bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability of physiotherapists using the Pirani scoring system for clubfoot
Authors: Harvey Nicole , Daley Deborah , Mudge Anita , Sims Susan , Adams Roger
Published: May 2014

Aim:

The purpose of this study was to examine the intra-rater and inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot to score digital photographs of infants’ feet.

Methods:

Twelve infant feet were photographed to reflect variations in the six clinical signs of clubfoot. Physiotherapists viewed the photographs and scored the feet using the Pirani scoring system on two separate occasions.

Results:

Intra-rater reliability was excellent when scoring photographs, while inter-rater reliability was found to be fair to good for most subscales. Experienced therapists demonstrated higher reliability than novice therapists but not significantly so. Reliability was equivalent between the Pirani scoring system and a modified five-point scoring system created for this study. Scoring the rigidity of equinus subscale was found to be more reliable than the other subscales (P<0.01), which did not differ significantly from each other.
The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for post-stroke cognitive impairment screening
Authors: Green Steven , Sinclair Emma , Rodgers Emma , Birks Emily , Lincoln Nadina
Published: May 2014

Aims:

Clinical guidelines recommend stroke patients are routinely screened for cognitive impairment. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was evaluated for screening for post-stroke cognitive impairment.

Methods:

The RBANS and a neuropsychological test battery were administered to 60 participants recruited from acute stroke wards.

Results:

Using a cut-off of < 70 points, the RBANS Total Index demonstrated 50% sensitivity and 100% specificity for detecting any cognitive impairment. ROC curve analysis identified an optimum total index cut-off score of < 84 points (sensitivity 84%; specificity 90%). The RBANS Indices did not have acceptable sensitivity and specificity using a cut-off of < 70 points. ROC curve analysis identified higher optimum cut-offs (sensitivity 79–89%; specificity 48–96%).

Conclusion:

The RBANS was an acceptable measure for detecting post-stroke cognitive impairment but does not include assessment of executive ability.
Burnout in physiotherapists: Use of clinical supervision and desire for emotional closeness or distance to clients
Authors: Fischer Marcel , Mitsche Marion , Endler Peter Christian , Mesenholl-Strehler Elke , Lothaller Harald , Roth Roswith
Published: May 2014

Aims:

This study aimed to investigate burnout among physiotherapists in hospitals within four health districts in South Tyrol (the German and Italian speaking area of Italy).

Method:

Data were collected anonymously by envelope. The German version of the Maslach Burnout Inventory (MBI-D) ( Büssing and Perrar, 1992 ; Büssing and Glaser, 1998 ), socio-demographic, occupational data, the use of clinical supervision or support and the desire for emotional distance and closeness to clients were recorded. Questionnaires were sent to 191 physiotherapists in South Tyrol; and 132 participated in the study (return rate 69.63%).

Results:

In the MBI-D, which contains three scales: ‘emotional exhaustion’, ‘depersonalisation’ and ‘personal accomplishment’; the risk of burnout is reflected in high values in the emotional exhaustion and the depersonalisation scales and low values in personal accomplishment. The present study found that about 35% of the physiotherapists who responded to the questionnaire showed burnout risk in emotional exhaustion, 18% in depersonalisation and 14% in personal accomplishment. This is in agreement with many other studies conducted among health professionals. Gender differences were observed only on the depersonalisation scale, with men scoring higher than women. No differences were found regarding length of stay in the profession. Only one third of physiotherapists are offered clinical supervision or support by their employer but about 50% of physiotherapists sought psychological support. The use of supervision or support was 2.72 times more likely when available at work than not. Contrary to expectations, the impact of supervision or support did not reach significance in the burnout scales. The desire for more closeness is predicted by gender (male), higher emotional exhaustion and depersonalisation, and the desire for more distance is predicted by higher emotional exhaustion.

Conclusions:

More attention to mental hygiene and support in the workplace and during training would help to prevent burnout among physiotherapists, and benefit the profession, patients and organisations.
Development and evaluation of the Primary Healthcare-based Physiotherapy Intervention and its effects on selected indices of stroke recovery
Authors: Olaleye Olubukola A , Hamzat Talhatu K , Owolabi Mayowa O
Published: May 2014

Aim:

To develop a Primary Healthcare-Based Physiotherapy Intervention (PHCPI) that requires simple, inexpensive, easy-to-use equipment for stroke rehabilitation and evaluate its effects on selected clinical indices of recovery among post-acute stroke survivors over a 10-week period.

Methods:

Three databases (Medline, Pubmed and PEDro) were used to identify treatment approaches with proven efficacy. The authors synthesised these treatment approaches to develop the PHCPI, which was used in a repeated measure design involving 25 (mean age=60.6 ± 10.2 years) consenting individuals with first-incidence stroke. These individuals were treated at a primary health centre, twice weekly for 10 consecutive weeks. Outcomes were assessed using the Modified Motor Assessment Scale (MMAS), the Short Form Postural Assessment Scale for Stroke (SF-PASS) and the Reintegration to Normal Living Index (RNLI), before the intervention and fortnightly thereafter. Walking speed and quality of life were also assessed before the intervention and at week 10 of it.

Results:

Within-subject multivariate analysis, after controlling for gender, showed a significant increase in motor function, postural balance, walking speed and quality of life. Their community reintegration scores also improved over the period.

Conclusion:

The PHCPI resulted in improved motor function, community reintegration, walking speed, postural balance and quality of life among community-dwelling stroke survivors. This intervention can be used for stroke rehabilitation at primary health centres.
Cardiac rehabilitation programmes for low-risk patients and leisure athletes: A potential paradox
Authors: Bjerke Wendy , Steinman Stu , Cotto Vincent
Published: May 2014

Background

Athletes are enrolled in cardiac rehabilitation (CR) programmes in small numbers and require unique diagnostic testing and training considerations. Additionally, many physiotherapists, exercise physiologists, athletic trainers and physicians lack experience treating athletes in CR due to their limited exposure to these types of patients.

Content

This analysis distinguishes athletes from typical CR patients within the context of diagnostic testing, assessment, exercise prescription, and management. Several case studies present unique challenges and approaches to the rehabilitation of athletes in a CR setting.

Conclusions

Athletes enrolled in CR should be treated and trained according to their abilities and goals. Combining traditional guidelines with alternative approaches may be the optimal manner to treat these unique patients.
Oral therapy options for type-2 diabetes
Authors: Morris David
Published: May 2014

Good glycaemic control often requires more than one oral agent.
Pneumococcal disease update
Authors: Milburn Melanie
Published: May 2014

From April, all 65s and over will be eligible for pneumococcal vaccination.
Understanding prostate cancer
Authors: Ross Tania
Published: May 2014

To highlight Prostate Cancer Awareness Week.
When to refer a severe case of headache
Authors: Kernick David
Published: May 2014

Diagnosing serious brain pathology in those suffering severe headache can be tricky.
Emergency contraception
Authors: Hearton Lynn
Published: May 2014

Preventing pregnancy with emergency contraception is effective and nurses need to be fully aware of all the options available to women.
Preventing falls in care homes
Authors: Wall Alison
Published: May 2014

Conducting simple risk assessments can help to reduce residents’ falls and fractures.
Spotting sleep problems in a primary care setting
Authors: King Martin
Published: May 2014

In the first of a three-part series, Martin King explains how to spot and assess sleep problems
How to survive Christmas
Authors: Le Saux Katrina
Published: May 2014

Katrina Le Saux takes a light-hearted look at the festive season in general practice, but also offers some practical advice for holiday healthcare
Managing patients who have sleep disorders
Authors: King Martin
Published: May 2014

In the final part of his series on sleep disorders.
Q&A: Hypertension part 1
Authors: Clark Andrew
Published: May 2014

Hypertension is a very common condition. Andrew Clark answers questions on the best ways to treat two patients at different stages in their lives
Malaria prevention is simple
Authors: Wilson-Howarth Jane
Published: May 2014

Malaria prophylaxis may seem complex but, as Dr Jane Wilson-Howarth explains, it is simply a matter of choosing one of four regimens
How to meet your CHD targets
Authors: Kenyon Joanne
Published: May 2014

Running a successful disease management programme need not be stressful.
Breaking the cycle
Authors: Wild Sarah
Published: May 2014

Men should be targeted to help remedy poor eating habits in low-income families.
Q&A: Hypertension part 3
Authors: Clark Andrew
Published: May 2014

The basic ABCD strategy, atenolol queries, and the difference between types ofthiazides. Andrew Clark answers your questions and explains his treatment choices
How IT will affect nurses
Authors: Barr Fiona
Published: May 2014

IT is set to transform the NHS. Fiona Barr looks at what the changes mean for primary care nurses
Consultation skills for nurse practitioners
Authors: Sprague Debra
Published: May 2014

Consultation models can be an invaluable resource to help newly qualified nurse practitioners.
How to spot West Nile virus
Authors: Townend Mike
Published: May 2014

Be on the lookout for the infection, even in people without a recent travel history, as new diseases can migrate to the UK.
Anaemia in cancer patients
Authors: Charlton Rodger
Published: May 2014

Treatment of anaemia in cancer patients can improve the quality of their lives.
How to get the most out of your appraisal
Authors: Applebee Kathie
Published: May 2014

Employers and employees will benefit from effective staff appraisals.
Running a self-help clinic for depression
Authors: Rogers Melanie
Published: May 2014

Depression accounts for 15 per cent of presentations in general practice. Melanie Rogers explains how nurse practitioners can set up assessment clinics to help patients help themselves
Familial hypercholesterolaemia
Authors: Lyttle Dip Kelly
Published: May 2014

Early diagnosis and good management can help reduce the impact of this inherited disorder.
Negotiating a job share
Authors: Applebee Kathie
Published: May 2014

A new job share arrangement needs careful planning if it is to be successful
Case Study: Managing a difficult case of eczema
Authors: Stollery Nigel
Published: May 2014

A patient with persistent eczema puzzled Dr Nigel Stollery but the answer proved surprisingly straightforward
Referring for endoscopy
Authors: Cottrill Mark
Published: May 2014

There is still uncertainty about when to refer patients for endoscopic investigations.
Flying with a respiratory disease
Authors: Townend Mike
Published: May 2014

Travelling with a respiratory condition such as COPD or asthma can cause problems.
Pictures in practice: Before and after treatment
Authors: Watkins Jean
Published: May 2014

Before and after treatment pictorial comparison of cystic acne vulgaris, phytophotodermatitis and discoid lupus erythematosus
Working in partnership to tackle workload in general practice
Authors: Griffiths Julie
Published: May 2014

A number of initiatives aimed at addressing workload capacity are about to roll out to practices
Introducing a new policy on X-ray referrals
Authors: Aston Jenny
Published: May 2014

Determination, hard work and genuine collaboration have enabled the development of a national guideline for X-ray referrals
Acute loss of vision
Authors: Warburton Louise
Published: May 2014

Case study: Patients who complain of a loss of visual acuity should be taken seriously.
Reporting adverse drug reactions
Authors: Thompson Angus
Published: May 2014

In the sixth article in our prescribing series, independent prescribing adviser Angus Thompson discusses the important contribution to patient safety made by the reporting of adverse drug reactions
Options for treating depression
Authors: Rogers Melanie
Published: May 2014

Guidelines advocate tackling depression with a combination of psychological therapies and antidepressants.
Diseases transmitted by food and water
Authors: Townend Mike
Published: May 2014

Travellers should take steps to avoid diseases contracted from infected food and water.
The Mantoux test: uses and misuses
Authors: Davies Peter
Published: May 2014

Clinicians now need to use the Mantoux test for TB immunity
T'ai chi used as therapy
Authors: Ernst Edzard
Published: May 2014

T'ai chi is growing in popularity. Professor Edzard Ernst casts an eye over the evidence for its therapeutic use
Prescribing antiepileptic medication
Authors: Morris David
Published: May 2014

To highlight National Epilepsy Week from 14-20 May, Dr David Morris looks at the prescribing options for seizure control
How to spot and treat haemochromatosis
Authors: Brown Harry
Published: May 2014

Hereditary iron disorders can be diagnosed in primary care.
Proactive phobia management
Authors: McIntosh Iain
Published: May 2014

Phobias and fears can be very debilitating for some people. Dr Iain McIntosh explains how to manage these problems effectively
Eyes: conjunctivitis
Authors: Sprague Debra
Published: May 2014

Infective conjunctivitis is an extremely common, irritating condition, which can be easily managed by nurses, explains Debra Sprague, as she continues our series on common conditions in primary care
Case Study: Coping with COPD
Authors: Morris David
Published: May 2014

A history of smoking leaves a patient needing life-long treatment.
Using botox in clinical practice
Authors: O'Connor Rory
Published: May 2014

Botox is not just for hiding wrinkles, it also has important clinical uses, says Dr Rory O'Connor.
How to tackle treatment failure in atopic eczema
Authors: Jackson Karina
Published: May 2014

Understanding disease and a sound treatment regimen are key to patient compliance.
Investigating chronic diarrhoea
Authors: Cottrill Mark
Published: May 2014

The majority of patients with chronic diarrhoea can be successfully managed in primary care
Prescribing for migraine
Authors: Dowson Andy
Published: May 2014

Simple steps can help patients better manage their migraines.
Case Study: Tackling a non-responding chest infection in asthma
Authors: Warburton Louise
Published: May 2014

A chest infection in those with asthma may be fungal and complex to diagnose.
Identifying and treating UTIs
Authors: Chadha Pushpam , Car Josip
Published: May 2014

Nurses must distinguish between upper and lower tract infections to treat UTIs, write Dr Pushpam Chadha and Dr Josip Car
Managing stiffness and pain in osteoarthritis
Authors: Lipscombe Sue
Published: May 2014

Short-term analgesia, rest and weight loss were all helpful in the care of a swollen knee, says Dr Sue Lipscombe
Herbal supplements in the elderly
Authors: Huntley Alyson
Published: May 2014

Many elderly patients choose to use herbal supplements. Dr Alyson Huntley advises on their safety and efficacy
Looking out for systemic sclerosis
Authors: Warburton Louise
Published: May 2014

It is important to be aware of this rare rheumatological condition
Creating virtual wards in the community
Authors: Lepper Joe
Published: May 2014

A predictive tool designed to reduce hospital admissions has enabled the development of an award-winning case management initiative.
When iron-deficiency anaemia may indicate a bowel-related cause
Authors: Morris David
Published: May 2014

A diagnosis of coeliac disease can be easily missed.
Recognising hypopituitarism
Authors: Collison Kiren , Wass John
Published: May 2014

Spotting pituitary hormone deficiency can reduce morbidity and mortality.
Improving awareness of autistic spectrum disorder
Authors: Thompson Anne
Published: May 2014

Autistic spectrum disorder is not always apparent in early childhood. Dr Anne Thompson describes the condition and what can be done to help parents
A-Z Kidney stones
Authors: Sprague Debra
Published: May 2014

Continuing our series on common conditions in primary care, Debra Sprague examines the formation of kidney stones and outlines the differential diagnosis and the options for management of associated pain
The elderly osteoporosis patient
Authors: Cooper Alun
Published: May 2014

Whatever a patients age, it is never too late to initiate osteoporosis management.
Ethnicity and the risk of hypertension
Authors: Barnett Anthony
Published: May 2014

A targeted, culturally-specific approach to hypertension and CVD risk factor management is vital.
Nurses at the forefront of practice-based commissioning
Authors: Barr Fiona
Published: May 2014

Nurses in Hartlepool have developed a community respiratory assessment and management service under PBC.
Using healthcare assistants to improve access for patients
Authors: Chambers Ruth
Published: May 2014

Employing healthcare assistants may result in a more efficiently run surgery.
Weighing up the use of LABAs
Authors: Upadhyay Bhavin , Upadhyay Neil
Published: May 2014

Long-acting beta agonists may be associated with asthma exacerbations.
Distinguishing acute facial palsy
Authors: Brown Harry
Published: May 2014

Not all cases of acute facial paralysis are due to Bell's palsy, says Dr Harry Brown.
Understanding endometriosis
Authors: Brown Harry
Published: May 2014

Despite being relatively common, the cause of endometriosis remains unclear. Dr Harry Brown provides an overview.
Reducing rates of teenage pregnancy
Authors: Staines Richard
Published: May 2014

The battle to cut teenage pregnancy rates is far from over, writes.
Prescribing options in urinary incontinence
Authors: Kehinde Lola
Published: May 2014

A combination of drug and behavioural therapy can improve quality of life in people with urinary incontinence, although it may not lead to a cure.
Treating varicose veins
Authors: Palfreyman Simon
Published: May 2014

Although the trend is to restrict access to treatment, patients will continue to seek treatment for varicose veins.
Constipation in children
Authors: Rogers June
Published: May 2014

Although idiopathic constipation is one of the commonest problems in childhood, it is often the most poorly managed, and can become chronic.
Empowering district nurses
Authors: Wood Cate
Published: May 2014

District nurses must stand up, speak out and be counted in a modern primary-care led NHS.
Pruritis diagnosis and management
Authors: Karim Kelvin
Published: May 2014

Pruritis is a ubiquitous symptom with many presentations that can often cause considerable distress for many individuals, writes Kelvin Karim
Diabetes in older people
Authors: Morris David
Published: May 2014

GERONTOLOGY

Managing diabetes in elderly patients has particular challenges, explains Dr David Morris
A model for nurse-led care
Authors: Bhardwa Seeta
Published: May 2014

Cuckoo Lane is one of the only nurse-led practices in the country. Seeta Bhardwa looks at how it all started and what the future holds
Paramedics in prehospital emergency medical systems across Europe
Authors: Chenaitia Hichem , Massa Horace , Noel Cyril , Fournier Marc , Verges Marc , Emeric Stephane , Guibert Stephane , Michelet Pierre
Published: May 2014

Emergency medical services (EMS) vary across Europe, with two predominant models: the Anglo-American model which uses mainly paramedics in a prehospital setting, where ‘the patient goes to the doctor’; and the Franco-German model which uses mainly physicians in a prehospital setting, where ‘the doctor goes to the patient’. No perfect model exists, and each country has an EMS model based upon the needs of the community and the available economic resources. This overview shows that the EMS in Europe are modern, efficient and structured in the same way. The dispatch centre, the means and the response times are similar; the biggest differences concern the personnel who staff ambulances and their training, although they all have to perform the same emergency procedures and manage similar types of patient. The role of emergency medical technicians (EMT) is vital in all prehospital EMS systems. However, the training of EMT with equal skills is very different, with great variations as a function of each country. European harmonization appears to be necessary, even if it seems difficult.
Adolescent communication: perceptions and beliefs
Authors: Kelsey Janet , Abelson-Mitchell Nadine
Published: May 2014

This article discusses the communication issues arising from one of the themes identified in a phenomenological study exploring young people’s perceptions of their involvement in healthcare decisions affecting management of their care (Kelsey et al, 2007). Communications were described in terms of ‘satisfactory’ and ‘poor’ experiences. Satisfactory experiences included being spoken to directly and asked to provide information, appropriate modification of technical language, good listening skills and demonstrating empathy. Poor experiences included inadequate non verbal communication, power imbalances, exclusion from conversation and judgemental attitudes. These experiences are depicted utilising extracts from the young people’s interviews and discussed in relation to current literature on adolescent developmental and communication theory. Implications for future practice are identified.
Children’s nurse education in Ireland: current status and challenges ahead
Authors: Coyne Imelda , O’Shea Rita
Published: May 2014

It is generally accepted that children require ‘special nursing’ because they are different from adults and have unique needs. To ensure the highest standard of quality care, it is imperative that appropriately educated nurses care for sick children. Successive policy reports have made recommendations about the need for nurses caring for children to be appropriately prepared, linking this to the quality of care that children should receive. Despite numerous reports and explicit recognition of the need for children’s nurse education, children’s nursing as a distinct speciality has waxed and waned over the years. In Ireland the profession were fortunate in 2006 to achieve the establishment of a direct entry degree programme in children’s nursing, albeit combined with general nursing. This paper will discuss the developments that led to this position, by reviewing the background to children’s nursing education in Ireland. These developments will be contrasted with current challenges to the education of children’s nurses in the UK. This paper will conclude with recommendations on how we, as children’s nurses, should meet the challenges to children’s nursing remaining as a distinct speciality and a direct entry programme.
Self-harm and attempted suicide in young people looked after in state care
Authors: Cousins Wendy , McGowan Iain , Milner Sharon
Published: May 2014

Suicide rates in Northern Ireland have steadily increased over the last three decades leading to the recognition of suicide as a major public health issue in the region. Statistics relating to hospital admissions for self-harm in Northern Ireland indicate that the number of such admissions has increased by 9% since 2000. In 2006 the Northern Ireland Suicide Prevention Strategy was launched with the strategic aim ‘to reduce the Northern Ireland suicide rate, particularly among young people and those most at risk.’ However no specific mention is made of young people who live in state care. This paper uses social worker accounts to highlight the emotional and behavioural vulnerabilities as measured by the Strengths and Difficulties Questionnaire (SDQ) in a group of adolescents (n=165) who are ‘looked after’ away from home. It was found that 49.6% of the young people scored within the abnormal range of the SDQ Total Difficulties score and social worker reported prevalence of suicidal behaviour (10.3%) and self-harm (12.7%) was high. It is argued that widespread special interventions need to be put in place for this especially vulnerable population.
Pharmacology of antioxidants: how do they work and what are the benefits?
Authors: Fromage Gemma
Published: May 2014

Antioxidants are increasing in popularity and are now commonly used in skin care products. It is often thought that antioxidants are miracle substances that will protect us from ageing and disease, yet few realise what they are how they work and what exactly they are protecting our body against. This article will discuss what antioxidants are, the action of free radicals within the body and cells and what effects they have when oxidative stress occurs and the damage they cause accumulates. The free radical theory of ageing suggests that cells accumulate this free radical damage over time and that long-term damage leads to the release of inflammatory molecules and visual signs of ageing such as loss of elasticity and skin tone. Damage caused by free radicals can also contribute to major illnesses such as Parkinson's disease. It has been shown that a diet rich in fruits and vegetables, which have high antioxidant levels can increase lifespan and give protection against certain diseases. It could therefore be assumed that antioxidants, with their free radical neutralising properties, could also be used as a preventative measure. Supportive studies for the use of antioxidants discussed in this article however have not been able to confirm that it is the antioxidant content that exerts this affect. It could be assumed that you could take an antioxidant with a high ORAC value and formulate a topical product, however many factors need to be taken into consideration, including pH, stability, base, oxygen exposure and ingredient percentages.
Adult acne vulgaris: dispelling the myths and exploring the barriers to clinical care
Authors: Brackenbury Julie
Published: May 2014

Acne vulgaris can affect individuals of all racial and ethnic backgrounds. Variations in clinical presentation and approaches to acne treatment exist and it is a disease where both the patient and practitioner can be left feeling hopeless and frustrated. Despite acne persisting into adulthood in up to 50% of the population, very few therapeutic studies have been performed in this age group. In addition, there are many myths surrounding the causes of acne. This article examines and dispels the genetic and dietary myth associated with the condition. The psychological impact of acne can be devastating, affecting relationships, self-confidence and even work performance. Quality of life can be seriously debilitated through the additional psychological effects of acne. Aesthetic nurses may well be presented with patients asking for help with the management of their acne who have already been to their GP for help. This article aims to provide an understanding of the barriers to the management of acne in the NHS, including the GP Quality Outcome Framework (QOF) and the lack of education in the medical curriculum. Aesthetic nurses who are competent in the management of acne have the opportunity to offer management and care to acne patients to improve their quality of life.
Psoriasis: exploring the associated clinical issues and how to support your patients
Authors: Onselen Julie Van
Published: May 2014

Although psoriasis is a common condition manifesting in the skin and joints, recent clinical evidence has shown health professionals that it is a systemic disease that is more than skin deep. The most recent guidelines from the National Institute for Health and Clinical Excellence (2012) on psoriasis offer a comprehensive evidence-base to psoriasis management. Aesthetic nurses have an important role with their clients who have psoriasis, in supporting them in coping with and treating psoriasis and having an awareness of how cosmetic treatments may affect psoriasis. This article aims to inform and update aesthetic nurses' knowledge of the psoriasis signs and symptoms, evidence-based treatment options and implications for cosmetic treatment.
Managing common rhinoplasty patient concerns and expectations in practice
Authors: Jones Emma-Rowe
Published: May 2014

Changing the appearance of someone's nose can have a profound psychological on patients, especially if they had unrealistic expectations that were not managed from the offset. In this short interview with Rhinoplasty Clinical Nurse Specialist Emma-Rowe Jones, she gives aesthetic nurses an insight into the common concerns and challenges that come along with augmentation at The Nose Clinic
An introduction to literature searching: helpful tips for aesthetic nurses
Authors: Goddard Rachel
Published: May 2014

Aesthetic nurses taking on the non-medical prescribing course, which is more commonly known as the V300, will be required to complete a literature search. However, for those who have been out of education for some time, this can be quite a daunting task. In this article, the author will help aesthetic nurses to identify key information resources in the field of health studies, and perform effective information retrieval searches using online databases, electronic journals and electronic books.
Ageing, anxiety and appearance: exploring the body image of women in midlife
Authors: Lewis-Smith Helena
Published: May 2014

Most research surrounding body image has focused on young women, yet appearance dissatisfaction and eating disorders are on the rise in middle-aged and older women. In this article, PhD researcher Helena Lewis-Smith provides aesthetic nurses with some insight into the factors contributing to these issues, and discusses novel methods for promoting positive body image within this group
Vasovagal syncope: highlighting an understated event in aesthetic medicine
Authors: COLLIER HELENA
Published: May 2014

Vasovagal syncope, also known as cardioneurogenic syncope, is a condition in which a temporary loss of consciousness occurs owing to a neurological reflex, which leads to sudden dilation of the blood vessels in the legs and/or a very slow heart rate (bradycardia) ( Fogoros, 2012 ). Although many clinicians refer to this event as a ‘simple faint’, the author maintains that vasovagal syncope is an understated medical condition that arises frequently in the practice of aesthetic medicine. In this article, the author will give an overview of vasovagal syncope in the context of medical aesthetics, examine the diagnostic process and discuss why there is a need to consider differential diagnoses. Further to this, the condition's pathogenesis, symptom management and available treatment options will be explored, and the author will outline how aesthetic practitioners and patients can implement simple strategies to avoid the occurrence of this often extremely distressing event.
A descriptive review of magnesium in homeostasis
Authors: Vizcaychipi Marcela Paola
Published: May 2014

Magnesium plays a vital role in maintaining the body's homeostasis. Magnesium is involved in multiple intracellular processes and ameliorates the sympathetic response, which may well help with the preservation of energy and prevention of avoidable complications in the perioperative period. The aim of this descriptive review is to highlight the physiological mechanism of action of magnesium and how the use of regular magnesium during anaesthesia may reduce the incidence of critical events and enhance a patient's recovery after surgery.
Using central venous catheters in the perioperative environment
Authors: Haynes Sebastian
Published: May 2014

Central venous catheters (CVCs) are commonly used within the perioperative environment. They are primarily used to administer drugs, fluids and to monitor haemodynamic status. Their use is associated with infections, either localised at the site of insertion, or systemic with bloodstream infection, which can cause complications, increasing morbidity. The use of CVCs are estimated to increase mortality risk by 25% and the cost of care in the US by $16550 on average per patient ( Bion et al, 2012 ). There is currently no available UK equivalent. Catheter-related bloodstream infections (CRBSIs) are the most common cause of healthcare-associated infections and are preventable ( Centers for Disease Control and Prevention (CDC), 2011 ). Preventive strategies, which have been demonstrated in various countries to reduce the risk of CRBSIs, include effective hand hygiene, using maximal sterile barrier precautions, including full barrier drapes during insertion of CVCs, chlorhexidine-containing cutaneous antiseptics, site selection, educational programmes for health-care workers and comprehensive guidelines. With good knowledge of these evidence-based practices and a positive attitude towards infection prevention, perioperative practitioners can help to reduce the rate in occurrence of CRBSIs.
The importance of patient warming for enhanced recovery
Authors: Bernard Helena
Published: May 2014

Protecting patients from developing inadvertent perioperative hypothermia is an integral element of the enhanced recovery after surgery (ERAS) programme because this protection promotes physical wellbeing throughout a patient's surgical journey. Inadvertent perioperative hypothermia (IPH) is preventable in most cases, yet as many as 70% of surgical patients experience it ( Niranjan et al, 2011 ). It is associated with multiple devastating complications for the patient. As ERAS programmes focus on optimising the patient's physical state prior to, during and after surgery, it fits that maintaining a healthy body temperature forms part of the programme. In this article, the risk factors at all stages of the patient's surgical journey will be discussed, as well as strategies for warming patients and why this is vital for the success of ERAS programmes.
Reducing cross-contamination with single-use equipment
Authors: Parry Andy
Published: May 2014

In the interest of reducing risk of infection for patients during surgery, there has been an increasing emphasis on using single-use equipment in theatre practice. This article explores the literature surrounding single-use laryngoscope blades, surgical gloves and drapes. Evidence suggests single-use versions of these devices have reduced infection rates and have shown an equal, if not better, performance than their re-usable equivalents.
Considering the impact of dyslexia
Authors: Jane Louise
Published: May 2014

This article will consider the impact of dyslexia in the clinical learning environment and how students with dyslexia can be best supported in their clinical placements, in order to meet the learning outcomes of their programme and provide safe and effective care. There is an excess of literature supporting the notion that the number of students with disabilities entering higher education increases each year. Therefore, the number of health practitioners with a specific learning disability (SPLD) entering higher education to commence on academic programmes is also increasing. This can present complex challenges for academic staff and clinical mentors. It is evident throughout the literature, that support is often inadequate to develop competence. However, registered practitioners have an ethical, moral and legal obligation to support their students. Higher education providers and clinical mentors need to be aware of their responsibilities toward students with SPLDs, supporting their needs in a non-discriminatory manner.
The application of role models in health education
Authors: Hinton Jean
Published: May 2014

A role model, according to the Online Oxford English Dictionary (2014) , is ‘A person looked to by others as an example to be imitated’. However, can we say that in health care—within its multi-faceted, complex environments—this simple definition is sufficient to demonstrate exactly what defines a role model in a clinical setting? Flynn (2011) discusses how within health care, role modelling is used not only to convey knowledge as a means to effective learning, but is a means to embed within the student qualities, such as behaviour, attitudes and values. Flynn ( 2011 : 167) suggests that by teaching these qualities it is hoped to encourage the development of ‘sound professional characteristics’. The development of professionalism is considered to be essential in health education within all professions ( Davis, 2013 (nurses); Hinton, 2014 (operating department practitioners); Lombarts et al, 2010 (radiographers); Ainsworth and Szauter, 2006 (doctors)). This final article—of a series of three examining professionalism—will examine the application of role modelling in health education and consider the impact and benefits of good role models and the implications of bad examples of role modelling for all students, with a particular emphasis on perioperative students.
How parenting assessment strengthens family services
Authors: Gordon Philip R , Comfort Marilee
Published: May 2014

There is a great deal of evidence to suggest that parenting behaviour is one of the most important factors in child development and wellbeing. Recent initiatives have argued for the societal benefits of investment in early intervention in childhood development ( WAVE Trust, 2013 ). In the UK, health visitors are the key professionals involved in parenting support, and this is part of the Universal offer laid out in the Health Visitor Implementation Plan ( Department of Health, 2011 ). Parenting assessment tools can help practitioners to demonstrate outcomes, which is essential in order to gain funding and resources. This paper provides a US perspective on how observational parenting assessment can strengthen family services and why it should be considered best practice.
Couple relationships: Why are they important for health and wellbeing?
Authors: Coleman, Lester , Mitcheson, Jan , Lloyd, Gareth
Published: May 2014

High quality couple relationships are linked to high levels of overall wellbeing. Conversely, there is a strong link between poor quality relationships and poor physical and psychological health among adults and children. When characterised by destructive conflict between couples, including verbal aggression, the outcomes for health are particularly damaging. Physical health outcomes include coronary heart disease and raised blood pressure; psychological outcomes include lower ‘life satisfaction’ and increased depression. The impacts however, are far from universal and supportive friends or trusted professionals can help minimise these outcomes. The transition to parenthood is characterised by increased relationship strain, but is also a time of increased motivation to ‘get things right’ among new parents. Health visitors are in a prime position to discuss relationship issues and offer support to families. Training in Brief Encounters®, focusing on active listening skills and a strength-based approach, has been shown to enable professionals to provide a timely intervention at a time of stress and prevent longer term decline and crisis.
Vaccination programme: Reducing rotavirus gastroenteritis in children
Authors: Macdonald Emily , Lang Sarah
Published: May 2014

Rotavirus is the leading cause of gastroenteritis in children living in the UK ( Public Health England (PHE), 2013 ). On 1 July 2013, a live oral rotavirus vaccine, Rotarix (made by GlaxoSmithKline), was introduced into the national routine childhood immunization schedule for all children born on or after 1 May 2013. The programme is expected to reduce the incidence of rotavirus gastroenteritis in young children. This article provides a background to the introduction of the new vaccination programme, discussing the epidemiology and clinical features of rotavirus infection. As a major influence on vaccine uptake is the way in which health professionals communicate with parents and carers, this article highlights key vaccine and programme information for practitioners who promote and advise parents and carers about immunizations.
How can health visitors support parents of children with ADHD?
Authors: Lavis Paula
Published: May 2014

Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed condition among children and, if left untreated, it can result in a number of negative outcomes during both childhood and adulthood. This article looks at what ADHD is, its likely causes and prevalence, how it is diagnosed and how it can be managed or treated. It is a controversial condition, so the article will also consider the often polarised views about ADHD. Early intervention is necessary to help children who are at risk of developing the condition, and this article considers how health visitors can help identify emerging problems and assist families in getting help at an early stage.
How could a breakdown in the parent–child feeding relationship be an indicator for risk?
Authors: Patience Sara , Beazley Caroline
Published: May 2014

Food is one of the most basic needs of human beings, so people who control the supply of food to others have power over them. Failure to provide adequate food to children is an example of neglect; it is estimated that one to two serious case reviews each year will involve a child who has died through starvation. Withdrawal of food supply may also be a factor in domestic abuse situations, particularly in circumstances where a parent is suffering abuse and therefore cannot prioritise the needs of the child. In addition, there is evidence that food may be used to coerce children to be sexually exploited. Reflecting on the evidence that exists, this article poses the question of whether food-related problems and a breakdown in the parent–child feeding relationship could be an early indicator for the risk of neglect or abuse.
Health visitor V100 prescribing: The current context
Authors: Nuttall Dilyse
Published: May 2014

The main purpose of nurse prescribing has always been to provide patients with safe and timely access to medicines. Prescribing is a valuable tool in realising the ambitions of current health-care policy to improve health outcomes through safe and effective care. Health visitors have a key role in today's health service in the areas of health protection and prevention, so there is a need to ensure that prescribing remains an integral part of the health visitor's role. Over the years, both prescribing itself and the content and assessment of the V100 prescribing education programme have developed. Health visitors have a responsibility to ensure that they are making effective use of prescribing and remain up to date with any developments; there are many useful resources available. Consultation skills and prescribing for children are two areas of particular relevance to health visitors.
Managing children with coeliac disease in the community
Authors: Paul Siba Prosad , Thomas Phillipa
Published: May 2014

Coeliac disease is an autoimmune condition caused by sensitivity to gluten-containing foods. It affects around 1% of children, although many cases may remain undiagnosed. Health visitors should be aware of the classic gastrointestinal features of coeliac disease and make an early referral to medical professionals. Breastfeeding is considered to have a protective role. Suspicion of coeliac disease should lead to antibody screening tests and the diagnosis is confirmed by an intestinal biopsy. A gluten-free diet (GFD) should always be started by paediatric dietitians, but health visitors can play an important role in educating and supporting families. Extra-intestinal manifestations (e.g. severe iron-deficiency anaemia or short stature) can pose a diagnostic challenge, and a suspicion of coeliac disease should always be discussed with a medical professional. Strict adherence to a GFD is essential to maintain good health and to prevent development of long-term complications.
Making Scotland the best place for a child to grow up
Authors: Hogg Rhona
Published: May 2014

The Scottish Government has stated that it aims to make Scotland the best place in the world for children to grow up. Rhona Hogg explains why a commitment to increasing the country's health visitor workforce must be a central part of that aim.
Working to ensure children are physically ready for school
Authors: Reynolds Jane , Joy Wendy
Published: May 2014

Paediatric physiotherapists Jane Reynolds and Wendy Joy are looking to expand a project that improves motor skills to include children under 5, and are interested in working alongside health visitors and other professionals with an interest in this area.
Working with refugees and asylum seekers: The role of the health visitor
Authors: Lawrence Dawn M
Published: May 2014

Health visitors have reported feeling ill-prepared for the complexities of working with refugees and asylum seekers ( Drennan and Joseph, 2005 ). This paper highlights some of the main physical and mental health issues that health visiting teams are likely to encounter and discusses the role of the health visitor in reducing inequalities for this group. Some of the particular challenges in safeguarding work with asylum seekers and refugees, who often have very complex needs, are highlighted. The unique role of the health visitor means they are well placed to support and empower individuals and improve health outcomes in this group.
Gastro-oesophageal reflux in infants: A common concern for parents
Authors: Cremonesini Louise
Published: May 2014

This article will examine the most recent definitions for gastro-oesophageal reflux (GOR) and gastro-oesophageal reflux disease (GORD). It will identify common symptoms seen in infants and explore potential investigations that may be required. There are a variety of treatment options available, and the health visitor has a significant role in taking appropriate history, referring parents to fellow health professionals and providing support for families. This article will discuss important points to consider when engaging with families where GOR/GORD may be of concern.
National Smile Month: A time to reinforce key oral health messages
Authors: Carter Nigel
Published: May 2014

The British Dental Health Foundation's Dr Nigel Carter says his organisation's annual campaign offers an opportunity to promote the importance of good oral health for all.
Assessing renal patients for their suitability for peritoneal dialysis
Authors: Keddo Maxine
Published: May 2014

Maxine Keddo provides an overview of how best to assess patients with chronic kidney disease for their suitability for peritoneal dialysis (PD). Advocating home assessments, the author explains how to fully inform the patient about the options available to him/her, take a detailed history of the patient's circumstances, and perform a thorough physical examination.
How to learn to delegate effectively in the renal unit
Authors: Ellis Peter , Abbott Jane
Published: May 2014

Peter Ellis and Jane Abbott identify delegation as an important skill for the renal nurse manager. They outline the process the manager should go through to ensure that the purpose and timeframe of the delegation is clearly established and the skills involved to find the best person to delegate to.
Managing difficult people: competence vs competency
Authors: Ellis Peter , Abbott Jane
Published: May 2014

Peter Ellis and Jane Abbott outline the difference between competence and competency. They explore the meaning of competency and what managers might have to do to develop competency within themselves and their team. Developing competency, the authors suggests, is a way to establish harmonious team work.