bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of exercise interventions on physical condition and health of Vietnam veterans
Authors: Sealey Rebecca M , Tope Susanna B
Published: May 2014

Background: Vietnam war veterans report a high incidence of chronic diseases. Clinicians should prescribe exercise programmes to improve their health that the patients are likely to follow. This study compared the adherence rate to and the health and functional changes resulting from various 12-week exercise interventions on Vietnam war veterans.

Methods: Thirty-one participants (aged 62±6 years; body mass index 33±4 kg/m2 were divided into three groups which performed: 1) stretching, lower-body vibration and upper-body resistance training; or 2) stretching, lower-body vibration, upper-body resistance and aerobic training; or 3) stretching, upper- and lower-body resistance and aerobic training. Measures taken before and after interventions included cardiorespiratory health, body composition, strength, flexibility and functional capacity. Paired t-tests and ANOVAs were used to analyze the data within and between groups.

Findings: Eighty-two per cent of participants completed the programme, with an average attendance of 80%. Significant main effect improvements in all participants were evident for the six-minute walk (F(1,28) = 77.167, P<0.001), static squat (F(1,28) = 18.854, P<0.001), timed up-and-go (F(1,28) = 26.252, P<0.001), sit and reach (F(1,28)=9.842, P = 0.004), leg strength (F(1,28) = 7.121, P = 0.013), resting heart rate (F(1,28) = 11.623, P = 0.002), resting systolic (F(1,28) = 8.524, P = 0.007) and diastolic (F(1,28) = -4.348, P = 0.046) blood pressures, waist girth (F(1,28) = 38.917, P<0.001), hip girth (F(1,28) = 27.473, P<0.001) and body mass (F(1,28) = 8.833, P = 0.006). Only the static squat test was found to be significantly different between groups (F(2,28) = 4.257, P = 0.024).

Discussion and conclusion: All exercise protocols improved health and function in Vietnam war veterans. Future research with a larger group is needed to verify these findings.
The influence of significant others upon participation in cardiac rehabilitation and coronary heart disease self-help groups
Authors: Jackson Angela M , McKinstry Brian , Gregory Susan
Published: May 2014

Aims: Despite identified benefits, many people do not participate in cardiac rehabilitation (CR) programmes and coronary heart disease (CHD) self-help groups when recovering from myocardial infarction (MI). Little is known about the influence of ‘significant others’ regarding participation, their role, and the significant others’ experience of rehabilitation without these resources. This article describes research aiming to explore the role of significant others in such non-participation, and their experiences and perspectives, and, from this, identify implications for policy and practice.

Methods: A qualitative study was carried out in Lothian, Scotland. In-depth interviews were carried out with 27 people who had not participated in CR and/or a CHD Group after discharge from hospital 6–14 months previously following myocardial infarction, and 17 of their nominated significant others.

Findings: Significant others are influential regarding their family members'/friends' use/non-use of rehabilitation resources. However, there are important limitations upon this influence.

Conclusions: Significant others should be an essential consideration in post-MI rehabilitation, as influences on rehabilitation resource participation, potentially key providers of support, and regarding their own wellbeing.
Effect of a token economy behaviour therapy on drooling in children with cerebral palsy
Authors: Sethy Damayanti , Mokashi Sunil
Published: May 2014

Objective: To investigate the effect of token economy-a behaviour therapy technique for controlling drooling in children with cerebral palsy associated with mild intellectual disability.

Methodology: A total number of 25 children with cerebral palsy associated with mild intellectual disability attending the occupational therapy department of Swami Vivekanand National Institute of Rehabilitation Training and Research (SVNIRTAR), Orissa, India, participated in a single blind randomized pre-and post-test control group training study. Subjects were randomly allocated to group A (experimental n=12) and group B (control n=13). Baseline frequency of drooling was observed by two independent raters for 20 minutes for both the groups. After the baseline data collection, subjects in group A received conventional therapy along with behaviour therapy (token economy) and group B received conventional therapy alone.

Results: The result showed that there was a significant decrease in frequency of drooling after application of token economy as a behaviour modification technique in the experimental group (P=0.001) as compared to the control group (P=0.070).

Conclusion: The result of the study demonstrated that the token economy program was effective in controlling drooling in children with cerebral palsy associated with mild intellectual disability.
A Patient with Midthoracic Back Pain and Dysphagia: a Case Report
Authors: Schoots Esther J.M. , Bouman Jenneke L. , Weusten Bas L.A.M.
Published: May 2014

This case study reports on complaints of midthoracic back pain and dysphagia in a patient with significant osteophytes in the context of Diffuse Idiopathic Skeletal Hyperostosis (DISH). The clinical and radiologic phenomena of DISH are discussed. Despite the presence of important structural radiologic abnormalities in the thoracic spine in our patient, there was a good clinical recovery after exercise and manual therapy aimed at improvement of posture, functional scapulothoracic stability, strength of the interscapular muscles, length of the pectoral muscles, and mobility of the cervicothoracic and upper thoracic spine. We suggest that functional factors rather than structural abnormalities played a causal role in the genesis of midthoracic back pain in our patient.
Assessing knee hyperextension in patients after stroke: comparing clinical observation and Siliconcoach software
Authors: Richardson Susan , Cooper Allison , Alghamdi Ghalib , Alghamdi Mohammed , Altowaijri Abdulrahman
Published: May 2014

Background:

Observational gait analysis used by clinicians has been shown to have moderate reliability in relation to joint angles. Siliconcoach movement analysis software uses a digital image to determine joint angles. The aim of this study was to compare Siliconcoach software against experienced clinicians in assessing knee hyperextension in patients following stroke.

Method:

This was an observational comparison study with a convenient sample of 20 ambulant participants with a unilateral stroke videoed during three walks. To determine knee hyperextension and the reliability of Siliconcoach the recordings were assessed by three raters using Siliconcoach and by three experienced clinicians.

Findings:

The Kappa statistic for intra-observer agreement for knee hyperextension ranged from 0.8 to 1.0 (substantial to almost perfect) and from 0.6 to 0.9 for inter-observer agreement (moderate to almost perfect). Intra-rater and inter-rater ICC scores for Siliconcoach were all >0.75 suggesting very high reliability. Clinicians compared with Siliconcoach ranged from 0.4 to 0.7(fair to substantial).

Conclusion:

Observational gait analysis appears to be an adequate measurement tool in clinical practice particularly when undertaken by the same experienced therapist. However, Siliconcoach may be a more reliable measure and provides an objective measure of quantifying knee joint angles for both research and clinical practice.
Motor versus cognitive dualtask effects on obstacle negotiation in older adults
Authors: Plummer-D'Amato Prudence , Shea Gillian , Dowd Colleen
Published: May 2014

Aim:

The primary aim of this study was to compare the effects of motor and cognitive dual-tasks on obstacle negotiation in older adults.

Methods:

Seventeen community-dwelling older adults (76.7 years, SD 5.6) were timed to perform an obstacle negotiation task under single-task and three dual-task conditions (coin transfer, spontaneous speech, alphabet recitation).

Findings:

Participants made few obstacle contacts, but slowed significantly during the coin transfer task compared to all other conditions. Participants who appeared to prioritize the coin transfer task during obstacle negotiation had higher ratings of balance confidence, suggesting that older adults with greater balance confidence may be more likely to shift attention away from gait when performing an upper extremity motor task during walking.

Conclusions:

A simultaneous upper extremity motor task had a greater effect than spontaneous speech or alphabet recitation on timed obstacle negotiation in healthy older adults.
How do physiotherapists assess and treat patellofemoral pain syndrome in North Wales? A mixed method study
Authors: Papadopoulos Konstantinos D. , Noyes Jane , Barnes Moyra , Jones Jeremy G. , Thom Jeanette M.
Published: May 2014

Background/Aim:

Little is known about how individual physiotherapists assess, treat and measure outcomes for patients with patellofemoral pain syndrome (PFPS) in the clinic. Previous research has revealed no gold standard methods. This study therefore set out to explore beliefs and practices of physiotherapists working in a non-academic health community in North Wales (NW).

Methods:

Methodology involved a mixed-method approach. 4 quantitative questionnaire exploring how physiotherapists assess, treat, and measure outcomes in PFPS, was emailed to physiotherapists working in NW. Thirty responded (62.5%) and eleven were then interviewed (qualitative). Interviews were recorded, transcribed, and organised into categories. Number and frequency of the different assessments, treatments, and outcome measures were triangulated against the quantitative survey data. Findings were then synthesised.

Findings:

Physiotherapists are aware of the different types of presentation of PFPS; however, individual clinical practice differs. Although the questionnaire reported a large number of outcome measures, interviews reported mainly only the visual analogue pain scale and subjective functional tasks. Moreover, physiotherapists treat function, not syndromes. Home exercises aim for simplicity and function rather than complex muscle group specific exercises. Peers were reported to be the most important source of knowledge and influence on their practice.

Conclusion:

There is a need to develop an evidence-based assessment and outcome measurement protocol for routine clinical practice.
‘I know how to look after myself a lot better now’: service user perspectives on mental health in-patient rehabilitation
Authors: Notley Jenny , Pell Hannah , Bryant Wendy , Grove Mary , Croucher Anna , Cordingley Kevin , Blank Alison
Published: May 2014

Aims:

This research explored experiences of an in-patient mental health rehabilitation unit. This setting has a place in current services but has not been the focus for recent developments. Perspectives were sought from people who had been discharged more than a year previously.

Method:

A qualitative method was used. Ten service users were interviewed individually, using photographs of the unit to elicit responses. The data were subject to detailed analysis.

Findings:

Of the three overarching themes, the first, ‘past’, suggested that a need for the unit arose from complex and severe problems, often for people in transition. The experience of the unit, the second theme, ‘present’, considered four aspects; routine, looking after yourself, time and space, and choice, based on the staff approach. The third theme, ‘future’, identified that following time at the unit, participants had restored, reconstructed, and developed routines, identities, and roles.

Conclusions:

Overall, these themes suggested the diversity of experiences and indicated the importance of recovery-oriented practice. Most participants valued their time in the unit and could see the benefits for others. Staff skills in enabling individual rehabilitation and recovery are critical, to ensure individual goals are identified and remain the focus of interventions.
The adoption and implementation of evidence-based practice (EBP) among allied health professions
Authors: Upton Penney , Scurlock-Evans Laura , Stephens Danielle , Upton Dominic
Published: May 2014

Background and aims:

Evidence-based practice (EBP) is widely accepted within patient care as it ensures health care professionals remain informed of recent evidence and research relating to their clinical practice. However, the particular characteristics detrimental to the successful implementation of EBP within Allied Health Professionals' (AHP) clinical practice are unknown. The purpose of this study was to assess and characterise adoption of EBP within AHP's clinical practice.

Methods:

Questionnaires comprising the Evidence-Based Practice Questionnaire (EBPQ; Upton and Upton, 2006a ) were administered to 154 (response rate=273%) newly qualified practitioners (NQPs) from NHSScotland. Data were analysed to determine attitudes, knowledge and skill of EBP; K-means cluster and chi-square analyses were conducted in order to differentiate profiles of NPQs within high-, medium-and low-categories on the EBPQ practice and knowledge/skills sub-sections.

Findings:

Moderate scores were recorded for NQP's implementation, knowledge, and attitudes toward EBP. Chi-square analysis performed on the high-, moderate-and low-practice and skills' profiles revealed no significant results for NQP's year qualified, age, or year of clinical practice.

Conclusions:

The findings illustrate that the majority of NQPs have a good understanding of the application and importance of EPB, and suggests the improvement in NQPs training with regards to EBP enables them to successfully transfer acquired knowledge within their clinical practice.
Single- and dual-task assessments in elderly patients in a falls intervention programme
Authors: Quinn Patricia , Horgan Frances
Published: May 2014

Background/aim:

Falls are associated with impaired cognitive performance in the elderly, but the optimal method of assessing cognitive risk factors remains to be determined. We investigated the association between measures of balance under single- and dual-task conditions, with cognition and falls in older people participating in a falls intervention programme in a long-term care facility.

Methods:

This was a cross-sectional study. The Timed Up and Go (TUG) test was performed under single-task (TUG1) and dual-task (TUG2) conditions to evaluate the impact of a concurrent attentionally demanding cognitive task. Dynamic balance was assessed using the Berg Balance Scale (BBS).

Results:

Sixty-six patients with a mean age of 84 years (SD=5.7) participated. The mean delta TUG (the difference in time to complete TUG1 and 2) was 13.7 seconds (SD=9.25). Using a paired sample t test, the delta TUG was found to be statistically significant (t=12.089, df=65, P < 0.001, [95% CI 11.48–16.03 seconds]). Logistic regression analysis also found the delta TUG2 to be statistically significant (beta=2.34, SD=0.87, P < 0.0075) and associated with fallers.

Conclusions:

An error score in cognitive task in TUG2 was the best discriminator of fallers. The TUG2 may be used to optimise risk identification in patients with balance deficits that are attentional in origin, and not detected under single-task conditions.
Who's next? Referral prioritisation criteria for home care occupational therapy
Authors: Raymond Marie-Hélène , Feldman Debbie , Prud'homme Marie-Pier , Demers Louise , Hunt Linda A , Bissett Michelle , Slater Craig E
Published: May 2014

Background/aims:

Prioritising referrals on waiting lists is common practice in rehabilitation. However, little is known about the exact criteria that are used in home-based occupational therapy to determine the level of urgency. This study aimed to identify prioritisation criteria in home-based occupational therapy services in Quebec, Canada, and to describe how they are used in practice.

Methods:

A mail and telephone survey of 55 home care programmes across Quebec was conducted. Participants provided information about occupational therapy wait times, and referral prioritisation tools and practices. A detailed quantitative content analysis compared the content of all referral prioritisation tools.

Results:

This study identified 48 main categories of referral prioritisation criteria, but only nine of them were present in the majority of tools. Wait times vary greatly between priority levels, with a median of 2 days for urgent referrals and 20 months for low-priority referrals. In general, problems related to safety and remaining at home are considered more urgent than problems related to independence, quality of life, and activities outside the home.

Conclusions:

These findings highlight the need for more consistent and evidence-based prioritisation criteria for occupational therapy in home care in order to facilitate equitable access to these services.
Rehabilitation after pectus excavatum corrective surgery: A single case report
Authors: Schewitz Jacqui , Aswegen Helena Van
Published: May 2014

Background:

Pectus excavatum deformity, often diagnosed in children and adults, results in psychological and physiological impairments. The minimally invasive Nuss surgical procedure is more frequently used to correct this deformity. The purpose of this single case report is to report on the interdisciplinary management provided for a 9-year-old girl who underwent this procedure for congenital pectus excavatum deformity.

Content:

A retrosternal steel bar was surgically placed through two small chest wall incisions made on either side of the chest and twisted over to push the sternum upwards. Interventions such as pre- and postoperative patient and family education, early postoperative mobilization, regular assessment of analgesic needs, deep breathing and coughing formed part of the rehabilitation provided in the intensive care unit and continued in the ward.

Conclusion:

This evidence-based inter-disciplinary approach to rehabilitation was important in the postoperative management of the patient to facilitate an uncomplicated recovery. This case report contributes to the limited body of evidence available on rehabilitation after the Nuss procedure for pectus excavatum deformity.
Adverse effects of central tendency, lateral difference, and reciprocal inter-limb weight adjustment on performance accuracy during lateral body weight shifting
Authors: Watanabe Miyoko , Higuchi Takahiro , Ishihara Masami , Tani Hiroaki , Imanaka Kuniyasu
Published: May 2014

Aims:

Lateral body weight shifting tasks are used in rehabilitation programmes, particularly in programmes for patients with orthopaedic complaints or hemiparesis. In the present study, we aimed to identify the inherent factors that could lead to deterioration of performance in such tasks.

Methodology:

Twenty four healthy participants were asked to accurately load a target of one or two thirds of their body weight onto their left and right lower limbs.

Results:

Constant error showed a relative central tendency effect during body weight shifting. ‘Central tendency’ refers to people undershooting heavier target loads by a large extent, and undershooting lighter target loads by a small extent during body weight shifting. Overall accuracy (root-mean-squared error) and variability significantly differed for the two target loads during weight shift to the left but not during that to the right. Inter-limb weight adjustment between the upper and lower limbs deteriorated the weight adjustment for the target load.

Conclusion:

Having a central tendency can potentially deteriorate a person’s performance of the task both in the early (when a lighter target is used) and late (when a heavier target is used) phases of rehabilitation. Lateral differences in both overall accuracy and consistency may occur while shifting heavy (rather than light) loads, particularly when the left lower limb is affected. Heavy reliance on the upper limb while attempting accurate loading on the target limb can also deteriorate loading accuracy.
Sustainable development and allied health professionals
Authors: Gower Gill
Published: May 2014

Background:

Allied health professionals and health-care providers work within organisations and communities that are having to respond to the effects of climate change and the demand for lower carbon consumption. This requires changes for all individuals whatever their skills or level of responsibility.

Content:

This article considers the role of allied health and social care professionals in developing and delivering a low carbon or sustainable care service. It looks at services in the light of international and national policy and guidelines, and gives an overview of legislation and targets relevant to healthcare. There is also discussion of the drivers for change as well as the aspects of health promotion, models of care and practice development. This article also considers personal and professional aspects of a sustainable lifestyle.

Conclusion:

Sustainable development is now an essential factor for health and social care providers to consider in how they provide their services. Adaptions can be made at all levels of these services and allied health professions can be vital at both an individual and organisational level.
How Agenda for Change will affect you
Authors: McQuarrie Rosemary
Published: May 2014

Practice nurses may need to take the initiative if they are to benefit from improved terms and conditions.Rosemary McQuarrie explains
Alternatives to breastfeeding
Authors: Welford Heather
Published: May 2014

Mothers may seek advice on formula feeds for their babies.
The hepatitis C health challenge
Authors: Clements Amanda
Published: May 2014

The government is hoping to increase hepatitis C awareness.
Flower remedies
Authors: Ernst Edzard
Published: May 2014

Flower remedies are popular, however many users will not see a specialised practitioner and few trials have examined their efficacy.
Focus on post-traumatic stress
Authors: Short Nigel , Hardcastle Mark
Published: May 2014

Distressing events may trigger long-term effects in some people.
Hydrating for health
Authors: Wild Sarah
Published: May 2014

Ensuring the elderly receive enough fluids can help prevent deaths.
How to manage your time
Authors: Applebee Kathie
Published: May 2014

Time is precious in primary care, but assessing your daily routines can reveal ‘lost time’.
Not all seizures are epilepsy
Authors: Hardcastle Mark , Short Nigel
Published: May 2014

Patient seizures may suggest epilepsy, but that diagnosis is not the only possible cause.
Using honey in clinical practice
Authors: White Richard
Published: May 2014

In part two of his series, Dr Richard White offers some guidance on the clinical use of honey-based dressings.
Boosting recruitment of nurse practitioners
Authors: Burt Lynda
Published: May 2014

An initiative in Bradford is aiding the recruitment and retention of nurse practitioners by giving training and support.
When to introduce solid foods
Authors: Welford Heather
Published: May 2014

Parents can be unsure about when to begin feeding their baby solids.
Improving services through competition
Authors: Jenner David
Published: May 2014

Payment by results and practice-based commissioning will help divert more services into primary care.
Case History: Benefits of proactive screening
Authors: Gupta Ajay Kumar
Published: May 2014

Dr Ajay Kumar Gupta investigates a case which emphasises the need for active investigation of all patients at high risk of diabetes
Options for insulin prescribing
Authors: Morris David
Published: May 2014

Insulins are used in combination to mimic the natural, non-diabetic insulin profile.
Opinion: Nurse prescribers make a difference
Authors: Griffiths Matt
Published: May 2014

Doctors are wrong to think wider prescribing powers for nurses raise safety issues.
Dealing with the complex issues of MS
Authors: Elrington Giles
Published: May 2014

The variety of symptoms and lack of a specific test means that the diagnosis of MS can be difficult.
Incontinence update
Authors: Morrow Linda
Published: May 2014

Incontinence can be a difficult subject to broach.
Identifying best career paths
Authors: Persaud Joy
Published: May 2014

As the NMC sets a standard for post-registration competency, a nurse is researching the training needs of practice-based staff,
Risk factors for CVD
Authors: Foster Rebecca
Published: May 2014

The British Nutrition Foundation has reviewed the evidence on CVD risk factors.
Opinion: Why nurses should care about IT
Authors: Tierney-Moore Heather
Published: May 2014

The technology revolution will change healthcare, so nurses need to be involved.
Metabolic syndrome and dyslipidaemia
Authors: Polak Monika
Published: May 2014

Monika Polak explains how clinical attention is shifting to address the whole lipid profile, not just LDL
Q&A: Hypertension part 2
Authors: Clark Andrew
Published: May 2014

What would you do about a middle-aged man with uncontrolled hypertension? Are home readings reliable or useful? Andrew Clark answers more of your questions about managing patients with high blood pressure
TB - the forgotten pandemic
Authors: Davies Peter
Published: May 2014

TB cases are on the increase worldwide. Professor Peter Davies explains how and why the fight against this disease should continue
Bowel cancer: Screening for early diagnosis
Authors: Dawson Charlotte
Published: May 2014

A national bowel screening programme is on the way. Charlotte Dawson outlines its development.
Prescribing for osteoporosis
Authors: Morris David
Published: May 2014

Be aware of the risk factors for bone problems and prescribe and advise accordingly.
Case History: Tackling the spiral of migraine
Authors: Kernick David
Published: May 2014

Breaking the cycle of escalating migraine means matching treatment to individual need.
Medication and elderly patients
Authors: Morris Heather
Published: May 2014

Elderly people are prone to drug interactions, adverse effects and poor compliance.
Lung cancer
Authors: Fitzpatrick Tessa
Published: May 2014

Guide to the key clinical issues covering risk factors and presentation, investigations and diagnosis, treatment and service organisation
The health benefits of omega fats
Authors: Phillips Frankie
Published: May 2014

In the first of two articles, Dr Frankie Phillips explains the role of polyunsaturated fats
An update on prescribing COX-2 inhibitors and NSAIDs
Authors: Morris David
Published: May 2014

Prescribing for arthritic conditions has been mired in confusion after the withdrawal of some drugs.
Professional Prescriber series: Drug switches
Authors: Thompson Angus
Published: May 2014

In the fourth article in our prescribing series, independent prescribing adviser Angus Thompson explores some of the issues involved in drug switches, which are a possible source of significant cost savings for general practice
Pictures in practice: Various types of eczema
Authors: Watkins Jean
Published: May 2014

Pictorial guide to atopic eczema, allergic contact dermatitis, juvenile plantar dermatosis, pompholyx eczema, asteatotic eczema and gravitational eczema
How to distinguish asthma from COPD
Authors: Crockett Anthony
Published: May 2014

Differentiating between conditions with shared features is important for correct treatment.
Controlling genital herpes
Authors: Bickford Jane
Published: May 2014

Herpes infection rates are on the rise. Jane Bickford outlines the diagnosis and treatment options
Managing necrobiosis
Authors: Watkins Jean
Published: May 2014

The true cause of necrobiosis lipoidica is still unknown
Watching for prostate cancer
Authors: Hamill Maureen
Published: May 2014

This week is Prostate Cancer Awareness Week. Maureen Hamill outlines how to spot the disease
Managing genital warts
Authors: Wright RGN Simon
Published: May 2014

Genital warts are a common and distressing STI. Simon Wright outlines the treatment options
How to develop a specialism
Authors: Barr Fiona
Published: May 2014

Developing specialist skills or roles will enable nurses to grasp new opportunities.
Anticoagulation monitoring services in primary care
Authors: Waterfield Carol
Published: May 2014

A community anticoagulation service provides flexible care and opportunities for nurses
Detecting and treating postnatal depression in primary care
Authors: Edworthy Zai , Kuyken Willem
Published: May 2014

Many new mothers will struggle with depression.
Erythema infectiosum and chondrodermatitis nodularis helicis management guides
Authors: Watkins Jean
Published: May 2014

A quick reference pictorial guide to managing erythema infectiosum and chondrodermatitis nodularis helicis.
Pre-pregnancy planning for women with diabetes
Authors: Page Renee
Published: May 2014

Most women do not plan pregnancy in a medical sense, but this is important for those with diabetes.
How primary care nurses can reduce the burden of COPD
Authors: Scullion Jane
Published: May 2014

Early identification of COPD and effective interventions could ameliorate symptoms
Bacterial vaginosis
Authors: Feder Angie
Published: May 2014

The most common cause of vaginal discharge is bacterial vaginosis. Angie Feder explains the symptoms, diagnosis and treatment
Diseases transmitted by contact with animals, soil and water
Authors: Townend Mike
Published: May 2014

Travellers need to be aware of the risks associated with animal, soil and water contact
Understanding and assessing malignant melanomas
Authors: Stollery Nigel
Published: May 2014

Skin cancer incidence is rising and we need to be alert to the signs.
Q&A: Nurse prescribing
Authors: Gagan Mark
Published: May 2014

Common questions about prescribing and the opening of the full formulary are answered by Mark Gagan
The fight against cervical cancer
Authors: Torjesen Ingrid
Published: May 2014

Two vaccines for cervical cancer are likely to be available in the UK soon. Ingrid Torjesen explains how they differ
What to prescribe for psoriasis
Authors: Tubb Clive , RN Dip
Published: May 2014

Psoriasis is an irritating condition and relapses are unpredictable. Clive Tubb examines holistic treatment and the prescribing options
Recognising basal cell carcinoma
Authors: Stollery Nigel
Published: May 2014

Despite low death rates, basal cell carcinomas can cause significant disfigurement. Hence, early diagnosis is vital.
Dealing with syphilis
Authors: Bickford Jane
Published: May 2014

Cases of syphilis are rising in the UK. Jane Bickford outlines the management of this unpleasant STI
Knowing when to refer patients with diabetes
Authors: Gadsby Roger
Published: May 2014

While care of diabetics is generally routine, there are some situations where patients will need to be referred.
Case Study: Maintaining long-term control in diabetes
Authors: Morris David
Published: May 2014

A patient who is newly diagnosed with type-2 diabetes needs careful management to reach treatment targets.
Developing education for new practice nurses
Authors: Greenfield Jenny
Published: May 2014

A work-based learning induction programme for new practice nurses is enhancing nurses' skills and benefiting practices, writes Jenny Greenfield
Over-the-counter medicines
Authors: Thompson Angus
Published: May 2014

In the final article in our prescribing series, independent prescribing adviser Angus Thompson discusses developments in over-the-counter medicines
The benefits of 24-hour blood pressure control
Authors: Jarvis Sarah
Published: May 2014

How important is round-the-clock blood pressure monitoring, asks Dr Sarah Jarvis.
Pterygium vs pinguecula
Authors: Gnanapragasam Vasa
Published: May 2014

Differential diagnosis
Going it alone
Authors: Griffiths Julie
Published: May 2014

Becoming self-employed can be a scary prospect but, as Julie Griffiths discovers, nurses have a lot to gain.
Q&A: Urological issues
Authors: Muir Gordon
Published: May 2014

Assessing scrotal pain in young men and investigating sterile pyuria in women. Mr Gordon Muir explains.
Assessing a case of dyspepsia
Authors: Brown Harry
Published: May 2014

Case Study - Not all patients with dyspepsia will need investigation.
How to cost a service
Authors: Wilson Nicky
Published: May 2014

Nurses who are thinking of launching or developing a service must know how to cost it accurately. Nicky Wilson explains the best way to make an assessment.
Prescribing for chest infections
Authors: Robinson Gina M
Published: May 2014

Careful assessment will help to identify which patients need antibiotics.
Understanding topical corticosteroids
Authors: Oliver Paula
Published: May 2014

Confusion is common around the use of topical corticosteroids and their associated risks. Paula Oliver explores the facts and myths.
Clinical Focus - Cardiac arrhythmias
Authors: Griffith Kathryn E
Published: May 2014

Presentation and treatment.
CVD prevention in diabetes
Authors: Barwell Nick , Fisher Miles
Published: May 2014

Using antiplatelets for primary prevention may not be the best strategy, say Dr Nick Barwell and Dr Miles Fisher
Evening clinics ease access problems
Authors: Mills Denise
Published: May 2014

Running womens health clinics in the evenings has improved access for patients at a surgery in Bangor.
Primary care for cancer patients
Authors: Walton Wendy-Jane
Published: May 2014

Clinicians in primary care have much to offer.
A competency framework for out-of-hours nursing
Authors: Gallacher Trudi , Garlick Edie
Published: May 2014

A competency-based framework is ensuring the safe and effective clinical practice of out-of-hours nurses in Lothian. Trudi Gallacher and Edie Garlick explain how it was developed
Bringing anxiety under control
Authors: Tyrrell Ivan , Winn Denise
Published: May 2014

Managing unmet needs is the key to resolving anxiety.
Management of glandular fever
Authors: Markham Julia
Published: May 2014

Treatment of the Epstein-Barr virus should be symptomatic using simple analgesia unless there are complications.
Encouraging green care initiatives
Authors: Wild Sarah
Published: May 2014

Exposure to nature can have a positive effect on peoples health and nurses have a role in supporting and signposting such initiatives
Achieving glycaemic targets
Authors: Jarvis Sarah
Published: May 2014

Glitazones can help clinicians to improve outcomes in patients with type-2 diabetes.
Assessing the safety of tea tree oil
Authors: Huntley Alyson
Published: May 2014

Tea tree essential oil is widely used, but there are concerns about its safety.
Diastolic dysfunction in heart failure
Authors: Obeid Amira , Sundar Kalpa
Published: May 2014

An estimated 40 per cent of HF patients have left ventricular diastolic dysfunction (LVDD).
Biofeedback for bowel disorders
Authors: Evans Patricia
Published: May 2014

Bowel disorders can be extremely distressing. Patricia Evans takes a look at a successful treatment option.
Cancers affecting men
Authors: Gray Morag
Published: May 2014

June is Everyman Male Cancer Awareness month. Professor Morag Gray describes two specifically male cancers.
Choosing a needle for vaccination
Authors: Diggle Linda
Published: May 2014

Is needle length more important than gauge in vaccination?
Foetal alcohol spectrum disorders
Authors: Mukherjee Raja AS
Published: May 2014

Foetal alcohol syndrome (FAS) is a condition at one end of a spectrum of disorders - foetal alcohol spectrum disorders (FASD) - caused by alcohol consumption while pregnant.
The role of advanced nurse practitioners in nursing homes
Authors: Lawrence Stephanie
Published: May 2014

ANPs are making visits to nursing homes and acting as a first port of call for urgent issues, explains Stephanie Lawrence
Understanding deep vein thrombosis
Authors: Glenesk
Published: May 2014

What we need is a safe alternative to warfarin for high-risk patients, says Dr Alison Glenesk.
Injury to the anterior cruciate ligament
Authors: Mohan  , Chapman-Sheath
Published: May 2014

Mr Arvind Mohan and Mr Phil Chapmen-Sheath advise on diagnosing and treating ACL injuries.
Helping patients quit smoking
Authors: Croghan Emma
Published: May 2014

There has never been a better time to encourage patients to stop smoking, writes Emma Croghan
The psychological impact of skin disease
Authors: Fortune Donal , Richards Helen
Published: May 2014

Psychosocial therapies can augment standard care in dermatology, say Dr Donal Fortune and Dr Helen Richards
Optimising breast health
Authors: Cant Sarah
Published: May 2014

Nurses play a vital role in helping women to recognise the symptoms of breast cancer, explains Dr Sarah Cant.
Musculoskeletal - Managing Tennis elbow
Authors: Brown Harry
Published: May 2014

Lateral epicondylitis usually responds to conservative treatment.
How telephone support can promote self-care
Authors: Wild Sarah
Published: May 2014

A proactive, nurse-led telephone service is providing patients with dedicated support and reducing use of acute services, writes.
Evaluating training for nurse practitioners
Authors: Rogers Melanie , Bindless Linda
Published: May 2014

A review of nurse practitioner education in West Yorkshire shows that courses are meeting participants' needs.
Developments in type-2 diabetes
Authors: Morris David
Published: May 2014

The latest developments relating to treatments for patients with type-2 diabetes are outlined.
Encouraging new mothers to stop smoking
Authors: Stringer Heather
Published: May 2014

Peer support from a stop smoking support worker can help new mothers to give up smoking.
Insulin and managing weight
Authors: Zachariah Sunil , Russell-Jones David
Published: May 2014

Clinicians can help patients on insulin limit weight gain, say Dr Sunil Zachariah and Professor David Russell-Jones.
An update on oral contraception
Authors: Ward Julia , Cruse Alison
Published: May 2014

Prescribing the right contraceptive pill requires both science and art. Julia Ward and Alison Cruse explain.
Dealing with head lice
Authors: Newson Louise
Published: May 2014

Treatments for head lice must be used correctly to be effective, writes Dr Louise Newson.
Wolverhampton's walk-in success
Authors: Kular Narinder
Published: May 2014

Wolverhampton PCT's award-winning, nurse-led walk-in centre is continuing to evolve.
Understanding hyperventilation syndrome
Authors: Duncan Debbie
Published: May 2014

Hyperventilation is often overlooked as the underlying cause for a patient's symptoms.
Current advice on hormone replacement therapy
Authors: Currie Heather
Published: May 2014

Hormone replacement therapy still has a role to play in menopause management. Dr Heather Currie explains.
Understanding haemochromatosis - Iron metabolism
Authors: Hill Barry
Published: May 2014

This genetic disorder is more common than previously realised, says Barry Hill.
Practical prescribing - Unlicensed and off-label medicines
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers.
Undertaking immunisation
Authors: Robinson Gina
Published: May 2014

Various practical issues need to be addressed before, during and after vaccine administration. Gina Robinson explains.
New drugs for type-2 diabetes
Authors: Morris David
Published: May 2014

NICE has outlined when to prescribe newer drugs for type-2 diabetes, writes Dr David Morris.
Best practice in Otitis media
Authors: Bartrop Pauline
Published: May 2014

This common condition often resolves without treatment, writes Pauline Bartrop.
Maintaining vigilance for postnatal depression
Authors: Rogers Melanie
Published: May 2014

All practitioners have a role in the management of postnatal depression, be it with treatment or ongoing support.
Practical prescribing - Adjusting insulin
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers
Social enterprises in healthcare
Authors: Lepper Joe
Published: May 2014

Right to Request has encouraged health professionals to establish social enterprises.
The menopause and hormone replacement
Authors: Cooper Maggie
Published: May 2014

Myths about HRT may dissuade women from using this therapy at the menopause. Nurses can help ensure patients make informed choices
Avoiding a healthcare time bomb
Authors: Dixon Michael
Published: May 2014

Promote self-care by suggesting a free online NHS MidLifeCheck to patients.
The nurse contribution to out-of-hours care
Authors: Edwards Jane
Published: May 2014

Nurse teams deliver safe, high-quality out-of-hours care.
Psoriasis, antibiotics and statins
Authors: Mongin-Bulewski Carole
Published: May 2014

In-depth analysis of the latest research. Compiled by Carole Mongin-Bulewski
From link worker to practice nurse
Authors: Jamal Shamem
Published: May 2014

Support and training enables link workers to move into nursing.
The Private Finance Initiative and the NHS
Authors: Griffiths Julie
Published: May 2014

Is PFI crippling the NHS or improving patient care.
Classifying heart failure
Authors: Bell Suzanne
Published: May 2014

A patient's perception of their symptoms can aid management, writes Suzanne Bell.
Anaemia in paediatric CKD
Authors: Reid Chris
Published: May 2014

Overall key points

Anaemia is common in children and adolescents with chronic kidney disease. Iron deficiency and anaemia can impair neurocognitive development in infancy, which may have long-lasting effects. Correction of anaemia improves exercise tolerance and appetite, and may improve protein intake. Intravenous iron is standard therapy in children on haemodialysis; darbopoietin is increasingly used.
Improving health services for ex-servicemen and women
Authors: White Alison
Published: May 2014

Military veterans require tailored and accessible health services that meet their needs.
Preparing for quality commission regulation
Authors: Lepper Joe
Published: May 2014

With the Care Quality Commission taking on a regulatory role in general practice, nurses should start preparing early for the changes.
Diabetic foot ulcers
Authors: Roberts Peter , Newton Victoria
Published: May 2014

Diabetic foot ulcers have a complex pathology that requires expert management. The key principles of assessment and management are outlined by Peter Roberts and Victoria Newton
Best practice technique for injectable diabetes therapies
Authors: Hicks Debbie
Published: May 2014

Educating patients on good technique can improve management of their condition
Weight loss in type 2 diabetes
Authors: Kime Nicky
Published: May 2014

Support from nurses is crucial to help obese and overweight patients achieve and maintain weight loss.
Ringworm in images
Authors: Watkins Jean
Published: May 2014

FUNGAL INFECTION

Ringworm has several different presentations. Jean Watkins provides examples and suggests treatments
Adherence, smoking, arthritis
Authors: Greener Mark
Published: May 2014

JOURNALS WATCH

In-depth analysis of the latest research. Compiled by Mark Greener
Treating heavy menstrual bleeding
Authors: Jones Siân , Ludkin Helen , Rogers Melanie
Published: May 2014

MENSTRUATION

Melanie Rogers, Helen Ludkin and Siân Jones describe the best approach to managing this physically and emotionally draining condition
Erectile problems and cardiovascular disease
Authors: Peate Ian
Published: May 2014

Men's Health

An insight and understanding of the condition, associated risk factors and treatment is necessary to provide effective care, writes Ian Peate
Evaluating the impact on 911 calls by an in-home programme with a multidisciplinary team
Authors: Ruest Michel , Stitchman Amber , Day Chris
Published: May 2014

Introduction

Collaboration of emergency medical services and community organisations such as primary health care providers, social service agencies, and public safety groups can enable innovative initiatives that have the potential to improve the level of health care within a community and reduce health care system pressures. The purpose of this research is to evaluate the impact of an ‘aging at home’ program that uses an integrated health care team involving community paramedics on 911 calls.

Methods

This study involved a retrospective case series involving a chart review of clients participating in the ‘Aging at Home’ program located in a rural community in Ontario between January 1 2010 and April 30 2011. Each record was evaluated for the presenting problem and whether transport to a local hospital emergency department was initiated by using 911.

Results

Of the 129 client interactions by community paramedics and personal support workers, 13 chief complaint categories were determined and 15 incidents resulted in emergency department visits by using 911.

Conclusion

The use of community paramedics in an integrated health care team aimed at supporting clients living at home demonstrates a negative correlation in the use of 911 calls.
Which paediatric weight formula is best suited for the out-of-hospital field?
Authors: Winship Christian , Williams Brett , Boyle Malcolm
Published: May 2014

Background: Weight estimation in pre-hospital paediatric emergencies is often required for the calculation of drug dosages, fluid therapy and defibrillation. In the pre-hospital field the treatment of a patient needs to occur in a timely and accurate fashion, this necessity drives the need for an accurate weight estimation formula. The objective of this study was to identify a paediatric weight estimation formula relevant to the pre-hospital field.

Methods: A literature review was undertaken using a variety of electronic medical databases from their commencement date until the end of May 2012. Keywords used in the search included: Weight estimation, drug calculations, pediatric, paediatric, EMS, EMT, paramedic, emergency medical service, emergency medical technician, pre-hospital, out-of-hospital and ambulance. The keywords were used individually and in combination. The inclusion criterion was any study type that described the development or evaluation of a paediatric weight calculation in the pre-hospital or hospital setting.

Findings: There were 635 articles located with 25 meeting the inclusion criteria. The commonly used APLS weight estimation formula significantly underestimates a child's weight. The best guess formula appears to be more accurate at estimating the weight; however more research needs to be conducted to validate this method for the pre-hospital field.

Conclusion: As the average weight of children increases, the accuracy of weight estimation formulas decreases, suggesting that these methods will be unable to sufficiently adjust to deal with future rises in average weights of children. Further research is required to determine the most appropriate formula for paramedics to use in the pre-hospital setting.
Prevention, assessment and management of altitude sickness
Authors: Mallinson Tom , Eaton Georgette
Published: May 2014

With the growing prevalence of adventure holidays and international travel, exposure to the extremes of altitude is becoming more and more common. With this increase in adventure travel the need for expedition medics is expanding, although education in this area is understandably lacking from most medical and allied health professional core training. This article provides a brief overview of the pathophysiology, assessment and management of high-altitude disorders. It does not discuss the complex issues surrounding pre-expedition planning.