeletal patients
Authors: Guengerich Mandy , Brock Kim , Cotton Susan , Mancuso Sam
Published: May 2014

Aims:

To determine if primary contact physiotherapists (PCPs) in the emergency department (ED) improve patient flow while providing management comparable to doctors for musculoskeletal patients.

Methodology:

Prospective observational design comparing PCPs to doctor treatment of musculoskeletal patients. Participants: 559 ED patients—275 patients treated by a PCP and 284 by a doctor.

Measures:

The primary outcome measure was wait time. Secondary outcomes were total length of stay, patient satisfaction, recovery and follow-up, re-presentations and adverse events.

Results:

The median wait time for patients managed by a PCP was statistically significantly shorter than for patients managed by a doctor, with a median of 22 minutes compared with 63 minutes (P<0.001). The median total time spent in the ED for patients managed by a PCP was also statistically significantly shorter than for patients managed by a doctor, 120 minutes compared with 201 minutes (P<0.001).

Conclusion:

PCP services in ED improve patient flow for musculoskeletal patients.
Efficacy of proprioceptive neuromuscular facilitation on shoulder function in secondary shoulder impingement
Authors: Nakra Nishtha , Quddus Nishat , Khan Sohrab A , Kumar Suraj , Meena Roshan Lal
Published: May 2014

Objective:

To determine the efficacy of proprioceptive neuromuscular facilitation (PNF) on shoulder function in participants with secondary shoulder impingement.

Background:

Previous research has established a relationship between shoulder muscle weakness and causation of secondary shoulder impingement. Recent evidence has shown that proprioceptive neuromuscular facilitation was effective in relieving pain and increasing overhead reach. However, none of the studies have measured shoulder function after PNF application.

Methods:

This study used a pretest–posttest experimental group design. Thirty participants (15 male and 15 female) with a diagnosis of secondary shoulder impingement were recruited from a hospital setting and divided into two groups. Group 1 received both PNF and the conventional protocol while group 2 received only the conventional protocol. Both groups received the intervention for a period of 3 weeks. Shoulder Pain And Disability Index (SPADI) score and overhead reach were analysed in both groups.

Results:

Group 1 showed significant improvement over Group 2 in terms of SPADI score and overhead reach. The experimental group showed significant improvement in (reduction of) SPADI score over the control group (23.8 ± 4.9) at a significance level of P<0.0001. The experimental group showed a significant difference over the control group for overhead reach (3.63 ± 1.8) at a significance level of P<0.03.

Conclusion:

The addition of PNF to conventional treatment brings significant improvement in shoulder function in comparison to conventional treatment alone in participants with secondary shoulder impingement. PNF helps in early recovery.
A pilot study to explore the feasibility, validity and reliability of a visual version of the CARE Measure
Authors: Murphy Joan , Mercer Stewart W , Duncan Edward AS
Published: May 2014

Aim:

Empathy is an essential component of any therapeutic encounter. The Consultation and Relational Empathy (CARE) Measure is a validated, reliable patient assessment of practitioners’ communication and relational empathy abilities. This study piloted a visual version of the CARE Measure for use by people with communication, cognition and/or literacy difficulties.

Methods:

A visual version of the CARE Measure was developed and piloted in two routine general practice settings with 42 patients, and in two rehabilitation settings with 13 patients who have communication difficulties while consulting with allied healthcare professionals.

Results:

The Visual CARE Measure performed well when compared to the standard measure as it had less of a ‘ceiling effect’ and showed less skew and kurtosis than the standard measure. The internal reliability of the Visual CARE Measure was high, and removal of any items resulted in a reduction in reliability. The number of ‘not applicable’ values overall was low, suggesting that the items in the measure were regarded by patients as relevant to their consultation. The Visual CARE Measure was reported to be very easy to understand, easy to complete and perceived as important.

Conclusions:

The Visual CARE Measure appears to perform well in comparison with the standard measure.
Providing nursing services under an SPMS contract
Authors: Pritchard Jo
Published: May 2014

Pioneering nurses in Surrey are setting up a limited company to provide local services.
How to spot a case of schistosomiasis
Authors: Morris David
Published: May 2014

Travellers may be at risk of bilharzia. Dr David Morris gives an overview of this unpleasant condition.
Active ageing
Authors: Persaud Joy
Published: May 2014

Encouraging care home residents to exercise can cut falls and boost morale.
Prescribing for constipation
Authors: Norton Christine
Published: May 2014

Professor Christine Norton explains what prescribing options are available for this common condition
Reflexology
Authors: Ernst Edzard
Published: May 2014

Any negative effects seem to be minor, but there are no clear positive benefits.
Addressing cardiometabolic risk factors
Authors: Hill Jill
Published: May 2014

Simple measures can identify those patients at risk of cardiovascular events, explains Jill Hill
Interventions to combat osteoporotic fracture
Authors: Bainbridge Penny
Published: May 2014

In the second part of her osteoporosis overview Penny Bainbridge covers the preventive treatments available for those at risk of fractures
Evaluating guidelines for patients
Authors: Hanley Janet , McKinstry Brian
Published: May 2014

The impact of patient guidelines has not been widely evaluated.
Treating candidiasis
Authors: Hashmi Taqi
Published: May 2014

Infection with Candida species is common but usually simple to treat.
Understanding carpal tunnel syndrome
Authors: Brown Harry
Published: May 2014

Early diagnosis and the offer of treatment may prevent potentially irreversible damage.
An update on childhood immunisation
Authors: Robinson Gina
Published: May 2014

The schedule of the childhood vaccination programme is complex. Gina Robinson explains.
Human givens in primary care
Authors: Potts Liz
Published: May 2014

Community psychiatric nurse Liz Potts describes her experience as one of the few primary care professionals in Coventry using the human givens approach.
How to make the most of email
Authors: Brown Harry
Published: May 2014

Electronic messages can be a great help to busy health professionals if managed effectively.
Discussing sexual dysfunction
Authors: Lehmann Victoria
Published: May 2014

Patients need to feel safe and secure to express their innermost concerns, says Victoria Lehmann.
Prescribing antiplatelets
Authors: Morris David
Published: May 2014

There is strong evidence to show that antiplatelet drugs can benefit people with established CVD, says Dr David Morris.
Gold standard palliative care
Authors: Thomas Keri
Published: May 2014

Nurses are leading the way in implementing good practice in end-of-life care.
Vaccinating against shingles
Authors: Parr Chris
Published: May 2014

Proposals to vaccinate older people against shingles could help prevent the debilitating symptoms illustrated in the following case study, writes Chris Parr
Providing pre-travel guidance
Authors: Peate Ian
Published: May 2014

Pre-travel health advice from nurses helps patients to avoid preventable problems and manage risk
Putting patients first in practice
Authors: Woods David
Published: May 2014

Plans to improve care could focus on condoning shortcomings instead of rewarding best practice, writes David Woods In Putting Patients First, the government's initial response to the Francis report into care failings in Mid Staffordshire, heal
Loneliness: a silent epidemic
Authors: Wood Cate
Published: May 2014

Loneliness contributes to poor health and should be viewed as a public health issue,writes Cate Wood
Cholera: advising travellers
Authors: Simons Hilary
Published: May 2014

INFECTIOUS DISEASE

Hilary Simons advises on risk assessment for global travellers
Parental responsibility: A legal perspective
Authors: Cornock Marc A
Published: May 2014

Parental responsibility is often discussed in relation to the care and treatment of children—but what is parental responsibility? Who has it and what does it allow the person who has it to do? This commentary aims to answer these questions from a legal perspective.
Restraint in children’s nursing: Addressing the distress
Authors: Brenner Maria , Parahoo Kader , Taggart Laurence
Published: May 2014

The use of restraint in children’s nursing is a sensitive and often a taboo subject. This article aims to encourage discussion on the use of restraint in children’s nursing. The topic of child restraint is not new yet there is little research on its impact on the child, parents or healthcare professionals. Factors which influence healthcare professionals’ decision to restrain a child are presented, and highlight some of the distress and sensitivities surrounding the use of restraints. This is followed by current expert guidance on the use of restraint in children’s nursing. Finally some suggestions are made regarding the variety of research that could contribute to improved understanding of this controversial issue.
Parents whose children have complex needs: experiences of hospitalization
Authors: Hewitt-Taylor Jaquelina
Published: May 2014

This paper discusses the experiences of parents’ whose children have complex and continuing health needs in relation to their child’s hospitalisation. The findings are taken from two qualitative studies.

The principal findings are that the challenges which parents whose children have complex health needs experience as a result of their child’s hospitalisation may appear to be very similar to those of other parents. However, the nature of their child’s needs and their level of dependency usually makes the demands on their parents even greater. There generally appears to be an expectation that parents will remain with their child, and provide for all their care needs, including many of their specialist medical or technical needs. This may be because of the workload which nurses carry, the skills, knowledge and confidence which staff have in meeting the needs of children who have complex and continuing health needs, and staff attitudes towards children and their families. However, although parents are often expected to take on a role which acknowledges and makes use of their expertise, they are not always seen as equals to staff in relation to respect for their expertise, knowledge of their child, and decision making about them, and are not given the opportunities which staff have to take breaks or have time off duty.

This paper describes what were largely unstructured additional findings from two studies of the experiences of children who have complex and continuing health needs and their families. Despite the limitations which this poses to their validity, they provide some insights which may be useful in directing more specific studies.
Prime Minister backs concept of presumed consent
Authors: Glasper Edward Alan
Published: May 2014

The parents of children with chronic illnesses, where future transplant might be necessary to prolong life, will have applauded the overt stance as reported in the Mail on Sunday in January 2008 ( http://www.mailonsunday.co.uk/pages/live/articles/news/news.html?in_article_id=507945&in_page_id=1770 ) of Prime Minister Gordon Brown regarding his support for the collection of potential organs for transplant from deceased patients, predicated on the concept of presumed consent. Mr Brown, himself the parent of a child with cystic fibrosis, has endeavoured to raise the level of debate which, if successfully concluded, might help many children and young people who are waiting for an organ donation. The current system of consent for organ donation is an ‘opt in’ rather than an ‘opt out’ system. It is reinforced by the Human Tissue Act (2004), which followed the disquieting events at Bristol Royal Infirmary and the Royal Liverpool Children’s Hospital (Alder Hey), where body parts from children were removed without proper consent procedures being applied. Ironically, this act is now seen by some as an obstacle to increasing the availability of donors, as it is predicated on informed consent and contains no provision for presumed consent.
A community health needs evaluation: improving uptake of services at a children’s centre in a deprived and geographically isolated town
Authors: Long Tony , Fallon Debbie , Devitt Patric , Oak Eileen , Murphy Michael , Dugdill Lindsey
Published: May 2014

The evaluation identified health and social trends for this deprived and geographically isolated area, elicited perceived health needs of under-fives in the local community, and informed development and improvement of services offered by a children’s centre.

Sure Start children’s centres are crucial to delivery of outcomes of the Every Child Matters policy initiative as well as offering support for parenting. The children’s centre in the study sought to develop its services and to increase the numbers of registered users particularly among ‘hard to reach’ groups in the locality.

Leafleting, street-canvassing, primary school newsletters and posters were used to advise the community of the consultation. Data were collected by telephone interviews, group and face-to-face interviews with parents and professionals, structured interviews in the town centre streets and analysis of policy and health statistics documents.

The area was characterized by inadequate transport links and limited sources of good value local food supplies. The key areas of Every Child Matters were not meaningful concepts to most parents in connecting to their children’s health. Residents and professionals recognized low levels of parental expectations for their children. Specific barriers to service uptake were identified, but the children’s centre made a positive contribution to the health and well-being of the population, providing an effective service in terms of variety, resources and professional help.

Additional services, better access to some services, revised opening times, additional transport, and integration of provision for siblings resulted from the study.
Training in aesthetic nursing: are you ticking all the right boxes?
Authors: Davies Emma
Published: May 2014

In the current climate, it is essential that official bodies such as the Royal College of Nursing and the Medicines and Healthcare Products Regulatory Agency invest in the training of aesthetic nurses. Not only must these organisations support education and training, but product manufacturers are also advised to take responsibility for raising standards in aesthetic medicine. In this article, the author provides an overview of the current status of education and training, and outlines the topics that should ideally be included in every course. The author also discusses the need for improvement in these courses and how that might best be achieved.
Sun protection: an essential update on the use of physical and chemical sunscreens
Authors: Bowes Lorna
Published: May 2014

Sun protection has traditionally been seen as the application of chemical or physical sunscreens to the skin; however, better understanding of skin care and particularly photoprotective topicals is affecting opinions on the best products to apply to protect against ultraviolet (UV) exposure. New European Union (EU) regulations come in to force this in July of this year, insomuch as the EU Cosmetics Directive 76/768/EEC is to be replaced by Cosmetic Products Regulation 1223/2009), affecting changes to manufacturing, labelling, safety reports, product information files (PIFs) and serious undesirable effect reporting. The Food and Drug Administration has implemented also new regulations for sun protection factor (SPF) claims and drug facts labelling for SPF products. Last year, the author reviewed the effects of UV exposure and relevant regulations, as well as imminent regulatory changes in the US, and briefly reviewed new ingredients making an impact on cosmeceutical sun protection and damage repair ( Bowes, 2012 ). This update paper reflects these changes and explores ways we can support our patients wishing to achieve a healthy glow.
Preoperative patient warming in the prevention of hypothermia
Authors: Singh Arwinder
Published: May 2014

Inadvertent perioperative hypothermia is associated with morbidity leading to prolonged recovery and hospitalisation, increased incidence of wound infections, increased risk of morbid cardiac events and increased bleeding during and after surgery. Guidelines for the prevention of perioperative hypothermia have been issued, but there is uncertainty as to the most effective means of preventing hypothermia in this patient population, leading to inconsistencies in clinical practice. To determine whether implementation of these guidelines would be effective in practice, the present study was designed. Different methods of pre-warming were applied and temperature measurements for patients receiving general anaesthesia during surgery were recorded. Data were collected for 47 (24.5%) of 192 patients who were enrolled in the study. The mean temperature of patients was 36.96°C (standard deviation=0.43), with a range between 36.1°C and 37.6°C, demonstrating that there were no hypothermic patients in the study. The precautionary measures taken to prevent hypothermia in this study were found to be effective, indicating that adherence to published guidelines should be encouraged in surgical practice.
Surgical gowns and drapes: maximising patient safety
Authors: Al-Hashemi
Published: May 2014

Surgical drapes and gowns are manufactured specifically to meet the exacting demands of a range of procedures, providing the appropriate protection according to the type of surgical intervention, maximising clinical patient safety and user comfort. Surgical gowns and drapes are classed as medical devices and should carry the CE mark, while conforming to the European Standard EN 13795. They are bound legally by minimum standards in specific areas, such as microbial penetration, tensile strength, linting and permeability to fluids. Surgical gowns and drapes are either reusable or single-use. Surgical gowns and drapes create a sterile barrier to help prevent surgical site infections. It is vital that practitioners are aware of how to safely don the gown and handle and safely apply drapes to the patient.
Interprofessional learning: a student's perspective
Authors: Wooding Ashley
Published: May 2014

Interprofessional learning is key to becoming a health practitioner. This involves not only knowing your role and limitations, but also knowing that of other professionals within the clinical multidisciplinary team. This learning can help prevent negative outcomes in patient care. Reflecting on practical experiences while implementing communication and interpersonal skills can enhance learning outcomes by producing a competent, confident and compassionate practitioner.
Implementing maternal early childhood sustained home visiting in Essex
Authors: Plastow Liz
Published: May 2014

This paper looks at an evidence-based model of intervention being implemented in the east of England in Essex which will help to deliver the Health Visitor Implementation Plan: A Call to Action ( Department of Health, 2011 ). It describes the recent history of health visiting in England and the importance of building relationships with families in order to improve child health outcomes. It describes and explains the four levels stated in the plan, how the maternal early childhood sustained home visiting (MECSH) programme will deliver this, what this means for health visiting in the future, and how MECSH fits with safeguarding, family nurse partnership and existing health visiting practice.