bluuebunny/crossref_metadata_2025 huggingface dataset:
The lived experience of freezing in people with Parkinson's: an interpretive phenomenological approach
Authors: Redmond Lucy , Suddick Kitty
Published: May 2014

Background/Aims:

The aim of this study was to explore the experience of freezing for people with Parkinson's where there is currently limited understanding.

Methods:

An interpretive phenomenological approach was used. Semi-structured interviews were undertaken with a purposive sample of 6 participants from the UK in 2009. The first interview was undertaken in person and the next five by telephone. The interviews were transcribed verbatim and thematically analysed.

Findings:

The experience, triggers, and methods used to overcome or cope with freezing were individual and varied. Freezing was experienced as an entity, which was unpredictable and uncontrollable. Its impact was a heightened physical awareness, and a feeling of separation and alienation from one's body. This affected the person's emotions and heightened the link between their emotional and physical self.

Conclusions:

The findings of this small scale study highlight the need for further research into the lived experience of people with Parkinson's. They have provided a starting point for generating greater understanding of freezing, by those who experience it. Further work may be needed to explore and broaden this concept. The implementation of coping and supportive strategies that emphasize the emotional consequences, impact on daily life, and relationships may be warranted.
Alcohol disorders and older people: a preliminary exploration of healthcare professionals’ knowledge, in Ireland
Authors: Waldron Ashleigh , McGrath Margaret
Published: May 2014

Aims:

To explore knowledge of alcohol disorders in older adults among healthcare professionals in Ireland.

Methods:

A cross sectional postal survey of 480 healthcare professionals was conducted. Knowledge was explored using 25 true/false statements which focused on four key areas relating to alcohol disorders among older people: (i) general knowledge of alcohol disorders among older people (ii) impacts of alcohol disorders on health outcomes for older people (iii) management of alcohol disorders among older people and (iv) treatment of alcohol disorders in older people. Demographic data was gathered using a short form designed for the study.

Findings:

157 usable surveys were returned giving a response rate of 33%. The majority of respondents had not undertaken specialist training in alcohol disorders among older people. However despite this, overall knowledge of the topic was high. The mean score was 17.9 (SD 2.6) out of a possible 25. The study identified gaps in participants’ knowledge of intervention strategies for alcohol disorders among older people. A statistically significant difference in knowledge was found between professional groups with psychologists having significantly higher scores than occupational therapists. Professionals who spent less than 50% of their clinical time working with older adults had significantly higher knowledge scores than those who spent 100% of their time working with older people.

Conclusions:

The findings suggest that healthcare professionals in Ireland would benefit from further education which focuses on intervention strategies in order to ensure that the need of older people with alcohol disorders are appropriately addressed.
Applications of whole body vibration therapy in the clinical setting: a brief review
Authors: Kessler Nathan , Kim Sylvia , McGeehan Michael , Hong Junggi
Published: May 2014

Introduction:

Whole body vibration therapy (WBV) is an emerging treatment modality that is currently being applied to many age-related chronic conditions including balance and gait deficiencies, fibromyalgia, multiple sclerosis, cystic fibrosis, Parkinson's disease, and peripheral neuropathy. However, while many preliminary studies have demonstrated intriguing results for WBV as a therapy for several chronic conditions, WBV remains an enigma in the medical community, partially due to a lack of any comprehensive reviews of the literature. The purpose of this study is to provide a concise review of the theoretical basis for whole body vibration as well as its experimental clinical applications.

Methods:

38 studies were included, which examined the application of WBV for six known conditions. Since few trials have been conducted, specific inclusion criteria based on study methodology were deemed to be inappropriate for this review.

Results:

This review shows conclusive results supporting the use of WBV therapy for improving balance and gait deficiencies as well as reducing pain symptoms associated with fibromyalgia, Parkinson's disease, and peripheral neuropathy. Inconclusive results were found for the effects of WBV therapy on cystic fibrosis and multiple sclerosis.

Conclusions:

WBV therapy appears to be an effective non-pharmaceutical treatment alternative for improving balance and gait deficiencies as well as symptoms associated with fibromyalgia, Parkinson's disease, and peripheral neuropathy. It may also be a good complimentary aspect of physical therapy protocols for some of these conditions. However, the effectiveness of WBV for treatment of cystic fibrosis and multiple sclerosis remains unknown.
Managing widowhood in later life: The challenges encountered
Authors: Collins Tracy
Published: May 2014

Background/aim

Widowhood in later life is a transition experienced by many older people, particularly older women. This paper explores the challenges encountered by a group of older women experiencing the loss of a spouse or partner.

Methods

The data is drawn from a longitudinal study exploring the significance of personal communities in managing the transition of later life widowhood. A series of qualitative interviews were conducted with 26 older widows (62–90 years of age) over a period of 18 months. Interview transcripts were subjected to thematic analysis.

Results

This paper presents a number of themes from the women's accounts of their Christmas celebrations and their Christmas cards, which illustrate the challenges to managing widowhood in later life. Themes included: family friction, dependence, additional losses, over commitment, passivity and feeling different.

Conclusion

The findings reveal that Christmas can be an isolating and excluding experience for some older women, and that widowhood can be compounded by age-related illness, and the loss of social relationships and roles in later life. The research has a number of implications for practice with older women who are widows.
Convergent validity of a newly developed occupational performance assessment: A pilot study
Authors: Ikiugu Moses N
Published: May 2014

Aim:

This pilot study aimed to investigate the validity of an assessment for instrumental use of the mind: the Assessment and Intervention Instrument for Instrumentalism in Occupational Therapy (AIIIOT). The AIIIOT is used to guide individuals being assessed in developing personal mission statements to guide their lives. The individuals then assess themselves on perceived frequency, adequacy, satisfaction, and belief in ability to perform occupations that would help them achieve the stated missions.

Method:

The validity of the AIIIOT in evaluating occupational performance was investigated by comparing it with the Canadian Occupational Performance Measure (COPM). Eleven people, aged 19–58 years, comprising of nine women and two men, participated in this convergent validity study. Data were gathered using the AIIIOT and the COPM. Pearson moment correlation and linear regression analyses were conducted to determine the convergent and predictive validities.

Results:

The participants' AIIIOT belief scores were correlated with the COPM performance and satisfaction scores, indicating that the AIIIOT belief scale had convergent validity. The AIIIOT belief scores were good predictors for the performance and satisfaction with performance of prioritised occupations as measured on the COPM. The AIIIOT adequacy scores were good predictors for the AIIIOT Frequency scores. Adequacy scores were also good predictors of the AIIIOT satisfaction scores.

Conclusion:

The above findings suggested that the AIIIOT had reasonable convergent and predictive validities. Further research with larger, more representative samples is indicated to confirm these findings.
Assessing functional ability in older patients
Authors: Nielsen Louise Møeldrup , Maribo Thomas , Nielsen Hanne Grethe , Jensen Jonna , Petersen Kirsten
Published: May 2014

Aim:

This study aimed to develop an understanding of how primary and secondary care health professionals perceive current practice and challenges in assessing older patients' functional abilities. A secondary aim was to gain insight into how these professionals perceive the need for generic tools for assessing functional ability among older patients.

Method:

A qualitative design was used to explore health professionals' perspectives on the assessment of older patients' functional ability. Two groups of health professionals participated in focus group interviews, with one group for each of the two different settings: the local hospital and the municipality.

Results:

Focus group interviews showed that health professionals in the hospital and the municipality expressed the need for an observation-based tool to predict and guide decisions about the rehabilitation needs of older patients. Participants from the hospital expressed a need for a fast and simple screening tool to identify those in need of further rehabilitation and care after discharge. Participants from the municipality expressed a need for a more detailed assessment tool to capture information about patients' ability to perform daily activities, any need for food delivery, and information about social relationships and home environment.

Conclusion:

The health professionals at the hospital and in the municipality had different expectations when it comes to assessment tools. All participants would like a simple tool that is quick to administer, to assess the quality of functional ability and predict the need for rehabilitation. The different context (hospital or primary care) seems to influence the way health professionals perceive the need for assessment of functional ability in older patients.
Case History: Investigating breathlessness
Authors: Booker Rachel
Published: May 2014

A supportive nurse can help make a difference for patients with COPD.
Genetic counselling
Authors: Wiggins Jennifer
Published: May 2014

Patients worried about an inherited condition may need a referral to genetic services.
Options for treating erectile dysfunction in primary care
Authors: Dinsmore Wallace
Published: May 2014

Effective oral therapies have changed erectile dysfunction treatment, but consult carefully before prescribing, explains Professor Wallace Dinsmore
Admission avoidance
Authors: Davis Carol
Published: May 2014

To reduce inappropriate referrals to A&E, district nurses in Basildon, Essex, are working collaboratively with the local ambulance service.
Improving palliative care for patients with learning disabilities
Authors: Wild Sarah
Published: May 2014

A palliative care pathway is being developed in Manchester for patients with learning disabilities, in order to reduce health inequalities
Developments in the management of leg ulcers
Authors: Troxler Max , Scott Julian
Published: May 2014

Selection of an appropriate, cost-effective treatment is essential. By Mr Max Troxler and Professor Julian Scott
Managing patients with alopecia
Authors: Bostock Jenny
Published: May 2014

Hair loss can have a major psychological impact. Jenny Bostock explains how to diagnose, treat and support those affected.
How to recognise oral allergy syndrome
Authors: Radcliffe Michael
Published: May 2014

Case study: Hay fever patients can suffer a form of food allergy. Dr Michael Radcliffe explains.
Caring for carers
Authors: Griffiths Julie
Published: May 2014

Unpaid carers save taxpayers 87 billion per year, so how can they be better supported?
The risk of tick-borne encephalitis in Europe
Authors: Somerville Gael
Published: May 2014

Tick Alert Week (5-11 May) aims to raise awareness of tick-borne disease. Gael Somerville advises on avoidance and prevention.
Focus on yellow fever vaccination
Authors: Grieve Sandra
Published: May 2014

Under International Health Regulations, vaccination is important for travel to yellow fever endemic areas. Sandra Grieve explains.
Transfusing patients in a community setting
Authors: Hill Barry
Published: May 2014

Giving patients blood transfusions at home is cost-effective and preferred by patients.
CVD - Managing unstable coronary syndromes - Acute coronary syndrome
Authors: Turner Alison M. , Jowett Nigel I.
Published: May 2014

It can be difficult to differentiate ACS from non-cardiac chest pain. Alison Turner and Dr Nigel Jowett explain.
Immunising children against disease
Authors: Robinson Gina
Published: May 2014

In part two of her update, Gina Robinson covers HPV and vaccines for at-risk groups.
Psychological and psychosocial issues for patients with epilepsy
Authors: Casswell Miranda , McEwan Lauren , Baker Gus
Published: May 2014

Epilepsy can have a major psychological impact.
Managing joint pain in arthritis
Authors: Oliver Susan M.
Published: May 2014

Determining the cause of joint pain is essential but a focus on providing pain relief is also key, writes Susan Oliver.
Patient-centred care in rheumatoid arthritis
Authors: Owen Olwen Glynn
Published: May 2014

There is an unmet need for pain control among patients with RA, writes Olwen Glynn Owen.
Diagnosing abdominal pain
Authors: Brown Harry
Published: May 2014

Independent Nurse: A man presents with abdominal cramps and diarrhoea. Dr Harry Brown outlines his diagnosis and treatment.
Paget's disease
Authors: Hughes Rod
Published: May 2014

Aetiology, diagnosis, management and complications.
Alternative approaches in child health
Authors: Huntley Alyson
Published: May 2014

Can alternative medicine treat self-limiting illness in childhood? Dr Alyson Huntley investigates.
Constipation in children
Authors: Ahmad Afzal Nadeem , Thomson Mike
Published: May 2014

Epidemiology, aetiology, diagnosis and treatment.
Models used to reach diagnosis
Authors: Haidar Elizabeth
Published: May 2014

Many strategies can be utilised to help clinicians reach a diagnosis.
Minimising polypharmacy in hypertension
Authors: Barnett Anthony , Samat Ashish
Published: May 2014

Addressing the issue of polypharmacy can improve outcomes.
Domestic violence and the role of nurses
Authors: Griffiths Julie
Published: May 2014

Nurses may soon receive better training to help them identify and support victims.
Succeeding in job interviews
Authors: Hill Barry
Published: May 2014

Whether you are the interviewer or interviewee, be prepared and professional writes.
Practical prescribing - ‘Vicarious indemnity’
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers.
Resting heart rate as a cardiovascular risk factor
Authors: Menown Ian
Published: May 2014

Reducing heart rate may improve outcomes in patients with CVD.
Dermatology Identifying fish tank granuloma
Authors: Stollery Nigel
Published: May 2014

The diagnosis of this uncommon condition is often delayed, says Dr Nigel Stollery.
How COPD care will change
Authors: Scullion Jane , Holmes Steve
Published: May 2014

In the second of their articles on the national strategy for COPD, Jane Scullion and Dr Steve Holmes outline what it means for primary care.
The evidence on probiotics
Authors: Phillips Frankie
Published: May 2014

Evidence to support the role of certain probiotic strains is growing, writes Dr Frankie Phillips.
Diet and depression
Authors: Phillips Frankie
Published: May 2014

Certain dietary changes can have a beneficial effect on mental health, writes Dr Frankie Phillips.
Practical prescribing - Restrictions on diazepam
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers.
Talking with people from other cultures
Authors: Washer Peter
Published: May 2014

Becoming culturally-aware will improve clinical communication, writes Peter Washer.
Clinical - Maintaining vigilance for cancer
Authors: Kochhar Suneeta
Published: May 2014

Awareness of red flag symptoms that can indicate cancer is vital, says Dr Suneeta Kochhar.
Breaking the infection chain
Authors: Hill Barry
Published: May 2014

Robust infection control in primary and community care is vital.
Advising travellers on bite prevention
Authors: Grieve Sandra
Published: May 2014

Travellers need to be advised on bite prevention measures to minimise the risk of disease.
Supporting victims of childhood sexual abuse
Authors: Wilmer Graham
Published: May 2014

Health professionals can help patients recover from psychosexual trauma.
Ensuring access to cardiac rehabilitation
Authors: Ridley Jill
Published: May 2014

Participation in cardiac rehabilitation is lower than expected, but many patients can benefit, writes Jill Ridley.
Dressing minor wounds
Authors: Stephen-Haynes Jackie
Published: May 2014

The principles of wound care relating to trauma wounds that are often seen in primary care are outlined by Jackie Stephen-Haynes.
Protecting vulnerable children
Authors: Lepper Joe
Published: May 2014

Reviews into child deaths are looking at how health visitors can be supported to safeguard children.
Medical management of inflammatory bowel disease
Authors: Morris David
Published: May 2014

Settling acute attacks and maintaining remission are the key goals of treatment, writes Dr David Morris.
The expansion of family nurse partnerships
Authors: Lepper Joe
Published: May 2014

Are FNPs vital for vulnerable families or a threat to traditional health visiting services?
Sexually transmitted infections
Authors: McOwan Alan
Published: May 2014

service director for sexual health, Chelsea and Westminster Hospital NHS Foundation Trust
Diagnosing rashes in children
Authors: Dickson Terrina
Published: May 2014

A careful history and close examination are essential, writes Dr Terrina Dickson.
Treating hypertension with beta-blockers
Authors: Turner Alison , Jowett Nigel
Published: May 2014

Beta-blockers remain a reasonable choice for some patients with hypertension.
Undertaking a travel risk assessment
Authors: Grieve Sandra
Published: May 2014

Advice and treatment offered to travellers should be underpinned by a travel health risk assessment.
Learning disability and health
Authors: Ali Afia , Hall Ian
Published: May 2014

Primary care is the main provider of medical care for people with learning disability, write Dr Afia Ali and Dr Ian Hall.
Managing acute cough in children
Authors: Gupta Atul , Bush Andrew
Published: May 2014

Children with a cough require thorough clinical review. Dr Atul Gupta and Professor Andrew Bush explain.
Education for nurse prescribers
Authors: Courtenay Molly , Gordon John
Published: May 2014

A study provides a vital overview of nurses' prescribing CPD needs.
Red flag symptoms - Constipation
Authors: Croton Lizzie
Published: May 2014

Constipation is extremely common but if branded trivial, serious pathology such as cancer may be missed.
Where now for NHS Direct?
Authors: Staines Richard
Published: May 2014

The new helpline will be better integrated with existing services, argue ministers.
Management of epilepsy
Authors: Robinson Gina
Published: May 2014

It is important to classify the type of seizures occurring in the patient before implementing pharmacological treatment, writes Gina Robinson
Recognising zoonoses
Authors: Hill Barry
Published: May 2014

Animals can pass on infections that are harmful to human health.
Case study - Diagnosing a case of progressive breathlessness
Authors: Morris David
Published: May 2014

Consider the patient's history carefully when diagnosing progressive breathlessness.
Practical prescribing - Prescribing unlicensed medicines
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers.
Clinical - Case Study - Reflecting on stroke
Authors: Cornforth Amber
Published: May 2014

This short report by Amber Cornforth looks at assessing a stroke patient's wellbeing.
A case of acute back pain
Authors: Hinchy Samantha
Published: May 2014

CASE STUDY - Treatment for low back pain involves simple analgesia. Samantha Hinchy explains.
Advising on contraception in women over 40
Authors: Robinson Gina
Published: May 2014

Pre-existing medical problems and lifestyle will influence the options, writes Gina Robinson.
Managing schizophrenia: the role of primary care
Authors: Gupta Geetika , Pant Milind
Published: May 2014

Annual physical health checks are an important part of managing schizophrenia.
Nurses and the new government
Authors: Staines Richard
Published: May 2014

How will the profession fare under the coalition government's proposed policies?
How personality affects leadership
Authors: Elias Robert
Published: May 2014

Analysis of personality helps us understand why some people are driven to attain leadership status and why others support them, writes Robert Elias
Practical prescribing - Repeat prescribing of controlled drugs
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers
Pathology question time: Testing for E coli infection
Authors: Hill Barry
Published: May 2014

In the fourth of his case studies on the role of laboratory testing, Barry Hill covers E coli 0157 infection diagnosis.
Peer appraisal schemes for ANPs
Authors: Topping Annie , Burt Lynda
Published: May 2014

A West Yorkshire pilot could provide a national model, write Ghislaine Young
Rehabilitation for COPD patients
Authors: Kearney Sarah
Published: May 2014

Pulmonary rehabilitation helps improve quality of life for people with COPD, writes.
Practical prescribing - Intra-nasal morphine in paediatrics
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay helps resolve everyday issues for nurse prescribers
Prevention and cure of malaria
Authors: Ainsworth Steve
Published: May 2014

Every time a nurse persuades a patient to take precautions regarding malaria prophylaxis, a life may be saved, Steve Ainsworth explains
Pharmacological treatment of ED
Authors: Steggall Martin J
Published: May 2014

Both pharmacological interventions and a thorough assessment are needed in the management of erectile dysfunction.
Managing fish tank granuloma
Authors: Watkins Jean
Published: May 2014

It is important for care providers to recognise fish tank granuloma when it presents and to treat it early, in order to achieve good results.
Managing hypoglycaemia
Authors: Holt Paula
Published: May 2014

Overall key points

Hypoglycaemia is a life-threatening side effect of insulin and oral insulin secretagogue therapy. Many lifestyle issues contribute to the development of hypoglycaemia. Common causes include injection technique, insulin errors and mistiming of medication. All healthcare professionals who care for people with diabetes must have a thorough understanding of the causes and effective treatment of hypoglycaemia.
Investigating travel diarrhoea
Authors: Willcox Adrienne
Published: May 2014

Adrienne Willcox investigates the assessment and diagnosis of travellers who return home with diarrhoea
Smoking, NSAIDs and nutrition
Authors: Mongin-Bulewski Carole
Published: May 2014

In-depth analysis of the latest research.
Rubella
Authors: Watkins Jean
Published: May 2014

Rubella is a mild viral infection with few serious complications when occurring in childhood. Adults are more at risk of complications.

Rubella is difficult to diagnose; in pregnancy, a check of the immune status should always be made.

The rubella and MMR vaccines have dramatically reduced the incidence of rubella, as well as congenital rubella syndrome.
Understanding the patient perspective in alcohol misuse
Authors: Tirbutt Helen , Tirbutt Edmund
Published: May 2014

Patients need tailored support and specialist help.
Guiding referrals to social care
Authors: Adams Cheryll
Published: May 2014

SAFER is a tool to guide health visitors in making urgent child protection referrals.
Assessing persistent post-surgical pain
Authors: Cox Felicia
Published: May 2014

Pain lasting longer than two months after surgery must be assessed and treated, and neuropathic components treated according to guidelines
Managing acquired haemophilia
Authors: Anguita Maria
Published: May 2014

Acquired haemophilia is a rare but serious condition that can be managed successfully if diagnosed early, writes Maria Anguita
Helping people with autism to assess their social care needs
Authors: Barber Christopher
Published: May 2014

Nurses can provide advocacy for patients with an autism spectrum disorder, helping to identify and signpost relevant social care services and related resources.
Antimicrobial dressings
Authors: Hampton Sylvie
Published: May 2014

A wide range of anti-microbial dressings is available to reduce wound colanization and clinical infection.
Advice for older travellers with co-morbidities
Authors: Grieve Sandra
Published: May 2014

A focus on health promotion and ill health prevention strategies can enable older travellers to stay healthy and active while they are abroad.
Stroke prevention in atrial fibrillation
Authors: Williams Helen
Published: May 2014

Risk of bleeding must be weighed against risk of stroke. Helen Williams details the stroke prevention agents available and those that may soon reach the market
Vulval Diseases - Lichen sclerosus
Authors: Hollingworth Tony
Published: May 2014

Clinical presentation

Vulval itching (pruritus vulvae) can be an embarrassing and distressing symptom. It can be associated with systemic disease (e.g. jaundice), infections, general dermatological conditions and conditions specific to the vulva
Paediatric Crohn's disease
Authors: Ellis Michelle
Published: May 2014

Overall key points Crohn's disease is a disease predominantly found in the terminal ileum, colon and peri-anal region. Its cause is unknown, although risk of irritable bowel disease (IBD) increases ten-fold in first-degree relatives of a patient with IBD. In childhood, symptoms are often non-specific, including abdominal pain, weigh loss and diarrhoea. Exclusive enteral nutrition for six weeks is an effective first-line therapy for small and large bowel disease.
Practical negotiating skills
Authors: Agrawal Priya
Published: May 2014

Unresolved conflict can be a costly factor in healthcare provision.
IUDs, stroke and alcoholism
Authors: Mongin-Bulewski Carole
Published: May 2014

In-depth analysis of the latest research.
Managing diabetes in obese patients
Authors: Haslam David
Published: May 2014

Obesity management is only of clinical importance because of beneficial effects on diabetes and other long-term conditions, argues Dr David Haslam
Bed bugs: infestations and eradication
Authors: Nazarko Linda
Published: May 2014

Bed bugs belong to a family of insects (Hemiptera) that includes greenfly.1 Bed bugs belong to the Cimicidae class of these insects and they have evolved to feed on blood.
Honing your leadership skills
Authors: Humpris Penny
Published: May 2014

Leadership skills must be acquired by identifying, learning and honing them through practice.
An apprentice scheme for practice nursing
Authors: Finch Helen
Published: May 2014

An innovative general practice apprentice scheme has supported surgeries in south London to recruit and train new practice nurses.
Recent progress in smoking cessation
Authors: Linden Belinda
Published: May 2014

Methods of supporting smokers to give up their addiction have been the object of recent research.
Pre-eclampsia and PPIs
Authors: Mongin-Bulewski Carole
Published: May 2014

In-depth analysis of the latest research.
Parkinson's disease
Authors: Heisters Daiga
Published: May 2014

Parkinson's disease is an incurable, progressive neurological condition. The diagnosis of Parkinson's is mainly based on physical signs and patient history. The most common symptoms of Parkinson's are stiff, rigid or frozen muscles, slowness of movement and tremor. Patients may also have non-motor symptoms. The symptoms of Parkinson's disease are mostly treated with drug therapy.
A review of the NICE standard for diabetes
Authors: Oldroyd Julie
Published: May 2014

Implementing the NICE quality standard in diabetes will represent a challenging cultural change for patients and health professionals.
Managing chickenpox infection
Authors: White Sharon
Published: May 2014

Chickenpox is an extremely common childhood disease that primary care nurses are likely to encounter. Sharon White discusses its management and possible complications
Causes and prevalence of type-1 and 2 diabetes
Authors: Udiawar Maneesh , Bain Stephen
Published: May 2014

The diagnosis of diabetes is often complex, explain Dr Maneesh Udiawar and Professor Stephen Bain in this first instalment in our series on the condition
Smoking and the diabetic patient
Authors: Morris David
Published: May 2014

It is crucial to encourage smoking cessation in patients with type-1 and type-2 diabetes.
Case study: treating an infected wound of unknown aetiology
Authors: Lloyd-Jones Menna
Published: May 2014

Menna Lloyd-Jones presents a case study demonstrating the effective use of honey as a topical antimicrobial agent in the treatment of a wound infection
Obesity and type 2 diabetes
Authors: Morris David
Published: May 2014

“Dr David Morris discusses how we can manage the evolving epidemic of the associated conditions of obesity and type 2 diabetes”
Preventing the spread of whooping cough
Authors: Kochhar Suneeta
Published: May 2014

Cases of whooping cough are on the increase, writes Dr Suneeta Kochhar
Being overweight in pregnancy
Authors: Furber Christine , McGowan Linda
Published: May 2014

Pregnancy can have a psychological impact on women who are obese or overweight, write Christine Furber and Linda McGowan
Management of postnatal depression
Authors: Kochhar Suneeta
Published: May 2014

Identifying women at risk of postnatal depression and managing them with an individualised plan is important, as discussed by Suneeta Kochhar
Cognitive impairment in diabetes patients
Authors: Pritchard Megan , Velayudhan Latha
Published: May 2014

People with mild cognitive impairment and diabetes are at increased risk of developing dementia, write Megan Pritchard and Latha Velayudhan
COPD, cancer risk and obesity
Authors: Greener Mark
Published: May 2014

In-depth analysis of the latest research
Taking the initiative: Dave Dawes provides practical advice for nurse leaders and entrepreneurs
Authors: Dawes Dave
Published: May 2014

I keep hearing about ‘social enterprise’ organisations; what are these and how do they fit into the NHS?
Managing persistent thrush
Authors: Duncan Deborah
Published: May 2014

Persistent thrush can be painful and embarrassing for patients and causes a variety of symptoms writes Deborah Duncan.
Hypoglycaemia in diabetes
Authors: Holt Paula
Published: May 2014

Hypoglycaemia is a serious, life-threatening complication of insulin and insulin secretagogue therapy in people with diabetes, writes Paula Holt
Addressing TB rates in the UK
Authors: Karim Kelvin
Published: May 2014

Reversing tuberculosis rates in the UK involves targeting patients at highest risk and ensuring concordance with medication.
Treating childhood meningitis
Authors: Paul Siba Prosad , Izett Mary
Published: May 2014

Childhood meningitis needs early recognition and management.
Valuing and prioritising care
Authors: Higgins Bernadette
Published: May 2014

Neither the health service, nor society, puts sufficient value on caring.
The management of fever in children
Authors: Paul Siba Prosad , Mee Abigail , Mayhew Joseph
Published: May 2014

Fever should not automatically be considered harmful in children, although it may cause distress and discomfort, write Siba Prosad Paul, Abigail Mee, and Joseph Mayhew
Assessing and managing risk
Authors: Forrest Caroline
Published: May 2014

Nurses must know how to assess risk and communicate it to patients
Relating your values, morals and ethics to nursing practice
Authors: Carvalho Sally , Reeves Maggie , Orford Jacquie
Published: May 2014

Understand how your values affect patient care
Management of children with constipation in the community
Authors: Paul Siba Prosad , Lam Candy , Dewdney Cathy
Published: May 2014

Constipation is a common childhood problem but involves a wide range of factors, write Siba Prosad Paul, Candy Lam and Cathy Dewdney
Boosting access to healthcare
Authors: Bradby Matthew
Published: May 2014

Improving clients’ language skills can lead to more appropriate use of local services, writes Matthew Bradby
Managing eczema
Authors: Bowman Conor , Ali Faisal , Yell Jennifer
Published: May 2014

Eczema is a chronic condition and management relies on patient education and understanding.
Treatment of persistent thrush
Authors: Hamzah Lisa
Published: May 2014

Persistent thrush can have a significant impact on psychological well-being. Dr Lisa Hamzah looks at treatment and management options.
Importance of holistic wound assessment
Authors: Cook Leanne , Ousey Karen
Published: May 2014

It is important to undertake a holistic assessment of the patient who presents with a wound. Karen Ousey and Leanne Cook give an overview of the key responsibilities.
Travel health: routine and required vaccines
Authors: Wong Claire , Simons Hilary
Published: May 2014

Vaccines are an important public health measure and may prompt travellers to attend for pre-travel health advice, write Claire Wong and Hilary Simons.
BMI, ovarian cancer and CBT
Authors: Goodrick Steven
Published: May 2014

In-depth analysis of the latest research. Compiled by Steven Goodrick
Assessment and management of an exacerbation of COPD
Authors: Bostock-Cox Beverley
Published: May 2014

COPD exacerbations can increase the risk of irretrievable loss of lung function, careful diagnosis and treatment is crucial, writes Beverley Bostock-Cox
Universal flu vaccination for children gets underway
Authors: Craig Laura
Published: May 2014

Workloads will increase but benefits should include fewer cases and lower mortality rates. Laura Craig, explains the influenza immunisation programme.
Theory of moist wound healing
Authors: Yarwood-Ross Lee
Published: May 2014

Lee Yarwood-Ross explains why moist wound healing is better than dry healing and discusses the optimal level of moisture
Folic acid, CVD and pneumonia
Authors: Greener Mark
Published: May 2014

In-depth analysis of the latest research, compiled by Mark Greener
Key issues to consider in men's mental health
Authors: Peate Ian , Cohen Frances
Published: May 2014

Primary care nurses should be responsive to men's mental health and aware of gender issues, explains Ian Peate
Allergic rhinitis and asthma
Authors: Scullion Jane , Holmes Steve
Published: May 2014

A number of treatment options are available for co-existing asthma and allergic rhinitis.
Developing your consultation skills
Authors: Edwards Marilyn
Published: May 2014

Nurses should review and improve their consultation skills on an ongoing basis to provide optimum care.
Treating tobacco dependence
Authors: Kochhar Suneeta
Published: May 2014

Smoking cessation strategies in pregnant women, adolescents and patients with CVD are outlined by
How we can support ourselves through the process of change
Authors: Forrest Caroline
Published: May 2014

Challenging perspectives and exploring benefits may lead to acceptance of change.
Revisions to the GMS contract: the key changes at a glance
Authors: Woods David
Published: May 2014

The revised GMS contract will change practice funding, QOF targets and enhanced services.
Managing erectile dysfunction
Authors: Peate Ian
Published: May 2014

Men newly presenting with erectile dysfunction should be evaluated for cardiovascular and endocrine conditions
Heart disease, menopause and smoking
Authors: Greener Mark
Published: May 2014

In-depth analysis of the latest research, compiled by Mark Greener
The influence of food on mood
Authors: Dunne Annette
Published: May 2014

Annette Dunne explores the role of diet in the development, prevention, and management of mental health problems
In your workplace: employment advice
Authors: White Graham
Published: May 2014

NHS Trust HR director Graham White offers advice on employment issues affecting nurses
Effective support for young people with type 1 diabetes
Authors: Kime Nicky
Published: May 2014

Young people require support in developing personal self-care strategies, writes Dr Nicky Kime
Diagnosing pancreatic cancer earlier in primary care
Authors: Greener Mark
Published: May 2014

SYMPTOMS

Pancreatic cancer is the fifth largest cause of deaths from cancer in the UK. Mark Greener discusses diagnosis and advances in treatment
Tips for understanding the medical literature
Authors: Greener Mark
Published: May 2014

Interpreting research can sometimes be a challenge. Mark Greener suggests some tips for critical thinking when reading studies
Drug rashes, in images
Authors: Watkins Jean
Published: May 2014

Side Effects

Adverse drug reactions can present as rashes in patients of all ages. Jean Watkins describes the presentation and treatment of some commonly seen drug rashes
Managing co-morbid allergic rhinitis and asthma
Authors: Holmes Steve , Scullion Jane
Published: May 2014

ALLERGY

A case highlighting key areas in managing allergic rhinitis and asthma is discussed by Steve Holmes and Jane Scullion
Management of heat emergencies in the military setting
Authors: Paterakis Timothy
Published: May 2014

The Australian Defence Force (ADF) has long battled in hot and arduous environments. From the trenches of Tobruk during World War II and the thick jungle of Vietnam through to current theatres of war such as the rugged mountains of Afghanistan. Australian soldiers are exposed to the constant threat of heat illness, and while avoidable in training settings, it cannot be prevented in some combat situations. Prevention however, is a key factor in the exclusion of heat illness cases, a matter that the ADF has worked hard to highlight through mandatory annual training. It is for this reason that military heat casualty rates remain low in the ADF. This article provides some useful assessment tools which help to differentiate between the different levels of heat illness; and furthermore, underlines the critical stages of heat illness and includes literature on the aetiology, pathophysiology, clinical manifestations and prehospital care management of heat illness.
Work readiness in paramedic graduates: what are employers looking for?
Authors: O'Brien Kylie , Hartley Peter , Dawson David , Quick Jason , Moore Amber
Published: May 2014

Background:

This study investigated the perceptions of employers on workplace readiness of paramedic graduates from Australian paramedic education programmes.

Objective:

The investigators sought an understanding of what skills and knowledge are required by employers from a graduate paramedic in order to inform educators and improve the work preparedness capabilities of graduates of Australia paramedic education programmes.

Design:

In-depth, one-on-one, semi-structured, qualitative interviews were carried out in person or by telephone.

Study participants:

Senior operational and educational personnel representatives from Australian employers of paramedic degree graduates.

Analysis and main outcome measures:

Interview data from 11 interviews was analysed using thematic analysis.

Results:

Employers perceived new graduates to be work ready for supervised practice, but not independent practice. Employers understood work readiness along a continuum of skill development, and that this was developed in partnership with universities. Graduate attributes were highly desired by employers, and were seen to align well with organisational values. Employers reported that university graduates often lacked significant life experience and clinical experiences relevant to the work environment; however, they understood that it was the employers role to adapt to this and to provide and support the integration of these developing experiences in the clinical setting.

Conclusions:

This study provides new insight into the expectations and observations of paramedic employers within Australia. The results from this study may inform further educational and professional development opportunities resulting in improvements within the field of paramedicine.
Improving student nurses’ ability to perform drug calculations: guesstimate, estimate, calculate
Authors: Barrett Gary
Published: May 2014

The purpose of this study was to explore strategies for the teaching and testing of drug calculation skills to student nurses undertaking a nursing qualification leading to registration with the Nursing and Midwifery Council (NMC), as a registered nurse (Child). The study aimed to identify the method of teaching and learning to best achieve acceptable levels of calculation skills. An adapted Solomon Four Group (SFG) testing system, using the pre-test, intervention and post-test experimental design, was developed to test student nurses’ calculation ability without the use of a calculator. Each participant was part of a group of students exposed to a variety of calculation tests in the classroom setting. Participants were subject to pre-intervention testing at the beginning of the course and were randomly allocated an intervention in the form of an interactive lecture, a calculation workbook, or assigned to the control group who received no intervention. Post-intervention calculation tests were then performed. The findings of the study demonstrate that certain interventions do improve ability to perform accurate calculations and as a consequence, new strategies have been identified to facilitate students’ learning before and during clinical practice in training.
Evidence-based practice: non-invasive blood pressure measurement in children
Authors: Summers Kathryn
Published: May 2014

Blood pressure (BP) reflects a person’s cardiovascular status. BP alterations may indicate particular diseases, response to illness, and outcomes of treatment. Systolic and diastolic BPs rose substantially in children and teenagers between 1988 and 2004 (Muntner et al, 2004). In children, hypertension is most often associated with coarctation of the aorta or renal disease; more recently it has been linked to obesity (National High Blood Pressure Education Program Working Group, 2004). For premature neonates, rapid recognition of hypotension is crucial in preventing cerebral complications (Strebor, 2005). For these reasons, BP measurement is a skill frequently performed by nurses and healthcare workers in a variety of paediatric settings.

However, the variety of devices used for measuring BP and the advent of automated BP measurement has resulted in many nurses losing this valuable skill. Few nurses are aware of the potential inaccuracy of automated machines (Schell et al, 2006) and there are studies indicate a disturbing lack of clarity among practitioners about the basic recommendations for accurate BP measurement. This often results in children receiving sub-optimal care. This review aims to demonstrate the complexities of measuring BP in children, highlighting an awareness of the limitations of automated machines and provide recommendations for good practice when measuring BP in children.
Understanding participation in activities and quality of life in children with cerebral palsy
Authors: McManus Vicki
Published: May 2014

Cerebral palsy (CP) is the most common cause of physical disability in children. The impact of CP on quality of life is not well understood. This paper explores the literature to understand what participation in everyday activities and quality of life means for children living with CP and their families.

Quality of life and participation in disability, namely CP, are starting to be researched but the longitudinal element of QOL has not yet been done.

Further studies based on longitudinal designs should be carried out to determine the quality of life and activity levels of these children long into adult life.
The K Wire Project: removal of percutaneous kirschner wires from children without general anaesthetic
Authors: Moreton Mary Lucy , Proctor Ishbel , Henderson Annette , Robb JE
Published: May 2014

Percutaneous Kirschner (K) wires are used to hold the position of a fracture of a bone following manipulation under anaesthetic. The K wire is left protruding through the skin so that the wire can be removed as the fracture heals. This audit reviews a change in practice in the removal of K wires without a general anaesthetic (GA), which resulted in ‘The K Wire Project’, which set a standard of treatment and a clinical pathway for these children. The change in practice proposal offered a less invasive procedure for the children and their families and reduced the time the child had to spend in hospital. This was a collaborative project which involved developing the skills of the paediatric orthopaedic practitioner combined with preparation and distraction techniques facilitated by the hospital play specialist. The project set a standard of treatment and a clinical pathway for these children.

Before June 2001 children attending the Royal Hospital for Sick Children in Edinburgh (RHSC), who required having K wires removed, were admitted to the Day Care Unit (DCU) to have the procedure carried out under GA. Occasionally, the orthopaedic surgeon would consider the child ‘old enough’ to have the wire removed in the Fracture Clinic. This was not usually planned and children who had the procedure carried out in the fracture clinic received very little, if any, preparation and distraction for the procedure. However, orthopaedic surgeons and anaesthetists felt that in many cases this short procedure could be undertaken in a controlled environment, with the child awake.
Administering subcutaneous injections to children: what does the evidence say?
Authors: Cocoman Angela , Barron Carol
Published: May 2014

The administration of subcutaneous injections to babies, children and adolescents is a fundamental nursing task and one that should be underpinned by an evidenced-based practice. The subcutaneous route is used routinely with children to administer a wide variety of pharmacological preparations including vaccinations, anticoagulants, analgesics, insulin, growth hormones and some anti-carcinogen agents (Torben et al, 2006). These medications are predominantly administered via injection or continuous infusion. Subcutaneous injection technique varies greatly among nurses and children who self-administer, ranging from the angle of insertion (a 45-degree angle to a 90-degree angle) to the use of an elevated skin-fold or not. The variation in the selection of needle lengths may also result in the possibility of intramuscular injections rather than achieving a true subcutaneous injection (Prettyman, 2005). Paediatric nursing text books (Trigg and Mohammed, 2006), journal articles (Annersten and Willlman, 2005; Tubiana-Rufi et al, 1999) and patient instruction leaflets often give conflicting or inconsistent advice regarding subcutaneous injection technique.

The administration of subcutaneous injections can cause stress, anxiety and pain to children (Trigg and Mohammed, 2006) often leaving them apprehensive about receiving future medications, or even becoming noncompliant with medical care (Ellis and Bentz, 2007). Injection pain is often the result of injury to the nerve fibre endings located in the skin and tissue from mechanical trauma caused by the needle puncture. Kuzu and Ucar (2001) have noted that site-pain causes the patient physical and psychological discomfort and bruising often limits possible sites for subsequent injections. This article examines the literature that guides clinical practice and considers recent changes in relation to the administration of subcutaneous injection in children, while acknowledging that there is little evidence-based practice to support the formulation of recommendations regarding the technical aspects of subcutaneous administration (Annersten and Willman, 2005). This paper examines the nurse’s role in administration of subcutaneous medications.